The meaning of depression: Swedish nurses' perceptions of depressed inpatients.

People suffering from depressive disorder are affected by one of the western world's largest medical groups of disorders in both psychiatric and general medicine. Drug treatment is usually the first-line intervention and has been shown to be an effective treatment. Other therapies, including nursing interventions that could be implemented in care, are infrequently used. It is therefore important to understand whether nurses' perceptions of depressed people could be explained from the medical model by defining the nurses' view of psychiatric inpatients. Therefore, the aim of this study was, with the clinical picture as the starting point, to investigate the nurses' view of hospitalized patients with a diagnosis of depression. In this prospective study, 155 nurses' opinion of depression among depressive inpatients was assessed using a questionnaire based on the Montgomery-Asberg Depression Rating Scale. To elucidate the relationship between the variables in the questionnaire, factor analysis rotated by the Varimax method with Kaiser's normalization was used. The factor analysis identified five factors. The number of variables was reduced from 61 to 34. Based on the factor interpretation, an initial factor structure for the depressive inpatient was defined. The identified factors were interpreted and labelled to create the nurses' fused "picture" or meaning of the depressed inpatient as an individual who experienced feelings of annihilation, alienation, fatigue, emptiness and affliction, an individual who is disconnected from the whole of temporality.

Differential sorting of SNAP-25a and SNAP-25b proteins in neuroblastoma cells.

Exocytosis is mediated by high-affinity interactions between different SNARE proteins. The existence of several variants of each SNARE protein suggests that the specificity of fusion may be directed by unique combination of SNARE family members. We examined if two alternatively spliced variants of synaptosomal-associated protein of 25 kD, SNAP-25a and SNAP-25b, possessed distinct cellular distribution if coexpressed within the same neuroblastoma cell. Double-labelling immunofluorescence histochemistry in combination with confocal laser microscopy of individual cell clones revealed a different subcellular localisation pattern for the two SNAP-25 variants. Sucrose density gradient centrifugation of cell homogenates followed by Western blotting showed that the SNAP-25 protein variants associated with intracellular organelles of different density. Taken together, this study shows that two alternatively spliced variants of SNAP-25, differing in only nine amino acids, possess distinct properties at the level of intracellular trafficking, suggesting that the cellular localisation of SNAP-25 protein is regulated at the level of mRNA splicing.

Judging the other: psychiatric nurses' attitudes towards identified inpatients as measured by the semantic differential technique.

Nurses' attitudes towards psychiatric patients can be expressed in terms of either a symptom-oriented approach or a personhood-focused approach where the latter is characterized by the ambition to establish a genuine and lasting relationship, while the former places the emphasis on correcting 'defective' patient behaviour. To study whether previous typologies found in a qualitative in-depth interview study exist in a larger quantitative investigation and, if so, to identify and describe a structure for the nurses' attitudes connected to each of the identified typologies. Six psychiatric group dwellings and six acute psychiatric hospital wards participated in the study. In all, 2700 assessments of 163 patients were sent out to 160 respondents and 2436 answers were returned, that is, the external dropout rate was 9.8%. The semantic differential technique was used. This is a method for quantifying the meaning that is attached to an identified phenomenon through series of bipolar pairs of adjectives. The scale has 57 bipolar pairs of adjectives, which estimates an unknown number of dimensions of nurses' attitudes towards an identified patient. The respondents' answers were analysed through entropy-based measures of association combined with structural plots. The analysis revealed that the four typologies existed as a delimited group, especially the groups of 'good' and 'evil' patients, while the 'crazy' and 'invisible' patients existed in a more blurred form. The analysis also revealed that the two groups, 'good' and 'evil', were connected to the nurses' ethical and aesthetic attitude structure, while the 'crazy' patients were linked to the cognitive structure and the 'invisible' patients to the empathetic structure. The study indicates that the two typologies, 'good' and 'evil', could be seen as each other's antithesis and, together with the other two typologies, 'crazy' and 'invisible', they touched upon a structure of the nurses' attitudes that was closely connected to a negative view of the patient except in one case -'the good' patients, which was probably based on his/her exterior symptoms.

Regulatory volume decrease in cultured astrocytes. I. Potassium- and chloride-activated permeability.

Regulatory volume decrease (RVD) in detached cerebellar astrocytes in culture after acute exposure to hyposmolarity was characterized in this and the accompanying paper [H. Pasantes-Morales, R. A. Murray, R. Sanches-Olea, and J. Moran. Am. J. Physiol. 266 (Cell Physiol. 35): C172-C178, 1994]. RVD was independent of extracellular calcium, was accelerated at pH 8-9 and retarded at pH 6, and was reduced at temperatures < 18 degrees C. The cationic pathway activated by hyposmolarity was specific for K+ and Rb+, since RVD was abolished and secondary swelling occurred when these ions replaced Na+. However, Li+, choline, tris(hydroxymethyl)aminomethane, and glucosamine, all as Cl- salts, did not affect RVD. The anion pathway was unselective, since RVD was inhibited when NaCl was replaced by anion K+ salts with a permeability rank of SCN- = I- > NO3- > Cl- > benzoate > acetate >> SO3- > gluconate. RVD was unaffected by bumetanide (50 microM) and weakly inhibited by furosemide (2 mM). Quinidine but not other K+ channel blockers inhibited RVD, and its effect was reversed by gramicidin. RVD was inhibited by 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid and dipyridamole but not by diphenylamine-2-carboxylate or anthracene-9-carboxylate. These results suggest that diffusion possibly via channels rather than cotransporters is involved in the swelling-activated K+ and Cl- fluxes. Gramicidin did not change astrocyte volume in isosmotic conditions, but greatly accelerated RVD, suggesting that low Cl- permeability in isosmotic conditions markedly increases by swelling, thus making K+ permeability the rate-limiting step for RVD.

Cyclin-dependent kinase 5 promotes insulin exocytosis.

Cyclin-dependent kinase 5 (Cdk5) is widely expressed although kinase activity has been described preferentially in neuronal systems. Cdk5 has an impact on actin polymerization during neuronal migration and neurite outgrowth and deregulation of the kinase has been implicated in the promotion of neurodegeneration. Recently it was shown that Cdk5 modulates dopamine signaling in neurons by regulating DARPP-32 function. In addition, Cdk5 phosphorylates munc-18 and synapsin I, two essential components of the exocytotic machinery. We have shown by reverse transcriptase-polymerase chain reaction, immunocytochemistry, and Western blotting that Cdk5 is present in the insulin-secreting pancreatic beta-cell. Subcellular fractionation of isolated beta-cells revealed a glucose-induced translocation of membrane-bound Cdk5 protein to lower density fractions. Inhibition of Cdk5 with roscovitine reduced insulin secretion with approximately 35% compared with control after glucose stimulation and with approximately 65% after depolarization with glucose and KCl. Capacitance measurements performed on single beta-cells that expressed a dominant-negative Cdk5 mutant showed impaired exocytosis. The effect on exocytosis by Cdk5 appeared to be independent of changes in free cytoplasmic Ca(2+) concentration. Taken together these results show that Cdk5 is present in beta-cells and acts as a positive regulator of insulin exocytosis.