Comparisons of neural and pacing activities in intestinal segments from W/W++ and W/W(V) mice.

We studied pacing and neurotransmission in longitudinal (LM) and circular muscle (CM) in intestine of W/W++ and W/W(V) mice. Electrical field-stimulation (EFS) of nerves in LM segments was more inhibitory in W/W(V) mice than in W/W++ mice. No inhibitory input to CM segments of W/W(V) mice was found. The EFS, after nerve block, entrained segments of both W/W++ and mutant mice with 10 ms pulses, and entrained those of mutant mice more readily at 1 and 3 ms pulses. Pacing with external electrodes did not depend on interstitial cells of Cajal in the myenteric plexus (ICC-MP). 2-Aminoethoxydiphenyl borate (2-APB), putative antagonist at IP3 receptors, store-operated channels and the Sacro-endoplasmic reticulum Ca2+ ATPase pump, reduced frequency and amplitudes of pacing of LM segments from W/W(V) mice as it did in BALB/c mice. Thus, its actions may not require ICC-MP. SKF 96365, a putative inhibitor of store-operated channels, reduced frequencies and amplitudes of intestinal segments in W/W++ mice at 10 or 30 micromol L-1. This resulted from blocking L-Ca2+-channels. Thus, no evidence was found that store-operated channels play a role in pacing. In LM segments of W/W(V), SKF 96365 had no effects on frequency of contractions. We conclude, results from models of severely reduced systems may not be applicable to intact ICC networks.

Randomised controlled trial of brief psychological intervention after deliberate self poisoning.

OBJECTIVES: To determine the effects of a brief psychological intervention (brief psychodynamic interpersonal therapy) for patients after deliberate self poisoning compared with usual treatment. To compare the impact of the active intervention and usual treatment on patients' satisfaction with care. DESIGN: Randomised controlled trial. PARTICIPANTS: 119 adults who had deliberately poisoned themselves and presented to the emergency department of a teaching hospital. SETTING: Community based study. INTERVENTION: Four sessions of therapy delivered in the patient's home. Control patients received "treatment as usual," which in most cases consisted of referral back to their general practitioner. OUTCOME MEASURES: Severity of suicidal ideation six months after treatment as assessed by the Beck scale for suicidal ideation. Secondary outcome measures at six month follow up included depressive symptoms as measured by the Beck depression inventory, patient satisfaction with treatment, and self reported subsequent attempts at self harm. RESULTS: Participants randomised to the intervention had a significantly greater reduction in suicidal ideation at six month follow up compared with those in the control group (reduction in the mean (SD) Beck scale 8.0 v 1.5). They were more satisfied with their treatment and were less likely to report repeated attempts to harm themselves at follow up (proportion repeating 9% v 28% in control group; difference 19%, 95% confidence interval 9% to 30 %, P=0.009). CONCLUSION: Brief psychodynamic interpersonal therapy may be a valuable treatment after people have deliberately tried to poison themselves.

Action research: a suitable method for promoting change in nurse education.

This paper arose from a research study and its follow-up in four schools of nursing and midwifery. The study was concerned with evaluating the extent to which a philosophy of health had been integrated into the educational curricula of nurses, midwives and health visitors. The purpose of the follow-up was to disseminate and implement the study findings in the four centres. The findings showed that the interpretation and implementation of a philosophy of health in nursing had been variable. Health was operationalized as both health education and health promotion ranging from individualized information giving and disease prevention. Action research was chosen as the appropriate methodology for the follow-up because of its emphasis on participation and partnership. As the follow-up study progressed a number of issues emerged which were indicative of the changes taking place in nurse education as its institutional base shifted into higher education. Other issues were associated with the gap between the rhetoric and reality of action research and the expectations and needs of the key partners. The authors conclude that the follow-up study presented both challenges and opportunities to nurse educators in their endeavour to undertaken research and implement educational change.