A comparative cross-sectional questionnaire survey of the work of UK and US mental health nurses.

BACKGROUND: Comparative inter-country research which identifies similarities and differences in the work of mental health nurses in different social and political contexts is an important means of determining how changes in health care systems could lead to better outcomes for patients. OBJECTIVE: This study sought to compare aspects of the work of nurses in US and UK mental health care settings. Nurses were invited to reflect on aspects of their role including identifying the most and least satisfying elements of their work and suggesting ways in which it could be improved. METHODS AND PARTICIPANTS: A 12-item questionnaire, comprising closed and open-ended questions, based on the literature and the authors' own experiences of mental health nursing practice, was piloted and subsequently distributed to respondents in both countries. RESULTS: The US nurses tended to be more willing to accept a wider range of clients than their UK counterparts, although they had lower expectations of their clients' likelihood of recovery. Both groups of nurses felt that being part of a team and having direct contact with clients were the most satisfying aspects of their work, while administration was the least. Although both US and UK nurses utilised a variety of intervention models, it would appear that Cognitive Behavioural Therapy was the favoured model for the majority of nurses. CONCLUSIONS: The implications of these findings for the work of nurses and mental health care services in the UK and US, and the purpose, nature and need for future international comparative research are discussed.

Nurse prescribing: the experiences of psychiatric nurses in the United States.

AIM: This study sought to elicit the views of psychiatric nurses in the United States on various aspects of nurse prescribing, with the aim of informing UK nurses about future problems and possible solutions. METHOD: A survey design with an opportunistic sample of psychiatric nurse clinical specialists was used. The questionnaire consisted of 14 items seeking to elicit information on demographic data, current involvement in medication management, perceptions of the advantages and disadvantages of nurse prescribing, awareness of research about nurse prescribing, accountability and autonomy, and the prescribers' relationship with the pharmaceutical industry. Of the 80 questionnaires distributed, 51 (43 completed by female nurses and eight by male nurses) were returned--a response rate of 64 per cent. RESULTS: The results highlight the many advantages of nurse prescribing, which centre on improving the quality of care for patients; concerns relating to the relationship between nurse prescribers and non-prescribers; and the relationship between nurse prescribers and medical supervisors. CONCLUSION: Nurse prescribing has advantages for nurses and patients, including enhanced career development opportunities and better quality of patient care. However, though nurses may feel ready for this development, some members of the public may take longer to accept it.

The Ubr2 Gene is Expressed in Skeletal Muscle Atrophying as a Result of Hind Limb Suspension, but not Merg1a Expression Alone.

Skeletal muscle (SKM) atrophy is a potentially debilitating condition induced by muscle disuse, denervation, many disease states, and aging. The ubiquitin proteasome pathway (UPP) contributes greatly to the protein loss suffered in muscle atrophy. The MERG1a K(+) channel is known to induce UPP activity and atrophy in SKM. It has been further demonstrated that the mouse ether-a-gogo-related gene (Merg)1a channel modulates expression of MURF1, an E3 ligase component of the UPP, while it does not affect expression of the UPP E3 ligase Mafbx/ATROGIN1. Because the UBR2 E3 ligase is known to participate in SKM atrophy, we have investigated the effect of Merg1a expression and hind limb suspension on Ubr2 expression. Here, we report that hind limb suspension results in a significant 25.6% decrease in mouse gastrocnemius muscle fiber cross sectional area (CSA) and that electro-transfer of Merg1a alone into gastrocnemius muscles yields a 15.3% decrease in CSA after 7 days. More interestingly, we discovered that hind limb suspension caused a significant 8-fold increase in Merg1a expression and a significant 4.7-fold increase in Ubr2 transcript after 4 days, while electro-transfer of Merg1a into gastrocnemius muscles resulted in a significant 6.2-fold increase in Merg1a transcript after 4 days but had no effect on Ubr2 expression. In summary, the MERG1a K(+) channel, known to induce atrophy and MURF1 E3 ligase expression, does not affect UBR2 E3 ligase transcript levels. Therefore, to date, the MERG1a channel's contribution to UPP activity appears mainly to be through up-regulation of Murf1 gene expression.