A simplified protocol for differentiation of electrophysiologically mature neuronal networks from human induced pluripotent stem cells.

Progress in elucidating the molecular and cellular pathophysiology of neuropsychiatric disorders has been hindered by the limited availability of living human brain tissue. The emergence of induced pluripotent stem cells (iPSCs) has offered a unique alternative strategy using patient-derived functional neuronal networks. However, methods for reliably generating iPSC-derived neurons with mature electrophysiological characteristics have been difficult to develop. Here, we report a simplified differentiation protocol that yields electrophysiologically mature iPSC-derived cortical lineage neuronal networks without the need for astrocyte co-culture or specialized media. This protocol generates a consistent 60:40 ratio of neurons and astrocytes that arise from a common forebrain neural progenitor. Whole-cell patch-clamp recordings of 114 neurons derived from three independent iPSC lines confirmed their electrophysiological maturity, including resting membrane potential (-58.2±1.0 mV), capacitance (49.1±2.9 pF), action potential (AP) threshold (-50.9±0.5 mV) and AP amplitude (66.5±1.3 mV). Nearly 100% of neurons were capable of firing APs, of which 79% had sustained trains of mature APs with minimal accommodation (peak AP frequency: 11.9±0.5 Hz) and 74% exhibited spontaneous synaptic activity (amplitude, 16.03±0.82 pA; frequency, 1.09±0.17 Hz). We expect this protocol to be of broad applicability for implementing iPSC-based neuronal network models of neuropsychiatric disorders.

Changing patterns in emergency involuntary admissions in the Netherlands in the period 2000-2004.

BACKGROUND: In England, rates of involuntary admissions increased in subgroups of patients. It is unknown whether this is true in other European countries. AIMS: To establish whether the increase in emergency commitments was uniform across subgroups of patients and dangerousness criteria used to justify commitment in The Netherlands. METHOD: National data on all commitments in the period 2000-2004. RESULTS: Commitments increased from 40.2 to 46.5 (16%) per 100,000 inhabitants. Controlling for population changes in age and sex, relatively large increases were found in patients over 50 years (25-40% increase), in patients with dementia (59%), 'other organic mental disorders' (40%) and substance abuse (36%). 'Arousing aggression', increased most strongly as a dangerousness criterion for commitment (30%). CONCLUSION: Changing patterns of commitments in The Netherlands and England might indicate a wider European shift in diagnoses and reasons for admission of committed patients.

Is the reducing effect of the Staff Observation Aggression Scale owing to a learning effect? An explorative study.

Is the reducing effect of the Staff Observation Aggression Scale owing to a learning effect? An explorative study Abstract This study explores the decline in the amount of reported aggression incidents when using the Staff Observation Aggression Scale (SOAS). Because this decline could hold significant implications for practice or research, the objective of this study was to explore the plausible explanations for this phenomenon. The influence of systematic feedback of the gained data was also studied. The SOAS was introduced on a closed ward in a psychiatric institution in the Netherlands as a measuring instrument to assess the amount of aggression incidents during a 16-week period. The standard procedure for reporting general incidents was continued. After 10 weeks of registration, systematic feedback of the gathered data took place. Statistic analysis was used to determine significant changes in the total amount as well as on the various forms of aggression. During this observation period, qualitative data were collected to support the analysis of the quantitative data. A significant decrease in the total amount of reported aggression incidents as well as in the categories of 'verbal aggression' and 'remaining aggression' was found. However, the category 'physical aggression' was stable during the entire observation period. The number of standard procedure reports did not decrease when compared with the pre-test period. Nursing staff did not recognize a reduction in the amount of aggression incidents. The role of a learning effect in the reduction of reports on aggression incidents is not excluded but there are indications that the reduction is also the result of 'reporting fatigue' and 'shifting attention'.

[The use of isolation in psychiatry--a literature study]. / Het gebruik van separatie in de psychiatrie--een literatuurstudie.

This article reports on a literature review into the publications on the practise of seclusion. Attention will be paid to the moral debate on seclusion. The major part of the publications consider seclusion as a necessary intervention to manage problem behaviour. The first part of the article will consider definitional aspects and will result in concept clarification. The review shows differences at definitional aspects, motives for seclusion and patient characteristics. Data on frequencies, incidence and duration appear to be different. The experience of patients who are secluded are mostly negative, but positive reactions are also reported. Publications on the influence of the hospital characteristics to the use of seclusion seem to increase during time. Finally it is concluded that seclusion is an effective way to manage (potential) dangerous behaviour and that seclusion is an intervention which may create therapeutic conditions.

[Utilization of seclusion. Motives and reasons of nurses]. / De toepassing van separatie. Motieven en redenen van verpleegkundigen.

Seclusion is one of several possible interventions with which patients and health care professionals can be confronted on units for admission and crisis intervention in mental health care institutions. The way in which psychiatric nurses shape their practice with regard to seclusion and how they experience this intervention is unclear. The goal of this study is to describe this practice. The results render insight in the motives and reasons of nurses for use of seclusion, the content of the term emergency situation, the way in which decisions to seclude are taken and which interventions can be labelled as preventive. Finally conclusions are given and the questions raised in this study are discussed.

The use of seclusion in psychiatry: a literature review.

This article reports on a literature review of the practice of seclusion in psychiatric inpatient facilities. Attention is paid to the moral debate on seclusion. Most publications consider seclusion as a necessary intervention to manage problem behavior. The first part of the article deals with definitional aspects leading toward concept clarification. The review shows differences in definitional aspects, motives for seclusion, hospital characteristics, and patient characteristics. Data on frequency, incidence, and duration appear to be widely divergent. The experiences of patients who have been secluded are mostly negative, but positive reactions are also reported. In the publications of the last decade, there is emphasis on the contribution of hospital characteristics to trends in use of seclusion. Finally, it is concluded that seclusion is an effective way to manage (potentially) dangerous behavior and that seclusion is an intervention that may create therapeutic possibilities for care.