Longitudinal patterns of antidepressant prescribing in primary care in the UK: comparison with treatment guidelines.

The objective of this study was to determine whether patients beginning therapy on the most common tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) differed in their likelihood of having antidepressant treatment that was consistent with recommended treatment guidelines in the UK. An analytical file constructed from a large general practitioner medical records database (DIN-LINK) from the UK for the years 1992-97 was constructed. A total of 16,204 patients with a new episode of antidepressant therapy who initiated therapy on one of the most often prescribed TCAs (amitriptyline, dothiepin, imipramine and lofepramine) or SSRIs (fluoxetine, paroxetine and sertraline) were analysed.

Facilitation of long-term potentiation in layer II/III horizontal connections of rat motor cortex following layer I stimulation: route of effect and cholinergic contributions.

The ability of layer I activation to facilitate the induction of long-term potentiation (LTP) in layer II/III horizontal connections of motor cortex (MI) was examined in rat brain slice preparations. Field potentials evoked in layer I and layer II/III horizontal pathways were recorded from radially aligned MI sites. While theta burst stimulation (TBS) of layer II/III pathways alone failed to induce LTP, simultaneous TBS of layer I and layer II/III inputs on alternate sides of the recording electrodes induced LTP in the layer II/III input in 8 out of 13 slices (mean change +20+/-6%; N=13).

Nurses' perceptions of their professional growth on completion of two years of postgraduate education.

In a climate of diminishing financial resources in service industries such as health care and education, it is not surprising that a focus on measuring and ensuring appropriate outcomes is widespread. Graduate education has the potential to make a significant difference to the professional behaviour of graduates. Postgraduate nursing coursework programs have been developed and offered in such a climate, many now charging full course fees, which no doubt stimulates participants and employers to look for value for money in terms of outcomes.

Strengthening of horizontal cortical connections following skill learning.

Learning a new motor skill requires an alteration in the spatiotemporal pattern of muscle activation. Motor areas of cerebral neocortex are thought to be involved in this type of learning, possibly by functional reorganization of cortical connections. Here we show that skill learning is accompanied by changes in the strength of connections within adult rat primary motor cortex (M1).

Information about movement direction obtained from synchronous activity of motor cortical neurons.

Although neuronal synchronization has been shown to exist in primary motor cortex (MI), very little is known about its possible contribution to coding of movement. By using cross-correlation techniques from multi-neuron recordings in MI, we observed that activity of neurons commonly synchronized around the time of movement initiation. For some cell pairs, synchrony varied with direction in a manner not readily predicted by the firing of either neuron.

The impact of graduate education on the career paths of nurses.

This paper reports the findings of the first phase of a ten year longitudinal study of nurses graduating with higher degrees and diplomas. The higher education sector in Australia has been subjected to a variety of changes in the past decade. Amalgamations and restructuring, altered funding formulae, recognition of prior learning and credit transfer are some of the initiatives, many dictated by governmental bodies, which impact on the education system.

Neural discharge and local field potential oscillations in primate motor cortex during voluntary movements.

The role of "fast," or gamma band (20-80 Hz), local field potential (LFP) oscillations in representing neuronal activity and in encoding motor behavior was examined in motor cortex of two alert monkeys. Using chronically implanted microwires, we simultaneously recorded LFPs and single or multiple unit (MU) discharge at a group of sites in the precentral gyrus during trained finger force or reaching movements, during natural reaching and grasping, and during quiet sitting. We evaluated the coupling of oscillations with task-related firing at the same site, the timing of oscillations with respect to the execution of trained and untrained movement, and the temporal synchrony of oscillations across motor cortical sites.

Renal revascularisation by gastroduodenal-renal bypass as treatment of renal artery stenosis.

We report the case of a 63 year old hypertensive male who presented with acute renal failure following treatment of his hypertension with the ACE antagonist, captopril. He was documented to have bilateral renal artery stenosis, which was treated by left renal artery angioplasty and revascularisation of the right kidney by anastomosis of the right renal artery to the superior gastroduodenal branch of the hepatic artery. Postoperatively, he made an excellent recovery, with restoration of his renal function to normal and improved control of his hypertension.

Do clinical nurse specialists and nursing unit managers believe that the provision of quality care is important?

The nursing profession has a long tradition of evaluating the quality of its product in order to ensure that the best possible care can be given. However, in the climate of economic rationalism which prevails worldwide, it is possible that the emphasis on fiscal restraint has distracted nurses from their previous focus on quality. This paper discusses the findings of two research studies designed to determine the competencies expected of nursing unit managers and clinical nurse specialists.

Conditions for the induction of long-term potentiation in layer II/III horizontal connections of the rat motor cortex.

1. The present studies investigated conditions for the induction of long-term potentiation (LTP) in the local horizontal pathways of layers II/III in the primary motor cortex (MI) of the adult rat. Field potential and intracellular recordings demonstrated synaptic interactions across the superficial layers within MI that could be enhanced transiently by focal application of the gamma-aminobuturic acid-A receptor antagonist bicuculline methiodide (Bic) at the recording site.

Long-term depression of horizontal connections in rat motor cortex.

The possibility for long-term depression (LTD) of synaptic transmission in layer II/III horizontal connections within motor cortex was investigated using field potentials and intracellular recordings in rat brain slices. The LTD was induced by low-frequency stimulation at 2 Hz for 10 min in sites displaced horizontally by 0.5 mm from the stimulating electrode.

The treatment of depression: prescribing patterns of antidepressants in primary care in the UK.

Background: Consensus has been achieved about how depression should be treated in primary care, and guidelines have been issued by the Royal Colleges of General Practitioners and Psychiatrists, and by the British Association for Psychopharmacology. One of the principal recommendations is to prescribe antidepressant medicine at effective doses. This study was established to investigate how current prescribing practices in primary care compared with these guidelines.

Long-term potentiation and long-term depression of horizontal connections in rat motor cortex.

This paper reviews studies that investigate conditions resulting in long-lasting modifications of synaptic efficacy in horizontal connections within layers II/III of adult rat motor cortex using the in vitro slice preparation. Long-term potentiation (LTP) was induced by high frequency theta burst stimulation (TBS) when local synaptic inhibition was transiently suppressed by bicuculline methiodide application at the recording site immediately prior to TBS of the horizontal pathway. Without bicuculline, TBS failed to produce LTP.