Interleukin-17-targeted treatment in patients with spondyloarthritis and associated cardiometabolic risk profile.

Spondyloarthritis is a group of immune-mediated rheumatic disorders that significantly impact patients' physical function and quality of life. Patients with spondyloarthritis experience a greater prevalence of cardiometabolic disorders, such as obesity, hypertension, dyslipidemia and diabetes mellitus, and these comorbidities are associated with increased spondyloarthritis disease activity and risk of cardiovascular events. This narrative review summarizes the evidence for a physiological link between inflammatory status and cardiometabolic comorbidities in spondyloarthritis, as well as the impact of interleukin (IL)-17 blockade versus other molecular mechanisms in patients with cardiometabolic conditions.

Enhanced Stress Response in 5-HTR Overexpressing Mice: Altered HPA Function and Hippocampal Long-Term Potentiation.

Postsynaptic 5-HT receptors (5-HTR) play an important role in anxiety and stress, although their contribution is still controversial. Previous studies report that mice overexpressing postsynaptic 5-HTRs show no changes in basal anxiety, though the influence of stress conditions has not been addressed yet. In this study, we used this animal model to evaluate the role of 5-HTRs in anxiety response after pre-exposure to an acute stressor.

Behavioral, neurochemical and molecular changes after acute deep brain stimulation of the infralimbic prefrontal cortex.

Deep brain stimulation (DBS) is a treatment that has shown some efficacy in treatment-resistant depression. In particular, DBS of the subcallosal cingulate gyrus (Brodmann's area 25, Cg25) has been successfully applied to treat refractory depression. In the rat, we have demonstrated that DBS applied to infralimbic (IL) cortex elevates the levels of glutamate and monoamines in the prefrontal cortex, and requires the stimulation of cortical α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptors for its antidepressant-like effects.

Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors.

Cannabidiol (CBD), the main non-psychotomimetic component of marihuana, exhibits anxiolytic-like properties in many behavioural tests, although its potential for treating major depression has been poorly explored. Moreover, the mechanism of action of CBD remains unclear. Herein, we have evaluated the effects of CBD following acute and chronic administration in the olfactory bulbectomy mouse model of depression (OBX), and investigated the underlying mechanism.

Planned change or emergent change implementation approach and nurses' professional clinical autonomy.

Background: Nurses' clinical autonomy is considered important for patients' outcome and influenced by the implementation approach of innovations. Emergent change approach with participation in the implementation process is thought to increase clinical autonomy. Planned change approach without this participation is thought not to increase clinical autonomy.

Intensive insulin therapy implementation by means of planned versus emergent change approach.

Background: Nurses' participation in decisions about new care procedures and protocols is potentially of benefit for patient outcomes. Whether nurses' participation in decisions is allowed in the implementation of innovations depends on the implementation approach used for the introduction. A planned change implementation approach does not allow it, an emergent change implementation approach does.

Serotonin 5-HT4 receptors: A new strategy for developing fast acting antidepressants?

The regulation of the activity of brain monoaminergic systems has been the focus of attention of many studies since the first antidepressant drug emerged 50 years ago. The search for novel antidepressants is deeply linked to the search for fast-acting strategies, taking into account that 2-4 weeks of treatment with classical antidepressant are required before clinical remission of the symptoms becomes evident. In the recent years several hypotheses have been proposed on the basis of the existence of alterations in brain synaptic plasticity in major depression.

Neural plasticity and proliferation in the generation of antidepressant effects: hippocampal implication.

It is widely accepted that changes underlying depression and antidepressant-like effects involve not only alterations in the levels of neurotransmitters as monoamines and their receptors in the brain, but also structural and functional changes far beyond. During the last two decades, emerging theories are providing new explanations about the neurobiology of depression and the mechanism of action of antidepressant strategies based on cellular changes at the CNS level. The neurotrophic/plasticity hypothesis of depression, proposed more than a decade ago, is now supported by multiple basic and clinical studies focused on the role of intracellular-signalling cascades that govern neural proliferation and plasticity.

Social isolation differentially affects anxiety and depressive-like responses of bulbectomized mice.

Social isolation in rodents may interfere in their behavioural responses on paradigms used to test anxiety- and depressive-like states. Herein we study the influence of social isolation upon the behavioural responses of olfactory bulbectomized mice (OBX). In the open-field test (OFT), social isolation enhanced OBX-induced hyperactivity and exploratory behaviour.

Feasibility of a nursing rehabilitation guideline for patients with stroke: evaluating the use by nurses.

Purpose: To determine the feasibility of the Clinical Nursing Rehabilitation Stroke-guideline (CNRS-guideline) in the care of stroke patients in terms of the experiences, views and attitudes of nurses towards the guideline and their adoption of the guideline and how often the recommendations were used.

Method: A four phase cross sectional design was used. Demographic data were collected from nurses (n=30) and patients (n=105).

Psychometric properties of the Dutch version of the American Nursing Activity Scale in an intensive care unit.

Aim: To report the development and psychometric testing of the Dutch version of the Nursing Activity Scale in a Dutch intensive care unit nursing population.

Background: The Nursing Activity Scale developed by Schutzenhofer measures professional clinical autonomy, by inquiring about the nurses' intention to exercise their own clinical decisions. This autonomy is increasingly relevant due to the ongoing professionalization, nurses increasingly have to make their own clinical decisions.

A contingency perspective on team learning and innovation in nursing.

Aims: To report a correlational study of the relation between team learning activities and implementation-effectiveness of innovations in nursing teams.

Background: Non-compliance to implementation of innovations is a problem in nursing teams. In the literature, team learning is proposed as a facilitator for change.

Team learning and innovation in nursing, a review of the literature.

The capability to learn and innovate has been recognized as a key-factor for nursing teams to deliver high quality performance. Researchers suggest there is a relation between team-learning activities and changes in nursing teams throughout the implementation of novelties. A review of the literature was conducted in regard to the relation between team learning and implementation of innovations in nursing teams and to explore factors that contribute or hinder team learning.

New strategies in the development of antidepressants: towards the modulation of neuroplasticity pathways.

Over the past five decades, the pharmacological treatment of depression has been based on the pathophysiological hypothesis of a deficiency in monoamines, mainly serotonin and noradrenaline. Antidepressant prescribed today, all of them designed to enhance central monoaminergic tone, present several important limitations, including a 2-5 weeks response lag and also a limited clinical efficacy. As it is increasingly evident that the abnormalities associated to depression go beyond monoamines, the development of better antidepressants will depend on the identification and understanding of new cellular targets.

Innovative behaviour: the effect of structural and psychological empowerment on nurses.

Aim: This paper is a report of a study to investigate the relationship between structural empowerment/psychological empowerment and innovative behaviour.

Background: Innovative behaviour is essential for nurses in today's dynamic healthcare systems. Empowerment has become an increasingly important factor in predicting innovative behaviour.

Implementation of outpatient preoperative evaluation clinics: facilitating and limiting factors.

Background: Several studies have shown that outpatient preoperative evaluation by anaesthetists increases quality of care and is cost-effective. The aim of this study was to gain insight into the factors that positively or negatively influence the implementation of outpatient preoperative evaluation clinics (OPE clinics).

Methods: After an extensive literature study and pilot interviews, we constructed written questionnaires that were sent to all Dutch hospitals.

The tailored implementation of the nursing programme 'Coping with Itch'.

Aim: The aim of the study was to implement the nursing programme 'Coping with itch'.

Background: The nursing programme 'Coping with itch' is intended to reduce itch and to help patients to cope with itch. The programme is carried out at a nurse clinic at the dermatology outpatient department.

The influence of staffing levels on the use of seclusion.

This study focussed on the relationship between the use of seclusion and staff characteristics, such as number of nurses on shift, male-female staff ratio, level of education and level of work experience. A retrospective analysis of staff characteristics was applied to administrative data from ten wards in four mid-sized general psychiatric hospitals in the Netherlands. The data show that two variables were associated with seclusion rates: the male-female staff ratio and the variability in team's work experience.

The effect of national guidelines on the implementation of outpatient preoperative evaluation clinics in Dutch hospitals.

Background And Objectives: Preoperative evaluation performed by anaesthesiologists primarily aims to estimate the risk of perioperative complications and to create opportunities to optimize the patients' condition before surgery. In this study an inventory was made of the current practice of preoperative evaluation in Dutch hospitals. It was estimated how many hospitals had implemented an outpatient preoperative evaluation clinic in 2004.