A close-up on the expanding landscape of CD21–/low B cells in humans

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The VpreB1 enhancer drives developmental stage-specific gene expression in vivo

In adult mice, the VpreB genes are expressed in bone marrow progenitor (pro-) and precursor (pre-) B cells. As part of the pre-B cell receptor, the proteins are crucial for the proliferation of these cells and consequently normal B lymphocyte development. Using cell lines, we identified a lineage- and developmental-stage-specific VpreB1 enhancer. Here, we analyze its specificity in vivo by generating transgenic mice in which expression of a reporter gene (human CD122) is regulated by the VpreB1 enhancer in the context of its own promoter. All transgenic lines expressed the reporter gene in the bone marrow in a copy number-independent manner, whereas expression levels were integration site-dependent. While the enhancer is not tissue specific, within the B cell lineage the expression pattern of human CD122 mimicked that of endogenous VpreB1. Thus, low levels were detected in pro-B cells, high levels in pre-BI and slightly lower levels in pre-BII cells; no expression was detected in immature/mature B cells. Furthermore, when in vitro cultured transgenic pre-B cells differentiated into immature B cells there was concomitant down-regulation of human CD122 and endogenous VpreB1. Thus the VpreB1 enhancer is sufficient to ensure developmental stage-specific expression of a reporter gene in B lymphocytes in vivo.     

The roles of knowledge and supervision in work with suicidal patients

Despite caregivers' impact on suicidal patients' compliance with treatment and suicide prevention, little is known about mental-health professionals' perceptions of work with suicidal patients. The roles of psychiatric staff's training and supervision in the care of suicidal patients were investigated by means of a postal questionnaire sent to a random sample of 1543 psychiatric staff members. The response rates were 71% for psychiatrists and 57% for nurses and assistant nurses. The responses of 53 psychiatrists, 164 nurses and 333 assistant nurses working with suicidal patients on a regular basis were compared and analysed using the Kruskal-Wallis test. Thirty-five per cent of the assistant nurses, 43% of the nurses and 74% of the psychiatrists who worked with suicidal patients on a regular basis perceived that they were sufficiently trained for this work, while 75% of the assistant nurses, 72% of the nurses and 34% of the psychiatrists received supervision in their work with suicidal patients. In spite of receiving supervision, nursing staff who perceived that they lacked training reported uncertainties in their work with suicidal patients to a larger extent than those who perceived that their training was sufficient. Uncertainties were significantly more prevalent among nursing staff than among psychiatrists. Basic and specific training in suicidology is needed and cannot be replaced solely by supervision, since psychiatric staff often have to deal with suicidal patients in emergency situations and must be able to rely on their own skills.     

Regulation of interleukin 2 gene expression: discrepancy between enhancer activity and endogenous gene expression

A 630-bp fragment of the human interleukin 2 (IL 2) promoter (+51 to -584) permitted expression of a reporter gene transfected into a mouse T cell lymphoma line (EL4) upon induction with phorbol ester. In contrast, when a human T cell lymphoma (Jurkat) was transfected with the same plasmid and subsequently induced with phorbol ester together with phytohemagglutinin, a very low expression of the transfected gene was observed. The endogenous IL 2 gene was equally well expressed in both cell lines upon induction. Thus, the expression of the endogenous and the transfected gene did not correlate in Jurkat cells. An SV 40 enhancer element cloned 5' of the IL 2 promoter did not result in constitutive expression after transfection to either cell line, rather the IL 2 promoter retained the need for induction. The addition of an enhancer element increased the induced expression of the transfected gene in Jurkat cells into proximity of that observed in induced EL4 cells, indicating that additional sequence elements not contained in the 630-bp fragment are needed for proper expression of the IL 2 gene in Jurkat cells.     

Are trends in work and health conditions interrelated? A study of Swedish hospital employees in the 1990s

Swedish hospital personnel were followed over an 8-year period, characterized by staff redundancies and restructuring processes. Self-rated and administrative data sets from 1994 to 2001 allowed for studying long-term consequences of organizational instability for staff health and work conditions. The aim was to identify, on a work-unit level, trends in work and health conditions and their interdependence. Regression analysis showed a downward trend in mental health and an upward trend in long-term sick leave. Increasing trends of work demands were accompanied by deteriorating mental health, and decreasing time to plan work showed the strongest association with increasing long-term sick leave. Job satisfaction and support were decreasing. A stable short-term sick leave rate over years related to lack of support.