Caring for the Involuntarily Hospitalized Adolescent: The Issue of Power in the Nurse-Patient Relationship

TOPIC: The power relations between involuntarily hospitalized adolescents and their caregivers from the viewpoint of theory development in nursing and the concept of medicalization. PURPOSE: To contribute to the development of nursing theories that can guide nursing care of involuntarily hospitalized adolescents by examining the power relations between the adolescents and their caregivers. SOURCES: Published literature in medical sociology, and nursing and psychiatric ethics. Nursing and psychiatric literature, in which Michel Foucault's theories are used to explicate the disciplinary power of psychiatry. CONCLUSIONS: To empower involuntarily hospitalized adolescents nurses must both recognize the inevitable power imbalance and seek guidance from the egalitarian ideals of nursing. Nurses can draw from postmodern thinkers who dismiss the idea that one theory can explain human relationships.     

Ineffectiveness of organic calcium channel blockers in antagonizing long-term potentiation

Evidence has accumulated suggesting that the presence of calcium is critical for development of hippocampal long-term potentiation (LTP). However, there is a paucity of information about whether calcium's role in LTP is pre- or postsynaptic. In the present study, we examined the effectiveness of nitrendipine, verapamil, flunarizine and the benzodiazepine diazepam in: blocking voltage-dependent calcium channels; blocking synaptic transmission; and preventing development of LTP. Using the in vitro slice preparation, we obtained intracellular and extracellular recordings from guinea pig hippocampal CA1 pyramidal cells. At the cellular level, all 4 drugs were ineffective in blocking voltage-dependent calcium spikes (TTX resistant) and the calcium-dependent afterhyperpolarization. Verapamil and diazepam appeared to antagonize synaptic transmission, as reflected in smaller population spike amplitudes. Development of long-term potentiation was not affected by the presence of verapamil, flunarizine and diazepam. Nitrendipine appeared to reduce the percentage of slices exhibiting LTP; however, ethanol, the vehicle used to dissolve nitrendipine, was shown in separate experiments to reduce the percentage of slices exhibiting LTP. These results suggest that neither the organic calcium channel blockers--nitrendipine, verapamil, and flunarizine--nor micromolar concentrations of diazepam are potent blockers of extrasynaptic voltage-sensitive calcium channels in hippocampus. They thus cannot be used to demonstrate a specific pre- or postsynaptic calcium role in LTP.     

Characterization of gp 50, a major glycoprotein present in rat brain synaptic membranes, with a monoclonal antibody

Several cell lines secreting monoclonal antibodies (Mabs) against a major forebrain synaptic membrane (SM) glycoprotein, gp 50, have been raised. Western blots show that the Mabs react with a polypeptide doublet of Mrs 49 and 45 kDa. These polypeptides exist solely in a concanavalin A (Con A) binding form. Removal of the Con A receptors by digestion with endo-beta-N-acetylglucosaminidase H (endo H) lowers the Mrs of the glycoprotein doublet to 36.5 and 34 kDa. Western blots of 2D polyacrylamide gels indicate that gp 50 exists in several isoforms. Solid phase radioimmunoassay (RIA) and Western blots of brain subcellular fractions show the antigenic material to be concentrated in the SM fraction, but to be present in much lower amounts in synaptic junctions and postsynaptic densities. Gp 50 appears to be brain specific. Regional distribution studies show that it is present in all brain regions but is two-fold concentrated in cerebellum, brainstem and midbrain compared to forebrain. Immunocytochemical studies of several brain regions show that gp 50-like immunoreactivity is neuron specific and is concentrated in selected neuronal species, particularly granule cells. In both cerebellar and hippocampal granule cells gp 50-like immunoreactivity is localized in the perikarya and primary dendrites. Though immunocytochemistry did not show staining of synaptic regions this may be due to masking of the reactive epitope. The results are discussed in terms of the molecular properties of gp 50 and its subcellular localization in brain tissue.     

Menstrual Perceptions and Preparation Among Female Adolescents

Seventy-four 8th- and 10th-grade students attending a private girls' school in Hawaii were queried about their perceptions of and preparation for menstruation using a questionnaire administered in a health education class. Eighty percent had already started menstruating. The most frequently cited perceptions by the respondents referred to both the inconveniences and the normalcy of menstruation. Many were first informed about menstruation by their mothers and stated that they also first informed their mothers when they started menstruating. Surprise, fear, and embarrassment were common initial reactions, while strong negative or positive emotions were more rare. Only 35% wanted boys and girls together during class discussion, but 89% stated that boys needed to be informed about menstruation. The most frequent reasons cited for noncoed settings were the girls' concern about their comfort in openly discussing menstruation. Thirty-eight percent thought parents should inform other siblings when they started menstruation, although almost half gave specific conditions the parents should consider. The majority thought the fifth to sixth grades were the best times to introduce menstruation content.