The dual dopamine‐glutamate phenotype of growing mesencephalic neurons regresses in mature rat brain

Coexpression of tyrosine hydroxylase (TH) and vesicular glutamate transporter 2 (VGLUT2) mRNAs in the ventral tegmental area (VTA) and colocalization of these proteins in axon terminals of the nucleus accumbens (nAcb) have recently been demonstrated in immature (15‐day‐old) rat. After neonatal 6‐hydroxydopamine (6‐OHDA) lesion, the proportion of VTA neurons expressing both mRNAs and of nAcb terminals displaying the two proteins was enhanced. To determine the fate of this dual phenotype in adults, double in situ hybridization and dual immunolabeling for TH and VGLUT2 were performed in 90‐day‐old rats subjected or not to the neonatal 6‐OHDA lesion. Very few neurons expressed both mRNAs in the VTA and substantia nigra (SN) of P90 rats, even after neonatal 6‐OHDA. Dually immunolabeled terminals were no longer found in the nAcb of normal P90 rats and were exceedingly rare in the nAcb of 6‐OHDA‐lesioned rats, although they had represented 28% and 37% of all TH terminals at P15. Similarly, 17% of all TH terminals in normal neostriatum and 46% in the dopamine neoinnervation of SN in 6‐OHDA‐lesioned rats were also immunoreactive for VGLUT2 at P15, but none at P90. In these three regions, all dually labeled terminals made synapse, in contradistinction to those immunolabeled for only TH or VGLUT2 at P15. These results suggest a regression of the VGLUT2 phenotype of dopamine neurons with age, following normal development, lesion, or sprouting after injury, and a role for glutamate in the establishment of synapses by these neurons. J. Comp. Neurol. 517:873–891, 2009. © 2009 Wiley‐Liss, Inc.     

Developmental changes in group climate in two types of group therapy for binge-eating disorder: A growth curve analysis

Abstract

The development of group climate across 16 sessions of group psychodynamic–interpersonal psychotherapy (GPIP) and group cognitive–behavioral therapy (GCBT) for 65 female treatment completers with binge-eating disorder (BED) was assessed. Engaged scale growth for GPIP patients varied across sessions and was best represented by a cubic growth curve. This suggested that GPIP progressed in definable phases that reflected a rupture and repair sequence of engaged group climate. For patients receiving GCBT, engaged, avoiding, and conflict scale growth was gradual and consistent (i.e., linear), indicating an increase in positive group climate across sessions. This likely reflected patients taking greater responsibility for treatment as suggested by the CBT model. Linear growth in engaged climate mediated the relationship between attachment anxiety and outcome in GPIP. A consistent increase in engaged group climate through the rupture and repair phase may be a necessary condition for successful treatment of BED patients with high attachment anxiety who receive GPIP.

Zusammenfassung

Entwicklung von Veränderungen im Gruppenklima bei zwei Arten von Gruppentherapie für Essstörungen: Eine Wachstumskurven-Analyse

Es wurde die Entwicklung des Gruppenklimaklimas über 16 Sitzungen bei psychodynamisch - interpersoneller Gruppentherapie (psychodynamic-interpersonal psychotherapy [GPIP]) und kognitiv-verhaltensmässiger Gruppentherapie (group cognitive-behavioral therapy [GCBT]) eingeschätzt. An der Untersuchung nahmen 65 Frauen mit Essanfallstörungen, die die Behandlung auch zu Ende geführt haben, teil. Der Zuwachs der Engagement-Skala variierte für GPIP-Patienten und ließ sich am besten mit Hilfe einer kubischen Wachstumskurve wiedergeben. Das legt für das engagierte Gruppenklima das Fortschreiten vom GPIP-Patienten mit einer Phasensequenz von Einbrüchen und ihrer Wiederherstellung nahe. Für GCBT-Patienten war der Anstieg der Skalen für engagiertes, vermeidendes und konflikthaftes Gruppenklima graduell und konsistent (d. h. linear) und wies insgesamt auf einen kontinuierlichen Anstieg des positiven Gruppenklimas über die Sitzungen hin. Das spiegelt wahrscheinlich die größere Verantwortung der Patienten für die Behandlung, wie sie nach dem CBT-Modell angenommen wird, wider. Ein linearer Anstieg des engagierten Gruppenklimas, über die Phasen von Einbrüchen und Wiederherstellung hinweg, könnte eine notwendige Bedingung für eine erfolgreiche Behandlung von Essanfallstörungs-Patienten mit hoher Bindungsangst unter der GPIP Bedingung sein.

Résumé

Changements du climat dans le groupe dans deux types de thérapies de groupe pour le binge-eating?: une analyse par courbe de croissance

Le développement du climat dans le groupe était évalué à travers 16 séances de psychothérapie de groupe psychodynamique–interpersonnelle (GCBT) et de thérapie de groupe cognitivo–comportementale (GCBT) pour 65 femmes avec un trouble de binge–eating (BED) ayant terminé le traitement. La croissance sur l’échelle d'engagement des patients en GPIP variait à travers les séances et était le mieux représentée par une courbe de croissance cubique. Ceci suggère que la GPIP progressait par phases définies reflétant une séquence de rupture et de réparation du climat d'engagement du groupe. Pour les patients en GCBT, la croissance des échelles d'engagement, d’évitement et de conflit était graduel et consistant (linéaire), indiquant une augmentation du climat de groupe positif à travers les séances. Ceci pourrait refléter une plus grande prise de responsabilité par les patients pour leur traitement, comme suggéré par le modèle CBT. La croissance linéaire du climat engagé était médiatrice de la relation entre l'anxiété d'attachement et l'issue en GPIP. Une augmentation consistante du climat d'engagement dans le groupe dans la phase de rupture et de réparation pourrait être une condition nécessaire pour un traitement réussi de patients BED avec une haute anxiété d'attachement qui bénéficient d'une GPIP.

Resumen

Cambios en el clima grupal en dos tipos de terapia para la bulimia: análisis de la curva de crecimiento

Se evaluó el desarrollo del clima grupal a lo largo de 16 sesiones de una psicoterapia grupal psicodinámica-interpersonal (GPIP) y de otra grupal cognitivo-comportamental (GCBT) de sesenta y cinco mujeres que completaron su tratamiento para desorden bulímico (BED). El crecimiento de la escala comprometida para pacientes GPIP varió a través de las sesiones y se lo representó mejor por medio de una curva de crecimiento cúbico. Esto sugiere que la GPIP progresó en fases definibles que reflejaron una secuencia de ruptura y reparación del clima comprometido grupal. Para los pacientes que recibieron GCBT, el crecimiento en las escalas comprometida, evitativa y conflictiva fue gradual y consistente (esto es, lineal), lo que indica un aumento en el clima positivo grupal a lo largo de las sesiones. Probablemente, esto fue reflejo de que los pacientes tomaron su tratamiento con mayor responsabilidad, según lo sugiere el modelo CBT. Un crecimiento lineal en el clima comprometido medió entre la ansiedad de apego y el resultado en GPIP. Un aumento consistente en el clima grupal comprometido a través de las fases de ruptura y reparación puede ser una condición necesaria para un tratamiento exitoso con GPIP de pacientes BED con gran ansiedad de apego.

Resumo

Mudanças no ambiente de grupo em dois tipos de terapia de grupo para a perturbação de ingestão alimentar compulsiva: uma análise da curva de crescimento

Foi avaliado o desenvolvimento de atmosfera de grupo durante 16 sessões de psicoterapia interpessoal psicodinâmica de grupo (PIPG) e terapia cognitivo-comportamental de grupo (TCCG) no tratamento de 65 mulheres que completaram o tratamento para a perturbação de ingestão alimentar compulsiva (PIAC). O aumento na escala do envolvimento em pacientes com PIPG variou ao longo das sessões e era melhor descrito por uma curva de crescimento cúbica. Isto sugere que a PIPG progrediu em fases definidas que reflectem a ruptura e restauram a sequência da atmosfera de envolvimento do grupo. Para os pacientes que receberam TCCG, a elevação nas escalas de envolvimento, evitamento e conflito foi gradual e consistente (i.e. linear), indicando um aumento positivo no ambiente do grupo ao longo das sessões. Isto parece reflectir que os pacientes tomam maiores responsabilidades no tratamento tal como é sugerido no modelo cognitivo-comportamental. O crescimento linear no envolvimento mediava a relação entre a vinculação ansiosa e o resultado da PIPG. Um aumento consistente no envolvimento do ambiente de grupo ao longo da ruptura e fase de reconciliação poderá ser necessário para o sucesso no tratamento de pacientes com BED, com elevada vinculação ansiosa, que recebem PIPG.

Sommario

Cambiamenti nel clima di gruppo in due tipi di terapia di gruppo per il binge-eating disorder: un'analisi della curva crescente

E’ stato valutato lo sviluppo del clima di gruppo mediante 16 sedute di psicoterapia di gruppo psicodinamico-interpersonale (GPIP) e di terapia di gruppo cognitivo-comportamentale (GCBT) per 65 donne con binge-eating disorder (BED) che hanno terminato il trattamento.

La crescita nelle scale impiegate per i pazienti GPIP è variata tra le sedute ed è stata al meglio rappresentata da una curva di crescita cubica. Ciò ha suggerito che il GPIP è progredito in fasi determinabili che hanno riflettuto una sequenza di rottura e riparazione del clima di gruppo instaurato.

Per i pazienti che hanno ricevuto la GCBT, la crescita nelle scale di adesione, evitamento e conflitto è stata graduale e consistente (lineare), indicando un incremento nel positivo clima di gruppo attraverso le sedute. Ciò probabilmente ha rispecchiato i pazienti che hanno assunto la maggiore responsabilità per il trattamento, come suggerito dal modello CBT.

La crescita lineare nel clima instaurato ha mediato la relazione tra ansia d'attaccamento ed esito nel GPIP. Un incremento consistente nel clima di gruppo instaurato attraverso la fase di rottura e riparazione potrebbe essere una condizione necessaria per un trattamento di successo dei pazienti con BED con alta ansia d'attaccamento che ricevono GPIP.

     

Barriers to kidney transplants in Indonesia: a literature review

Background: People living with chronic kidney disease will require renal dialysis or a kidney transplant to maintain life. Although Indonesia has a developing healthcare industry, Indonesia's kidney transplant rates are lower than comparable nations. Purpose: To explore the healthcare literature to identify barriers to kidney transplants in particular in relation to Indonesia. Methods: Healthcare databases were searched (CINAHL, Medline, EBSCOhostEJS, Blackwell Synergy, Web of Science, PubMed, Google Scholar and Proquest 5000) using the search terms: transplant, kidney disease, renal, dialysis, haemodialysis, Indonesia and nursing. The search was limited to English and Indonesian language data sources from 1997 to 2007. Reference lists of salient academic articles were hand searched. Results: The results of our search identified six articles that met our criteria. Costs are the major barrier to kidney transplant in Indonesia, followed by cultural beliefs, perception of the law, lack of information and lack of infrastructure. In addition, kidney disease prevention strategies are required. Conclusions: There are many complex socio‐economic, geographical, legal, cultural and religious factors that contribute to low kidney transplant rates in Indonesia. Although an increase in transplantation rates will require strategies from various agencies, healthcare professionals, including nurses, can play a role in overcoming some barriers. Community education programmes, improving their own education levels and by increasing empowerment in nursing we may contribute to improved kidney transplant rates in Indonesia.     

Attachment dimensions and group climate growth in a sample of women seeking treatment for eating disorders

Adult attachment and group process research are emerging areas of research for treating eating disorders. In this study, we examined several aspects of group processes: the weekly growth of group therapy climate, the relationship between group climate growth and outcomes, and the impact of the group on individual experiences of group climate. Further, we assessed the relationship between adult attachment dimensions and these group processes. Women (n = 264) diagnosed with an eating disorder completed attachment scales pre-treatment, eating disorder symptom scales pre- and post-treatment, and group climate scales weekly during treatment. Treatment consisted of a specialized eating disorders group-based day hospital program with rolling admissions. Engaged group climate increased and Avoidance group climate decreased across weeks of treatment. Engaged group climate growth was associated with improved eating disorder symptoms post-treatment. Higher attachment avoidance at pre-treatment was related to lower Engaged group climate at week 1, and was related to a greater impact of the group on the individual's experience of group engagement. Clinicians might improve group processes and outcomes by tailoring interventions to individuals' attachment avoidance when treating women for eating disorders.     

Regional expression and ultrastructural localization of EphA7 in the hippocampus and cerebellum of adult rat

EphA7 is expressed in the adult central nervous system (CNS), where its roles are yet poorly defined. We mapped its distribution using in situ hybridization (ISH) and immunohistochemistry (IHC) combined with light (LM) and electron microscopy (EM) in adult rat and mouse brain. The strongest ISH signal was in the hippocampal pyramidal and granule cell layers. Moderate levels were detected in habenula, striatum, amygdala, the cingulate, piriform and entorhinal cortex, and in cerebellum, notably the Purkinje cell layer. The IHC signal distribution was consistent with ISH results, with transport of the protein to processes, as exemplified in the hippocampal neuropil layers and weakly stained pyramidal cell layers. In contrast, in the cerebellum, the Purkinje cell bodies were the most strongly immunolabeled elements. EM localized the cell surface‐expression of EphA7 essentially in postsynaptic densities (PSDs) of dendritic spines and shafts, and on some astrocytic leaflets, in both hippocampus and cerebellum. Perikaryal and dendritic labeling was mostly intracellular, associated with the synthetic and trafficking machineries. Immunopositive vesicles were also observed in axons and axon terminals. Quantitative analysis in EM showed significant differences in the frequency of labeled elements between regions. Notably, labeled dendrites were ～3–5 times less frequent in cerebellum than in hippocampus, but they were individually endowed with ～10–40 times higher frequencies of PSDs, on their shafts and spines. The cell surface localization of EphA7, being preferentially in PSDs, and in perisynaptic astrocytic leaflets, provides morphologic evidence that EphA7 plays key roles in adult CNS synaptic maintenance, plasticity, or function. J. Comp. Neurol. 524:2462–2478, 2016. © 2016 Wiley Periodicals, Inc.