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  • 1
    ISSN: 1471-4159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cholecystokinin (CCK) is one of the most abundant peptide transmitters in the mammalian brain. Despite the physiological significance of CCK expression in long-term memory and psychiatric disorders, little is known about the factors that regulate the expression of CCK peptides. Here, we report that KCl and forskolin synergistically increase CCK gene transcription via protein kinase A (PKA) and extracellular signal-regulated kinase (ERK) signalling pathways, activating cAMP response element-binding protein (CREB) associated with the CRE(− 80) element of the CCK promoter. Whereas, CREB Ser133 phosphorylation was essential for transcriptional activation, the synergistic stimulation was not correlated to the level of Ser133 phosphorylation, indicating that recruitment and/or activation of additional downstream factors were required for maximal stimulation. Transcriptional activation was reduced by co-expression of adenovirus 12S E1A, that inhibits binding of CREB-binding protein (CBP) to CREB. Moreover GAL4-CREB-DIEDML, which mediates the phosphorylation-independent binding of CBP, and the C-terminal domain of CBP was synergistically activated by forskolin and KCl. Taken together the results imply that neuronal CCK gene transcription is regulated by the cumulative action of calcium and cAMP via stimulation of the PKA and ERK signalling pathways and that synergy is accomplished by the coordinate activation of CREB and CBP.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background.  Sensitivity to and respect for the user perspective are important facets of user-centred services and empowerment in contemporary mental health care. Little is known about the extent to which new policies influence mental health work in practice. Aims.  To investigate discrepancy between patients and professionals in the assessment of patient needs. Analyses could indicate emphasis on user orientation in Norwegian mental health care. Methods.  Patients and their respective health professionals ( n  = 1080) completed separate questionnaires regarding patient characteristics and needs. Identifiers were removed from the data locally and then entered into a national database. Descriptive statistics and multiple regression analysis were used to explore mean levels of discrepancy and predictors of discrepancy. Results.  Mean discrepancy was low, as, on average, 30 of the listed 40 needs were considered absent by both the patients and their respective professional. However, the parties showed distinct disagreement as to the amount and type of needs that were present. Specifically, professionals identified more needs than patients (9·3 vs. 4·3, respectively) and this difference was characterized by a strong professional emphasis on needs regarding professional monitoring and follow-up. Results showed that symptoms of severe cognitive disability were over-represented in the group of patients with the highest level of discrepancy, however, the majority of high-discrepancy patients were not severely disabled on cognitive functions. A multiple regression analysis revealed 10 predictors of high discrepancy. Discussion.  A low professional emphasis on user-orientation may be indicated in some cases. Results are discussed with relation to the tension between autonomy and beneficence. Suggestions for practice and further research conclude the paper.
    Type of Medium: Electronic Resource
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