Naar natuurlijke stranden in Nederland!

Natuurstranden waren vroeger algemeen. Wie nu over het strand wandelt, zal nauwelijks meer een natuurlijk strand tegenkomen, laat staan een strand voor de natuur. Voor natuurlijke processen is weinig ruimte, terwijl deze kunnen bijdragen aan dynamisch kustbeheer en het halen van Natura 2000-doelstellingen. Een groot deel van de kust is beschermd natuurgebied, maar de stranden zijn bijna overal vrij toegankelijk. Naast de zeereservaten uit het vorige artikel, pleiten de auteurs dan ook voor het instellen van meer strandreservaten

Activation of WNT/beta-Catenin Signaling in Pulmonary Fibroblasts by TGF-beta(1) Is Increased in Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is characterized by abnormal extracellular matrix (ECM) turnover. Recently, activation of the WNT/β-catenin pathway has been associated with abnormal ECM turnover in various chronic diseases. We determined WNT-pathway gene expression in pulmonary fibroblasts of individuals with and without COPD and disentangled the role of β-catenin in fibroblast phenotype and function.We assessed the expression of WNT-pathway genes and the functional role of β-catenin, using MRC-5 human lung fibroblasts and primary pulmonary fibroblasts of individuals with and without COPD.Pulmonary fibroblasts expressed mRNA of genes required for WNT signaling. Stimulation of fibroblasts with TGF-β₁, a growth factor important in COPD pathogenesis, induced WNT-5B, FZD₈, DVL3 and β-catenin mRNA expression. The induction of WNT-5B, FZD₆, FZD₈ and DVL3 mRNA by TGF-β₁ was higher in fibroblasts of individuals with COPD than without COPD, whilst basal expression was similar. Accordingly, TGF-β₁ activated β-catenin signaling, as shown by an increase in transcriptionally active and total β-catenin protein expression. Furthermore, TGF-β₁induced the expression of collagen1α1, α-sm-actin and fibronectin, which was attenuated by β-catenin specific siRNA and by pharmacological inhibition of β-catenin, whereas the TGF-β₁-induced expression of PAI-1 was not affected. The induction of transcriptionally active β-catenin and subsequent fibronectin deposition induced by TGF-β₁ were enhanced in pulmonary fibroblasts from individuals with COPD.β-catenin signaling contributes to ECM production by pulmonary fibroblasts and contributes to myofibroblasts differentiation. WNT/β-catenin pathway expression and activation by TGF-β₁ is enhanced in pulmonary fibroblasts from individuals with COPD. This suggests an important role of the WNT/β-catenin pathway in regulating fibroblast phenotype and function in COPD

The establishment of an international collaboration to support the implementation of an illness management and recovery programme for consumers with a severe mental illness in the Netherlands

In the Netherlands, the concept of recovery in mental health care has taken on new meanings in recent years that emphasize personal empowerment and de-emphasize traditional medical definitions focusing on the absence of psychopathology. According to Anthony, recovery involves the development of new meaning and purpose in one\u27s life as one grows beyond the catastrophic effects of mental illness. Essentially, recovery can be thought of as managing one\u27s illness so that the person can develop or regain a sense of self and place in society. Illness Management and Recovery (IMR) is a curriculum-based approach to helping consumers of mental health services identify recovery goals and learn the skills to manage illnesses independently. It is an evidence based intervention aimed at teaching consumers with severe mental illness how to manage their disorder in the context of pursuing personally defined recovery goals. To support the implementation of IMR in Dutch mental health institutions the department of mental health of Saxion University established a national IMR network. To date, nine mental health organizations participate. These organizations are in different stages of implementing IMR. In this national network we work in close collaboration with the department of psychology of the Indiana University Purdue University Indianapolis USA as they have been studying IMR and its implementation since 2003. During the STTI Biennial Conference in 2009 I visited dr. Salyers and her team to discuss collaboration in the Dutch National IMR Network. The aims of the network are fourfold: to establish opportunities for knowledge sharing, to organise education and training, to promote quality assurance and fidelity assessment, and to undertake research projects. During my presentation I will talk about how the national IMR network is organised, the activities in the network and what is achieved. The value of international collaboration with UIPUI will be discussed

Cooperation of Helix Insertion and Lateral Pressure to Remodel Membranes

Nature has developed different protein mediated mechanisms to remodel cellular membranes. One of the proteins that is implicated in these processes is α-synuclein (αS). Here we investigate if besides αS's membrane bound amphipathic helix the disordered, solvent exposed tail of the protein contributes to membrane reshaping. We produced αS variants with elongated or truncated disordered solvent exposed domains. We observe a transformation of opaque multi lamellar vesicle solutions into nonscattering solutions containing smaller structures upon addition of all αS variants. Experimental data combined with model calculations show that the cooperation of helix insertion and lateral pressure exerted by the disordered domain makes the full length protein decidedly more efficient in membrane remodeling than the truncated version. Using disordered domains may not only be cost-efficient, it may also add a new level of control over vesicle fusion/fission by expansion or compaction of the domain

A Multilevel Meta-analysis of Single-Case Research on Interventions for Internalizing Disorders in Children and Adolescents

The effectiveness of interventions for internalizing disorders in children and adolescents was studied using a review and meta-analysis of published single-case research. Databases and other resources were searched for quantitative single-case studies in youth with anxiety, depressive, and posttraumatic stress disorders. Raw data from individual cases were aggregated and analyzed by means of multilevel meta-analytic models. Outcome variables were symptom severity assessed across baseline and treatment phases of the studies, and diagnostic status at post- and follow-up treatment. Single-case studies were rated for quality. We identified 71 studies including 321 cases (Mage = 10.66 years; 55% female). The mean quality of the studies was rated as below average, although there were considerable differences between the studies. Overall, positive within-person changes during the treatment phase in comparison to the baseline phase were found. In addition, positive changes in the diagnostic status were observed at post- and follow-up treatment. Yet high variability in treatment effects was found between cases and studies. This meta-analysis harvests the knowledge from published single-case research in youth-internalizing disorders and illustrates how within-person information from single-case studies can be summarized to explore the generalizability of the results from this type of research. The results emphasize the importance of keeping account of individual variability in providing and investigating youth interventions

Elder abuse

Although attention for elder abuse has been growing in the last couple of years, it is still difficult to get to grips with this phenomenon. For instance the size of the problem is still unknown. How to do reliable research on elder abuse is one of the topics dealt with in this special issue of Justitiële verkenningen (Judicial Explorations). The articles deal furthermore with the advantages and disadvantages of the dominant and rather broad definition of elder abuse. Elder abuse is often understood as the result of stress in personal relations between the elder and his (informal) care givers. However, some authors argue that elder abuse also is a result of the way in which society and its institutions are organized . Research shows that the elderly feel often marginalized and mistreated by ‘the system’. The prosecution of financial abuse of elderly is also a topic in this issue, while another article analyzes the so-called ‘levenstestament’, a power of attorney giving certain trusted people the authority to manage money affairs, property and medical decisions on behalf of an older person who is ill or mentally incapable. Also the Dutch policy aiming to fight and prevent elder abuse is described. On top of this two articles are dealing with elderly becoming victims of crime.ARTIKELEN: I. Plaisier en M. de Klerk - Ouderenmishandeling: Een verkenning naar aard en omvang J. Pattiwael en I. Brons - Ouderen in veilige handen: Een overzicht van het beleid ter bestrijding van ouderenmishandeling J. Lindenberg, Y. Mysyuk en R.G.J. Westendorp - Systeemmishandeling: Recht doen aan de zienswijzen van ouderen zelf T. Royers - Ontspoorde zorg, gehechtheid en interactie C.G.C. Engelbertink - Het levenstestament L.M. Cremers en E.J.H. de Kluijs - Een kwestie van integraal slim slaan? B. Rovers en S. Mesu - Woningovervallen op ouderen: Een zeldzaam, maar heftig fenomeen M. Akkermans - Ouderen als slachtoffer van criminaliteit: Een kwantitatief beeld van de Nederlandse situatie SAMENVATTING: Ouderenmishandeling staat sinds 2010 op de politieke agenda en krijgt de laatste jaren steeds meer aandacht. Het ministerie van Volksgezondheid, Welzijn en Sport (VWS) stelde in 2011 het Actieplan ‘Ouderen in veilige handen’ op, waarna er verschillende initiatieven, voorlichtingscampagnes en scholingen van de grond kwamen om hulpverleners, artsen, familieleden van ouderen en ouderen zelf nader te informeren over dit probleem. Het laatste onderzoek naar de prevalentie van ouderenmishandeling in Nederland dateert uit 1996. Hierin gaf 5,6% van de geïnterviewde ouderen aan slachtoffer te zijn van fysiek of verbaal geweld, verwaarlozing of financiële uitbuiting. Staatssecretaris Martin van Rijn van VWS kondigde afgelopen zomer aan dat er op korte termijn een groot onderzoek zal plaatsvinden naar aard en omvang van ouderenmishandeling. Het is niet eenvoudig daar een goed beeld van te krijgen. Onderschatting van het probleem dreigt bijvoorbeeld als een methode wordt gekozen die de meer kwetsbare en afhankelijke ouderen niet of moeilijk bereikt. Daar staat tegenover dat de meest in zwang zijnde en zeer ruime definitie van ouderenmishandeling zou kunnen leiden tot een overschatting van de prevalentie. Deze luidt: ‘al het handelen en het nalaten van handelen van al degenen die in een terugkerende persoonlijke of professionele relatie met de oudere (iemand van 65 jaar of ouder) staan, waardoor de oudere persoon lichamelijke en/of psychische en/of materiële schade lijdt en waarbij van de kant van de oudere sprake is van een vorm van gedeeltelijke of volledige afhankelijkheid’. In de praktijk kunnen hier zowel zware mishandeling onder vallen als situaties waarin – al dan niet opzettelijk – (mantel)zorgers steken laten vallen. Psychische mishandeling is soms eveneens moeilijk aan te tonen, zeker als er sprake is van familierelaties die al jarenlang worden gekenmerkt door conflicten en/of onaangename interactiepatronen. Ouderenmishandeling wordt nogal eens in verband gebracht met ‘ontspoorde’ mantelzorg. O.a. vanuit oppositiepartijen is erop gewezen dat mantelzorgers overbelast raken als onbedoeld effect van het huidige beleid om veel verzorgings- en verpleeghuizen te sluiten en ouderen zo lang mogelijk thuis te laten wonen. Het is de bedoeling dat gemeenten ervoor zorgen dat hulpverleners tijdig misstanden signaleren en adequate maatregelen nemen, maar de praktijk wijst uit dat dit in de ene gemeente beter lukt dan in de andere. In dit themanummer komen diverse aspecten van ouderenmishandeling evenals het gevoerde beleid van VWS aan de orde. Daarnaast is er enige aandacht voor ouderen als slachtoffer van criminaliteit