Standpunt Preventie van Vrouwelijke Genitale Verminking (VGV) door de Jeugdgezondheidszorg

Nederland beschouwt de besnijdenis van meisjes als een ernstige en onherstelbare vorm van mishandeling, een fundamentele schending van de mensenrechten en van de lichamelijke integriteit. De overheid wijst het daarom af: het is bij wet verboden en dient te worden voorkomen en bestreden. De Jeugdgezondheidszorg (JGZ) heeft een belangrijke taak om besnijdenis te voorkomen door het gesprek aan te gaan met de etnische groeperingen die deze praktijk bezigen. Dat staat in het Standpunt Preventie van Vrouwelijke Genitale Verminking (VGV) door de Jeugdgezondheidszorg. Het standpunt is ontwikkeld door het Centrum Jeugdgezondheid van het RIVM, in samenwerking met Pharos. Het standpunt is ontwikkeld op basis van experimenten in de grote steden van Nederland. GGD-en hebben samen met de etnische groepen en samenwerkingspartners een aanpak ontwikkeld om besnijdenis bespreekbaar te maken, het risico erop in te schatten, de juiste hulp aan te bieden bij een voorgenomen besnijdenis of bij problemen als het heeft plaatsgevonden. De experimenten hebben het onderwerp uit de taboesfeer gehaald en ouders aan het denken gezet over de gevolgen ervan voor hun dochter(s). JGZ vervult een belangrijke rol, omdat zij in principe in contact komt met alle meisjes vanaf hun geboorte. JGZ werkt hierbij nauw samen met samenwerkingspartners zoals zelforganisaties, verloskundigen, kraamzorg, huisartsen, gynaecologen, kinderartsen en het Advies- en Meldpunten Kindermishandeling. Het besnijden van meisjes is een eeuwenoud cultureel gebruik in Afrikaanse landen en bij bepaalde bevolkingsgroepen in het Nabije Oosten, Azië en Zuid-Amerika. Praktiserende gemeenschappen die naar het Westen zijn gemigreerd, hebben het gebruik meegenomen, zo ook naar Nederland. Meer informatie staat op meisjesbesnijdenis.nl. In Nederland wordt de term vrouwelijke genitale verminking (VGV) gebruikt om aan te geven dat het niet wordt getolereerd. Om het gesprek aan te gaan met de doelgroep gebruiken preventiewerkers in de praktijk de minder confronterende term 'meisjesbesnijdenis'.Dutch society rejects Female Genital Mutilation (FGM) outright. FGM is a very serious form of child abuse, a fundamental breach of human rights and a degradation of the human body's integrity and must not be tolerated. FGM is an age old tradition in a number of African countries, within some groups in the Middle East and Asia and also in South America. Prevalence in the latter countries is not known. Information is available on www.meisjesbesnijdenis.nl. Four types of FGM are recognized. FGM is usually performed on girls between 4 to 12 years old. Migration may influence the age at which FGM is performed. FGM came to the Netherlands in the eighties when large groups of refugees from African countries sought asylum. FGM is still performed within these groups living in the Netherlands. The term FGM is used in the Netherlands to express the severity of the practice in a country where FGM is not tolerated. However, professionals in prevention and care prefer to use the term 'girl circumcision' (meisjesbesnijdenis) because for some people the term FGM is so confrontational that it is not possible to talk about the subject. 'Girl circumcision' is less confrontational and provides the possibility to talk about the diverse aspects of FGM, such as criminality and the health consequences. Youth Health Care (YHC) plays a central role in the prevention of FGM, because YHC regularly examines all girls from birth until the age of 18. YHC contributes by providing information and discussing FGM with the parents. YHC also cooperates closely with key people in the groups themselves, midwives, maternity care, GP's, gynecologists, pediatricians and the Office for dvice and Report of Child Abuse (Advies en Meldpunt Kindermishandeling). The YHC-professional discusses all aspects of FGM, assesses the risks of FGM, acts when FGM is suspected and offers help if there are problems resulting from FGM. Providing information, both individually and in groups, about the functions of the human body, sexuality and the consequences of FGM is vital. YHC-professionals also help to get the message across that FGM is prohibited by law and that imprisonment is inevitable, because violation of the integrity of the human body, violation of the rights of the child and the health consequences are all unacceptable.VW

Synthetic Mimic of Antimicrobial Peptide with Nonmembrane-Disrupting Antibacterial Properties

Proteolysis in dairy lactic acid bacteria has been studied in great detail by genetic, biochemical and ultrastructural methods. From these studies the picture emerges that the proteolytic systems of lactococci and lactobacilli are remarkably similar in their components and mode of action. The proteolytic system consists of an extracellularly located serine-proteinase, transport systems specific for di-tripeptides and oligopeptides (> 3 residues), and a multitude of intracellular peptidases. This review describes the properties and regulation of individual components as well as studies that have led to identification of their cellular localization. Targeted mutational techniques developed in recent years have made it possible to investigate the role of individual and combinations of enzymes in vivo. Based on these results as well as in vitro studies of the enzymes and transporters, a model for the proteolytic pathway is proposed. The main features are: (i) proteinases have a broad specificity and are capable of releasing a large number of different oligopeptides, of which a large fraction falls in the range of 4 to 8 amino acid residues; (ii) oligopeptide transport is the main route for nitrogen entry into the cell; (iii) all peptidases are located intracellularly and concerted action of peptidases is required for complete degradation of accumulated peptides.

Towards the reconstruction of the genome-scale metabolic model of Lactobacillus acidophilus La-14

Lactobacillus acidophilus is a probiotic lactic acid bacterium used in food and dietary supplements for many years. However, despite its importance for industrial development and recognized health-promoting effects, no genome-scale metabolic model has been reported. A GSM model for L. acidophilus La-14 was developed, accounting 494 genes and 783 reactions. A genome annotation was performed to identify the metabolic potential of the bacterium. The biomass composition was determined based on information available in literature and previously published models. The model was validated by comparing in silico simulations with experimental data, regarding the aerobic and anaerobic growth. The reconstruction of the metabolic model has confirmed the fastidious requirements of L. acidophilus for amino acids, fatty acids, and vitamins. This model can be used for a better understanding of the metabolism of this bacterium and identification of industrially desirable compounds.This study was performed under the scope of the project “BIODATA.PT – Portuguese Biological Data Network” (ref. LISBOA-01-0145-FEDER-022231), funded by FCT/MCTES, through national funds of PIDDAC, Fundo Europeu de Desenvolvimento Regional (FEDER), Programa Operacional de Competitividade e Internacionalização (POCI) and Programa Operacional Regional de Lisboa (Lisboa 2020).info:eu-repo/semantics/publishedVersio

Effectiveness of a self-management training for patients with chronic and treatment resistant anxiety or depressive disorders on quality of life, symptoms, and empowerment : results of a randomized controlled trial

Background: Anxiety and depressive disorders are common mental disorders. A substantial part of patients does not achieve symptomatic remission after treatment in specialized services. Current care as usual (CAU) for these patients consists of long-term supportive contacts. Termination of CAU is often not considered to be an option due to persistent symptoms, a low level of functioning, and the absence of further treatment options. A new intervention, ZemCAD, offers a program focused on rehabilitation and self-management, followed by referral back to primary care. Methods: This multicenter randomized controlled trial was carried out in twelve specialized outpatient mental health care services in the Netherlands. Consenting and eligible patients were invited for the MINI interview and the baseline questionnaire. Assessments were done at 6 (T1), 12 (T2) and 18 (T3) months post baseline. We used linear mixed model analysis (LMM) to ascertain the effectiveness of the ZemCAD group relative to the CAU group on quality of life, symptom severity and empowerment. Results: In total 141 patients were included. The results at 18-month follow-up regarding to quality of life and symptom severity, showed no significant differences between the ZemCAD group and the CAU group, except on the 'social relationships'-domain (d = 0.37). With regard to empowerment a significant difference between both groups was observed in the total empowerment score and one empowerment dimension (d = 0.45 and d = 0.39, respectively). After the ZemCAD intervention, more patients went from specialized outpatient mental health services back to a less specialized health care setting with less intensive treatment, such as primary care. Conclusion: The findings in this study suggest that patients with chronic and treatment-resistant anxiety and depression using the ZemCAD intervention improve on empowerment but not on symptom severity or quality of life. Since little is known about the effects of rehabilitation and self-management in patients with chronic and treatment resistant anxiety and depressive disorders, this is a first attempt to provide a proof-of-concept study in this under-researched but important field. Trial registration: Netherlands Trial Register: NTR3335, registered 7 March 2012