Moral dilemmas in contact-based care:The relevance of Moral Case Deliberation for forensic psychiatry

Currently, forensic psychiatry shows a shift from a control-based to a contact-based approach. Working from contact may, however, entail new moral questions and dilemmas. How to secure safety when focusing on contact? Does contact imply being physically close to the patient, or should one refrain from intimate relations? In order to help care professionals to deal with these moral issues, clinical ethics support can be useful. A specific approach in clinical ethics support is moral case deliberation (MCD). An MCD is a structured dialogue between professionals on a moral issue they experience in practice, structured by a conversation method and guided by a facilitator. In this article, we describe the background and procedures of MCD. Furthermore, we present a case example in which care professionals reflect on the moral question of whether provision of care in forensic psychiatry may entail physical closeness. The MCD shows that an open conversation results in a better understanding of different perspectives and creates the basis for finding a joint way to proceed in the case. We conclude that MCD can enable professionals to reflect on moral issues and develop shared values in forensic psychiatry

Excavation and Survey in the Jabbul Plain, Western Syria: The Umm el-Marra Project 1996-1997

The 1996 and 1997 seasons of the Hopkins-Amsterdam project in the Jabbul plain, western Syria, have generated new results on Bronze Age urbanism at Tell Umm el- Marra and elucidated longer-term settlement patterns in the Jabbul region. Excavation results have documented the foundation of Umm el-Marra as a regional center in the Early Bronze Age, provided new data on a period of decentralization in Middle Bronze I, and supplied evidence of the regeneration of urbanism in MB II. Faunal and archaeobotanical analysis broaden our understanding of these developments, attesting to an economy overwhelmingly dependent on the steppe environment, with an emphasis on large-scale onager hunting in MB II. Finally, a regional survey provides data on long-term demographic and socioeconomic trends, furnishing an expansive time range and spatial context for our under- standing of developmental patterns in the region. The survey results supply new information on the limits of the Uruk expansion, cycles of Bronze Age urbanization, changing patterns of steppe exploitation, and demo- graphic and agricultural extensification in the Byzantine and Early Islamic periods

Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches without extension (n = 74) and with subjects who had worn a mandibular extension removable partial denture in the past (n = 19). Subjects with complete dentitions (n = 72) were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function

Water heritage for sustainable cities: proposals for the revalorization of the Valens Aqueduct in Istanbul

Middle Eastern Studie

Isolation and function of a human endothelial cell C1q receptor

It has been shown previously that cultured human venous and arterial endothelial cells (EC) bind C1q in a time- and dose-dependent manner. Cultured human endothelial cells express an average number of 5.2 × 105 binding sites/cell. In the present study the putative receptor for C1q (C1qR) was isolated from the membranes of 1–5 × 109 human umbilical cord EC by affinity chromatography on C1q–Sepharose. During isolation, C1qR was detected by its capacity to inhibit the lysis of EAC1q in C1q-deficient serum. The eluate from C1q–Sepharose was concentrated, dialysed and subjected to QAE-A50 chromatography and subsequently to gel filtration on HPLC–TSK 3000. C1qR filtered at an apparent molecular weight of 60 kDa. Purified C1qR exhibited an apparent molecular weight of 55–62 kDa in the unreduced state and a molecular weight of 64–68 kDa in reduced form. Two IgM monoclonal antibodies (mAb) D3 and D5 were raised following immunization of mice with purified receptor preparations. Both monoclonal antibodies increased the binding of 125I-C1q to endothelial cells but F(ab')2 anti-C1qR mAb inhibited the binding of a125I-C1q to EC in a dosedependent manner. The D3 mAb recognized a band of 54–60 kDa in Western blots of membranes of human EC and polymorphonuclear leukocytes. Previously, the authors showed that C1q induces the binding of IgM-containing immune complexes to EC. Therefore, it was hypothesized that during a primary immune response generation of IgM-IC may occur, resulting in binding and activation of C1, dissociation of activated C1 by C1 inhibitor and subsequent interaction of IgM-IC bearing C1q with EC–C1qR

Forced migration and health - diarrhoea among adult Zimbabwean immigrants in Limpopo

The political and economic decline in Zimbabwe has forced many Zimbabweans to migrate to neighbouring countries and abroad. A large number of Zimbabwean migrants live in poverty in the border region. The high demand for shelter forces some people to create and occupy very basic dwellings and cook food in tin cans over fires. Many live in cardboard and plastic shelters, some in the back yards of overcrowded homes where they have to pay rent. Others sleep under trees next to roads or on open fields on farms, at railway stations or on the street. Recently many people fled to South Africa from the deadly cholera epidemic in Zimbabwe, which killed more than 2 000 people in 4 months. Cholera outbreaks have been experienced in Zimbabwe since October 2008. People who are infected but have no symptoms can carry the disease and cause it to spread. Initially most of the cholera cases in South Africa were Zimbabweans seeking health care. We show that the conditions under which informal residents live put them at high risk of diarrhoea

Characterization of immune response to neurofilament light in experimental autoimmune encephalomyelitis

PMCID: PMC3856490This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.PMCID: PMC385649

Star formation thresholds and galaxy edges: why and where

We study global star formation thresholds in the outer parts of galaxies by investigating the stability of disk galaxies embedded in dark halos. The disks are self-gravitating, contain metals and dust, and are exposed to UV radiation. We find that the critical surface density for the existence of a cold interstellar phase depends only weakly on the parameters of the model and coincides with the empirically derived surface density threshold for star formation. Furthermore, it is shown that the drop in the thermal velocity dispersion associated with the transition from the warm to the cold gas phase triggers gravitational instability on a wide range of scales. The presence of strong turbulence does not undermine this conclusion if the disk is self-gravitating. Models based on the hypothesis that the onset of thermal instability determines the star formation threshold in the outer parts of galaxies can reproduce many observations, including the threshold radii, column densities, and the sizes of stellar disks as a function of disk scale length and mass. Finally, prescriptions are given for implementing star formation thresholds in (semi-)analytic models and three-dimensional hydrodynamical simulations of galaxy formation.Comment: 16 pages, 6 figures, accepted for publication in the Astrophysical Journal. Version 2: text significantly revised (major improvements), physics unchanged. Version 3: minor correction