When Cultures Meet in Medical Practice: Improvement in intercultural communication evaluated

__Abstract__ Working in an urban general practice in a deprived neighborhood for 23 years it was clear from the beginning that contacts with patients from an ethnic minority were sometimes problematic. Although this did not really manifest itself at the level of the personal relationship, there were indeed some barriers in communication. In general, ethnic minority patients were loyal and polite and on the one hand had the same worries and questions as Dutch patients, on the other hand in a substantial number of medical encounters the contact appeared to be difficult. The reason for this included: not understandable or recognizable reasons for the encounter, lack of patient’s compliance from the physician’s point of view, impossibility of discussing psycho-social matters, and a high frequency of encounters. It was obvious that language was not the only barrier: the cultural background appeared to play an even more important role. In 1982 Dorrenboom clearly indicated cultural difficulties in contacts with ethnic minority patients by describing a number of cases. Similar to most other physicians, in those days I expected that in the course of time these patients would integrate in Dutch society

Kunstmatige intelligentie als uitdaging voor de praktische theologie

We leven in een samenleving waarin technologie ons leven en samenleven vormgeeft. Een belangrijk onderdeel van die technologie is digitale technologie, van de computer waarop we werken tot de cloud waarin we onze artikelen schrijven en delen. Een volgend onderdeel van deze technologisering van de samenleving is automatisering. Het is overal om ons heen vaak ongemerkt aan het werk

The Impact of Vegetation on Archaeological Sites in the Low Arctic in Light of Climate Change

Vegetation is changing across the Arctic in response to increasing temperatures, which may influence archaeological sites in the region. At the moment, very little is known about how different plant species influence archaeological remains. In this study we visited 14 archaeological sites stretching across a climatic gradient from the outer coast to the inner fjords in the Nuuk Fjord area of West Greenland to assess the impact of vegetation growth on archaeological preservation. Examination of the physical disturbance of archaeological layers and materials by roots from different plant species showed that horsetail (Equisetum arvense) was particularly destructive because of its deep penetrating rhizomes and ubiquity across the study area. Willow (Salix glauca) also caused physical disturbance due to a dense root network, but its roots were mainly found in the upper 30 cm of the soil. Focus was also given to the impact from vegetation on the visibility of sites, where growth of willow was found be the main problem, especially in the inner fjords. Historic descriptions and aerial photographs from the sites show that shrub growth was already widespread in the region by the 1930s, but photos of some of the sites investigated show that the willow shrubs are significantly taller today, which has decreased the visibility of site features. The impact from horsetail and willow on archaeological sites may be mitigated using geotextiles and grazing by livestock, but both methods require further studies before being implemented in the study area.À la grandeur de l’Arctique, la végétation change en réaction aux températures à la hausse, ce qui peut exercer une influence sur les sites archéologiques de la région. En ce moment, on en sait peu sur la manière dont les différentes espèces végétales influencent les restes archéologiques. Dans le cadre de cette étude, nous avons visité 14 sites archéologiques répartis sur un gradient climatique allant de la zone côtière extérieure aux fjords intérieurs de la région du fjord de Nuuk, dans l’ouest du Groenland, afin d’évaluer l’incidence de la croissance de la végétation sur la préservation archéologique. L’examen de la perturbation physique des couches et du matériel archéologiques au moyen des racines de différentes espèces végétales a permis de constater que la prêle (Equisetum arvense) jouait un rôle particulièrement destructeur en raison de ses rhizomes profonds et omniprésents dans toute la zone étudiée. Le saule (Salix glauca) entraîne aussi des perturbations physiques en raison de son réseau de racines denses, bien que ses racines se trouvent principalement dans la couche supérieure de sol de 30 cm. Nous avons aussi accordé de l’importance à l’incidence de la végétation sur la visibilité des sites, ce qui a permis de conclure que la croissance du saule constituait le problème principal, surtout dans la zone intérieure des fjords. Les descriptions historiques et les photographies aériennes des sites montrent que la croissance d’arbustes était déjà répandue dans la région dans les années 1930, bien que certaines photos des sites étudiés permettent de comprendre que les saules arbustifs sont beaucoup plus grands aujourd’hui, ce qui diminue la visibilité des caractéristiques des sites. L’incidence de la prêle et du saule sur les sites archéologiques pourrait être atténuée par l’utilisation de géotextiles et le broutage du bétail. Il y a toutefois lieu de se pencher de plus près sur ces deux méthodes avant de les adopter dans la zone étudiée

The Pericytic Phenotype of Adipose Tissue-Derived Stromal Cells Is Promoted by NOTCH2

Long-term diabetes leads to macrovascular and microvascular complication. In diabetic retinopathy (DR), persistent hyperglycemia causes permanent loss of retinal pericytes and aberrant proliferation of microvascular endothelial cells (ECs). Adipose tissue-derived stromal cells (ASCs) may serve to functionally replace retinal pericytes and normalize retinal microvasculature during disease progression. We hypothesized that Notch signaling in ASC underlies regulation and stabilization of dysfunctional retinal microvascular networks such as in DR. ASC prominently and constitutively expressed NOTCH2. Genetic knockdown of NOTCH2 in ASC (SH-NOTCH2) disturbed the formation of vascular networks of human umbilical cord vein endothelial cells both on monolayers of ASC and in organotypical three-dimensional cocultures with ASC. On ASC SH-NOTCH2, cell surface platelet-derived growth factor receptor beta was downregulated which disrupted their migration toward the chemoattractant platelet-derived growth factor beta subunits (PDGF-BB) as well as to conditioned media from EC and bovine retinal EC. This chemoattractant is secreted by pro-angiogenic EC in newly formed microvascular networks to attract pericytes. Intravitreal injected ASC SH-NOTCH2 in oxygen-induced retinopathy mouse eyes did not engraft in the preexisting retinal microvasculature. However, the in vivo pro-angiogenic capacity of ASC SH-NOTCH2 did not differ from controls. In this respect, multifocal electroretinography displayed similar b-wave amplitudes in the avascular zones when either wild type ASC or SH-NOTCH2 ASC were injected. In conclusion, our results indicate that NOTCH2 is essential to support in vitro vasculogenesis via juxtacrine interactions. In contrast, ongoing in vivo angiogenesis is influenced by paracrine signaling of ASC, irrespective of Notch signaling