Prevalence of mental disorders and torture among Tibetan refugees: A systematic review

BACKGROUND: Many Tibetan refugees flee Tibet in order to escape physical and mental hardships, and to access the freedoms to practice their culture and religion. We aimed to determine the prevalence of mental illnesses within the refugee population and determine the prevalence of previous torture reported within this population. METHODS: We performed a systematic literature search of 10 electronic databases from inception to May 2005. In addition, we searched the internet, contacted all authors of located studies, and contacted the Tibetan Government-in-exile, to locate unpublished studies. We included any study reporting on prevalence of mental illness within the Tibetan refugee populations. We determined study quality according to validation, translation, and interview administration. We calculated proportions with exact confidence intervals. RESULTS: Five studies that met our inclusion criteria (total n = 410). All studies were conducted in North India and 4 were specifically in adult populations. Four studies provided details on the prevalence of torture and previous imprisonment within the populations. The prevalence of post-traumatic stress disorder ranged from 11–23%, anxiety ranged from 25–77%, and major depression ranged from 11.5–57%. CONCLUSION: Our review indicates that the prevalence of serious mental health disorders within this population is elevated. The reported incidence of torture and imprisonment is a possible contributor to the illnesses. Non-government organizations and international communities should be aware of the human rights abuses being levied upon this vulnerable population and the mental health outcomes that may be associated with it

Mechanisms of Psychological Distress following War in the Former Yugoslavia: The Role of Interpersonal Sensitivity

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This study was funded by a grant from the European Commission, contract number INCO-CT-2004-509176. AN was supported by a Clinical Early Career Research Fellowship (113295) and a Project Grant (104288

Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement – an epidemiological study

Onyut LP, Neuner F, Ertl V, Schauer E, Odenwald M, Elbert T. Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement – an epidemiological study. Conflict and Health. 2009;3(1):6.Background: The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD) and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n = 519 Somali and n = 906 Rwandese) refugees resident in Nakivale refugee settlement in South Western Uganda during the year 2003. Methods: The Posttraumatic Diagnostic Scale (PDS) and the Hopkins Symptom Checklist 25 were used to screen for posttraumatic stress disorder and depression. Results: Thirty two percent of the Rwandese and 48.1% of the Somali refugees were found to suffer from PTSD. The Somalis refugees had a mean of 11.95 (SD = 6.17) separate traumatic event types while the Rwandese had 8.86 (SD = 5.05). The Somalis scored a mean sum score of 21.17 (SD = 16.19) on the PDS while the Rwandese had a mean sum score of 10.05 (SD = 9.7). Conclusion: Mental health consequences of conflict remain long after the events are over, and therefore mental health intervention is as urgent for post-conflict migrant populations as physical health and other emergency interventions. A mental health outreach program was initiated based on this study

Evolution of the Properties of a Poly(L-lactic acid) Scaffold with Double Porosity During In Vitro Degradation in a Phosphate-Buffered Saline Solution

[EN] A poly(L-lactic acid) scaffold prepared by a combination of freeze-extraction and porogen-leaching methods was submitted to static degradation in a phosphate-buffered saline solution at pH 7.4 and 37 C for up to 12 months. After 6 months of degradation, the scaffold maintained its integrity, although noticeable changes in its permeability and pore size were recorded. After 12 months, scanning electron microscopy pictures showed that most of the trabeculae were broken, and the sample disaggregated under minimum loading. Neither weight loss nor crystallinity changes in the first heating calorimetric scan were observed during the degradation experiment. However, after 12 months, a rise in the crystallinity from 13 to 38% and a drop in the glass-transition temperature from 58 to 54 C were measured in the second heating scan. The onset of thermal degradation moved from 300 to 210 C after 12 months. Although the elastic modulus suffered only a very slight reduction with degradation time, the aggregate modulus decreased 44% after 6 months.The authors acknowledge the support of the Instituto de Salud Carlos III, Ministerio de Economıa y Competitividad, and the European Commission through FP7-ERANet EuroNanoMed 2011 PI11/03032 and FP7-PEOPLE-2012-IAPP (contract grant number PIAP-GA-2012–324386). The Biomedical Research Networking Center in Bioengineering, Biomaterials, and Nanomedicine is an initiative funded by the VI National R&D&i Plan 2008–2011, Iniciativa Ingenio 2010, and Consolider Program. Biomedical Research Networking Center actions are financed by the Instituto de Salud Carlos III with assistance from the European Regional Development Fund. The authors also thank the Tissue Characterization Platform of the Biomedical Research Networking Center in Bioengineering, Biomaterials, and Nanomedicine for its technical support. They also thank the Linguistic Assistance Services of the Language Centre, Universitat Politecnica de Valencia, for their help in revising this article.Deplaine, H.; Acosta-Santamaría, VA.; Vidaurre Garayo, AJ.; Gómez Ribelles, JL.; Doblare Castellano, M.; Ochoa-Garrido, I.; Gallego Ferrer, G. (2014). Evolution of the Properties of a Poly(L-lactic acid) Scaffold with Double Porosity During In Vitro Degradation in a Phosphate-Buffered Saline Solution. Journal of Applied Polymer Science. 131:40956-40966. https://doi.org/10.1002/APP.40956S4095640966131Zhao, J., Yuan, X., Cui, Y., Ge, Q., & Yao, K. (2003). Preparation and characterization of poly(L-lactide)/ poly(?-caprolactone) fibrous scaffolds for cartilage tissue engineering. Journal of Applied Polymer Science, 91(3), 1676-1684. doi:10.1002/app.13323Hutmacher, D. W. (2001). Scaffold design and fabrication technologies for engineering tissues — state of the art and future perspectives. 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Women in post-trafficking services in moldova: diagnostic interviews over two time periods to assess returning women's mental health

BACKGROUND: Trafficking in women is a widespread human rights violation commonly associated with poor mental health. Yet, to date, no studies have used psychiatric diagnostic assessment to identify common forms of mental distress among survivors returning to their home country. METHODS: A longitudinal study was conducted of women aged 18 and over who returned to Moldova between December 2007 and December 2008 registered by the International Organisation for Migration as a survivor of human trafficking. Psychiatric diagnoses in women at a mean of 6 months after return (range 2-12 months) were made by a trained Moldavian psychiatrist using the Structured Clinical Interview for DSM-IV, and compared with diagnoses recorded in the same women within 5 days of return. We described the socio-demographic characteristics of the women in the sample including both pre and post-trafficking information. We then described the distribution of mental health diagnoses recorded during the crisis intervention phase (1-5 days after return) and the re-integration phase (2-12 months after return). We compared diagnoses at the patient level between the two time points by tabulating the diagnoses and carrying out a kappa test of agreement and the Stuart-Maxwell test for marginal homogeneity (an extension of the McNemar test to kxk table). RESULTS: 120/176 (68%) eligible women participated. At 2-12 months after their return, 54% met criteria for at least one psychiatric diagnoses comprising post-traumatic stress disorder (PTSD) alone (16%); co-morbid PTSD (20%); other anxiety or mood disorder (18%). 85% of women who had been diagnosed in the crisis phase with co-morbid PTSD or with another anxiety or mood disorder sustained a diagnosis of any psychiatric disorder when followed up during rehabilitation. CONCLUSIONS: Trafficked women returning to their country of origin are likely to suffer serious psychological distress that may endure well beyond the time they return. Women found to have co-morbid PTSD or other forms of anxiety and depression immediately post-return should be offered evidenced-based mental health treatment for at least the standard 12-month period of rehabilitation

Studying Dynamics by Magic-Angle Spinning Solid-State NMR Spectroscopy: Principles and Applications to Biomolecules

International audienceMagic-angle spinning solid-state NMR spectroscopy is an important technique to study mo- lecular structure, dynamics and interactions, and is rapidly gaining importance in biomolecu- lar sciences. Here we provide an overview of experimental approaches to study molecular dy- namics by MAS solid-state NMR, with an emphasis on the underlying theoretical concepts and differences of MAS solid-state NMR compared to solution-state NMR. The theoretical foundations of nuclear spin relaxation are revisited, focusing on the particularities of spin re- laxation in solid samples under magic-angle spinning. We discuss the range of validity of Redfield theory, as well as the inherent multi-exponential behavior of relaxation in solids. Ex- perimental challenges for measuring relaxation parameters in MAS solid-state NMR and a few recently proposed relaxation approaches are discussed, which provide information about time scales and amplitudes of motions ranging from picoseconds to milliseconds. We also discuss the theoretical basis and experimental measurements of anisotropic interactions (chemical-shift anisotropies, dipolar and quadrupolar couplings), which give direct infor- mation about the amplitude of motions. The potential of combining relaxation data with such measurements of dynamically-averaged anisotropic interactions is discussed. Although the focus of this review is on the theoretical foundations of dynamics studies rather than their ap- plication, we close by discussing a small number of recent dynamics studies, where the dy- namic properties of proteins in crystals are compared to those in solution

Escape of HIV-1-Infected Dendritic Cells from TRAIL-Mediated NK Cell Cytotoxicity during NK-DC Cross-Talk—A Pivotal Role of HMGB1

Early stages of Human Immunodeficiency Virus-1 (HIV-1) infection are associated with local recruitment and activation of important effectors of innate immunity, i.e. natural killer (NK) cells and dendritic cells (DCs). Immature DCs (iDCs) capture HIV-1 through specific receptors and can disseminate the infection to lymphoid tissues following their migration, which is associated to a maturation process. This process is dependent on NK cells, whose role is to keep in check the quality and the quantity of DCs undergoing maturation. If DC maturation is inappropriate, NK cells will kill them (“editing process”) at sites of tissue inflammation, thus optimizing the adaptive immunity. In the context of a viral infection, NK-dependent killing of infected-DCs is a crucial event required for early elimination of infected target cells. Here, we report that NK-mediated editing of iDCs is impaired if DCs are infected with HIV-1. We first addressed the question of the mechanisms involved in iDC editing, and we show that cognate NK-iDC interaction triggers apoptosis via the TNF-related apoptosis-inducing ligand (TRAIL)-Death Receptor 4 (DR4) pathway and not via the perforin pathway. Nevertheless, once infected with HIV-1, DCHIV become resistant to NK-induced TRAIL-mediated apoptosis. This resistance occurs despite normal amounts of TRAIL released by NK cells and comparable DR4 expression on DCHIV. The escape of DCHIV from NK killing is due to the upregulation of two anti-apoptotic molecules, the cellular-Flice like inhibitory protein (c-FLIP) and the cellular inhibitor of apoptosis 2 (c-IAP2), induced by NK-DCHIV cognate interaction. High-mobility group box 1 (HMGB1), an alarmin and a key mediator of NK-DC cross-talk, was found to play a pivotal role in NK-dependent upregulation of c-FLIP and c-IAP2 in DCHIV. Finally, we demonstrate that restoration of DCHIV susceptibility to NK-induced TRAIL killing can be obtained either by silencing c-FLIP and c-IAP2 by specific siRNA, or by inhibiting HMGB1 with blocking antibodies or glycyrrhizin, arguing for a key role of HMGB1 in TRAIL resistance and DCHIV survival. These findings provide evidence for a new strategy developed by HIV to escape immune attack, they challenge the question of the involvement of HMGB1 in the establishment of viral reservoirs in DCs, and they identify potential therapeutic targets to eliminate infected DCs