The presence of alpha-catenin in the VE-cadherin complex is required for efficient transendothelial migration of leukocytes

The majority of the leukocytes cross the endothelial lining of the vessels through cell-cell junctions. The junctional protein Vascular Endothelial (VE)-cadherin is transiently re-distributed from sites of cell-cell contacts during passage of leukocytes. VE-cadherin is part of a protein complex comprising p120-catenin and beta-catenin as intracellular partners. Beta-catenin connects VE-cadherin to alpha-catenin. This VE-cadherin-catenin complex is believed to dynamically control endothelial cell-cell junctions and to regulate the passage of leukocytes, although not much is known about the role of alpha- and beta-catenin during the process of transendothelial migration (TEM). In order to study the importance of the interaction between alpha- and beta-catenin in TEM, we used a cell-permeable version of the peptide encoding the binding site of alpha-catenin for beta-catenin (S27D). The data show that S27D interferes with the interaction between alpha- and beta-catenin and induces a reversible decrease in electrical resistance of the endothelial monolayer. In addition, S27D co-localized with beta-catenin at cell-cell junctions. Surprisingly, transmigration of neutrophils across endothelial monolayers was blocked in the presence of S27D. In conclusion, our results show for the first time that the association of alpha-catenin with the cadherin-catenin complex is required for efficient leukocyte TEM

Systems training for emotional predictability and problem solving for borderline personality disorder:A systematic review

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed

Validation of the AUDIT and AUDIT-C for hazardous drinking in community-dwelling older adults

Background: One of the best-known tools in screening for hazardous drinking is the Alcohol Use Disorders Identification Test (AUDIT) and its abbreviated form, the AUDIT-C. The aim of the present study is to determine the cut-offs of both instruments in identifying hazardous drinking in older adults. Method: A sample of 1577 older adults completed a questionnaire regarding alcohol behavior. Hazardous drinking was defined as drinking >10 units/week. Receiver operating characteristics (ROC) curves of AUDIT and AUDIT-C were calculated and cut-off scores were derived. Results: Respectively 27.3% and 12.3% of older men and women drank >10 units/week. For the AUDIT the best trade-off between sensitivity and specificity was using a cut-off of ≥5 for men and ≥4 for women, which yielded in men sensitivity and specificity values respectively of 80.7% and 81.3% and in women 100% and 71.7%, respectively. We found the AUDIT-C to perform well with an optimal cut-off of ≥5 for men and ≥4 for women, which generated in men sensitivity and specificity values respectively of 76.5% and 85.3% and in women 100% and 74.1%, respectively. Conclusion: The AUDIT-C is accurate and sufficient in screening for hazardous drinking in community-dwelling older adults if the cut-offs are tailored by gender

Adapting group schema therapy for older adults with personality disorders:Lessons learnt

A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions

Возможностим развития конкуренции на рынках теплоснабжения Донбасса

Проаналізовано стан ситем теплопостачання Донбасу, виявлено зниження виробництва та відпуску теплової енергії, що викликано появою конкурента — автономного опалення. Обгрунтовано причини протиріччя законодавства, що регулює діяльність у сфері комунального теплопостачання — природної монополії, в результаті чого порушені конституційні, цивільні, споживчі права людей. Розглянуто практику регулювання ринків теплопостачання в країнах з розвиненою ринковою економікою, і можливості застосування їх досвіду в Україні. Визначено роль держави, як найважливішого регулятора, який здійснює контроль за ринком теплопостачання, і є влавником стратегічно важливих підприємств сектора. Ключові слова: централізоване теплопостачання, природна монополія, автономне опалення, конкуренція, приватний капітал, державне регулювання.Проанализировано состояние ситем теплоснабжения Донбасса, выявлено снижение производства и отпуска тепловой энергии, что вызвано появлением конкурента — автономного отопления. Обоснованы причины протеворечивости законодательства регулирующего деятельность в сфере коммунального теплоснабжения — естественной монополии, в результате чего нарушены конституционные, гражданские, потребительские права людей. Рассмотрена практика регулирования рынков теплоснабжения в странах с развитой рыночной экономикой, и возможности применения их опыта в Украине. Определена роль государства, как важнейшего регулятора, осуществляющего контроль за рынком теплоснабжения, и собственика стратегически важных предприятий сектора. Ключевые слова: централизованное теплоснабжение, естественная монополия, автономное отопление, конкуренция, частный капитал, государственное регулирование.The state of Donbass Heating System Works, showed a reduction in production and supply of heat energy that is caused by the emergence of competitors — independent heating. Substantiated reasons imperfect legislation governing activities in the field of district heating — natural monopoly, resulting in a violation of the constitutional, civil, consumer rights of people. The practical management of district heating markets in countries with developed market economies, and the possibility of applying their experience in Ukraine. Defined the place of government as an important regulator, controlling the heating market, and the owners of strategically important enterprises in the sector. Key words: district heating, natural monopoly, independent heating, competition, private capital, government regulation

Mediatieve therapie in de thuiszorg: Onbekend en onbenut

Psychologische interventies zijn nog weinig verkend in de thuiszorg voor ouderen met probleemgedrag. In deze gevalsbeschrijving uit een mannelijke patiënt zich krenkend jegens zorgverleners, die dit gedrag willen laten ophouden. Na observatie zijn via teamleden concrete interventies ingezet, welke vooraf werden ingeoefend met rollenspel. Niethelpende gedachten die bij het oefenen opkwamen, werden uitgedaagd en vervangen door helpende varianten. Psychosociale interventies kunnen in de thuiszorg voor ouderen vruchtbaar zijn, als de onderliggende principes zijn afgestemd op de afhankelijkheid en kwetsbaarheid van de doelgroep. Enkele relevante vertrekpunten hierin worden beschreven