Verblijfsregeling voor slachtoffers van mensenhandel en oneigenlijk gebruik: Een verkennende studie in het Verenigd Koninkrijk, Italië en België

__Abstract__ Verschillende Europese landen hebben regelingen getroffen waardoor (vermoede-lijke) slachtoffers van mensenhandel in aanmerking kunnen komen voor verblijf, begeleiding en opvang. In Nederland staat deze regeling bekend als de B9-rege- ling. Hier is het recht op tijdelijk verblijf en bescherming in principe afhankelijk van de medewerking van slachtoffers aan de opsporing en vervolging van de mensenhandelaar. Ook het recht op voortgezet verblijf is onder andere gekoppeld aan de vervolging van de dader(s) voor mensenhandel of een daaraan gerelateerd delict. Sinds enkele jaren zijn er in Nederland onder een aantal betrokkenen zorgen over mogelijk oneigenlijk gebruik van de B9-regeling. Hoewel er geen data beschikbaar zijn over de omvang van de problematiek, geven een aantal betrokkenen bij vooral de politie en het OM signalen af dat er vreemdelingen zijn die een mensenhandel-verhaal fingeren om gebr

Een onzekere toekomst:Kwalitatief onderzoek naar de ervaringen van afgewezen (ex-)alleenstaande minderjarige vreemdelingen en opvangouders met toekomstgerichte begeleiding

In 2016 werd een nieuw opvangmodel voor alleenstaande minderjarige vreemdelingen (AMV’s) van kracht. Het model wordt gekenmerkt door kleinschaligheid en begeleiding naar toekomstperspectief: jongeren van wie de asielaanvraag is ingewilligd en jongeren van wie deze is afgewezen worden, anders dan de situatie onder het oude model, apart opgevangen. Het onderhavige onderzoek had als doel meer zicht te krijgen op hoe AMV’s wier asielverzoek is afgewezen de begeleiding onder het nieuwe opvangmodel ervaren en wat hun ideeën zijn over de toekomst. De onderzoeksvragen luidden: 1. Wat zijn de ervaringen van jongeren van wie de asielaanvraag is afgewezen met de opvang en de (toekomstgerichte) begeleiding? 2. Past de begeleiding die ze krijgen bij hun behoeften? 3. Wat zijn hun ideeën over de toekomst (o.a. m.b.t verblijf in Nederland of terugkeer naar het land van herkomst)? INHOUD: 1. Inleiding, 2. AMV's en ex-AMV's over KWV's, mentoren en voogden, 3. Begeleiding in opvanggezinnen, 4. ConclusiesIn 2016, the Netherlands introduced a new model for the reception of unaccom-panied minor asylum seekers (UMAs). Distinctive features of the model are the small-scale housing facilities and the emphasis on guidance of UMA’s depending on their future prospects. In contrast to the past situation, minors who have been granted an asylum permit are now housed separately from those whose asylum application has been rejected. The current study aimed to provide more insight into rejected UMAs’ expe-riences about the guidance they receive under the new reception model, and how they see their future. The research questions were: 1. What are the experiences of youngsters whose asylum application has been rejected with the housing facility and (future oriented) guidance? 2. Does the guidance meet their needs? 3. How do they see their future (for instance with regards to staying in the Netherlands or returning to the country of origin)

Population pharmacokinetics of vancomycin in obesity: Finding the optimal dose for (morbidly) obese individuals

Aims: For vancomycin treatment in obese patients, there is no consensus on the optimal dose that will lead to the pharmacodynamic target (area under the curve 400–700 mg h L−1). This prospective study quantifies vancomycin pharmacokinetics in morbidly obese and nonobese individuals, in order to guide vancomycin dosing in the obese. Methods: Morbidly obese individuals (n = 20) undergoing bariatric surgery and nonobese healthy volunteers (n = 8; total body weight [TBW] 60.0–234.6 kg) received a single vancomycin dose (obese: 12.5 mg kg−1, maximum 2500 mg; nonobese: 1000 mg) with plasma concentrations measured over 48 h (11–13 samples per individual). Modelling, internal validation, external validation using previously published data and simulations (n = 10.000 individuals, TBW 60–230 kg) were performed using NONMEM. Results: In a 3-compartment model, peripheral volume of distribution and clearance increased with TBW (both p  90% target attainment (area under the curve > 400 mg h L−1) in individuals up to 200 kg, with corresponding trough concentrations of 5.7–14.6 mg L−1 (twice daily dosing). For continuous infusion, a loading dose of 1500 mg is required for s

Tobramycin Clearance Is Best Described by Renal Function Estimates in Obese and Non-obese Individuals: Results of a Prospective Rich Sampling Pharmacokinetic Study

Purpose Tobramycin is an aminoglycoside antibiotic of which the 24 h exposure correlates with efficacy. Recently, we found that clearance of the aminoglycoside gentamicin correlates with total body weight (TBW). In this study, we investigate the full pharmacokinetic profile of tobramycin in obese and non-obese individuals with normal renal function. Methods Morbidly obese individuals (n = 20) undergoing bariatric surgery and non-obese healthy volunteers (n = 8), with TBW ranging 57–194 kg, received an IV dose of tobramycin with plasma concentrations measured over 24 h (n = 10 per individual). Statistical analysis, modelling and simulations were performed using NONMEM. Results In a two-compartment model, TBW was the best predictor for central volume of distribution (p< 0.001). For clearance, MDRD (de-indexed for body surface area) was identified as best covariate (p < 0.001), and was superior over TBW ((p < 0.05). Other renal function estimates (24 h urine GFR and de-indexed CKD-EPI) led to similar results as MDRD (all p < 0.001)). Conclusions In obese and non-obese individuals with normal renal function, renal function estimates such as MDRD were identified as best predictors f

Final results from TAIL: updated long-term efficacy of atezolizumab in a diverse population of patients with previously treated advanced non-small cell lung cancer

In patients with previously treated advanced or metastatic non-small cell lung cancer (NSCLC), atezolizumab therapy improves survival with manageable safety. The open-label, single-arm phase III/IV TAIL study (NCT03285763) evaluated atezolizumab monotherapy in patients with previously treated NSCLC, including those with Eastern Cooperative Oncology Group performance status of 2, severe renal impairment, prior anti-programmed death 1 therapy, autoimmune disease, and age &amp; GE;75 years. Patients received atezolizumab intravenously (1200 mg) every 3 weeks. At data cut-off for final analysis, the median follow-up was 36.1 (range 0.0-42.3) months. Treatment-related (TR) serious adverse events (SAEs) and TR immune-related adverse events (irAEs) were the coprimary endpoints. Secondary endpoints included overall survival (OS), progression-free survival (PFS), overall response rate, and duration of response. Safety and efficacy in key patient subgroups were also assessed. TR SAEs and TR irAEs occurred in 8.0% and 9.4% of patients, respectively. No new safety signals were documented. In the overall population, median OS and PFS (95% CI) were 11.2 months (8.9 to 12.7) and 2.7 months (2.3 to 2.8), respectively. TAIL showed that atezolizumab has a similar risk-benefit profile in clinically diverse patients with previously treated NSCLC, which may guide treatment decisions for patients generally excluded from pivotal clinical trials

Can patient-led surveillance detect subsequent new primary or recurrent melanomas and reduce the need for routinely scheduled follow-up? A protocol for the MEL-SELF randomised controlled trial

This research project is funded by a National Health and Medical Research Council (NHMRC) Project grant (#1163054). The funder had no role in the design of the study and will have no role in the collection, analysis, and interpretation of the data; the writing of the report; or the decision to submit the report for publication. Funding Information: AEC is funded by a Career Development Fellowship from the National Health and Medical Research Council (NHMRC; 1147843). JFT is a recipient of an NHMRC Program Grant (1093017). RPMS is supported by Melanoma Institute Australia. RAS is supported by a NHMRC Program Grant and Practitioner Fellowship. For RAS, support from the from colleagues at Melanoma Institute Australia, Royal Prince Alfred Hospital and NSW Health Pathology is also gratefully acknowledged. RLM is supported with an NHMRC Investigator grant (1194703) and a University of Sydney Robinson Fellowship. HPS holds an NHMRC MRFF Next Generation Clinical Researchers Program Practitioner Fellowship (APP1137127). JH is supported by an NHMRC Early Career Fellowship (1112509). KB is supported by an NHMRC Investigator Grant (1174523) and a University of Sydney Research Accelerator (SOAR) Prize.Peer reviewedPublisher PD

Migration of Th1 Lymphocytes Is Regulated by CD152 (CTLA-4)-Mediated Signaling via PI3 Kinase-Dependent Akt Activation

Efficient adaptive immune responses require the localization of T lymphocytes in secondary lymphoid organs and inflamed tissues. To achieve correct localization of T lymphocytes, the migration of these cells is initiated and directed by adhesion molecules and chemokines. It has recently been shown that the inhibitory surface molecule CD152 (CTLA-4) initiates Th cell migration, but the molecular mechanism underlying this effect remains to be elucidated. Using CD4 T lymphocytes derived from OVA-specific TCR transgenic CD152-deficient and CD152-competent mice, we demonstrate that chemokine-triggered signal transduction is differentially regulated by CD152 via phosphoinositide 3-kinase (PI3K)-dependent activation of protein kinase B (PKB/Akt). In the presence of CD152 signaling, the chemoattractant CCL4 selectively induces the full activation of Akt via phosphorylation at threonine 308 and serine 473 in pro-inflammatory Th lymphocytes expressing the cognate chemokine receptor CCR5. Akt signals lead to cytoskeleton rearrangements, which are indispensable for migration. Therefore, this novel Akt-modulating function of CD152 signals affecting T cell migration demonstrates that boosting CD152 or its down-stream signal transduction could aid therapies aimed at sensitizing T lymphocytes for optimal migration, thus contributing to a precise and effective immune response