Self-determination in dependence

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The role of regulatory B cells in allergen immunotherapy

PURPOSE OF REVIEW Allergen immunotherapy (AIT) is currently the only curative treatment available for allergic diseases, and has been used in clinical practice for over a century. Induction and maintenance of immune tolerance to nonhazardous environmental and self-antigens is essential to maintain homeostasis and prevent chronic inflammation. Regulatory B (BREG) cells are immunoregulatory cells that protect against chronic inflammatory responses primarily through production of anti-inflammatory cytokines such as IL-10, transforming growth factor-β, and IL-35. The importance of BREG cells has been extensively demonstrated in the context of autoimmune diseases. Data showing their role in the regulation of allergic responses are slowly accumulating. This review summarizes recent findings relevant to the topic of BREG cells and their potential role in AIT. RECENT FINDINGS BREG cells support AIT in models of allergic airway inflammation and intestinal inflammation through induction of regulatory T (TREG) cells. In humans BREG frequency increases during venom immunotherapy while the phenotype of allergen-specific B cells changes. Mechanisms of BREG-mediated tolerance to allergens include IL-10-mediated suppression of effector T cell, including TH2 responses, induction of TREG cells, IL-10-mediated inhibition of Dendritic cell maturation, modulation of T follicular helper responses, and production of anti-inflammatory IgG4 antibodies. SUMMARY Current evidence supports a potential role for BREG cells in induction and maintenance of allergen tolerance during AIT. A better understanding of the role of B cells and BREG cells in AIT could open potential new windows for developing targeted therapies specifically focused on promoting BREG responses during AIT

Information technology and medication safety

Medication can harm patients. Measures to prevent medication errors, are often based on information technology (IT)to improve standardization, transparency, documentation and process structure. Despite this potential, medication errors were also reported when using IT-based interventions. The studies in this thesis aim to increase our understanding of the use of IT-based interventions in healthcare to prevent medication errors. We analyzed a significant number of medication errors reported by healthcare professionals from Dutch hospitals and community pharmacies. One in six reported medication errors was found to be IT related. Man- machine interactions played a crucial role in these errors. In almost 80% of the errors people miscommunicated with IT systems, e.g., not knowing how to react to system output or computer failures. Bad software design caused computer input problems. System designers and software programmers should learn from this. Our study in four hospitals in the Netherlands using Bar-Code-assisted Medication Administration (BCMA) systems identified workarounds in more than two-thirds of medication administrations. These were significantly associated with medication administration errors. Workarounds consisted of failures to scan patient wrist bands and medication barcodes, technological difficulties and nurses not following protocols. Our studies highlight the importance of good software design, training healthcare professionals in using IT-based interventions and increasing their awareness of potential IT system imperfections that can harm patients. Optimizing staffing levels can reduce the workload of nurses, potentially preventing workarounds. Finally, performing a prospective risk analysis before the implementation of IT-based interventions can be an excellent opportunity to engage end users

Monitor 2016/2017 Buurtsamenwerking Helpman/de Wijert Lectoraat Duurzaam Coöperatief Ondernemen:deel II uit de onderzoeksserie Monitor Lectoraat Duurzaam Coöperatief Ondernemen

Het lectoraat noemt dit Next Education, Next Governance en Next Business. Het lectoraat is nauw verbonden met Buurtsamenwerking Helpman/de Wijert, waarin alle hiervoor genoemde modellen tot uiting komen. In de Buurtsamenwerking wordt gezamenlijk een weg gezocht om ondernemers, overheid, wijkbewoners en onderwijs met elkaar te verbinden om samen te werken aan toepasbare oplossingen voor actuele vraagstukken. Aan de Buurtsamenwerking Helpman/de Wijert is de Innovatiewerkplaats verbonden. Annet Muller-ter Veen is als manager van de Innovatiewerkplaats verantwoordelijk voor het operationaliseren van de verbinding tussen alle partijen. Daarvoor vertaalt zij actuele vraagstukken naar concrete projecten, waarbij zich Community’s of Innovative Learners (COIL’s) vormen vanuit de participanten van het onderwijs, overheid, ondernemers en wijkbewoners. Al