Humane psychiatrische zorg in de Meander : een kwestie van ethiek

This article describes a number of concrete initiatives taken in the De Meander in Melle (near Ghent, Belgium), a psychiatric ward for patients with a mental disability or an acquired brain injury, with the aim of introducing and safeguarding a psychoanalytic ethic. In the latter, the particularity of the patient plays a central role. De Meander tried to achieve this by abolishing many of the ward rules, allowing more space for the singular solution of the patient. Furthermore, the author describes how aggression is addressed differently, in order to learn how to read this rather than punish it. From an ethical perspective, the values and standards of mainstream society are no longer strictly adhered to, but the starting point is the suffering and the questioning of the patient as a unique subject. The author describes how patients of De Meander are given more responsibility for their lives and future. Hierarchical positions are lifted by creating the possibility of circulation between different team members and by using the therapeutic potential of patients. Finally, the author describes how, via volunteer work, an opening to the outside world is created for so-called chronic patients. These various concrete initiatives are illustrated using clinical vignettes

Matrix elasticity of void-forming hydrogels controls transplanted-stem-cell-mediated bone formation

The effectiveness of stem cell therapies has been hampered by cell death and limited control over fate. These problems can be partially circumvented by using macroporous biomaterials that improve the survival of transplanted stem cells and provide molecular cues to direct cell phenotype. Stem cell behaviour can also be controlled in vitro by manipulating the elasticity of both porous and non-porous materials, yet translation to therapeutic processes in vivo remains elusive. Here, by developing injectable, void-forming hydrogels that decouple pore formation from elasticity, we show that mesenchymal stem cell (MSC) osteogenesis in vitro, and cell deployment in vitro and in vivo, can be controlled by modifying, respectively, the hydrogel’s elastic modulus or its chemistry. When the hydrogels were used to transplant MSCs, the hydrogel’s elasticity regulated bone regeneration, with optimal bone formation at 60 kPa. Our findings show that biophysical cues can be harnessed to direct therapeutic stem cell behaviours in situ