EMDR Treatment in People with Mild ID and PTSD: 4 Cases

Although there is evidence to suggest that people with intellectual disabilities (ID) are likely to be more susceptible to the development of posttraumatic stress disorder (PTSD) than persons in the general population, until now only eight case reports on the treatment of people with ID suffering from PTSD symptoms have been published. In an effort to enrich the literature on this subject, the aim was to investigate the applicability of an evidence-based treatment for PTSD (i.e., EMDR) in four people with mild ID, suffering from PTSD following various kinds of trauma. In all cases PTSD symptoms decreased and the gains were maintained at 3 months to 2.5 year follow-up. In addition, depressive symptoms and physical complaints subsided, and social and adaptive skills improved. It is concluded that clients′ improvements converge to suggest the applicability of EMDR in people with mild ID. Difficulties involved in arriving at an accurate PTSD diagnosis in ID clients are discussed

The contribution of the immune system to parturition

The immune system plays a central role before and during parturition, including the main physiological processes of parturition: uterine contractions and cervical ripening. The immune system comprises white blood cells and their secretions. Polymorphonuclear cells and macrophages invade the cervical tissue and release compounds, such as oxygen radicals and enzymes, which break down the cervical matrix to allow softening and dilatation. During this inflammatory process, white blood cells undergo chemotaxis, adherence to endothelial cells, diapedesis, migration and activation. Factors that regulate white blood cell invasion and secretion include cytokines such as tumour necrosis factor and interleukins. Glucocorticoids, sex hormones and prostaglandins, affect cytokine synthesis. They also modulate the target cells, resulting in altered responses to cytokines. On the other hand, the immune system has profound effects on the hormonal system and prostaglandin synthesis. In animals, nitric oxide has marked effects on uterine quiescence during gestation. At the same time, it plays an important role in regulating the vascular tone of uterine arteries and has anti-adhesive effects on leukocytes. Cytokines are found in amniotic fluid, and in maternal and foetal serum at term and preterm. Several intrauterine cells have been shown to produce these cytoldnes. Since neither white blood cells, cytokines nor nitric oxide seem to be the ultimate intermediate for human parturition, the immune system is an additional but obligatory and underestimated component in the physiology of delivery. Scientists, obstetricians and anaesthesiologists must thus be aware of these processes

The bio-artificial pancreas to treat type 1 diabetes:Perspectives from healthcare professionals in the Netherlands

Aims: Healthcare professionals are relevant stakeholders because of their gatekeeper role in the clinic. This studyaims to explore their perspectives on the potential future clinical implementation of the bio-artificial pancreas(BAP) for people with type 1 diabetes, and suitable target groups.Methods: Semi-structured interviews were conducted with 17 healthcare professionals, including endocrinologists, nurses, and pancreas transplant surgeons. Inclusion was stopped once data saturation was reached. Theaudiotaped interviews were transcribed verbatim. Qualitative content analysis using an inductive approach wasconducted to develop themes within a coding framework.Results: Three main themes emerged: (1) hoped-for benefits, which included improved clinical outcomes,enhanced sense of normality, reduced mental burden for patients and their significant others, greater societalparticipation, and lower costs; (2) concerns, which included safety and effectiveness, inequitable access, accurateinformation, control over self-management, and organizational challenges; and (3) allocating the BAP duringinitial implementation, which included prioritizing people who lack effective treatment options, people withmental health issues, and vulnerable people.Conclusions: The results of this study are important for researchers and practitioners involved in the developmentof the BAP, so that they can align its design and the process of clinical implementation with healthcare professionals’ perspectives

Giant isotope effect in the incoherent tunneling specific heat of the molecular nanomagnet Fe8

Time-dependent specific heat experiments on the molecular nanomagnet Fe8 and the isotopic enriched analogue 57Fe8 are presented. The inclusion of the 57Fe nuclear spins leads to a huge enhancement of the specific heat below 1 K, ascribed to a strong increase in the spin-lattice relaxation rate Gamma arising from incoherent, nuclear-spin-mediated magnetic quantum tunneling in the ground-doublet. Since Gamma is found comparable to the expected tunneling rate, the latter process has to be inelastic. A model for the coupling of the tunneling levels to the lattice is presented. Under transverse field, a crossover from nuclear-spin-mediated to phonon-induced tunneling is observed.Comment: Replaced with version accepted for publication in Physical Review Letter