Towards a new system of costs reimbursement in Dutch long-term care facilities: a confidence-building development?

Against the background of an increasingly ageing society, the Dutch government is redefining its role with regard to providing and financing care for the elderly. This results in restricting the benefits of the Exceptional Medical Expenses Act (AWBZ) to the care for severely dependent elderly - especially old people with dementia - who are in need of long term care that cannot be ensured on the market. In accordance with this policy, geriatric rehabilitation and (medical) care aimed at recovery will be transferred to the basic health insurance. One of the steps towards this restricted coverage of the AWBZ is the introduction of a new, but questionable method of costs reimbursement. Not only does this method lack transparency, it also entails the use of time-consuming, inefficient and bureaucratic questionnaires with a doubtful reliability. The question is raised whether this procedure is a right and trustworthy step to ensure the quality of care for dependent elderly.     

Chemokines: a new class of neuromodulator?

Chemokines are not only found in the immune system or expressed in inflammatory conditions: they are constitutively present in the brain in both glial cells and neurons. Recently, the possibility has been raised that they might act as neurotransmitters or neuromodulators. Although the evidence is incomplete, emerging data show that chemokines have several of the characteristics that define neurotransmitters. Moreover, their physiological actions resemble those of neuromodulators in the sense that chemokines usually have few effects by themselves in basal conditions, but modify the induced release of neurotransmitters or neuropeptides. These findings, together with the pharmacological development of agonists and antagonists that are selective for chemokine receptors and can cross the blood-brain barrier, open a new era of research in neuroscience.     

Health psychology: a new form of psychotherapy?

Psychotherapy in its traditional form is being challenged due to managed care pressures. Psychotherapy using the model of health psychology can adapt well in a managed care environment. Differences between traditional psychotherapy and the psychotherapeutic approach of health psychology are discussed in this article, with a focus on an overview of health psychology and its applications to primary care, and the concept of single-session therapy. A case example of a sample treatment emphasizing the model of brief health psychology treatment is illustrated.     

Haematemesis: a new syndrome?

Three patients presented with symptoms suggesting a Mallory-Weiss tear. Endoscopy showed a localized, clearly demarcated area of bright red mucosa near the gastro-oesophageal junction; this was thought to have arisen by retrograde intussusception of the stomach during vomiting or retching and may have caused the haemorrhage.     

Are species differences in maternal effects arising from maternal care adaptive?

Parental care benefits offspring through maternal effects influencing their development, growth and survival. However, although parental care in general is likely the result of adaptive evolution, it does not follow that specific differences in the maternal effects that arise from care are also adaptive. Here, we used an interspecific cross‐fostering design in the burying beetle species Nicrophorus orbicollis and N. vespilloides, both of which have elaborate parental care involving direct feeding of regurgitated food to offspring, to test whether maternal effects are optimized within a species and therefore adaptive. Using a full‐factorial design, we first demonstrated that N. orbicollis care for offspring longer regardless of recipient species. We then examined offspring development and mass in offspring reared by hetero‐ or conspecific parents. As expected, there were species‐specific direct effects independent of the maternal effects, as N. orbicollis larvae were larger and took longer to develop than N. vespilloides regardless of caregiver. We also found significant differences in maternal effects: N. vespilloides maternal care caused more rapid development of offspring of either species. Contrary to expectations if maternal effects were species‐specific, there were no significant interactions between caretaker and recipient species for either development time or mass, suggesting that these maternal effects are general rather than optimized within species. We suggest that rather than coadaptation between parents and offspring performance, the species differences in maternal effects may be correlated with direct effects, and that their evolution is driven by selection on those direct effects.     

Ubiquitination of intracellular bacteria: a new bacteria-sensing system?

Ubiquitination is a protein modification generally used by cells to tag proteins that are destined for proteasomal degradation. In a recent article, Perrin et al. reported that the ubiquitination system has a role in the recognition of bacterial pathogens in the cytosol of mammalian cells. They showed that polyubiquitinated proteins accumulate on the surface of cytosolic Salmonella typhimurium. In macrophages, but not epithelial cells, proteasomes become associated with the surface of cytosolic bacteria. The authors proposed that the ubiquitin-proteasome machinery might be implicated indirectly in bacterial clearance.     

Recombinant antibodies: towards a new generation of antivenoms?

Poisoning by scorpion venoms is a major health hazard in tropical and subtropical regions and serum therapy, which was discovered in 1894, remains the only specific treatment. No real progress has been made since this time and the therapeutic use of antivenoms which still consists in polyclonal antibody fragments from the sera of immunized animals may be associated with major drawbacks. Protein engineering now allows to design novel recombinant antibody fragments which are superior to polyclonal antivenoms in homogeneity, specific activity and possibly safety. Several single-chain antibody fragments (scFvs) which neutralize scorpion toxins have been produced and characterized over the last few years. These scFvs can also be used as building blocks to engineer more complex structures including multivalent monospecific antibody fragments (diabodies, triabodies) and bispecific molecules (tandem-scFv). Some of these molecules neutralize scorpion neurotoxins and protect mice from experimental envenoming. Thus, research projects currently underway suggest that new strategies might soon be available to treat poisonings in the absence of socio-economic considerations.     

A cost of maternal care in the dung beetle Onthophagus taurus?

Parental care theory assumes that investment in current offspring will trade against future investment. A number of field studies on birds have used clutch size manipulations to demonstrate a survival cost to chick rearing. However, such studies do not account for costs accrued during earlier stages of reproduction because not all aspects of reproductive effort are manipulated by varying the number of nestlings. In this study, we investigate the effect of reproductive effort on female survival in the dung beetle, Onthophagus taurus. By experimentally manipulating mating status and dung availability, we demonstrate that virgin females survive longer than mated females and that the survival of mated females was negatively associated with the number of brood masses produced. Using a novel manipulation of the mating system, we separated the effects of egg production and maternal care on female survival. Previously, we have shown that females provisioning with the assistance of a major male provide relatively less care than unassisted females. However, paternal assistance did not alter the number of brood masses produced and hence the amount of reproductive effort that was allocated to egg production. Therefore, our finding that female survival was increased when receiving paternal assistance provides, to our knowledge, the first definitive evidence that maternal care reduces female lifespan. These results are of major importance to theoretical models on the evolution of parental care.     

Towards a new politics of migration?

This paper reconsiders Stephen Castle’s classic paper Why Migration Policies Fail. Beginning with the so-called migration crisis of 2015 it considers the role of numbers is assessing success or failure. It argues that in the UK public debates about immigration changed with European Union (EU) Enlargement in 2004, when the emphasis shifted from concerns about asylum to concerns about EU mobility. Concerns were exacerbated by the government’s failure to meet its promise to reduce net migration. This policy is hampered by the general problem of definition of “migrant” and the gap between statistical measures and popular usage in which “migration” signifies problematic mobility. In fact, concern about migration has become a placeholder for concerns about globalization and democratic accountability. A new politics of migration must make connections between migrants and citizens, but also between migration and other global processes, particularly outsourcing and the exploitation of labour and resources in the global south.     

Condition-dependent calibration of men’s uncommitted mating orientation: evidence from multiple samples

Physical strength and physical attractiveness are both hypothesized as indicators of overall phenotypic condition in humans. Strategic Pluralism Theory (Gangestad & Simpson, 2000) predicts that men’s orientation toward uncommitted mating is facultatively calibrated (i.e. contingently adjusted over ontogeny) in response to condition-dependent physical features, such as strength and attractiveness. Herein, we suggest that previous research bearing on this hypothesis has been limited because (a) researchers have often neglected to distinguish between mating orientations and past sexual behavior and (b) sample sizes have not always been large enough to reliably detect correlations of moderate magnitude. To address these issues and extend previous findings, we present aggregated data from three independent samples of young adults that permit us to examine multiple measures of physical strength and attractiveness in relation to uncommitted mating orientation, committed mating orientation, and past sexual behavior. As predicted, meta-analyses across samples demonstrated that strength and attractiveness were positively correlated with men’s (but not women’s) uncommitted mating orientation (but not committed mating orientation). In addition, strength (in men only) and attractiveness (in both sexes) positively predicted participants’ number of past sex partners. Moreover, path analyses demonstrated that the association of men’s physical features with their number of sex partners was mediated via uncommitted mating orientation. These results (a) provide the most extensive support to date for the hypothesis that men’s uncommitted mating orientation is calibrated to condition-dependent features and (b) clarify the sex-specific functional links among physical features, mating orientations and sexual behavior.     

Pharmacological evaluation of a diarylmethylene-piperidine derivative: a new potent atypical antipsychotic?

A new diaryl-methylene piperidine derivative, 2, displayed an atypical antipsychotic profile both in vitro and in vivo. The main pharmacological characteristics of this compound appears to reside in a more potent antagonism of the 5-HT2 serotonergic receptor than of the D2 dopaminergic receptor. This confirms that molecules displaying a D2/5-HT2 binding ratio < 1 possess clozapine-like antipsychotic activity.     

The impact of new emerging drugs in the treatment of multiple myeloma: is there still a role for PBSC transplantation?

High-dose therapy with the rescue of autologous stem cells represents today the standard approach for multiple myeloma patients aged <65 years. Several studies, in fact, have demonstrated the superiority of high-dose therapy with respect to conventional chemotherapy in younger patients. Peripheral blood stem cells (PBSCs) provide a rapid and effective hematopoietic recovery after the administration of supra maximal chemotherapy and mainly for this reason have become the preferred source of stem cells for autologous transplantation. Recently, however, a number of new drugs have appeared in the armamentarium of the hematologist. Among these, thalidomide has been the first antiangiogenetic drug effectively adopted firstly in refractory-relapsed patients and now also as first line treatment with better results respect to VAD or VAD-like regimens. Inhibitors of proteasome, such as bortezomib, and other immunomodulatory agents, such as lenalidomide, have been also studied more recently in myeloma patients. In particular, bortezomib has shown to be very effective as single agent or in combination with high-dose dexamethasone. In this review, we try to define the potential role of these new drugs, how and when they can be included in the therapeutic program designed for younger and older patients, and mostly if and how these new agents could jeopardize the central role of autologous stem cell transplantation in the treatment of multiple myeloma.     

Evolution of trophic transmission in parasites: the need to reach a mating place?

Although numerous parasite species have a simple life cycle (SLC) and complete their life cycle in one host, there are other parasite species that exploit several host species successively. From an evolutionary perspective, understanding the mix of adaptive and contingent forces shaping the transition from an ancestral single‐host state to such a complex life cycle (CLC) has proved an intriguing challenge. In this paper, we propose a new hypothesis, which states that CLCs involving trophic transmission (i.e. transmission to a predator) evolved because they are an efficient way for parasites to meet a sexual partner, assuming that selective benefits are associated with cross‐fertilization. Predators that eat a lot of prey in a relatively short time interval act to concentrate isolated parasites. We use an optimality model to develop our hypothesis and discuss further directions of potential research.     

The CCN family: a new class of inflammation modulators?

Uncontrolled or sustained inflammation is the underlying cause of or actively contributes to the progression of many chronic pathologies such as atherosclerosis, arthritis, or neuroinflammatory diseases. Matricellular proteins of the CCN family (CYR61/CTGF/NOV) have emerged as localized multitasking signal integrators. These structurally conserved secreted proteins specifically interact with and signal through various extracellular partners, in particular integrins, which enable them to play crucial roles in various processes including development, angiogenesis, wound healing and diseases such as fibrosis, vascular disease and cancer. In this review, we discuss the possibility that the CCN family members could represent a putative new class of modulators of inflammation. In this context, we focused on their relationship with cytokines and chemokines. In vitro, CCN expression is finely regulated by diverse inflammatory mediators including cytokines (TNFα, IL1β, TGF-β), small factors such as prostaglandins, nitric oxide, histamine and serotonin, and extracellular matrix enzymes. In addition, CCN proteins acting alone or in concert with their specific partners appear to be potent regulators of the production of cytokines and chemokines in a context-dependent manner. Finally, emerging studies suggest a potential role for CCN proteins in chronic inflammatory diseases such as atherosclerosis, rheumatoid arthritis, inflammatory kidney diseases and neuroinflammatory pathologies such as Alzheimer’s disease. CCN members could therefore represent new potential therapeutic targets for drug development against such diseases.