In an early study, Maas et al (1998) found significantly higher

In an early study, Maas et al. (1998) found significantly higher activation in the anterior cingulate cortex (ACC) and left dorsolateral PFC (DLPFC) in crack-cocaine abusers compared with HCs. This was the first study that used a robust design (including HCs, a block design, and analyses following selected regions of interest [ROI]) and showed that fMRI was able to visualize craving in cocaine-dependent individuals, however, including important limitations such as the small sample size, the inclusion of cocaine-dependent individuals who were allowed to have a history of other drug use, and

presenting Inhibitors,research,lifescience,medical of the visual analog scale (VAS) only twice (before and after the experiment), so that carry-over effects of craving across blocks could not be ruled out. Fulvestrant supplier Subsequently, Childress et al. (1999) showed higher regional cerebral blood flow (rCBF) in limbic structures (amygdala and anterior cingulate) Inhibitors,research,lifescience,medical and lower

rCBF in basal ganglia (caudate) compared with HCs using [15O] PET. It should be noted that PET has lower spatial resolution than MRI, even when ROI are delineated on co-registered anatomical MRI scans, as in this study. Therefore, rCBF of the nucleus accumbens (NAcc) could not be assessed. A methodological problem was the small HC group (see Table 2), who were additionally significantly younger and higher educated than those in the cocaine-dependent group (Childress Inhibitors,research,lifescience,medical et al. 1999). Table 2 Overview of the selected reviewed studies using cue-reactivity paradigms in stimulant abusers versus healthy control subjects Whereas formal power calculations Inhibitors,research,lifescience,medical are problematic for [15O]-PET and fMRI, it has since been shown that in fMRI group sizes of at least 12 are required to reliably detect typical activations (Desmond and Glover 2002). Also, note that early imaging studies Inhibitors,research,lifescience,medical tend to report fixed-effects analyses, which limits generalizability

of findings. The first fMRI study on cue exposure using an adequate sample was conducted by Garavan et al. (2000). Watching a cocaine video was associated with greater activation (compared with the neutral video) in a number of ROIs, including various isothipendyl prefrontal and limbic areas in cocaine abusers but not in HCs. The authors thus replicated the limbic activation found by Childress et al. (1999), concluding that cue-induced cocaine craving was primarily reflected by higher activation of prefrontal and limbic regions, that craving was not associated with a specific neuroanatomical substrate, but that cocaine users have a unique ability for learned, drug-related cues to produce similar brain activation patterns as potent, nondrug evocative stimuli in HCs. Furthermore, lower prefrontal and limbic activations were found in cocaine abusers compared with HCs during sexually arousing stimuli (Garavan et al. 2000) and this may indicate a relatively low sensitivity to natural rewards in SAs, also referred to as reward deficiency (Blum et al. 2000). Strengths of the Garavan et al.

The animals were individually exposed to the challenge viruses (1

The animals were individually exposed to the challenge viruses (108 EID50 per animal) by connecting a SaHoMa™-II mobile ultrasonic nebulizer (NEBU-TEC International med. Produkte Eike Kern GmbH, Germany) to a head hood attached to the horse’s head; the mTOR inhibitor aerosol was generated from 7.5 ml egg allantoic fluid. Clinical observations and

body temperature were monitored daily for 21 days post-challenge as described above. Serum samples were collected on day 28 PC to determine the accumulation of influenza virus antibodies using the HAI assay, using the native viruses A/equine/Otar/764/07 (Н3N8) and A/equine/Sydney/2888-8/07 (Н3N8) in working doses of 4 hemagglutinating units as antigens. Nasal swabs were taken from the animals on days Selleck GDC-0068 1, 3, 5 and 7 post-challenge to assess the degree of viral shedding as described above. The significance of the differences between groups were determined using two-way ANOVA followed by Tukey’s

multiple comparisons test; P < 0.05 was considered significant. The vaccine was completely safe for yearlings in both single and double intranasal administration mode. After the prime and booster vaccinations, the general clinical status and body temperature of the yearlings remained within the normal limits throughout the observation period (21 days), with a rectal temperature of 37.5–38.5 °C. Lacrimation, mucopurulent discharge, Tolmetin signs of conjunctivitis or discharge from the nose was not observed

in any vaccinated animal (data not shown). Low vaccine viral shedding was observed in the upper respiratory organs. After the prime vaccination, the virus was shed in 47.7% (43/90) of animals on day 1 and 26.6% (24/90) on day 3, with titers ranging from 0.75 to 1.5 log10 EID50/0.2 ml (1.02 ± 0.04 and 1.29 ± 0.05 log10 EID50/0.2 ml at 1 and 3 days PV, respectively). After the booster vaccination, the virus was only shed on day 1 by 31.1% (28/90) of yearlings at titers ranging from 0.75 to 1.25 log10 EID50/0.2 ml (0.94 ± 0.04 log10 EID50/0.2 ml). As shown in Fig. 1 or Supplementary Table 1, both prime and booster vaccination of yearlings generated a protective immune response lasting 12 months (the observation period). After challenge with the Modulators wild-type homologous virus A/equine/Otar/764/07 (H3N8), the severity and duration of the clinical signs of disease, as well as the intensity and duration of viral shedding in the upper airway were significantly lower (from P = 0.03 to P < 0.0001) throughout the observation period in the vaccinated animals than the control group.

In treatment resistant OCD patients, who had failed two to six SR

In treatment resistant OCD patients, who had failed two to six SRI trials, doubleblind addition of once-weekly morphine resulted in a significant reduction of OCD symptoms at week two versus placebo, while lorazepam as another control condition was

undistinguishable from placebo.102 Augmentation with the opoid antagonist naltrexone did not Inhibitors,research,lifescience,medical show efficacy for OCD symptoms in a double-blind placebo-controlled study in SSRI or clomipramine refractory patients.103 For several other drugs preliminary interesting findings mostly from AZD2281 mouse short-term open studies or case reports exist. Addition of gabapentin seems to shorten the time of onset of fluoxetine’s antiobsessive effect.104 Restarting of previously untolerated serotonergic antidepressants after valproate pretreatment Inhibitors,research,lifescience,medical was reported to lead to better tolerance and reduction of OCD symptoms in a case series.105 Valproate monotherapy was successful in an SRI-intolerant OCD patient.106 The 5-HT3 receptor antagonist

Inhibitors,research,lifescience,medical ondansetrone may have promise both as monotherapy107 and as an augmentation strategy for some OCD patients.108 Amelioration of refractory OCD on treatment with clozapine was described in a few case reports.109-111 Antiandrogenic treatment with cyproterone acetate112 and the long-acting gonadotropin-releasing hormone analogue triptorelin113 was reported to result in Inhibitors,research,lifescience,medical considerable improvement of symptoms of OCD. Marked decreases of symptoms were observed shortly after single-dose exposures to the psychedelic drug psilocybin in patients with OCD.114 Nicotine treatment was reported to display a

favorable response, both in monotherapy as well as for augmentation,115-117 while inositol augmentation of SSRIs led to a clinically significant response in some OCD patients in an open study118; in a small Inhibitors,research,lifescience,medical double-blind crossover study no significant improvement by this second messenger precursor was seen.119 Acute significant antiobsessional effects for a single dose of dextroamphetamine were reported in a double-blind crossover study in patients with severe OCD120 Improvement of OCD was seen in treatment-resistant patients to serotonergic antidepressants after augmentation with both first dextroamphetamine and caffeine in a double-blind study without placebo arm.121 Future prospects Despite the considerable current knowledge that has been accumulated about evidence-based drug treatment of adults with OCD, as given account of above, and as summarized in Table I, several important clinical issues are still unresolved and need further research. There is still a paucity of long-term trials (especially for treatment with SRIs for more than 1 year and for augmentation with antipsychotics).

8,10,11,15,25–27 During this period of neuropraxia, there is abse

8,10,11,15,25–27 During this period of neuropraxia, there is absence of spontaneous nocturnal erections that leads to the loss of production of nitric oxide (NO), both by the neuronal isoform of nitric oxide synthase (nNOS) via the nerves themselves and the inducible isoform of nitric oxide synthase (iNOS) via the cavernosal smooth muscle cells, due to loss of Inhibitors,research,lifescience,medical tissue

oxygenation produced by tumescence.11,14,15 These changes induce the production of proapoptotic factors and profibrotic factors within the corpora cavernosa.11 The loss of nocturnal erections or damage to the accessory pudendal arteries during RP contributes to prolonged periods of penile smooth muscle hypoxia/ischemia, which leads to the production of transforming growth factor-β1 (TGF-β1) and TGF-β1-dependent endothelin-1 (ET-1).25 ET-1 has been shown to be a potent constrictor of penile smooth muscle and a profibrotic peptide, which induces collagen deposition in cavernosal tissue.25 Daley and associates showed that the production of prostaglandin E-1 (PGE-1) suppressed Inhibitors,research,lifescience,medical TGF-β1-induced collagen accumulation in cavernosal muscle cells.28 Moreland and colleagues also showed that the addition of PGE-1 to cavernosal cultures suppressed TGF-β1-induced collagen synthesis.29 Thereby, Inhibitors,research,lifescience,medical loss of erections due to decreased vascular inflow or loss of NO-induced tumescence contributes

to the loss of PGE-1 feedback control on TGF-β1 production and perpetuates penile fibrosis, apoptosis, and programmed cell death.25 Some studies have shown in rats after bilateral neurectomy and in men after RP that smooth muscle degradation is followed by increased levels of collagen type I and collagen type III deposition.10 User and coauthors30 demonstrated loss of penile wet weight in rats that underwent both bilateral and unilateral Inhibitors,research,lifescience,medical cavernous nerve transection. Their data show that the average penile weight reduction was 13.6%, with the greatest reduction of 17.4% seen in the bilateral cavernous neurotomy group on postoperative day 60 (P < .005). A statistically

significant Lumacaftor in vitro decrease in penile wet weight of 10.5% was seen at the 60-day point in the unilateral denervated penes (P = .029). They Inhibitors,research,lifescience,medical also demonstrated a statistically next significant decrease in DNA content in the bilaterally denervated penes (P < .05). Klein and associates showed increased DNA fragmentation and elevation of sulfated glycoprotein-2 (SGP-2) in the erectile tissue of denervated rat penes, which are both markers of apoptosis.27 Conversely, Müller and colleagues demonstrated the early use of hyperbaric oxygen therapy in rat cavernous nerve injury model improved erectile function recovery, endothelial nitric oxide synthase (eNOS), and nerve growth factor expression.31 The development of penile fibrosis leads to the long-term development of corporal veno-occlusive dysfunction/venous leakage because of the loss of cavernosal smooth muscle cell mass to adequately compress the subtunical veins during tumescence.

64 Many patients whose symptoms do not disappear completely are c

64 Many patients whose symptoms do not disappear completely are considered resistant to treatment, although, strictly

speaking, this is a pseudoresistance that can be caused by insufficient dosage, insufficient treatment time, poor adherence, or clinical evolution.65 Depression is an illness that is difficult to treat due to its inherent characteristics, factors that affect the prescription of medication and proper treatment (such as poor SB431542 molecular weight adherence and low dosage), comorbidity, and ineffective treatment.66 Inhibitors,research,lifescience,medical A great deal of the enormous personal, social, and economic cost brought on by depression is due to poor social functioning, which has generally been underestimated. While there are differences among the various treatments available to achieve better social functioning, it must be recognized than an improvement in symptoms docs not necessarily Inhibitors,research,lifescience,medical ensure better functioning in society67 or at work.68 Factors affecting adherence The arsenal of antidepressants available is much larger today, and the new medications are as efficient as the old tricyclics and monoamine oxidase inhibitors (MAOIs), but with fewer side effects. Although information on the diagnosis and treatment Inhibitors,research,lifescience,medical of

depression has been publicized in the media, nonadherence to therapy continues to be a major problem. Little research has been done into the factors associated with noncompliance in treatment for affective disorders, and nonadherence in unipolar and bipolar disorders has been estimated to range from 10% to 60%.69,70 Adherence studies using patients’ self-reports show that patients tend to overestimate their compliance, especially older subjects.71 A patient’s beliefs Inhibitors,research,lifescience,medical about the illness, unpleasant side effects, ineffective treatment, and cultural factors arc all variables in noncompliance.72 Among teenagers prescribed imipramine, it was determined that the oppositional defiant

disorder and family dysfunction Inhibitors,research,lifescience,medical affected adherence to the medication, rather than the side effects.73 The latency period in the early stages of medication and poor tolerance Carnitine palmitoyltransferase II for antidepressants have an effect on compliance.74 In addition, the physician’s initial communication style significantly influences a patient’s attitude toward the usefulness of antidepressants.75 Patients’ attitudes and beliefs about the illness and treatment have proven to be as effective in predicting adherence as the unpleasant side effects of the drugs.69,70 Treatment with selective serotonin reuptake inhibitors (SSRIs) is abandoned less frequently than therapy with conventional and modern tricyclics, but the difference is small and is based on short-term, controlled, randomized trials. Therefore, in clinical practice, generalizations cannot be made about a greater adherence to SSRIs.

Each fetal head contained the appropriate number of appendages, a

Each fetal head contained the appropriate number of appendages, although the ears appeared disproportionately large for each head. Length and weight measurements were disproportionate for the fetus; the fetus weighed 690 g (26 weeks), the crown–rump length was 16 cm (20 weeks), the crown–heel length was selleck 28 cm (22 weeks), and the heel–toe length was 5 cm (28 weeks). Both the hands and the feet appeared disproportionately large for the fetus, as demonstrated by the assigned gestational age by heel–toe length. Examination of the internal organs revealed abnormalities

predominantly within the thoracic cavity. Hypoplasia of the lungs was evident, with the right lung weighing 2.5 g and the left lung weighing 5.3 g (normal 24 week fetus would have a 17 gram combined lung weight). Furthermore, the right lung demonstrated a rudimentary fourth lobe. An adherent 0.4 cm diameter focus of this website ectopic pancreas was noted along the adventitia of the distal esophagus. The only abdominal duplication involved the formation of a bifid gallbladder. All other abdominal organs appeared appropriate in size and orientation. Of note, an additional focus of ectopic pancreas formation was evident as an adherent 0.2 cm diameter nodule along the

greater curvature. Microscopic analysis revealed extramedullary hematopoiesis in the liver, and congestion of the spleen. A single kidney was present on the right and left side and demonstrated vascular congestion. Mild abnormalities of the pelvic organs were noted, including a uterus with constriction along the superior aspect of the fundus. The remainder of the thoracic, abdominal, and pelvic organs appeared normal in orientation, although in size corresponded to a variable gestational age of 22–28 weeks. To our knowledge there are no published reports of the use of three-dimensional ultrasonography in clarifying this nonviable form of conjoined twins, although first trimester diagnosis

[3] and the use of MRI [4] to assist has been described. Recent reports have shown the value in both 2D and 3D ultrasound in the first trimester to classify conjoined twins and allow earlier reproductive choices [5], [6], [7] and [8]. Classification of conjoined twins is paramount for guiding obstetrical management. Linifanib (ABT-869) Prenatal diagnosis can help guide decisions so that both fetal and maternal Modulators morbidity and mortality can be minimized. When considered as a whole, 75% of conjoined twins do not survive the first 24 h of life [9]. The fetal chance for survival has to be weighed against the potential surgical morbidity to the mother and feasibility of vaginal delivery [9]. In this case of non-viable conjoined twins, the use of 2D and 3D ultrasound correlated very closely with the postmortem autopsy report and measurement of the combined cephalic diameter allowed for a successful trial of vaginal delivery.

These intriguing findings

These intriguing findings suggest that further investigation is essential to address if mDia1 plays roles in human diabetic neuropathy. Perhaps the impact of mDia1 in this setting is RAGE independent; for example, these findings might suggest that mDia1 contribution to the neuropathy pathogenesis might be a result of its primary, rho-mediated cytoskeleton regulatory functions (Rose et al. 2005; Shinohara et al. 2012), and is complementary to RAGE-stimulated phosphorylation of Akt (protein kinase B)

and cell proliferation/migration observed in other cell types such as smooth muscle cells (Rai et al. 2012). More detailed studies have been designed to decipher the role and expression

Inhibitors,research,lifescience,medical of these proteins over long periods of time in the human Inhibitors,research,lifescience,medical peripheral nerve. Acknowledgments The authors would like to thank Ms. Latoya Woods for her excellent technical assistance with manuscript preparations (Diabetes Research Center, New York University Medical Center). Conflict of Interest None declared.
Asahara et al. (1997) described endothelial progenitor cells (EPC) in human peripheral blood. EPC are immature endothelial circulating cells mobilized from the bone marrow. These cells are involved in repairing the damaged Inhibitors,research,lifescience,medical endothelium and in facilitating neovascularization after ischemia (Asahara et al. 1997; Urbich and Dimmeler 2004; Fadini et al. 2007; Rouhl et al. 2008). The role of EPC in health and disease is not understood completely. Most studies of healthy subjects and patients with coronary artery disease (CAD) report that the number and function of circulating EPC decrease with age and with the presence of classical

vascular risk factors (Hristov Inhibitors,research,lifescience,medical and Weber 2004; Fadini et al. 2007). Also, EPC levels (counts) increase after an ischemic event and a low number of EPC predict a higher frequency of vascular events during follow-up in healthy subjects (Hill et al. 2003) and in patients with CAD (Werner et Inhibitors,research,lifescience,medical al. 2005). These studies suggest that EPC play an important role in the risk of vascular events and in vascular Levetiracetam homeostasis. EPC counts have not been studied frequently in patients with ischemic stroke, and the results are conflicting. Some studies (Ghani et al. 2005; Chu et al. 2008; Zhou et al. 2009) reported lower counts of EPC in patients in the acute stage of ischemia compared to controls, while other studies (Dunac et al. 2007; Yip et al. 2008, 2011; Navarro-Sobrino et al. 2010) reported the opposite. Moreover, higher EPC levels have been associated with a favorable short and long-term outcome in some studies (Sobrino et al. 2007; Yip et al. 2008; Taguchi et al. 2009). Unfortunately, these investigations did not focus on the variables associated with the EPC counts and did not evaluate the significance of stroke etiology.

Modelling has been used to extrapolate outbreak and experimental

Modelling has been used to extrapolate outbreak and experimental virus transmission data to predict vaccine-based control in the field. This predicts that if vaccination is optimised and clinical surveillance effectively removes herds with diseased animals, then the number of undisclosed infected herds and animals should be small with few carriers [43], [44] and [45]. Undetected infected

animals would be found mainly in non-vaccinated sheep Icotinib research buy herds and vaccinated cattle and sheep herds. However, after serosurveillance, carried out according to the EU Directive, vaccination and pre-emptive culling strategies yielded comparable low numbers of undetected infected selleck kinase inhibitor animals [45]. Schley et al. emphasised that following effective vaccination, the quality of inspection is the principal factor influencing whether or not undisclosed carrier herds occur, supporting the importance of other control

measures [44]. Further studies are required to model virus Libraries persistence in vaccinated populations through transmission from acutely infected animals, rather than from carrier animals, as the former represent a more significant risk for new FMD outbreaks [12]. NSP serosurveillance of a large number of animals will give rise to many false positive test reactors, since the tests have imperfect specificity (Sp of 98–99.7% for cattle; [41]) and Se/Sp limitations cannot be overcome easily by using a combination of different NSP tests [46]. Furthermore, true positive test results cannot be distinguished readily from false positive ones [47], although a cluster analysis [48] and the use of likelihood ratios to weight the strength of seroconversion might improve the possible discrimination [49]. This makes classification of the infection status of large herds difficult. Arnold et al. concluded that in this situation, the best compromise between maximising the sensitivity for carrier detection, whilst minimising unnecessary culling,

will be met by adopting an individual-based testing regime in which all animals in all vaccinated herds are tested and positive animals rather than herds are culled Thalidomide [43]. The remaining risk with this approach is that any carriers that are missed will be free to move to unvaccinated herds on national territory once outbreak restrictions are lifted and those non-vaccinated animals may be traded. Requirements for recovering the FMD-free status where vaccination is not practised are laid out in the OIE Terrestrial Animal Health Code (Supplementary Table 1; [19]) and for EU Member States in the EU FMD Directive [9]. With stamping out (culling) of affected herds and suitable surveillance, the FMD-free status can be regained 3 months after the last case.

In general, the TCAs are distinguished by anticholinergic and ant

In general, the TCAs are distinguished by anticholinergic and antihlstamlc effects (Table V).36,41 Drug Interaction with TCAs and other medications affecting the hepatic enzyme (CYP 2D6) can lead to significantly altered TCA plasma levels. MAOIs are used sparingly, partly because of concern with hypertensive crises, as well

as their interaction with Inhibitors,research,lifescience,medical other prescribed medications and beer, red wine, and foodstuffs rich in the amino acid tyramine, such as aged cheese and liver. Clinical experiences in the last 15 years have shown that the SSRIs are relatively safe, but their adverse effect profile may not be the same across the entire class. While the efficacy and adverse effect profile should be considered in selecting among the SSRIs, in usual practice these drugs do not differ dramatically in efficacy from each other or from the older classes of antidepressants. Inhibitors,research,lifescience,medical The adverse effects that most frequently influence patients’ decisions to discontinue treatment are sexual dysfunction and weight gain. In inpatient Inhibitors,research,lifescience,medical settings, TCAs are still often used as first-line treatment. Not all SSRI (eg, citalopram and sertraline) have a high degree of drug-drug interaction via the cytochrome P450 (CYP) system. While nausea, sedation, appetite change, and sexual dysfunction seem approximately similar for the SSRI class, claims Inhibitors,research,lifescience,medical for reduced adverse effects on sexual

functioning have been made for fluvoxamine (only approved by the FDA for obsessive-compulsive disorder),42

as have claims for reduced discontinuation effects for fluoxetine.43 Finally, the high degree of comorbidity of depression and cigarette consumption needs to be fully understood. Tobacco smoking can induce CYP enzyme changes affecting blood levels of various antidepressants, as well as complicate drug management when Inhibitors,research,lifescience,medical smoking cessation occurs.44 Table V Adverse effects of antidepressants.36-41 SSRl, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant; NSRI, noradrenaline and serotonin reuptake inhibitor; MAOI, science monoamine oxidase inhibitor; AMX, amoxapine; DOX, doxepine; IMI, imipramine; … Depression across the life span While some aspects of the symptom picture may change across the life span, the core features of depression are recognizable. In children and adolescents, depression is not always characterized by BIBF 1120 mw sadness, but instead by irritability, boredom, or an inability to experience pleasure. Depression is present in about 1% of children and 5% of adolescents at any given time.45 Before puberty, boys and girls are at equal risk for depression, whereas after the onset of puberty, the rate of depression is about twice as high in girls. While prepubertal depression is less prevalent than postpubertal depression, appropriate management at any age for major depression is recommended.

My experience is that many Turks want very much to go back to Tur

My experience is that many Turks want very much to go back to Turkey to get a second opinion there and I don’t think that’s a bad thing at all. I can imagine very well how they feel (GP of Turkish male patient). Generally, care providers understand this choice and help to bring it about. But they do find the advice and intervention of their Turkish colleagues sometimes confusing as well, as they often recommend a more curative policy. Sometimes care providers can see that a trip like this is going to disrupt the treatment in the Netherlands.

If they believe that the plan is irresponsible, then they try to persuade the family Inhibitors,research,lifescience,medical that they should stay in the Netherlands. Then the daughters said that

he should go to Morocco, because he would be treated there and he could die there too. I said, ‘You decide, but I don’t know Inhibitors,research,lifescience,medical what the 3-MA supplier medical and palliative care is like there’. I gave a brief outline of what I as their GP could do, together with the hospital, with pain relief and in the Inhibitors,research,lifescience,medical case of mental confusion. And that I was worried about what it would be like in Morocco. Then, after a while, they decided to stay here after all (GP of Moroccan male patient). Often the extra attention and information result in the family making a joint decision to stay in the Netherlands or to postpone the trip. But it can also happen that any discussion of their choice appears Inhibitors,research,lifescience,medical impossible, as their desire to go back to their

own country is so overwhelming that any objections on the part of the care provider are simply not heard. I didn’t get a ‘fit-to-fly’ recommendation, and then the ambulance won’t take him to Schiphol (airport) because the airline probably won’t take him. The family was very angry; they had already bought a ticket for him. Then we decided to take the man off our books. We removed the oxygen. That was OK. Then we started using morphine plasters instead of the morphine Inhibitors,research,lifescience,medical pump. I found out for them which ambulance taxi they could call. The sister had told met that he was taken into hospital in Turkey and put on a drip and that the doctors said he would get better, but he died anyway (cancer nurse of Turkish male patient). If the aim of the journey is to take leave of 3-mercaptopyruvate sulfurtransferase important family members, but the journey is impossible because of the patient’s poor health, then care providers are sometimes prepared to help with bringing over Turkish or Moroccan relatives to the Netherlands. This could be by writing a recommendation for a visa, for example, or actively interceding with various funds to get the expenses of the trip paid for. Burial in the country of origin The care providers involved generally know that those of their patients with a Turkish or Moroccan background must be laid out after death according to Muslim rituals and that they generally want to be buried in Turkey or Morocco.