Development of a Decellularized Hydrogel Composite and its Application in a Novel Model of Disc-associated Low Back Pain in Female Sprague Dawley Rats

Chronic low back pain is a global socioeconomic crisis compounded by an absence of reliable, curative treatments. The predominant pathology associated with chronic low back pain is degeneration of intervertebral discs in the lumbar spine. During degeneration, nerves can sprout into the intervertebral disc tissue and be chronically subjected to inflammatory and mechanical stimuli, resulting in pain. Pain arising from the intervertebral disc, or disc-associated pain, is a complex, multi-faceted disorder which necessitates valid animal models to screen therapeutics and study pathomechanisms of pain. While many research teams have created animal models of disc degeneration, the translation of these platforms to disc-associated pain models has been limited by an absence of chronic pain-like behavior. Further, the few models which measure disc-associated pain-like phenotypes have been established in mice, which are not amenable to surgical treatment procedures due to their small size. This deficiency drives the need for a new model of disc-associated pain where pain-like behavior is measurable and intervertebral discs are large enough for surgical procedures. These criteria promote rats as the optimal platform for a disc-associated model of chronic low back pain. Herein, a rat model of disc-associated pain is described that displays chronic pain-like behavior, overt disc degeneration, and nerve sprouting in the intervertebral disc. In addition to the model, a novel method for measuring disc degeneration real-time, non-invasively, is delineated which exhibits remarkable precision and accuracy. Finally, a next generation treatment, derived from decellularized, porcine nucleus pulposus tissue is described which is injectable, thermally fibrillogenic, and cytocompatible. In the rat model of disc-associated pain, this biomaterial restores degenerated disc volume and dramatically decreases pain-like behavior. In summary, this dissertation describes the development of a method for quantifying degeneration real-time, establishes a rat model of disc-associated pain, and successfully treats disc-associated pain in this model with a next-generation biomaterial. Advisor: Rebecca Wach

An Action Research Study Engaging in the Use of Storyboarding as Research-based Approach to Teaching to Identify Issues Faced when Working with People with Dementia from Minority Ethnic Communities

The common view that research informs teaching assumes a linear approach whereby teaching is considered an output of research. This paper reports the findings of an action research project that identified the issues and challenges faced by those working across health and social care when working with people with dementia from minority ethnic communities. It explored the research-teaching nexus by using an approach to teaching that was research-based as opposed to research-led. A storyboarding technique was used which involved identifying and dissecting real life experiences for discussion. The realisation that each story was unique to the individual demonstrated the benefits and importance of education and training for applying a person-centred approach to dementia care. This project also revealed the benefits of actively engaging course participants with research moving them from being recipients of research, to research- active. Such a process not only encouraged their intrinsic motivations but, also, critical thinking and reflective practice to support deep learning. Such findings demonstrate the benefits of linking teaching with research

Preliminary Results of an International Study Exploring and Comparing Positive Aspects and Concerns of Growing Older in Different Societies

This paper aims to gain an understanding and insight into the older person’s experiences and perceptions of growing older within their own societies in relation to their independence, choice and decision making. In an attempt to identify what is happening in different countries and cultures and to share these experiences, attitudes and perceptions from older people, this study asked people from three developing countries (Tanzania, Indonesia and Peru), from three different continents, to take part in this study

Laying Down the Foundations for International Student Journey. Students as Academic Partners Project Report.

The aim of this project was to explore the lived experiences of being an international student studying at a University within the UK and to make recommendations for future provision. There are increasing numbers of international students studying at Universities within the UK. Positive learning environments and arrangements are the responsibility of the host University and international students’ needs should be taken into consideration. This project was led by international students in collaboration with academic staff. It involved a qualitative exploration of international student perspectives and their experiences of studying within the UK. Ten international students completed a questionnaire that was designed by international students. Respondents were asked questions in relation to three areas: coming to the UK, arriving in the UK and studying in the UK

Poetry With People With Dementia: An Evaluation of a Two Year Project Engaging in Poetry Activities With Older People in Residential and Nursing Homes.

This paper is a summary of an evaluation of the first two years of a three year poetry project for older people with dementia. The project was set up with a poet in residence who mentored six poets to deliver poetry activities to older people and those with dementia in residential and care homes in Herefordshire. The project was developed and run by the Courtyards Hereford. The evaluation was undertake through the use of questionnaires that were given to staff and carers undertaking training workshops and the poets, staff and carers in the homes who facilitated the activities and finally by the residents who took part in the project. The main findings were that participants that responded to the questionnaire for staff and carers it had increased confidence and assisted them in gaining more knowledge about the residents, whilst for residents it had a number of positive effects including enhanced communication, increased self-esteem and enhanced self-worth whilst making them feel less isolated

I Must Do the Post - Using Poetry for Raising Dementia Awareness

This paper reviews the use of a poem written by a care assistant as part of a dementia awareness course. the author of the poem went on to use the poem to help staff within the care home gain an insight and to promote reflection and discussion about caring for the person living with dementia as part of a training programme. an evaluation of its use was a also undertaken and staff reported that this poem was thought provoking, insightful and had helped them to reflect on how they work with people living with dementia

Injectable decellularized nucleus pulposus tissue exhibits neuroinhibitory properties

Background: Chronic low back pain (LBP) is a leading cause of disability, but treatments for LBP are limited. Degeneration of the intervertebral disc due to loss of neuroinhibitory sulfated glycosaminoglycans (sGAGs) allows nerves from dorsal root ganglia to grow into the core of the disc. Treatment with a decellularized tissue hydrogel that contains sGAGs may inhibit nerve growth and prevent discassociated LBP. Methods: A protocol to decellularize porcine nucleus pulposus (NP) was adapted from previous methods. DNA, sGAG, α-gal antigen, and collagen content were analyzed before and after decellularization. The decellularized tissue was then enzymatically modified to be injectable and form a gel at 37oC. Following this, the mechanical properties, microstructure, cytotoxicity, and neuroinhibitory properties were analyzed. Results: The decellularization process removed 99% of DNA and maintained 74% of sGAGs and 154% of collagen compared to the controls NPs. Rheology demonstrated that regelled NP exhibited properties similar to but slightly lower than collagen-matched controls. Culture of NP cells in the regelled NP demonstrated an increase in metabolic activity and DNA content over 7 days. The collagen content of the regelled NP stayed relatively constant over 7 days. Analysis of the neuroinhibitory properties demonstrated regelled NP significantly inhibited neuronal growth compared to collagen controls. Conclusions: The decellularization process developed here for porcine NP tissue was able to remove the antigenic material while maintaining the sGAG and collagen. This decellularized tissue was then able to be modified into a thermally forming gel that maintained the viability of cells and demonstrated robust neuroinhibitory properties in vitro. This biomaterial holds promise as an NP supplement to prevent nerve growth into the native disc and NP in vivo