Critical dialogical approach: A methodological direction for occupation-based social transformative work

Background: Calls for embracing the potential and responsibility of occupational therapy to address socio-political conditions that perpetuate occupational injustices have materialized in the literature. However, to reach beyond traditional frameworks informing practices, this social agenda requires the incorporation of diverse epistemological and methodological approaches to support action commensurate with social transformative goals. Aim: Our intent is to present a methodological approach that can help extend the ways of thinking or frameworks used in occupational therapy and science to support the ongoing development of practices with and for individuals and collectives affected by marginaliz- ing conditions. Method: We describe the epistemological and theoretical underpinnings of a methodological approach drawing on Freire and Bakhtin ’ s work. Results: Integrating our shared experience taking part in an example study, we discuss the unique advantages of co-generating data using two methods aligned with this approach; dialogical interviews and critical reflexivity. Discussion: Key considerations when employing this approach are presented, based on its proposed epistemological and theoretical stance and our shared experiences engaging in it. Significance: A critical dialogical approach offers one way forward in expanding occupational therapy and science scholarship by promoting collaborative knowledge generation and examin- ation of taken-for-granted understandings that shape individuals assumptions and actions

Mapping In Vivo Tumor Oxygenation within Viable Tumor by 19F-MRI and Multispectral Analysis

AbstractQuantifying oxygenation in viable tumor remains a major obstacle toward a better understanding of the tumor microenvironment and improving treatment strategies. Current techniques are often complicated by tumor heterogeneity. Herein, a novel in vivo approach that combines 19F magnetic resonance imaging (19F-MRI)R1 mapping with diffusionbased multispectral (MS) analysis is introduced. This approach restricts the partial pressure of oxygen (pO2) measurements to viable tumor, the tissue of therapeutic interest. The technique exhibited sufficient sensitivity to detect a breathing gas challenge in a xenograft tumor model, and the hypoxic region measured by MS 19F-MRI was strongly correlated with histologic estimates of hypoxia. This approach was then applied to address the effects of antivascular agents on tumor oxygenation, which is a research question that is still under debate. The technique was used to monitor longitudinal pO2 changes in response to an antibody to vascular endothelial growth factor (B20.4.1.1) and a selective dual phosphoinositide 3-kinase/mammalian target of rapamycin inhibitor (GDC-0980). GDC-0980 reduced viable tumor pO2 during a 3-day treatment period, and a significant reduction was also produced by B20.4.1.1. Overall, this method provides an unprecedented view of viable tumor pO2 and contributes to a greater understanding of the effects of antivascular therapies on the tumor's microenvironment

Dual function filtration and catalytic breakdown of organic pollutants in wastewater using ozonation with titania and alumina membranes

Water recycling via treatment from industrial and/or municipal waste sources is one of the key strategies for resolving water shortages worldwide. Polymer membranes are effective at improving the water quality essential for recycling, but depend on regular cleaning and replacement. Pure ceramic membranes can reduce the cleaning need and last significantly longer in the same applications while possessing the possibility of operating in more aggressive environments not suitable for polymers. In the current work, filtration using a tubular ceramic membrane (�-Al2O3 or TiO2) was combined with ozonation to remove organic compounds present in a secondary effluent to enhance key quality features of the water (colour and total organic carbon, TOC) for its potential reuse. ‘Bare’ commercial �-Al2O3 filters (pore size ∼0.58 �m) were tested as a microfiltration membrane and compared with the more advanced catalytically active TiO2 layer that was formed by the sol–gel method. The presence of anatase with a 4 nm pore size at the membrane surface was confirmed by X-ray diffraction (XRD) and N2 adsorption. Filtration of the effluent over a 2 h period led to a reduction in flux to 45% and 60% of the initial values for the �-alumina and TiO2 membrane, respectively. However, a brief dose (2 min) of ozone at the start of the run resulted in reductions to only 70% of the initial flux for both membranes. It is likely that the oxide’s functional property facilitated the formation of hydroxyl (OH•) or other radicals on the membrane surface from ozone decomposition which targeted the breakdown of organic foulants thus inhibiting their deposition. Interestingly, the porous structure therefore acted in a synergistic, dual function mode to physically separate the particulates while also catalytically breaking down organic matter. The system also greatly improved the efficiency of membrane filtration for the reduction of colour, A254 (organics absorption at the wavelength of 254 nm) and TOC. The best performance came from combined ozonation (2 min ozonation time with an estimated applied ozone dose of 8 mg L−1) with the TiO2 membrane, which was able to reduce colour by 88%, A254 by 75% and TOC by 43%. It is clearly evident that a synergistic effect occurs with the process combination of ozonation and ceramic membrane filtration demonstrating the practical benefit of combining ceramic membrane filtration with conventional water ozonation

Alberta Diabetes and Physical Activity Trial (ADAPT): A randomized theory-based efficacy trial for adults with type 2 diabetes - rationale, design, recruitment, evaluation, and dissemination

Background: The primary aim of this study was to compare the efficacy of three physical activity (PA) behavioural intervention strategies in a sample of adults with type 2 diabetes. Method/Design: Participants (N = 287) were randomly assigned to one of three groups consisting of the following intervention strategies: (1) standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group)]; (2) standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2); and (3) PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3). PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up). Clinical (biomarkers) and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM) analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1. Discussion: ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population

How the redox state regulates immunity

Oxidative stress is defined as an imbalance beween the levels of reactive oxygen species (ROS) and antioxidant defences. The view of oxidative stress as a cause of cell damage has evolved over the past few decades to a much more nuanced view of the role of oxidative changes in cell physiology. This is no more evident than in the field of immunity, where oxidative changes are now known to regulate many aspects of the immune response, and inflammatory pathways in particular. Our understanding of redox regulation of immunity now encompasses not only increases in reactive oxygen and nitrogen species, but also changes in the activities of oxidoreductase enzymes. These enzymes are important regulators of immune pathways both via changes in their redox activity, but also via other more recently identified cytokine-like functions. The emerging picture of redox regulation of immune pathways is one of increasing complexity and while therapeutic targeting of the redox environment to treat inflammatory disease is a possibility, any such strategy is likely to be more nuanced than simply inhibiting ROS production

Th17 Cells at the Crossroads of Autoimmunity, Inflammation, and Atherosclerosis

The connection between inflammation, autoimmunity, and atherosclerosis is long established. In this issue of Immunity, Lim et al. (2014) demonstrate that oxidized low-density lipoprotein is one of the key environmental factors driving the development of inflammatory T helper 17 cells in atherosclerosis

Creating a think tank for occupation-based social transformation

Summary of the Workshop: The convenors of this workshop recognise the context of contemporary Europe, including: •The hardening political climate •The economy and the limitations to health and social care provided by state organisations •Expanded understandings of health that incorporate the impact of social determinants on inequal- ities of health •Societal and cultural changes including demographics and the ageing population •The increasing mobility of populations including that of refugees •The strengthening of social accountability by citizen participation in practice, education and re- search (although with considerable regional and cultural variation) We also recognise the beginnings of a shift within occupational therapy education, practice and research towards addressing these challenges. As a result we see the need for critical analysis and conceptual development that will provide coherent foundations for ongoing developments around occupation-based social transformation. The objective of the workshop is the development of a think tank to work on these issues. This workshop will be an initial forum for interested people to engage in discussion and debate, and to prepare an agenda for the ongoing work of the think tank, with final output a publication. Critical questions will be introduced by the convenors, which participants may use to guide debate. Maximum number of participants: 20 Brief description of intended participants: This workshop is suitable for those wishing to engage in such conceptual development addressing current and future challenges in education, practice and research

Inhibition of VEGF-C modulates distal lymphatic remodeling and secondary metastasis.

Tumor-associated lymphatics are postulated to provide a transit route for disseminating metastatic cells. This notion is supported by preclinical findings that inhibition of pro-lymphangiogenic signaling during tumor development reduces cell spread to sentinel lymph nodes (SLNs). However, it is unclear how lymphatics downstream of SLNs contribute to metastatic spread into distal organs, or if modulating distal lymph transport impacts disease progression. Utilizing murine models of metastasis, longitudinal in vivo imaging of lymph transport, and function blocking antibodies against two VEGF family members, we provide evidence that distal lymphatics undergo disease course-dependent up-regulation of lymph transport coincidental with structural remodeling. Inhibition of VEGF-C activity with antibodies against VEGF-C or NRP2 prevented these disease-associated changes. Furthermore, utilizing a novel model of adjuvant treatment, we demonstrate that antagonism of VEGF-C or NRP2 decreases post SLN metastasis. These data support a potential therapeutic strategy for inhibiting distant metastatic dissemination via targeting tumor-associated lymphatic remodeling