Botulinum Toxin A for the Treatment of Keloids

Introduction: Keloids are the result of excessive scar tissue formation. Besides their poor aesthetic appearance, keloids can be associated with severe clinical symptoms such as pain, itching, and rigidity. Unfortunately, most therapeutic approaches remain clinically unsatisfactory. Recently, injections with botulinum toxin A (BTA) were proposed for the treatment of established keloids in a clinical trial. In this study, we aimed to verify the effects of intralesional BTA for the treatment of therapy-resistant keloids using objective measurements. In addition, the underlying molecular mechanisms were investigated using cultured keloid-derived fibroblasts. Materials and Methods: Four patients received BTA (doses varying from 70 to 140 Speywood units per session) injected directly into their keloids every 2 months for up to 6 months. Differences in height and volume were evaluated clinically and measured with a 3-D optical profiling system. Keloid-derived fibroblasts were treated with different concentrations of BTA, and expression of collagen (COL)1A1, COL1A2, COL3A1, TGF-beta 1, TGF-beta 2, TGF-beta 3, fibronectin-1, laminin-beta 2, and alpha-SMA was determined by real-time quantitative PCR. MTT and BrdU assays were used to analyze the effects of BTA on fibroblast proliferation and metabolism. Results: Intralesional administration of BTA did not result in regression of keloid tissue. No differences in expression of ECM markers, collagen synthesis, or TGF-beta could be observed after BTA treatment of keloid fibroblasts. In addition, cell proliferation and metabolism of keloid fibroblasts was not affected by BTA treatment. Conclusion: The suggested clinical efficiency of intralesional BTA for the therapy of existent keloids could not be confirmed in this study. Based on our data, the potential mechanisms of action of BTA on keloid-derived fibroblasts remain unclear. Copyright (C) 2012 S. Karger AG, Base

Occupational Disruption and Natural Disaster: Finding a ‘New Normal’ in a Changed Context

Individuals affected by natural disasters can undergo critical life changes throughout the recovery process. With a forecast increase in frequency and impact of natural disasters, it is important to consider the occupational recovery process that individuals experience post-disaster. This qualitative descriptive study explored the experience of occupational disruption and occupational recovery of individuals after Cyclone Yasi struck a small, regional town in Northern Queensland, Australia. Nine semi-structured interviews from long-term residents of the town affected by Cyclone Yasi were conducted 2 years after the event. Interviews were recorded, transcribed verbatim and independently coded using thematic analysis by three researchers. Five interrelated themes were identified: Recovery occupations; Interruption to leisure and productive occupations; Reconstruction: A second disaster; Occupational liminality and A new normal. These themes point to a phased process of occupational recovery through which disaster survivors encounter numerous personal and contextual barriers, encumbering their return to re-engagement in meaningful occupational routines. The findings from this research offer insights into the support needs of both individuals and communities as they endeavour to overcome challenges associated with the recovery process

Die Wirksamkeit von Medienbildungsinitiativen: Erfolge, Probleme und Lösungsansätze

Neben der Persönlichkeitsbildung obliegt der Schule ein Qualifizierungsauftrag (KMK 2012, 3). Im Zusammenhang dieses Auftrags, Schülerinnen und Schüler auf das (Berufs-) Leben vorzubereiten, hielten digitale Medien Einzug in nahezu alle Schulformen. Dort sollen sie neben der Förderung der Medienkompetenz in allen ihren Ausprägungen auf Seiten der Schülerinnen und Schüler, zudem die Lehr- und Lernkultur verbessern. Mit Hilfe landes- und städteweiter Initiativen wird dabei die Medienintegration und konkrete Mediennutzung vorangetrieben, wie bspw. durch die Medienbildungsinitiative der Stadt Frankfurt am Main, deren Erfolge, Probleme und Lösungsansätze nach zehnjährigem Bestehen in diesem Artikel betrachtet werden. Ziel war es dabei, den aktuellen Entwicklungsstand, noch bestehende Probleme und vor allem deren mögliche Lösung aus Perspektive der Lehrkräfte darzustellen. Insgesamt wurden Mängel bei der IT-Infrastruktur, den mediendidaktischen Unterstützungsangeboten und hinderliche organisatorische Rahmenbedingungen identifiziert

Physiotherapy Students’ Experiences of Role Emerging Placements; a Qualitative Study

Role emerging placements (REPs) have been firmly embedded into undergraduate occupational therapy curricula for a number of years. REPs aim to facilitate the development of essential professional skills to prepare students for an increasingly diverse and evolving workplace. The Chartered Society of Physiotherapy (CSP) has also emphasized the importance of adequately preparing graduates for new and emerging areas of practice. To date, however, there has been no published research exploring the use of REPs in physiotherapy. This study aimed to explore the experiences of undergraduate physiotherapy students who had each undertaken a REP. Six participants volunteered to take part in a focus group which used a research informed semi-structured topic guide. Group discussions were digitally recorded and professionally transcribed verbatim. Thematic analysis of the data revealed five main themes: (1) Establishing a Physiotherapy Role Independently; (2) Finding a Voice and Influencing Change; (3) Developing Professional Identity; (4) Professional Development and (5) Support. The findings highlighted the variability of student experiences in REP settings, both positive and negative. However, all appeared to result in professional and personal benefits for the students, through promoting graduate attributes and skills that may be attractive to employers

A multi-pronged empirical approach to mobile privacy investigation

We describe the design of three empirical studies planned as part of an investigation into privacy when mobile. The studies exemplify complementary investigation strands, whose aim is to uncover the multi-faceted nature of privacy for mobile computing applications

Occupational Wellbeing of People Experience Homelessness: Survival, Self Identity and Socialisation

Introduction A growing area of for the occupational therapy profession is the needs of people experiencing occupational injustice within our societies. Distinct from social justice, occupational justice focuses on ‘occupational equity, occupational fairness, occupational empowerment, occupational rights and responsibilities, occupational enablement, expression and opportunity, occupational satisfaction and occupational wellbeing’ (Wilcock, 2006, p. 247). Objectives This study aimed to understand the occupations of people experiencing homelessness and to contribute to occupational perspectives of health through exploring occupations that influence subjective perspectives of well-being in for people experiencing homelessness. Method This constructivist case study explored the lived experience of people who were homeless using observation and interviews with consumers of homeless services. A strengths-based approach to data collection prioritised the voices of participants and elicited situated accounts of occupations of meaning. Results Thirty-five in-depth conversational interviews explored the strengths, resilience, agency and capacity of participants to sustain wellbeing during homelessness. People who are homeless aim to achieve and sustain subjective wellbeing through occupation of survival, self identity and socialisation. Limited opportunities for occupational engagement due to poverty and marginalisation result in situations of occupational injustice for people experiencing homelessness. Conclusion Despite limited occupational opportunity resulting in occupational injustice, acts of personal autonomy and agency guard against descending into despair and afford a sense of satisfaction with life. Contribution to the practice/evidence base of occupational therapy An occupational perspective of subjective wellbeing is supported by this study, which challenges the appropriateness of universal definitions of wellbeing for all. Interpretive findings propose an expansion of the theoretical basis of occupational justice. The multiple meanings of human occupation are intricately affected and shaped by the social and cultural context and consistent with the gendered and cultural norms. Refs Wilcock, A. (2006). An Occupational Perspective of Health (2nd Ed). Slack: Thoroughfare