Editorial

To say that working on this issue of Migration and Society has been a challenge would be an understatement. For all of us, from the members of the editorial team to our guest editors, contributors, ever-important reviewers, and the publishing team, 2020 has brought significant barriers. We have feared for the safety of our loved ones; grieved unbearable losses, often from afar; faced different forms of containment; and sought to, somehow, find the time and energy to care for our loved ones, our selves, and one another while navigating unsustainable work commitments and responsibilities

An Intensive, Interdisciplinary Treatment Program for Persons with Aphasia

Traditionally, much of individual aphasia therapy has been focused on attempts to remediate underlying linguistic deficits. While many treatments have been shown to improve discrete language functions (Robey et al, 1998), those newly learned skills do not always transfer readily to non-trained environments. Over the past two decades, a growing number of aphasiologists have begun to focus their attention on social approaches to aphasia assessment and treatment (Elman, 2007). One such approach, group treatment, serves as a natural and dynamic vehicle to improve social communication, which has been shown to improve discrete language skills in persons with aphasia (pwa), (Elman & Bernstein-Ellis, 1999). Group treatment frequently co-occurs with individual therapy, but is rarely used as a formal mechanism to train generalization. Another area of broad discussion in aphasia rehabilitation is the concept of treatment intensity. Basso (2005) reported that pwa who received a higher number of therapy sessions improved more than those who received a lower number of therapy sessions. Bhogal et al (2003) found that treatment provided on a more intense level (>8.8 hours/week) for a shorter period of time resulted in stronger improvements compared to treatment provided on a less intense level over a longer period of time. A final issue is that individuals with stroke-induced aphasia often present with concomitant motor, cognitive and dietary/cardiac issues. Thus it seems that an interdisciplinary approach incorporating physical, occupational and nutritional therapy would also be beneficial. This paper explores the speech-language effects of a treatment program, which attempts to incorporate evidenced-based treatment, in an intensive, interdisciplinary format. Pilot data from an initial cohort completed June 2011 as well as multiple-baseline data from a second cohort completed June 2012 is presented

Typicality-based Differences in Treatment of Naming Deficits

Two anomic patients completed feature-based naming treatment using typical and atypical words in two different categories. One patient learned typical words but not atypical words; the other patient showed the opposite pattern of learning. No generalization to untrained words within the same category occurred. These findings argue against the use of atypical words in anomia treatment (Kiran & Thompson, 2003). Both patients demonstrated normal typicality effects during online category verification. Typicality-based differences in treatment outcomes are explained in terms of increased semantic interference for typical words, and decreased controlled selection in anterior aphasics

Effects of Syntactic Complexity in Discourse Comprehension

This study aimed to evaluate the effects of syntactic complexity in discourse comprehension in persons with aphasia (pwa) and age-matched controls.  Data suggest that syntactic complexity does influence processing at the discourse level and that heuristic processing alone is not enought to compensate for syntactic processing demands in disourcse.  Results also showed that the Test of Syntacitc Effects in Discourse Comprehension (Levy et al, 2010) is sensitive to syntactic complexity in a way that the Discourse Comprehension Test-Revised (Brookshire and Nicholas, 2008) is not

“Body bags ready”: Print media coverage of avian influenza in Australia

In 2006 the avian influenza A (H5N1) virus received considerable media coverage in Australia, as it did in many other countries. It is often argued that the media sensationalizes health crises, and experts cautioned about the risk of panic as a result of fear of avian influenza. The purpose of the present study was to systematically analyze Australian print media coverage of avian influenza in 2006 and to examine whether this coverage served the purpose of informing, rather than alarming, the general public. For the period January 1, 2006 to December 31, 2006, 20 Australian newspaper titles were monitored for coverage of avian influenza. The identified articles were analyzed using aspects of protection motivation theory for theoretical direction to determine whether there were any consistent themes or perspectives in the coverage. A total of 850 articles were identified for analysis. Concerning vulnerability, 46% of articles reported the incidence of human cases, with 24% noting that avian influenza was a potential threat to Australia. The most common severity theme was “deadly” with over 50% of mentions, followed by “pandemic” with 35%. Only 11% of articles referred to any form of self-protection. We found that a considerable proportion of the articles reporting on avian influenza were framed in a way that had the potential to incite fear and panic amongst the public; the intensity of media coverage reduced over time; and, of particular concern, that there was little media coverage that focused on protective or preventative issues. Whether an influenza pandemic eventuates or not, it is prudent for governments and health authorities to continually develop appropriate resources and strategies to prepare the health system and the general public to respond to current, and future, infectious disease risks

Mathematical modelling of fibre-enhanced perfusion inside\ud a tissue-engineering bioreactor

We develop a simple mathematical model for forced flow of culture medium through a porous scaffold in a tissue- engineering bioreactor. Porous-walled hollow fibres penetrate the scaffold and act as additional sources of culture medium. The model, based on Darcy’s law, is used to examine the nutrient and shear-stress distributions throughout the scaffold. We consider several configurations of fibres and inlet and outlet pipes. Compared with a numerical solution of the full Navier–Stokes equations within the complex scaffold geometry, the modelling approach is cheap, and does not require knowledge of the detailed microstructure of the particular scaffold being used. The potential of this approach is demonstrated through quantification of the effect the additional flow from the fibres has on the nutrient and shear-stress distribution

A growth hormone receptor SNP promotes lung cancer by impairment of SOCS2-mediated degradation

Both humans and mice lacking functional growth hormone (GH) receptors are known to be resistant to cancer. Further, autocrine GH has been reported to act as a cancer promoter. Here we present the first example of a variant of the GH receptor (GHR) associated with cancer promotion, in this case lung cancer. We show that the GHRP495T variant located in the receptor intracellular domain is able to prolong the GH signal in vitro using stably expressing mouse pro-B-cell and human lung cell lines. This is relevant because GH secretion is pulsatile, and extending the signal duration makes it resemble autocrine GH action. Signal duration for the activated GHR is primarily controlled by suppressor of cytokine signalling 2 (SOCS2), the substrate recognition component of the E3 protein ligase responsible for ubiquitinylation and degradation of the GHR. SOCS2 is induced by a GH pulse and we show that SOCS2 binding to the GHR is impaired by a threonine substitution at Pro 495. This results in decreased internalisation and degradation of the receptor evident in TIRF microscopy and by measurement of mature (surface) receptor expression. Mutational analysis showed that the residue at position 495 impairs SOCS2 binding only when a threonine is present, consistent with interference with the adjacent Thr494. The latter is key for SOCS2 binding, together with nearby Tyr487, which must be phosphorylated for SOCS2 binding. We also undertook nuclear magnetic resonance spectroscopy approach for structural comparison of the SOCS2 binding scaffold Ile455-Ser588, and concluded that this single substitution has altered the structure of the SOCS2 binding site. Importantly, we find that lung BEAS-2B cells expressing GHRP495T display increased expression of transcripts associated with tumour proliferation, epithelial–mesenchymal transition and metastases (TWIST1, SNAI2, EGFR, MYC and CCND1) at 2 h after a GH pulse. This is consistent with prolonged GH signalling acting to promote cancer progression in lung cancer

An archaeal family-B DNA polymerase variant able to replicate past DNA damage: occurrence of replicative and translesion synthesis polymerases within the B family

A mutant of the high fidelity family-B DNA polymerase from the archaeon Thermococcus gorgonarius (Tgo-Pol), able to replicate past DNA lesions, is described. Gain of function requires replacement of the three amino acid loop region in the fingers domain of Tgo-Pol with a longer version, found naturally in eukaryotic Pol zeta (a family-B translesion synthesis polymerase). Inactivation of the 3'–5' proofreading exonuclease activity is also necessary. The resulting Tgo-Pol Z1 variant is proficient at initiating replication from base mismatches and can read through damaged bases, such as abasic sites and thymine photo-dimers. Tgo-Pol Z1 is also proficient at extending from primers that terminate opposite aberrant bases. The fidelity of Tgo-Pol Z1 is reduced, with amarked tendency tomake changes at G:C base pairs. Together, these results suggest that the loop region of the fingers domain may play a critical role in determining whether a family-B enzyme falls into the accurate genome-replicating category or is an errorprone translesion synthesis polymerase. Tgo-Pol Z1 may also be useful for amplification of damaged DNA

Concepts émergents dans le référentiel de compétences CanMEDS pour les médecins

Background: The CanMEDS physician competency framework will be updated in 2025. The revision occurs during a time of disruption and transformation to society, healthcare, and medical education caused by the COVID-19 pandemic and growing acknowledgement of the impacts of colonialism, systemic discrimination, climate change, and emerging technologies on healthcare and training. To inform this revision, we sought to identify emerging concepts in the literature related to physician competencies. Methods: Emerging concepts were defined as ideas discussed in the literature related to the roles and competencies of physicians that are absent or underrepresented in the 2015 CanMEDS framework. We conducted a literature scan, title and abstract review, and thematic analysis to identify emerging concepts. Metadata for all articles published in five medical education journals between October 1, 2018 and October 1, 2021 were extracted. Fifteen authors performed a title and abstract review to identify and label underrepresented concepts. Two authors thematically analyzed the results to identify emerging concepts. A member check was conducted. Results: 1017 of 4973 (20.5%) of the included articles discussed an emerging concept. The thematic analysis identified ten themes: Equity, Diversity, Inclusion, and Social Justice; Anti-racism; Physician Humanism; Data-Informed Medicine; Complex Adaptive Systems; Clinical Learning Environment; Virtual Care; Clinical Reasoning; Adaptive Expertise; and Planetary Health. All themes were endorsed by the authorship team as emerging concepts. Conclusion: This literature scan identified ten emerging concepts to inform the 2025 revision of the CanMEDS physician competency framework. Open publication of this work will promote greater transparency in the revision process and support an ongoing dialogue on physician competence. Writing groups have been recruited to elaborate on each of the emerging concepts and how they could be further incorporated into CanMEDS 2025.Contexte : Le référentiel de compétences CanMEDS pour les médecins sera mis à jour en 2025. Cette révision intervient à un moment où la société, les soins de santé et l’enseignement médical sont bouleversés et en pleine mutation à cause de la pandémie de la COVID-19; on est aussi à l’heure où l’on reconnaît de plus en plus les effets du colonialisme, de la discrimination systémique, des changements climatiques et des nouvelles technologies sur les soins de santé et la formation des médecins. Pour éclairer cette révision, nous avons tenté d’extraire de la littérature scientifique les concepts émergents se rapportant aux compétences des médecins. Méthodes : Les concepts émergents ont été définis comme des idées ayant trait aux rôles et aux compétences des médecins qui sont débattues dans la littérature, mais qui sont absentes ou sous-représentées dans le cadre CanMEDS 2015. Nous avons réalisé une recherche documentaire, un examen des titres et des résumés, et une analyse thématique pour repérer les concepts émergents. Les métadonnées de tous les articles publiés dans cinq revues d’éducation médicale entre le 1er octobre 2018 et le 1er octobre 2021 ont été extraites. Quinze auteurs ont effectué un examen des titres et des résumés pour relever et étiqueter les concepts sous-représentés. Deux auteurs ont procédé à une analyse thématique des résultats pour dégager les concepts émergents. Une vérification a été faite par les membres de l’équipe. Résultats : Parmi les 4973 articles dépouillés, 1017 (20,5 %) abordaient un concept émergent. Les dix thèmes suivants sont ressortis de l’analyse thématique : l’équité, la diversité, l’inclusion et la justice sociale; l’antiracisme; humanisme des médecin; la médecine fondée sur les données; les systèmes adaptatifs complexes; l’environnement de l’apprentissage clinique; les soins virtuels; le raisonnement clinique; l’expertise adaptative; et la santé planétaire. L’ensemble de ces thèmes ont été approuvés comme concepts émergents par l’équipe de rédaction. Conclusion : Cet examen de la littérature a permis de relever dix concepts émergents qui peuvent servir à éclairer la révision du référentiel de compétences CanMEDS pour les médecins qui aura lieu en 2025. La publication en libre accès de ce travail favorisera la transparence du processus de révision et le dialogue continu sur les compétences des médecins. Des groupes de rédaction ont été recrutés pour développer chacun des concepts émergents et pour examiner la façon dont ils pourraient être intégrés dans la version du référentiel CanMEDS de 2025

‘I think I'm more free with them'—Conflict, Negotiation and Change in Intergenerational Relations in African Families Living in Britain

While the family is increasingly being recognised as pivotal to migration, there remain too few studies examining how migration impacts on intergenerational relationships. Although traditional intergenerational gaps are intensified by migration, arguably there has been an over-emphasis on the divisions between ‘traditional’ parents and ‘modern’ children at the expense of examining the ways in which both generations adapt. As Foner and Dreby [2011. “Relations Between the Generations in Immigrant Families.” Annual Review of Sociology 37: 545–564] stress, the reality of post-migration intergenerational relations is inevitably more complex, requiring the examination of both conflict and cooperation. This article contributes to this growing literature by discussing British data from comparative projects on intergenerational relations in African families (in Britain, France and South Africa). It argues that particular understandings can be gained from examining the adaptation of parents and parenting strategies post-migration and how the reconfiguration of family relations can contribute to settlement. By focusing on how both parent and child generations engage in conflict and negotiation to redefine their relationships and expectations, it offers insight into how families navigate and integrate the values of two cultures. In doing so, it argues that the reconfiguration of gender roles as a result of migration offers families the space to renegotiate their relationships and make choices about what they transmit to the next generation