Korte beschryvinge van de ongeluckige weer-om-reys van het schip Aernhem, in 1663 door Andries Stockram beschreven

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Grounding practices: How researchers ground their work in create-health collaborations for designing e-health solutions

From the article: Research through Design projects in the health domain often involve collaborations of design and healthcare researchers. All partners have their own ideas and expectations with regard to what they consider valid ways to support their work. The evidence-based approach that dominates healthcare research differs from the ways that are common in design research, in which more iterative approaches are applied with focus on developing solutions to fit to the users and their context. The question that we address is twofold: a) How do differences in grounding approaches manifest themselves in projects where design and healthcare researchers collaborate? And b) How do project teams deal with these differences? We analyzed the grounding practices within ten Dutch research projects that address the development of e-health applications to support people as they grow older. All projects are collaborations of design and healthcare researchers and practice partners. We applied a multiple case study research approach in two series of interviews, with a cross-case interpretation after the first series of interviews to direct the second series. Differences in grounding approaches in the projects manifest themselves on four themes, each representing a spectrum: time, structure, control and position. These differences provided challenges, but were also used to strengthen the project

CXCR4, but not CXCR3, drives CD8(+) T-cell entry into and migration through the murine bone marrow

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Are the effects of cognitive behavior therapy for severe fatigue in cancer survivors sustained up to 14 years after therapy?

© 2018, The Author(s). Purpose: Cognitive behavior therapy (CBT) reduces cancer-related fatigue (CRF) in cancer survivors in the short term. We examined fatigue levels up to 14 years after CBT. Methods: Eligible participants of two randomized controlled trials who had completed CBT for CRF and a post-treatment assessment were contacted (n = 81). Fatigue was assessed with the subscale “fatigue severity” of the Checklist Individual Strength (CIS-fatigue). The course of fatigue over time was examined with linear mixed model analyses. Fatigue levels of participants were compared to matched population controls at long-term follow-up. We tested with multiple regression analysis if fatigue at follow-up was predicted by the patients’ fatigue level and fatigue-perpetuating factors directly after CBT (post-CBT). Results: Seventy-eight persons completed a follow-up assessment (response rate = 96%, mean time after CBT = 10 years). The mean level of fatigue increased from 23.7 (SD = 11.1) at post-CBT to 34.4 (SD = 12.4) at follow-up (p <0.001). Population controls (M = 23,9, SD = 11.4) reported lower fatigue levels than participants. Half of the patients (52%) who were recovered from severe fatigue at post-CBT (CIS-fatigue <35) were still recovered at long-term follow-up. Patients with lower fatigue levels at post-CBT were less likely to show relapse. Conclusion: Despite initial improvement after CBT, levels of fatigue deteriorated over time. Half of the patients who were recovered from severe fatigue after CBT still scored within normal ranges of fatigue at long-term follow-up. Implications for Cancer Survivors: It should be explored how to help patients with a relapse of severe fatigue following an initially successful CBT. They may profit from CBT again, or another evidence-based intervention for fatigue (like mindfulness or exercise therapy). Future research to gain insight into reasons for relapse is warranted

CXCR4, but not CXCR3, drives CD8 + T-cell entry into and migration through the murine bone marrow

The BM serves as a blood-forming organ, but also supports the maintenance and immune surveillance function of many T cells. Yet, in contrast to other organs, little is known about the molecular mechanisms that drive T-cell migration to and localization inside the BM. As BM accumulates many CXCR3-expressing memory CD8 + T cells, we tested the involvement of this chemokine receptor, but found that CXCR3 is not required for BM entry. In contrast, we could demonstrate that CXCR4, which is highly expressed on both naive and memory CD8 + T cells in BM, is critically important for homing of all CD8 + T-cell subsets to the BM in mice. Upon entry into the BM parenchyma, both naïve and memory CD8 + T cells locate close to sinusoidal vessels. Intravital imaging experiments revealed that CD8 T cells are surprisingly immobile and we found that they interact with ICAM-1+VCAM-1+BP-1+ perivascular stromal cells. These cells are the major source of CXCL12, but also express key survival factors and maintenance cytokines IL-7 and IL-15. We therefore conclude that CXCR4 is not only crucial for entry of CD8 + T cells into the BM, but also controls their subsequent localization toward BM niches that support their survival