Virtual interprofessional (VIP) education, a family medicine-occupational therapy-physiotherapy collaborative experience: the perspectives of patients, learners and providers on the opportunities and challenges.

This study examined the experiences of patients, Occupational Therapy (OT), Physiotherapy (PT) and Medicine learners, Providers, and Faculty, in implementing a Virtual Interprofessional (VIP) education initiative in two academic Family Medicine (FM) collaborative clinics. A qualitative descriptive study drew on a strength-based approach as part of the evaluation of the interfaculty VIP initiative. Participants involved in VIP care were conveniently sampled. Interviews were conducted with four patients, and focus groups were held with a total of 16 providers, preceptors and learners in OT, PT and FM. Data were analyzed using content analysis and managed using NVivo12. Four main categories emerged: 1) Challenges in implementing VIP care in FM; 2) Operational challenges, 3) Facilitators of VIP care in FM; and 4) Experiential learning outcomes and benefits of VIP care. This innovation supported knowledge and insights on interprofessional competencies acquired during practice, provided inclusive and comprehensive access to care for patients, and identified opportunities to enhance medical, OT and PT education in VIP care in FM. A collaborative approach with faculty from different disciplines (FM, School of Health Professions: OT and PT) can provide ongoing opportunities for VIP care for patients, and foster IP learning and acquisition of competencies for FM, OT and PT learners and providers.

Retrospective review of work transition narratives: Advancing occupational perspectives and strategies.

BACKGROUND: In 2009 the journal WORK commenced a new column for the publication of Work Transition Narratives. Fourteen persons with lived experience published their narratives on approaches that helped them through work disruptions and change. OBJECTIVE: A review of the articles was conducted to understand how people navigated challenges and obstacles and made sense of their in-transition experiences to return to work or to find new employment. METHODS: A retrospective review was conducted using a convenience sample of N = 14 published narratives. A template approach was developed using micro (individual) and macro (social, cultural, political, structural) level issues to extract and analyze descriptive content. A senior researcher and two Masters of Science students independently reviewed the narratives and extracted data. A dialogic and inductive approach was used to achieve consensus on the description of the types of mechanisms used to move forward. RESULTS: The mechanisms evident in the narratives used by people to navigate work disruptions included drawing on anchors, catalysts, champions, opportunities, learning, coming to terms, critical conversations, and critical reflections. CONCLUSION: Mechanisms used to navigate in-transition experiences add to the knowledge on negotiating the dialectical relationship of micro and macro level challenges in occupational transitions of work. This review and analysis revealed commonly used strategies that may assist others in addressing in-transition work challenges. In addition, the findings have implications for ongoing research and the development of occupational mindfulness approaches that may help people through the overwhelming and often daunting experience of work transitions.

Profiling the Research Activities of Canadian Occupational Therapy and Occupational Science Faculty Members.

Background. There is a lack of knowledge on the scope and nature of the research by faculty members in occupational science (OS) and/or occupational therapy (OT) programs in Canada. Purpose. To describe the research activities of faculty members in these programs and directions. Method. A cross-sectional survey was distributed to 173 faculty members across all 14 Canadian OT that addressed: 1) research topics and methods, 2) populations, and 3) funding. Findings. Based on respondents (N = 121), research is focused on a range of topics and populations with most conducting qualitative research. Many conduct research examining the effectiveness of interventions, with few respondents focused on OS research. Federal and provincial grants agencies were the largest source of funding. Implications. Research topics studied were not always proportional to practice although emerging areas were being investigated that can expand the evidence base and scope of practice. Despite limited occupation-specific funding options, respondents were accessing funding from varied sources. Collaborations among faculty members, clinicians, and individuals with lived experience can create priorities for future OS and/or OT research in Canada.

The Councils on Chiropractic Education International Mapping Project: Comparison of Member Organizations' Educational Standards to the Councils on Chiropractic Education International Framework Document.

Objective: The purpose of this project was to investigate how well each member agency's standards complied with the Councils on Chiropractic Education International (CCEI) framework standards. Methods: Each of the CCEI member agencies were provided with a mapping template that was approved by all representatives. A representative from each agency independently mapped their agency's standards to the CCEI framework standards using the template document. Discrepancies were explored and discussed among members. Member agencies discussed with their constituents the omissions and areas that did not comply or adequately match the CCEI document. Changes or additions to member agency standards were made, and updated versions of the mapping were agreed by all CCEI representatives. Results: There were 12 sections containing 30 standards within the CCEI framework standards. The Council of Chiropractic Education Australasia and Council on Chiropractic Education Canada reported relevant standards for all 30 CCEI standards. The European Council on Chiropractic Education had 29 of 30 relevant standards, with no direct standard for service. The products that were created were an executive summary of our findings and a detailed map showing similarities for each of the member agencies. Conclusion: This mapping project demonstrated the similarities of the CCEI member agency standards and that these standards focused on outcomes-based chiropractic education. This quality improvement project resulted in useful dialogue among the member agencies during this project, which clarified areas of difference.

Prevalence of chronic musculoskeletal pain among active and retired military personnel: a systematic review protocol.

OBJECTIVE: The objective of this review is to assess the prevalence of musculoskeletal chronic pain among active and retired members of military forces and to characterize potential factors that could influence the frequency of musculoskeletal chronic pain. INTRODUCTION: Inherent to military occupations is a diverse source of occupational hazards that affect the well-being of individuals at any stage of their military career (active and retired). Chronic pain may result from the continuous exposure to physically demanding tasks and other risks. Moreover, chronic pain has been associated with other comorbidities, including mental health conditions. INCLUSION CRITERIA: Scientific papers in French or English reporting on chronic pain derived from a musculoskeletal cause in active and retired military personnel will be considered. There will be no restriction on participants' country, age, or length of service. METHODS: The published literature will be identified by exploring biomedical, pharmacological, and physiology bibliographic databases. The unpublished literature will be located through the search of thesis and gray literature repositories. This review will follow the condition-context-population approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The extracted data will include any detail about the anatomic location, diagnosis, types of studies, and risk factors. The review will follow JBI methods of critical appraisal, data extraction, and data synthesis for reviews containing prevalence data. If enough evidence is found, meta-regression analysis will performed, otherwise a narrative review will be completed. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020153704.

Developing guidelines to support injured workers who live and work with chronic pain.

BACKGROUND: Living and working with chronic pain requires persons to alter lifestyles and have the knowledge as well as support to manage unforeseen challenges. Knowledge for persons living with pain who want to participate in meaningful paid and unpaid work is not easily accessible. While there is literature on chronic pain management, work transitions and return to work, less emphasis has been placed on the complexity of living and working with chronic pain. The Creating a Way Forward Project was envisioned to address this gap and to identify the informational needs of workers with pain, health/helping professionals (workers' advisors, return to work specialists, legal representatives), and stakeholders. The overarching aim of the project was to use evidence and experiential knowledge to inform the development of a foundation for educational guides and toolkits to support workers with pain to achieve their outcomes for remaining at work. METHODS: Phase one of the project involved a scoping review of chronic pain and work. Phase two involved stakeholder consultations, a focus group and knowledge integration of the literature and experiential insights. Knowledge synthesis drew on a Template Analysis of multiple sources of data. RESULTS: Knowledge domains and key components were identified for persons with pain and for the health/helping professions. CONCLUSION: These domains reflect a foundation for knowledge in practical training and the development of curriculum for education in self-management program and in inter professional health profession education. These knowledge domains provide a basis for future research in integrated approaches and knowledge use toward improving transitions for persons living with chronic pain who want to participate in productive paid and unpaid work. Ongoing research in knowledge domains that health providers and persons with pain need will expand the potential for improving health outcomes in living with and managing pain.

Complementary Embryonic and Adult Cell Populations Enhance Myocardial Repair in Rat Myocardial Injury Model.

We compared the functional outcome of Isl-1+ cardiac progenitors, CD90+ bone marrow-derived progenitor cells, and the combination of the two in a rat myocardial infarction (MI) model. Isl-1+ cells were isolated from embryonic day 12.5 (E12.5) rat hearts and expanded in vitro. Thy-1+/CD90+ cells were isolated from the bone marrow of adult Sprague-Dawley rats by immunomagnetic cell sorting. Six-week-old female Sprague-Dawley rats underwent permanent left anterior descending (LAD) coronary artery ligation and received intramyocardial injection of either saline, Isl-1+ cells, CD90+ cells, or a combination of Isl-1+ and CD90+ cells, at the time of infarction. Cells were delivered transepicardially to the peri-infarct zone. Left ventricular function was assessed by transthoracic echocardiography at 1- and 4-week post-MI and by Millar catheterization (-dP/dt and +dP/dt) at 4-week post-MI. Fluorescence in situ hybridization (Isl-1+cells) and monochrystalline iron oxide nanoparticles labeling (MION; CD90+ cells) were performed to assess biodistribution of transplanted cells. Only the combination of cells demonstrated a significant improvement of cardiac function as assessed by anterior wall contractility, dP/dt (max), and dP/dt (min), compared to Isl-1+ or CD90+ cell monotherapies. In the combination cell group, viable cells were detected at week 4 when anterior wall motion was completely restored. In conclusion, the combination of Isl-1+ cardiac progenitors and adult bone marrow-derived CD90+ cells shows prolonged and robust myocardial tissue repair and provides support for the use of complementary cell populations to enhance myocardial repair.

Progenitor cell combination normalizes retinal vascular development in the oxygen-induced retinopathy (OIR) model.

Retinopathy of prematurity (ROP) is a disorder of the developing retina of preterm infants. ROP can lead to blindness because of abnormal angiogenesis that is the result of suspended vascular development and vaso-obliteration leading to severe retinal stress and hypoxia. We tested the hypothesis that the use of the human progenitor cell combination, bone marrow-derived CD34+ cells and vascular wall-derived endothelial colony-forming cells (ECFCs), would synergistically protect the developing retinal vasculature in a mouse model of ROP, called oxygen-induced retinopathy (OIR). CD34+ cells alone, ECFCs alone, or the combination thereof were injected intravitreally at either P5 or P12 and pups were euthanized at P17. Retinas from OIR mice injected with ECFCs or the combined treatment revealed formation of the deep vascular plexus (DVP) while still in hyperoxia, with normal-appearing connections between the superficial vascular plexus (SVP) and the DVP. In addition, the combination of cells completely prevented aberrant retinal neovascularization and was more effective anatomically and functionally at rescuing the ischemia phenotype than either cell type alone. We show that the beneficial effects of the cell combination are the result of their ability to orchestrate an acceleration of vascular development and more rapid ensheathment of pericytes on the developing vessels. Lastly, our proteomic and transcriptomic data sets reveal pathways altered by the dual cell therapy, including many involved in neuroretinal maintenance, and principal component analysis (PCA) showed that cell therapy restored OIR retinas to a state that was closely associated with age-matched normal retinas. Together, these data herein support the use of dual cell therapy as a promising preventive treatment for the development of ROP in premature infants.

Multicenter, Open-Label, Phase II Study of Bendamustine and Rituximab Followed by 90-Yttrium (Y) Ibritumomab Tiuxetan for Untreated Follicular Lymphoma (Fol-BRITe).

PURPOSE: Bendamustine and rituximab (BR) has been established as a superior frontline therapy over R-CHOP in the treatment of follicular lymphoma (FL). Yttrium-90 Ibritumomab tiuxetan (90YIT) is an effective consolidation strategy after chemotherapy induction. This prospective, single-arm, multicenter, phase II trial evaluated the response rate, progression-free survival (PFS), and tolerability of BR followed by consolidation with 90YIT in patients with untreated FL. PATIENTS AND METHODS: The study included grade 1 to 3a FL patients aged ≥18 years, chemotherapy-naïve, and requiring treatment for stage II-IV disease. Study treatment included an initial rituximab treatment, followed by four cycles of BR. Patients were eligible for consolidation with 90YIT, 6 to 12 weeks after BR, if they obtained at least a partial response after induction had adequate count recovery and bone marrow infiltration < 25%. RESULTS: Thirty-nine patients were treated. Eighty-two percent had an intermediate or high-risk Follicular Lymphoma International Prognostic Index score, and 6 of 39 (15%) were grade 3a. The response rate was 94.8%, and the complete response(CR)/CR unconfirmed (CRu) rate was 77% in the intention-to-treat analysis. The conversion rate from PR to CR/Cru after 90YIT was 81%. After median follow-up of 45 months, the PFS was 0.71 (95% confidence interval, 0.57-0.89). CONCLUSIONS: This report demonstrates that four cycles of BR followed by consolidation with 90YIT achieve high response rates that are durable. In addition, consolidation with 90YIT results in a high conversion rate of PR to CR/CRu. A short course of BR followed by 90YIT is a safe and effective regimen for frontline treatment of FL.

Out-of-pocket expenses related to aging in place for frail older people: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to describe the available evidence reporting out-of-pocket expenses for aging-in-place for frail older people and their caregivers. INTRODUCTION: There has been an increased focus on supporting frail older people to live in the community, rather than in costly long-term residential care. The out-of-pocket expenses associated with supporting older people with frailty to remain in their homes and communities contribute to caregiver burden and can influence decisions about where to live. INCLUSION CRITERIA: This scoping review will consider literature on community-dwelling older people 60 years and older who have been identified as frail. Research and policy papers that report the out-of-pocket expenses incurred by older people with frailty or by their family or friend caregivers to support aging well at home will be included. Studies in English will be considered with no date restriction. METHODS: The search strategy aims to find both published and unpublished literature (e.g. policy papers, theses and dissertations). Search databases include CINAHL, PubMed, Scopus, Embase, PsycINFO, Sociological Abstracts, and Public Affairs Index, as well as databases of unpublished sources. The language will be limited to English or French. Title and abstract screening, as well as full-text screening, will be completed by two reviewers. Data will be charted to describe the body of literature focusing on elements such as type of literature, methods used, setting and out-of-pocket expenses. Data will be presented graphically when possible, and accompanied by a narrative that describes the characteristics of the body of literature.

Enteral Arg-Gln Dipeptide Administration Increases Retinal Docosahexaenoic Acid and Neuroprotectin D1 in a Murine Model of Retinopathy of Prematurity.

Purpose: Low levels of the long chain polyunsaturated fatty acid (LCPUFA) docosahexaenoic acid (DHA) have been implicated in retinopathy of prematurity (ROP). However, oral DHA suffers from poor palatability and is associated with increased bleeding in premature infants. We asked whether oral administration of the neutraceutical arginine-glutamine (Arg-Glu) could increase retinal DHA and improve outcomes in a mouse model of oxygen-induced retinopathy (OIR). Methods: Postnatal day 7 (P7) pups were maintained at 75% oxygen for 5 days and then returned to room air on P12. Pups were gavaged twice daily with Arg-Gln or vehicle from P12 to P17 and eyes were harvested for analysis on P17. Vaso-obliteration and vascular density were assessed on retinal flat mounts and preretinal neovascularization was assessed on retinal cross sections. Retinas were used for measurement of DHA and 10,17S-docosatriene (neuroprotectin D1, NPD1), a key DHA-derived lipid, and for analysis by reverse-phase protein array (RPPA). Results: With Arg-Gln treatment, retinal DHA and NPD1 levels were increased in OIR pups. Arg-Gln reduced preretinal neovascularization by 39 ± 6% (P < 0.05) relative to vehicle control. This was accompanied by a restoration of vascular density of the retina in the pups treated with Arg-Gln (73.0 ± 3.0%) compared to vehicle (53.1 ± 3.4%; P < 0.05). Arg-Gln dipeptide restored OIR-induced signaling changes toward normoxia and was associated with normalization of insulin-like growth factor receptor 1 signaling and reduction of apoptosis and an increase in anti-apoptosis proteins. Conclusions: Arg-Gln may serve as a safer and easily tolerated nutraceutical agent for prevention or treatment of ROP.

Rap1B promotes VEGF-induced endothelial permeability and is required for dynamic regulation of the endothelial barrier.

Vascular endothelial growth factor (VEGF), a key angiogenic and permeability factor, plays an important role in new blood vessel formation. However, abnormal VEGF-induced VEGFR2 signaling leads to hyperpermeability. We have shown previously that Rap1, best known for promoting cell adhesion and vessel stability, is a critical regulator of VEGFR2-mediated angiogenic and shear-stress EC responses. To determine the role of Rap1 role in endothelial barrier dynamics, we examined vascular permeability in EC-specific Rap1A- and Rap1B-knockout mice, cell-cell junction remodeling and EC monolayer resistivity in Rap1-deficient ECs under basal, inflammatory or elevated VEGF conditions. Deletion of either Rap1 isoform impaired de novo adherens junction (AJ) formation and recovery from LPS-induced barrier disruption in vivo However, only Rap1A deficiency increased permeability in ECs and lung vessels. Interestingly, Rap1B deficiency attenuated VEGF-induced permeability in vivo and AJ remodeling in vitro Therefore, only Rap1A is required for the maintenance of normal vascular integrity. Importantly, Rap1B is the primary isoform essential for normal VEGF-induced EC barrier dissolution. Deletion of either Rap1 isoform protected against hyper permeability in the STZ-induced diabetes model, suggesting clinical implications for targeting Rap1 in pathologies with VEGF-induced hyperpermeability.

Successful return to work of individuals with chronic pain according to health care providers: a meta-synthesis / Retorno bem-sucedido ao trabalho para indivíduos com dor crônica, segundo os profissionais de saúde: uma metassíntese

: Introduction: Chronic pain is a persistent disease that causes personal and social economic problems when individuals are unable to return to work. Objective: This meta-synthesis investigated the perspectives of health professionals on the best mechanisms (triggering change) and approaches to support people with chronic pain on return to work. Method: Peer-reviewed articles published until October 2017 were searched in databases such as PsycINFO, EMBASE, CINAHL and Pubmed. The search was based on three concepts: "chronic pain", "return to work" and "therapist". Six articles were analyzed. Meta-ethnography was used to synthesize data extracted from qualitative studies. Results: Five second-order interpretations were revealed: social interactions contribute to rehabilitation and can interrupt the return to work; inadequate coordination and excessive bureaucracy complicates the return to work; communication between worker and other stakeholders is critical for return to work; health professionals are not clear about their roles; the congruence between health professionals and the workers'perspectives and goals on return to work impacts the treatment and its outcomes. A posterior analysis produced two third-order syntheses: 1. the need for assertive communication to lay the groundwork for best practices; and 2. inadequate coordination in the current system complicates return to work in cases of chronic pain. Conclusion: Stakeholders and health professionals need to understand their roles and responsibilities to consistently set goals and action plans for return to work.

Introdução: Dor crônica é doença persistente que causa problemas econômicos, pessoais e sociais, quando indivíduos não conseguem voltar ao trabalho. Objetivo: Esta metassíntese investigou as perspectivas dos profissionais de saúde acerca dos melhores mecanismos (desencadeantes da mudança) e abordagens para apoiar trabalhadores com dor crônica, no retorno ao trabalho. Método: Artigos revisados por pares foram pesquisados em bases de dados, como PsycINFO, EMBASE, CINAHL e Pubmed, publicados até outubro de 2017. As buscas empregaram três conceitos: "dor crônica", "retorno ao trabalho" e "terapeuta". Foram analisados seis artigos. Metaetnografia foi utilizada para sintetizar os dados extraídos de estudos qualitativos. Resultados: Foram reveladas cinco interpretações de segunda ordem: 1. as interações sociais contribuem para a reabilitação e podem interromper o retorno ao trabalho; 2. a coordenação inadequada e a burocracia excessiva complicam o retornoao trabalho; 3. a comunicação entre o trabalhador e os demais atores é fundamental para o retorno ao trabalho; 4. os profissionais de saúde não têm clareza sobre seus papéis, e 5. a congruência entre o profissional de saúde e as perspectivas e os objetivos do trabalhador, no retorno ao trabalho, impacta o tratamento e os resultados. Uma análise posterior produziu duas sínteses de terceira ordem: 1. a necessidade de comunicação assertiva para estabelecer as bases para as melhores práticas, e 2. a coordenação inadequada no sistema atual complica o retorno ao trabalho, nos casos de dor crônica. Conclusão: As partes interessadas precisam compreender seus papéis e responsabilidades para, de forma congruente, estabelecer metas e planos de ação para o retorno ao trabalho.

Hematopoietic stem/progenitor involvement in retinal microvascular repair during diabetes: Implications for bone marrow rejuvenation.

The widespread nature of diabetes affects all organ systems of an individual including the bone marrow. Long-term damage to the cellular and extracellular components of the bone marrow leads to a rapid decline in the bone marrow-hematopoietic stem/progenitor cells (HS/PCs) compartment. This review will highlight the importance of bone marrow microenvironment in maintaining bone marrow HS/PC populations and the contribution of these key populations in microvascular repair during the natural history of diabetes. The autonomic nervous system can initiate and propagate bone marrow dysfunction in diabetes. Systemic pharmacological strategies designed to protect the bone marrow-HS/PC population from diabetes induced-oxidative stress and advanced glycation end product accumulation represent a new approach to target diabetic retinopathy progression. Protecting HS/PCs ensures their participation in vascular repair and reduces the risk of vasogdegeneration occurring in the retina.

Increased Indoleamine 2,3-Dioxygenase and Quinolinic Acid Expression in Microglia and Müller Cells of Diabetic Human and Rodent Retina.

Purpose: We investigated the relationship between inflammation, neuronal loss, and expression of indoleamine 2, 3-dioxygenase (IDO) and quinolinic acid (QUIN) in the retina of subjects with type 1 diabetes (T1D) and type 2 diabetes (T2D) and in the retina of rats with T1D. Methods: Retinas from T1D (n = 7), T2D (n = 13), and 20 age-matched nondiabetic human donors and from T1D (n = 3) and control rats (n = 3) were examined using immunohistochemistry for IDO, QUIN, cluster of differentiation 39 (CD39), ionized calcium-binding adaptor molecule (Iba-1, for macrophages and microglia), Vimentin (VIM; for Müller cells), neuronal nuclei (NeuN; for neurons), and UEA1 lectin (for blood vessels). Results: Based on morphologic criteria, CD39+/ionized calcium binding adaptor molecule 1(Iba-1+) resident microglia and CD39-/Iba-1+ bone marrow-derived macrophages were present at higher density in T1D (13% increase) and T2D (26% increase) human retinas when compared with controls. The density and brightness of IDO+ microglia were increased in both T1D and T2D human retinas. The intensity of QUIN+ expression on CD39+ microglia and VIM+ Müller cells was greatly increased in both human T1D and T2D retinas. T1D retinas showed a 63% loss of NeuN+ neurons and T2D retinas lost approximately 43% when compared with nondiabetic human retinas. Few QUIN+ microglia-like cells were seen in nondiabetic retinas, but the numbers increased 18-fold in T1D and 7-fold in T2D in the central retina. In T1D rat retinas, the density of IDO+ microglia increased 2.8-fold and brightness increased 2.1-fold when compared with controls. Conclusions: Our findings suggest that IDO and QUIN expression in the retinas of diabetic rats and humans could contribute to the neuronal degeneration that is characteristic of diabetic retinopathy.

Bone Marrow-Derived Cell Recruitment to the Neurosensory Retina and Retinal Pigment Epithelial Cell Layer Following Subthreshold Retinal Phototherapy.

Purpose: We investigated whether subthreshold retinal phototherapy (SRPT) was associated with recruitment of bone marrow (BM)-derived cells to the neurosensory retina (NSR) and RPE layer. Methods: GFP chimeric mice and wild-type (WT) mice were subjected to SRPT using a slit-lamp infrared laser. Duty cycles of 5%, 10%, 15%, and 20% (0.1 seconds, 250 mW, spot size 50 µm) with 30 applications were placed 50 to 100 µm from the optic disc. In adoptive transfer studies, GFP+ cells were given intravenously immediately after WT mice received SRPT. Immunohistochemistry was done for ionized calcium-binding adapter molecule-1 (IBA-1+), CD45, Griffonia simplicifolia lectin isolectin B4, GFP or cytokeratin). Expression of Ccl2, Il1b, Il6, Hspa1a, Hsp90aa1, Cryab, Hif1a, Cxcl12, and Cxcr4 mRNA and flow cytometry of the NSR and RPE-choroid were performed. Results: Within 12 to 24 hours of SRPT, monocytes were detected in the NSR and RPE-choroid. Detection of reparative progenitors in the RPE occurred at 2 weeks using flow cytometry. Recruitment of GFP+ cells to the RPE layer occurred in a duty cycle-dependent manner in chimeric mice and in mice undergoing adoptive transfer. Hspa1a, Hsp90aa1, and Cryab mRNAs increased in the NSR at 2 hours post laser; Hif1a, Cxcl12, Hspa1a increased at 4 hours in the RPE-choroid; and Ccl2, Il1b, Ifng, and Il6 increased at 12 to 24 hours in the RPE-choroid. Conclusions: SRPT induces monocyte recruitment to the RPE followed by hematopoietic progenitor cell homing at 2 weeks. Recruitment occurs in a duty cycle-dependent manner and potentially could contribute to the therapeutic efficacy of SRPT.

A literature review on work transitioning of youth with disabilities into competitive employment.

BACKGROUND: The marginalisation of youth with disabilities from employment opportunities is evident from literature in as far as they form part of the larger groups 'people with disabilities' and 'youth'. A focused view of programmes that assist youth with disabilities into employment has not been presented, despite the worldwide crisis of youth unemployment. AIM: This review aimed to identify evidence on work transition programmes that are effective in assisting people with disabilities into open labour market (competitive) employment, as well as to highlight gaps in knowledge to inform future research on this topic. METHODS: Literature and policy on programmes that support such transitions were considered, firstly from a global perspective and then with a view from developing countries. The SALSA (Search, Appraisal, Synthesis and Analysis) framework was used to source and analyse information from a diverse set of documents. Various online databases were searched for research papers published between 1990 and 2016, and websites were searched for reports pertaining to this topic. RESULTS: Ninety-nine documents were selected to inform the review, out of an identified 259 scientific journal articles, policy documents, acts, organisational reports and book chapters. CONCLUSION: A synthesis of findings was presented in a narrative that reflects the themes of youth with disabilities and employment in the world, work transition endeavours in the developing world and a specific focus on this group in South Africa. The review revealed a gap in knowledge and evidence pertaining to youth with disabilities and employment, highlighting these as research foci, and emphasising the need for youth-focused research that generates knowledge about disability and transitions into the labour force.

Representations of workers with hearing loss in Canadian newspapers: a thematic analysis.

OBJECTIVE: Participation in the labour force with a hearing impairment presents a number of challenges. This study describes how Canadian newspapers represent workers with hearing loss. DESIGN: Taking a critical framing theory approach, thematic analysis was performed through coding relevant articles, abstracting and hierarchically categorising themes. STUDY SAMPLE: Seven English-language Canadian newspapers were searched for publications between 1995 and 2016. Twenty-six articles met our criteria: discussing paid workers with hearing loss who used English rather than sign language on the job and making reference to workers' competence. RESULTS: We identified a global theme, Focussing on a good worklife or focussing on a limited worklife, composed of three organising themes (1) Prominent individuals struggle, take action, and continue despite hearing loss, (2) Workers with hearing loss in the community create their best day themselves, and (3) Workers with hearing loss, as a generalised whole, are portrayed as either competent or limited. CONCLUSIONS: The dominant framing portrays individual workers as ingenious, determined, and successful. Negative framings were predominantly generalisations to these workers as a group. To generate more positive framings, professionals can build relationships with consumer groups and, when contacted by the media, direct journalists to interview workers with hearing loss.

A literature review on work transitioning of youth with disabilities into competitive employment

Background: The marginalisation of youth with disabilities from employment opportunities is evident from literature in as far as they form part of the larger groups 'people with disabilities' and 'youth'. A focused view of programmes that assist youth with disabilities into employment has not been presented, despite the worldwide crisis of youth unemployment.Aim: This review aimed to identify evidence on work transition programmes that are effective in assisting people with disabilities into open labour market (competitive) employment, as well as to highlight gaps in knowledge to inform future research on this topic.Methods: Literature and policy on programmes that support such transitions were considered, firstly from a global perspective and then with a view from developing countries. The SALSA (Search, Appraisal, Synthesis and Analysis) framework was used to source and analyse information from a diverse set of documents. Various online databases were searched for research papers published between 1990 and 2016, and websites were searched for reports pertaining to this topic.Results: Ninety-nine documents were selected to inform the review, out of an identified 259 scientific journal articles, policy documents, acts, organisational reports and book chapters.Conclusion: A synthesis of findings was presented in a narrative that reflects the themes of youth with disabilities and employment in the world, work transition endeavours in the developing world and a specific focus on this group in South Africa. The review revealed a gap in knowledge and evidence pertaining to youth with disabilities and employment, highlighting these as research foci, and emphasising the need for youth-focused research that generates knowledge about disability and transitions into the labour force

Invisible work of using and monitoring knowledge by parents (end-users) of children with chronic conditions.

BACKGROUND: Parents who care for young children with chronic conditions are knowledge users. Their efforts, time, and energy to source, consider and monitor information add to the 'invisible' work of parents in making decisions about care, school transitions, and interventions. Little is known or understood about the work of parents as knowledge users. OBJECTIVE: To understand the knowledge use patterns and how these patterns may be monitored in parents caring for their young children with cerebral palsy (CP). METHODS: An embedded case study methodology was used. In-depth qualitative interviews and visual mapping were employed to collect and analyze data based on the experiences of three mothers of young children with CP. RESULTS: Knowledge use in parents caring for their young children with CP is multi-factorial, complex and temporal. Findings resulted in a provisional model elaborating on the ways knowledge is used by parents and how it may be monitored. CONCLUSIONS: The visual mapping of pathways and actions of parents as end users makes the processes of knowledge use more visible and open to be valued as well as appreciated by others. The provisional model has implications for knowledge mobilization as a strategy in childhood rehabilitation and the facilitation of knowledge use in the lives of families with children with chronic health conditions.