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The SAGE handbook of international social work
\"Social work is a profession that is increasingly involved with issues which have a global dimension. This Handbook tackles the global/local aspect of social work in its various forms and interrogates the key concerns that societies are facing through an international lens. The contributors show that, with an appreciation of commonalities and differences, local practices and appropriate forms of international activity can be better developed. Analysis of 'International social work'. With a truly international range of contributions, the Handbook incorporates perspectives from Asia, Africa, Europe, Australasia, the Middle East and the Americas. It will be an invaluable resource for undergraduates, graduates, researchers and academics working in the fields of social work, social welfare, human services, and community development worldwide, as well as service providers and policy makers in the international arena.\"--Publisher's website.
Book
Smad2 and Smad3 Regulate Chondrocyte Proliferation and Differentiation in the Growth Plate
TGFβs act through canonical and non-canonical pathways, and canonical signals are transduced via Smad2 and Smad3. However, the contribution of canonical vs. non-canonical pathways in cartilage is unknown because the role of Smad2 in chondrogenesis has not been investigated in vivo. Therefore, we analyzed mice in which Smad2 is deleted in cartilage (Smad2CKO), global Smad3-/- mutants, and crosses of these strains. Growth plates at birth from all mutant strains exhibited expanded columnar and hypertrophic zones, linked to increased proliferation in resting chondrocytes. Defects were more severe in Smad2CKO and Smad2CKO;Smad3-/- (Smad2/3) mutant mice than in Smad3-/- mice, demonstrating that Smad2 plays a role in chondrogenesis. Increased levels of Ihh RNA, a key regulator of chondrocyte proliferation and differentiation, were seen in prehypertrophic chondrocytes in the three mutant strains at birth. In accordance, TGFβ treatment decreased Ihh RNA levels in primary chondrocytes from control (Smad2fx/fx) mice, but inhibition was impaired in cells from mutants. Consistent with the skeletal phenotype, the impact on TGFβ-mediated inhibition of Ihh RNA expression was more severe in Smad2CKO than in Smad3-/- cells. Putative Smad2/3 binding elements (SBEs) were identified in the proximal Ihh promoter. Mutagenesis demonstrated a role for three of them. ChIP analysis suggested that Smad2 and Smad3 have different affinities for these SBEs, and that the repressors SnoN and Ski were differentially recruited by Smad2 and Smad3, respectively. Furthermore, nuclear localization of the repressor Hdac4 was decreased in growth plates of Smad2CKO and double mutant mice. TGFβ induced association of Hdac4 with Smad2, but not with Smad3, on the Ihh promoter. Overall, these studies revealed that Smad2 plays an essential role in the development of the growth plate, that both Smads 2 and 3 inhibit Ihh expression in the neonatal growth plate, and suggested they accomplish this by binding to distinct SBEs, mediating assembly of distinct repressive complexes.
Journal Article
Roles for CCN2 in normal physiological processes
CCN2, also known as connective tissue growth factor, is a member of the CCN (CCN1–6) family of modular matricellular proteins. Analysis of CCN2 function in vivo has focused primarily on its key role as a mediator of excess ECM synthesis in multiple fibrotic diseases. However, CCN2 and related family members are widely expressed during development. Recent studies using new genetic models are revealing that CCN2 has essential roles in the development of many tissues. This review focuses on current and emerging data on CCN2 and its functions in chondrogenesis and angiogenesis, and on new studies showing that CCN2 has essential functions during embryonic and postnatal development in a number of epithelial tissues.
Journal Article
CCN2/Connective Tissue Growth Factor Is Essential for Pericyte Adhesion and Endothelial Basement Membrane Formation during Angiogenesis
CCN2/Connective Tissue Growth Factor (CTGF) is a matricellular protein that regulates cell adhesion, migration, and survival. CCN2 is best known for its ability to promote fibrosis by mediating the ability of transforming growth factor β (TGFβ) to induce excess extracellular matrix production. In addition to its role in pathological processes, CCN2 is required for chondrogenesis. CCN2 is also highly expressed during development in endothelial cells, suggesting a role in angiogenesis. The potential role of CCN2 in angiogenesis is unclear, however, as both pro- and anti-angiogenic effects have been reported. Here, through analysis of Ccn2-deficient mice, we show that CCN2 is required for stable association and retention of pericytes by endothelial cells. PDGF signaling and the establishment of the endothelial basement membrane are required for pericytes recruitment and retention. CCN2 induced PDGF-B expression in endothelial cells, and potentiated PDGF-B-mediated Akt signaling in mural (vascular smooth muscle/pericyte) cells. In addition, CCN2 induced the production of endothelial basement membrane components in vitro, and was required for their expression in vivo. Overall, these results highlight CCN2 as an essential mediator of vascular remodeling by regulating endothelial-pericyte interactions. Although most studies of CCN2 function have focused on effects of CCN2 overexpression on the interstitial extracellular matrix, the results presented here show that CCN2 is required for the normal production of vascular basement membranes.
Journal Article
Understanding the Effects of Ethylene as an Airborne Contaminant in Proton Exchange Membrane Fuel Cells and its Mitigation via Filtration
Proton exchange membrane fuel cells (PEMFCs) are a promising clean energy technology, but their performance and durability are highly sensitive to contaminants in both the fuel and oxidant streams. Among these, ethylene (C2H4) is of particular interest due to its presence in industrial and warehouse environments. This study investigates the impact of ethylene contamination on PEMFC performance when introduced into the cathode air feed. A combination of fuel cell performance testing, cyclic voltammetry, and gas chromatography is used to analyze the interaction of ethylene with the cathode catalyst. The presence of 20–300 ppm ethylene in air causes an immediate drop in the fuel cell operating voltage that is quickly recovered once the contaminant is removed, suggesting a reversible adsorption mechanism on the surface of the platinum cathode electrocatalyst, rather than the formation of strongly bound oxidation intermediates. Additionally, the study explores mitigation strategies by evaluating conventional and chemically modified air filters. While commercial air filters prove ineffective, a carbon supported platinum (Pt/Vulcan)‐coated filter demonstrates partial ethylene removal, reducing performance losses. These findings provide critical insights into ethylene contamination mechanisms and offer potential mitigation strategies to improve PEMFC reliability in real‐world applications. The effect of ethylene contamination in the proton exchange membrane fuel cell air feed on performance is studied. Operating cells are sensitive to the presence of ethylene down to 1 ppm, and it is determined that the mechanism for cell poisoning is adsorption on the cathode catalyst. To avoid this, Pt/Carbon‐based filters are assembled that enable partial ethylene removal, reducing performance losses.
Journal Article
Open Communication and Physical Intimacy in Young and Midlife Couples Surviving Cancer Beyond the First Year of Diagnosis
OBJECTIVES: To assess the association between levels of dyadic coping (e.g., collaboration, communication) and sexual satisfaction in young and midlife couples surviving cancer beyond the first year of diagnosis. SAMPLE & SETTING: This cross-sectional study included 49 young and midlife couples (aged 21-57 years) beyond the first year of diagnosis. Couples were from rural and urban areas. METHODS & VARIABLES: A mailed survey was used to gather data from cancer survivors and their partners. RESULTS: Controlling for cancer survivor sex and age, open communication was significantly associated with greater involvement in affectionate and sexual behaviors of the couple. Protective buffering behaviors (i.e., concealing worries and avoiding communication) were not significantly associated with engagement in physical intimacy. Perception of how much a partner openly communicates was more salient for engaging in physical intimacy than one's own open communication. IMPLICATIONS FOR NURSING: Nurses should include partners in planned care, assess the concerns of the partner, and treat the couple as the unit of care.
Journal Article
Symptom Frequency and Distress Underestimated in Decompensated Cirrhosis
BackgroundStudies assessing multiple symptoms and the distress of these symptoms in decompensated cirrhosis are lacking.AimsThe aims of this study were to assess symptom prevalence and distress among patients with decompensated cirrhosis and to describe medical management of the most prevalent symptoms.MethodsPatients were recruited from hepatology clinics within two health-care systems. Eligibility criteria included a model for end-stage liver disease (MELD-Na) score ≥15. Patients completed the Condensed Memorial Symptom Assessment Scale and Patient Health Questionnaire. Comparative statistics were used to analyze the cross-sectional survey data.ResultsOf the sample (n = 146), most patients were Child-Turcotte-Pugh (CTP) class B (49.7%) and C (46.2%). Mean age was 56.5 years, 65.1% were male, and 88.4% were white. Average MELD-Na score was 19.1 ± 4.5. The most prevalent symptoms were lack of energy and feeling drowsy while the most distressing were lack of energy and difficulty sleeping. Only 24 patients (16.4%) were treated for their difficulty sleeping with sleep medication. Importantly, those prescribed sleep medications had similar distress (3.9 ± 1.2 vs. 3.5 ± 1.2, p = 0.229) compared with patients not prescribed sleep medications. Opioids were prescribed to 57 (39.0%) patients; antidepressants to 34 (23.3%). Forty patients (27.4%) who reported moderate or greater depression were not prescribed an antidepressant.ConclusionsThe study highlights the multiple symptoms and distress experienced by patients with decompensated cirrhosis, and the need for improved medical management by health-care providers through enhanced awareness and attention to these complex symptoms. Future research should focus on improvements in symptom management.
Journal Article
Navigating sexual health in cancer survivorship: a dyadic perspective
Purpose
This qualitative study examined how young adult breast cancer survivors (YABCS) and their partners appraised and managed their sexual health and intimate relationships after cancer.
Methods
We conducted concurrent, individual telephone interviews with 25 YABCS and their male partners. We utilized a thematic, inductive analysis to examine individual interviews, followed by analysis within and across couples to identify dyadic themes. We explored how themes mapped on to the Theory of Dyadic Illness Management to build a conceptual model specific to the sexual health challenges of young adult couples living with cancer.
Results
Our analysis revealed five interconnected themes: (1) shared understanding of physical and psychological challenges of sexual health after cancer, (2) navigating role shifts and changes to sexual relationship, (3) getting through it as a team, (4) maintaining open communication, and (5) need for services and support for partners/caregivers and couples.
Conclusion
Both survivors and their partners articulated physical (e.g., painful sex, decreased libido) and psychological (e.g., guilt, self-consciousness) challenges to their sexual health in survivorship. Our dyadic focus revealed a spectrum of ways that couples managed the changes to their relationships and sexual health, highlighting “open communication” and strategies for “working as a team” as critical. There is no “one size fits all” solution, as individuals and couples cope with and manage these challenges in different ways. Study results can inform couple-focused intervention strategies, such as creating shared understanding of sexual health after cancer and improving communication skills.
Journal Article
Benefits of partnered strength training for prostate cancer survivors and spouses: results from a randomized controlled trial of the Exercising Together project
Background
Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver, but interventions rarely target the health of both partners simultaneously. We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors (PCS) and spouse caregivers.
Methods
Sixty-four couples were randomly assigned to 6 months of partnered strength training (Exercising Together,
N
= 32) or usual care (UC,
N
= 32). Objective measures included body composition (lean, fat and trunk fat mass (kg), and % body fat) by DXA, upper and lower body muscle strength by 1-repetition maximum, and physical function by the physical performance battery (PPB). Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS questionnaire.
Results
Couple retention rates were 100 % for Exercising Together and 84 % for UC. Median attendance of couples to Exercising Together sessions was 75 %. Men in Exercising Together became stronger in the upper body (
p
< 0.01) and more physically active (
p
< 0.01) than UC. Women in Exercising Together increased muscle mass (
p
= 0.05) and improved upper (
p
< 0.01) and lower body (
p
< 0.01) strength and PPB scores (
p
= 0.01) more than UC.
Conclusions
Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses.
Implications for cancer survivors
A couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners.
Trial registration
ClinicalTrials.gov NCT00954044
Journal Article
Delivering exercise medicine to cancer survivors: has COVID-19 shifted the landscape for how and who can be reached with supervised group exercise?
Purpose
Due to stay-at-home orders during COVID-19, we transitioned supervised, group, in-person resistance training interventions in two clinical trials in cancer survivors to live, online delivery using video-conferencing technology. We describe the feasibility, preliminary efficacy, and safety of live online group training and compare to in-person training.
Methods
Adherence (% sessions attended), retention (% participants completing intervention), and safety (# adverse events) data of resistance training groups from two randomized controlled trials in cancer survivors that participated before or during the COVID-19 pandemic were collated. Participants were post-treatment breast cancer survivors and their spouses (
n
= 62) and prostate cancer survivors (
n
= 32) (age range: 38–82 years). During COVID-19, delivery of supervised, group resistance exercise sessions was delivered live online via video-conference. Preliminary evidence for training efficacy was assessed by chair stand performance over the 6-month intervention.
Results
Feasibility of online resistance training was better than in-person for both studies (adherence: 86% vs 82% and 91% vs. 81% and retention 95% vs. 80% and 92% vs. 84% for online and in-person classes). Improvements in chair stand time were similar in prostate cancer and spouse groups that trained online vs. in-person, except for breast cancer survivors who improved more with in-person training (7% vs. 14% for online vs. in-person). Safety was similar between formats (12 vs. 11 adverse events for online vs. in-person).
Conclusion
Supervised, in-person group resistance training can be feasibly adapted for live, online delivery and could help broaden approaches to exercise delivery in cancer survivors, including older adults.
Trial registration
The studies described in this commentary were registered on ClinicalTrials.gov on August 3, 2018 (NCT03630354) and on October 30, 2018 (NCT03741335).
Journal Article