Exploring the Praxis of Occupational Therapy-Community Development Practitioners.

Background. A growing body of occupational therapy knowledge and practice focuses not on health but on social transformation, and couples occupational therapy with community development. A tension in both these fields is the disconnect between what practitioners espouse and what they do, limiting the potential of practice. To address this, practitioners are encouraged to engage in praxis-the critical synthesis of theory and practice. Purpose. To explore whether and how Australian occupational therapy-community development practitioners engage in critical praxis. Method. A critical dialogical method was employed to complete multiple in-depth interviews with four occupational therapy-community development practitioners. Interviews were transcribed and analyzed using thematic analysis. Findings. Practitioners appeared capable of praxis but were not consistently employing it. Findings were grouped into themes: disjointed praxis, authentic praxis, supporting praxis, and praxis challenges and solutions. Implications. Occupational therapists need to be supported to develop, use, and maintain skills in critical praxis.

Re-engaging in our role with communities: The coupling of occupational therapy and community development.

INTRODUCTION: A growing number of occupational therapists are re-engaging in work with communities and populations to advance a social justice agenda. To assist in this endeavour, many are coupling occupational therapy and community development theory, as reflected in the social occupational therapy field. Social occupational therapy practitioners work with groups of people who do not necessarily have a health diagnosis or illness but who nonetheless experience occupational issues due to structural barriers within society. Practitioners work across micro- and macro-levels to not only alleviate symptoms of these issues but also to transform their root causes. Although community development is a logical partner to assist such practice, there are inherent tensions in the coupling of these disciplines. This study aimed to explore what theory occupational therapists were using from occupational therapy and community development to guide them in their social occupational therapy practice. METHODS: This study employed a collaborative and participatory qualitative research method. Four occupational therapy community development practitioners each participated in two one-on-one dialogical interviews with the first author. These were transcribed and analysed using Braun and Clarke's method of thematic analysis. FINDINGS: Findings were grouped into two themes: (a) Occupational therapy and community development - synergies and tensions, and (b) Of the profession but not in it. Findings highlighted the theoretical shortcomings of occupational therapy for community development practice, theoretical tensions between the two disciplines, and the 'underground' nature of occupational therapy community development practice. CONCLUSION: Practitioners should be supported by the occupational therapy profession to be effective community development practitioners, capable of advancing the profession's vision of social justice. Future research should explore methods to support practitioners to navigate tensions between occupational therapy and community development, and bring this practice 'above ground'.

Mimicking the tumour microenvironment: three different co-culture systems induce a similar phenotype but distinct proliferative signals in primary chronic lymphocytic leukaemia cells.

Interactions in the tumour microenvironment can promote chronic lymphocytic leukaemia (CLL) cell survival, proliferation and drug resistance. A detailed comparison of three co-culture systems designed to mimic the CLL lymph node and vascular microenvironments were performed; two were mouse fibroblast cell lines transfected with human CD40LG or CD31 and the third was a human microvascular endothelial cell line, HMEC-1. All three co-culture systems markedly enhanced CLL cell survival and induced a consistent change in CLL cell phenotype, characterized by increased expression of CD38, CD69, CD44 and ITGA4 (CD49d); this phenotype was absent following co-culture on untransfected mouse fibroblasts. In contrast to HMEC-1 cells, the CD40LG and CD31-expressing fibroblasts also induced ZAP70 expression and marked CLL cell proliferation as evidenced by carboxyfluorescein succinimidyl ester labelling and increased Ki-67 expression. Taken together, our data show that co-culture on different stroma induced a remarkably similar activation phenotype in CLL cells but only the CD40LG and CD31-expressing fibroblasts increased ZAP70 expression and CLL cell proliferation, indicating that ZAP70 may play a critical role in this process. This comparative study reveals a number of striking similarities between the co-culture systems tested but also highlights important differences that should be considered when selecting which system to use for in-vitro investigations.