Resumen Introducción Las personas trans no binarias desarrollan sus experiencias ocupacionales en contextos heterocisnormativos que tienden a invisibilizar, invalidar y restringir sus formas de ser y hacer. Objetivo Explorar las experiencias de participación e involucramiento ocupacional de personas trans no binarias vinculadas a organizaciones y/o colectivos en la Región Metropolitana de Chile. Método Estudio cualitativo exploratorio que utilizó la técnica de fotovoz, complementada con narrativas y entrevistas semiestructuradas para profundizar en las experiencias de 4 participantes. Resultados Se identificaron tres categorías analíticas: (1) autorrepresentación e identificación, vinculadas a subjetividades y pertenencia comunitaria; (2) espacios y contextos, referidos a las condiciones sociales, materiales y simbólicas que configuran la participación; y (3) ocupaciones y sentires en el hacer, que abordan elecciones ocupacionales, significados y emociones. Conclusión Los hallazgos permiten problematizar los efectos del sistema heterocisnormativo en la configuración de las experiencias ocupacionales, destacando la necesidad de prácticas en Terapia Ocupacional que incorporen una perspectiva crítica y situada.
Abstract Introduction Non-binary trans people develop their occupational experiences within hetero-cisnormative contexts that tend to render their ways of being and doing invisible, invalidate them, and restrict them. Objective To explore the experiences of participation and occupational engagement of non-binary trans people linked to organisations and/or community collectives in the Metropolitan Region of Chile. Method An exploratory qualitative study was conducted using the photovoice technique, complemented by associated narratives and semi-structured interviews to further examine the experiences of four participants. Results Three analytical categories were identified: (1) self-representation and identification, related to subjectivities and community belonging; (2) spaces and contexts, referring to the social, material, and symbolic conditions shaping participation; and (3) occupations and emotional experiences of doing, addressing occupational choices, meanings, and emotions. Conclusion The findings allow for a critical examination of the effects of the hetero-cisnormative system on the configuration of occupational experiences, highlighting the need for Occupational Therapy practices that incorporate a critical and situated perspective.
Introduction:Early-stage stroke management is a complex, time-sensitive healthcare process requiring coordinated action and prompt decision-making. JOIN is a multiplatform communication application that streamlines and facilitates healthcare coordination. The objective of the study was to explore the process of implementing and using JOIN across a network of hospitals within the South-East Metropolitan Health Service to identify facilitators, barriers, and perceptions of its impact. Methods:A multiple-case study design was conducted based on a qualitative research framework. The process evaluation used purposive sampling to capture relevant experiences across diverse hospital contexts. Semi-structured interviews were conducted with individuals involved in implementing and using JOIN. Coding was performed using ATLAS.ti software, based on thematic analysis and an iterative procedure. The analysis was based on the components of process normalization theory and focused on evaluating key implementation outcomes. Results:During the interviews (n = 8), some of the facilitators identified ongoing training and the presence of a leader as factors in the use of JOIN. Overload of the emergency care system, resistance to change, and difficulties with technology use were among the barriers identified. Although the application's benefits (user-friendly and intuitive) were recognized, the implementation process posed significant challenges. Fidelity and feasibility were the most difficult implementation outcomes to achieve. Conclusions:The process evaluation highlights the importance of ongoing training and leadership for implementing new interventions within emergency healthcare settings. Furthermore, it emphasized the importance of achieving a comprehensive understanding of the context to improve implementation.
Obesity poses a global health challenge, demanding a deeper understanding of adipose tissue (AT) and its mitochondria. This study describes the role of the mitochondrial protein Methylation-controlled J protein (MCJ/DnaJC15) in orchestrating brown adipose tissue (BAT) thermogenesis. Here we show how MCJ expression decreases during obesity, as evident in human and mouse adipose tissue samples. MCJKO mice, even without UCP1, a fundamental thermogenic protein, exhibit elevated BAT thermogenesis. Electron microscopy unveils changes in mitochondrial morphology resembling BAT activation. Proteomic analysis confirms these findings and suggests involvement of the eIF2α mediated stress response. The pivotal role of eIF2α is scrutinized by in vivo CRISPR deletion of eIF2α in MCJKO mice, abrogating thermogenesis. These findings uncover the importance of MCJ as a regulator of BAT thermogenesis, presenting it as a promising target for obesity therapy. How adipose mitochondria activity is fine-tuned in response to obesity is an active area of study. Here, the authors show that mitochondrial protein MCJ can block thermogenesis and that silencing this gene can correct obesity-related comorbidities.
Translating trial findings to real-world cure rates for resectable oesophageal and gastroesophageal junction (GEJ) adenocarcinoma is critical. Standard endpoints like disease-free survival (DFS) may not distinguish durable cures from delayed recurrences. This analysis of the AGAMENON-SEOM registry (NCT04958720) compared perioperative chemotherapy versus neoadjuvant chemoradiotherapy (nCRT). We estimated cure rates and analysed DFS and overall survival (OS) using mixture cure models and Cox proportional hazards models. In 500 patients, perioperative FLOT improved DFS (HR 0.60; p = 0.01) and OS (adjusted HR 0.63; p = 0.015) compared to CROSS-based nCRT. Notably, cure models confirmed a higher cure fraction for FLOT in high-risk subgroups (e.g., stage III, high neutrophil-to-lymphocyte ratio). While platinum-fluoropyrimidine–based nCRT ± immunotherapy yielded higher R0 and pathological complete response rates, its estimated cure rate was comparable to FLOT, both overall and across all subgroups. Cure is an informative endpoint in localised oesophageal cancer. In this registry analysis, perioperative FLOT was associated with higher cure rates than CROSS, particularly in high-risk subgroups. Exploratory findings suggest that alternative neoadjuvant strategies, such as those incorporating ICIs or FOLFOX, warrant further investigation.
