Low back pain (LBP) is associated with degeneration of the intervertebral disc (IVD). We have previously described development of a jelly delivery system (hydrogel). This has the potential to deliver adult stem cells to the centre of the IVD, known as the nucleus pulposus (NP). Here, we have demonstrated that adult stem cells can be safely injected into the NP using small bore needles, reducing damage to the disc. Following injection the hydrogel integrates with surrounding NP tissue, promotes differentiation of stem cells towards disc cells and restores IVD mechanical function. The hydrogel could be used to restore mechanical function to the IVD and deliver cells to promote regeneration of the disc as a minimally invasive treatment for LBP.

We have previously reported a synthetic Laponite crosslinked poly N‐isopropylacrylamide‐co‐N, N′‐dimethylacrylamide (NPgel) hydrogel, which induces nucleus pulposus (NP) cell differentiation of human mesenchymal stem cells (hMSCs) without the need for additional growth factors. Furthermore NP gel supports integration following injection into the disc and restores mechanical function to the disc. However, translation of this treatment strategy into clinical application is dependent on the survival and differentiation of hMSC to the correct cell phenotype within the degenerate intervertebral disc (IVD). Here, we investigated the viability and differentiation of hMSCs within NP gel within a catabolic microenvironment. hMSCs were encapsulated in NPgel and cultured for 4 weeks under hypoxia (5% O 2 ) with ± calcium, interleukin‐1β (IL‐1β), and tumor necrosis factor alpha (TNFα) either individually or in combination to mimic the degenerate environment. Cell viability and cellular phenotype were investigated. Stem cell viability was maintained within hydrogel systems for the 4 weeks investigated under all degenerate conditions. NP matrix markers: Agg and Col II and NP phenotypic markers: HIF‐1α, FOXF1, and PAX1 were expressed within the NPgel cultures and expression was not affected by culture within degenerate conditions. Alizarin red staining demonstrated increased calcium deposition under cultures containing CaCl 2 indicating calcification of the matrix. Interestingly matrix metalloproteinases (MMPs), ADAMTS 4, and Col I expression by hMSCs cultured in NPgel was upregulated by calcium but not by proinflammatory cytokines IL‐1β and TNFα. Importantly IL‐1β and TNFα, regarded as key contributors to disc degeneration, were not shown to affect the NP cell differentiation of mesenchymal stem cells (MSCs) in the NPgel. In agreement with our previous findings, NPgel alone was sufficient to induce NP cell differentiation of MSCs, with expression of both aggrecan and collagen type II, under both standard and degenerate culture conditions; thus could provide a therapeutic option for the repair of the NP during IVD degeneration.

Purpose This study aims to weave together narrative analysis (hereinafter NA) and Actor-Network Theory (hereinafter ANT), in order to address recent calls for performative studies to combine approaches and specifically to use ANT. Particularly, they address how a conflicting narrative is mobilised through a network of internal–external and human–nonhuman actors. Design/methodology/approach A fragment of data, generated from a longitudinal case study, is explored using NA and ANT in combination. Findings By engaging with ANT’s rejection of dualisms (i.e. human–nonhuman and micro–macro) and its approach to relationality, the authors inform NA and performative studies. They also add to the limited literature addressing how conflicting antenarratives are mobilised and shape the organisation’s trajectory. Research limitations/implications Generalizing from a single case study is problematic, although transferability is possible. Generalisability could be achievable through multiple performative studies. Practical/implications By demonstrating how counter networks form and antenarrative is constructed to supplant hegemonic narrative, the authors are able to problematise the taken for granted and highlight the possibilities offered by divergent voices. Originality/value The performation provides a deeper understanding of organisational performance through our NA-ANT combination, and the authors provide insight into the mobilisation of conflicting narratives in organisation studies.

The COVID-19 lockdown has led to governments around the world imposing varying levels of restrictions and lockdowns leading to home confinement and closure of schools. Children with autism spectrum disorder (ASD) and their families may be particularly susceptible to increased anxiety. Parent-led cognitive-behavioral therapy (CBT) for child anxiety disorders has developed a growing evidence base. The current pilot study aimed to evaluate the preliminary clinical utility (acceptability, feasibility, and efficacy) of a parent-led CBT program through an online format. Parents of nine children completed the program. The child did not participate in any part of the online program. Acceptability was strong, and although technical issues were problematic at times, all families completed the program. Preliminary efficacy analysis is mixed, with significant reductions on youth anxiety as measured by clinician administered questionnaire but no reduction in parent-report measures. Findings suggest that the online program is acceptance, feasible, and effective.