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Over two decades in mid-century America, the professional approach to sites endangered by post-war construction and development projects was to excavate and “save the data” from certain loss. Archeologists led such salvage efforts from 1945 to 1970, first meeting the increased demand for their labor and skills. Then, in seeing the permanence of destruction, they shifted by extending their concept of safe preservation into the future: an early conservationist archeology. One broad impact of the River Basin Surveys was in memorializing tribal histories and relationships to the land environment by the recovery of large swaths of biological, ecological, palynological, and geological data from excavations coordinated from branch offices in Nebraska, Oregon, California, Washington, D.C., and Texas. With funding from the National Science Foundation, Texas professor E. Mott Davis created a meticulous record of such archeological practices through a film series which captures that shift from the perspective of one of its practitioners. Spadework for History (1964), subtitled “Salvaging American History,” seeks to document the country’s anthropological archeology through a pioneering academic collaboration between film and archeology. Weighing scholarship on the production of archives—including an awakening to power in their production of history—this article considers the power of film in creating a memory text. In retelling Davis’s contribution, evidence from the films’ reception and memory studies perspectives together expand the temporal framework available to support further audiovisual collection-based analyses of professional work.

Provenance has underpinned archival practice in America across the past century, guiding archivists in the arrangement, description, and accessioning of new and legacy collections. Provenance research is a necessary step taken to secure pending donations and title information, and ultimately tell the story of the object’s journey to the current possessor. Across four domains of key interest in the “Developing Extensible Methods for Provenance Research” project, we examine source-specific methods that are most useful to practitioners, and communicate them in an open educational resource (OER) meant to broaden access and awareness of provenance research among administrators and students engaging with collections. Our poster will demonstrate how archival workers seek and then combine information laboriously gathered from photographs, legal documents, and handwritten materials among other resources in creative, inventive, and engaging ways that invite visitors into stories that the objects – if only they are displayed – can tell about our shared pasts and futures. Such information sources can serve a multitude of stakeholder goals, e.g. employing datapoints about transfers and handoffs to encourage object-based learning, transparency, and accountability.

Objects in multiple formats can comprise both the subjects and the approach making up “material culture”: a mode of investigating and understanding culture. Some colleges and universities steward millions of objects in academic galleries, libraries, archives, and museums (GLAM institutions). Convergence among such information professionals has led to recent offerings of an undergraduate honors seminar around campus material culture which is the focus of analysis in this paper. Students in that setting interrogated and applied the concept of provenance in reflecting on their object-based interactions. We analyze three categories of provenance lessons from the students to inform future teaching: (1) an object’s origins and pathways, (2) what provenance is and helps people do, and (3) new storytelling contributions.

Malignant bowel obstruction (MBO) in patients with advanced gynecologic cancer (GyCa) can negatively impact clinical outcomes and quality of life. Oncology nurses can support these patients with adequate tools/processes.Patients with GyCa with/at risk of MBO endure frequent emergency or hospital admissions, impacting patient care.Optimizing oncology nurses' role to improve care for patients with GyCa with/at risk of MBO, the gynecology oncology interprofessional team collaborated to develop a proactive outpatient nurse-led MBO model of care (MOC).The MBO MOC involves a risk-based algorithm engaging interdisciplinary care, utilizing standardized tools, risk-based assessment, management, and education for patients and nurses. The MOC has improved patient-reported confidence level of bowel self-management and decreased hospitalization. Following education, nurses demonstrated increased knowledge in MBO management.An outpatient nurse-led MBO MOC can improve patient care and may be extended to other cancer centers, fostering collaboration and best practice.

Cuneiform tablets remain founding cornerstones of two hundred plus collections in American academic institutions, having been acquired a century or more ago under dynamic ethical norms and global networks. To foster data sharing, this contribution incorporates empirical data from interactive ArcGIS and reusable OpenContext maps to encourage tandem dialogues about using the inscribed works and learning their collecting histories. Such provenance research aids, on their own, initiate the narration of objects’ journeys over time while cultivating the digital inclusion of expert local knowledge relevant to an object biography. The paper annotates several approaches institutions are or might consider using to expand upon current provenance information in ways that encourage visitors’ critical thinking and learning about global journeys, travel archives, and such dispositions as virtual reunification, reconstructions, or restitution made possible by the provenance research.

Background Limited quantitative data suggests that patients who have chronic kidney disease without kidney replacement therapy (CKD without KRT) may present with psychosocial needs just as patients who have acute kidney injury and are treated by dialysis (AKI stage 3D) do. This systematic review aims to synthesise qualitative research on patients’ experiences of CKD without KRT to provide further insight into patients’ experience of the healthcare they receive and simultaneously, their psychosocial needs, to inform the development of appropriate psychological interventions. Methods The review followed ENTREQ guidelines. PubMed/MEDLINE, PsycINFO, EMBASE and CINAHL were searched in July and August 2021. Qualitative studies in English on the experiences of CKD without KRT care were included in the review. Thematic synthesis was conducted on the findings of the included studies. Results The search identified 231 articles for screening. Eight studies met the inclusion criteria, and one was excluded at the quality assessment stage. The final seven articles [n = 130 patients] were analysed. Five themes on psychosocial needs were developed: addressing patients’ CKD-related educational needs, supporting the patient’s relationships, honouring the patient’s need for control, adjusting to change, and recognising fear of disease and treatment. Discussion This review highlights the range of psychosocial needs of patients who have CKD without KRT. There are numerous intervention options that clinicians may develop that could benefit patients and address multiple needs, such as group educational programmes. Graphical abstract

The Exploring Together program is a group-based parent training program that comprises separate parent, child, and teacher components, and a combined parent–child interactive component. A cluster-randomized trial design was used to compare the Exploring Together program with (Exploring Together; ET) and without (Exploring Together-Adapted; ET-Adapted) the parent–child interactive component. One hundred and thirty-six parents and their children (aged 5–10 years) with externalizing and/or internalizing problems participated in the trial, recruited from primary schools. There was a significant reduction in negative parenting behavior across both treatment groups (ET and ET-Adapted) but no significant improvement in positive parenting behaviors. Parenting self-efficacy improved significantly across both treatment groups however there was no significant change in parenting satisfaction or parenting stress. There was no consistent evidence of superiority of one version of the Exploring Together program over the other. Further investigation regarding treatment dosage and mastery of parenting skills associated with the program is warranted.

The Exploring Together program is a group-based parent training program that comprises separate parent, child, and teacher components, and a combined parent-child interactive component. A cluster-randomized trial design was used to compare the Exploring Together program with (Exploring Together; ET) and without (Exploring Together-Adapted; ET-Adapted) the parent-child interactive component. One hundred and thirty-six parents and their children (aged 5-10 years) with externalizing and/or internalizing problems participated in the trial, recruited from primary schools. There was a significant reduction in negative parenting behavior across both treatment groups (ET and ET-Adapted) but no significant improvement in positive parenting behaviors. Parenting self-efficacy improved significantly across both treatment groups however there was no significant change in parenting satisfaction or parenting stress. There was no consistent evidence of superiority of one version of the Exploring Together program over the other. Further investigation regarding treatment dosage and mastery of parenting skills associated with the program is warranted.

PURPOSE: Malignant bowel obstruction (MBO) is a common and distressing complication in women with advanced gynecologic cancer. A pilot, interprofessional MBO program was launched in 2016 at a large Canadian tertiary cancer center to integrate these patients’ complex care needs across multiple disciplines and support women with MBO. METHOD: Retrospective analysis to evaluate the outcomes of women with advanced gynecologic cancer who were admitted to hospital because of MBO, before (2014 to 2016: baseline group) and after (2016 to 2018) implementation of the MBO program. RESULTS: Of the 169 women evaluated, 106 and 63 were in the baseline group and MBO program group, respectively. Most had ovarian cancer (n = 124; 73%) and had small-bowel obstruction (n = 131; 78%). There was a significantly shorter cumulative hospital length of stay (LOSsum) within the first 60 days of MBO diagnosis in the MBO program group compared with the baseline group (13 v 22 days, respectively; adjusted P = .006). The median overall survival for women treated in the MBO program was also significantly longer compared with the baseline group (243 v 99 days, respectively; adjusted P = .002). Using the interprofessional MBO care platform, a greater proportion of patients received palliative chemotherapy (83% v 56%) and less surgery (11% v 21%) in the MBO program group than in the baseline group, respectively. A subgroup of women (n = 11) received total parenteral nutrition for longer than 6 months. CONCLUSION: Implementation of a comprehensive, interprofessional MBO program significantly affects patient care and may improve outcomes. Unique to this MBO program is an integrated outpatient model of care and education that empowers patients to recognize MBO symptoms for early intervention.

SYNOPSISObjective: This study evaluated the role of parent-child interactive groups in a group-based parent training program for children with externalizing and/or internalizing behavior problems; ...

Epigenetic alterations, such as those linked to DNA methylation, may potentially provide molecular explanations for complications associated with altered gene expression in illnesses, such as chronic kidney disease (CKD). Although both DNA hypo- and hypermethylation have been observed in the uremic milieu, this remains only a single aspect of the epigenetic landscape and, thus, of any biochemical dysregulation associated with CKD. Nevertheless, the role of uremia-promoting alterations on the epigenetic landscape regulating gene expression is still a novel and scarcely studied field. Although few studies have actually reported alterations of DNA methylation via methyl donor nutrient intake, emerging evidence indicates that nutritional modification of the microbiome can affect one-carbon metabolism and the capacity to methylate the genome in CKD. In this review, we discuss the nutritional modifications that may affect one-carbon metabolism and the possible impact of methyl donor nutrients on the microbiome, CKD, and its phenotype.

Imbalanced nutrition is associated with accelerated ageing, possibly mediated by microbiota. An analysis of the circulatory microbiota obtained from the leukocytes of participants in the MRC Twenty-07 general population cohort was performed. We now report that in this cohort, the most biologically aged exhibit a significantly higher abundance of circulatory pathogenic bacteria, including Neisseria, Rothia and Porphyromonas, while those less biologically aged possess more circulatory salutogenic (defined as being supportive of human health and wellbeing) bacteria, including Lactobacillus, Lachnospiraceae UCG-004 and Kocuria. The presence of these salutogenic bactreria is consistent with a capacity to metabolise and produce Nrf2 agonists. We also demonstrate that associated one carbon metabolism, notably betaine levels, did not vary with chronological age, but displayed a difference with socioeconomic position (SEP). Those at lower SEP possessed significantly lower betaine levels indicative of a poorer diet and poorer health span and consistent with reduced global DNA methylation levels in this group. Our data suggest a clear route to improving age related health and resilience based on dietary modulation of the microbiota.

"What we found in this research is that news organizations are saving digital news content to at least a limited extent, one that often depends on the kind of technologies where news content resides, their purpose, and other key factors. We found that the degree to which your existing content is accessible and useful depends not only on the technologies used, but also on your policies, if any, about what is saved. Other factors that affect access to content include the workflows used to assemble and store content, the metadata that’s saved with your content--or missing depending on how it is managed--whether or not you have staff dedicated to preservation work, and how well content translates when you undergo a transition from one technology platform to another, an inevitable fact of life in today’s publishing industry. News organizations that use either an archive or digital asset management (DAM) system of some kind have the most control of the content used to post, publish, broadcast or stream the news. They are also in the best position to find and access past content, understand its origins and licensing rights, reuse it for new products, tap it for newsroom research, publish it in related content links, and take full advantage of the long-tail phenomenon by reselling to the public or research community. ..."--Findings summar

Summary Metal-organic frameworks (MOFs) have been proposed as biocompatible candidates for the targeted intracellular delivery of chemotherapeutic payloads, but the site of drug loading and subsequent effect on intracellular release is often overlooked. Here, we analyze doxorubicin delivery to cancer cells by MIL-101(Cr) and UiO-66 in real time. Having experimentally and computationally verified that doxorubicin is pore loaded in MIL-101(Cr) and surface loaded on UiO-66, different time-dependent cytotoxicity profiles are observed by real-time cell analysis and confocal microscopy. The attenuated release of aggregated doxorubicin from the surface of Dox@UiO-66 results in a 12 to 16 h induction of cytotoxicity, while rapid release of pore-dispersed doxorubicin from Dox@MIL-101(Cr) leads to significantly higher intranuclear localization and rapid cell death. In verifying real-time cell analysis as a versatile tool to assess biocompatibility and drug delivery, we show that the localization of drugs in (or on) MOF nanoparticles controls delivery profiles and is key to understanding in vitro modes of action., Graphical Abstract, Highlights Comprehensive analysis confirms in vitro biocompatibility of UiO-66 and MIL-101(Cr) Real-time observation of doxorubicin delivery from MOFs and subsequent cytotoxicity Location of drug within MOF nanoparticles greatly affects release mechanisms Tunable anticancer cytotoxicity profiles are possible by modifying drug location, Markopoulou et al. demonstrate that real-time cell analysis can be used to assess biocompatibility and drug delivery from MOFs. Different time-dependent cytotoxicity profiles occur when drugs are pore loaded versus surface loaded, making tunable drug release possible.

This systematic review and meta-analysis evaluates the efficacy of parent training group interventions to treat child externalizing and/or internalizing problems. A search identified 21 randomized controlled trials of parent group interventions aimed at ameliorating child externalizing and/or internalizing problems in children aged 4-12 years. Random effects meta-analyses yielded significant pooled treatment effect size (g) estimates for child externalizing (g = -0.38) and internalizing problems (g = -0.18). Child anxiety symptoms or internalizing problems evident in children with externalizing behavior problems did not change significantly following intervention. Study quality was a statistically significant moderator of treatment response for child externalizing problems, however hours of planned parent group treatment and treatment recipient were not. Findings support the use of parent group interventions as an effective treatment for reducing externalizing problems in children aged 4-12 years. Whilst statistically significant, programs had a limited impact on internalizing symptoms, indicating a need for further investigation.

This study aimed to explore the impact of an awareness tool for relatives of older drivers (OSCARPA) on i) their interest, openness and knowledge, ii) changes of abilities required for safe driving, and iii) utilization of compensatory strategies. A pre-experimental design with pretest (T0) and post-test (T1) eight to ten weeks after the intervention was realized with 45 relatives in contact with an older driver of 65 years old or older and who was driving at least once a week. Overall, the results demonstrated that OSCARPA increased i) interest, openness and knowledge of relatives (p

This thesis comprises an evaluation of a group-based parent training program for primary school aged children with behavioural and/or emotional problems. The study compares the relative effectiveness of two versions of Monash Health’s adapted Exploring Together program, with and without the parent-child interactive component, in terms of the impact on child behaviour, parenting behaviour, parenting stress and sense of competence. This thesis contributes to a deeper understanding of the effectiveness of group-based parent training programs for treatment of child behaviour problems in primary school settings, as well as highlighting areas requiring further clinical and research attention.

Under normal physiological conditions, free radical generation and antioxidant defences are balanced, and reactive oxygen species (ROS) usually act as secondary messengers in a plethora of biological processes. However, when this balance is impaired, oxidative stress develops due to imbalanced redox homeostasis resulting in cellular damage. Oxidative stress is now recognized as a trigger of cellular senescence, which is associated with multiple chronic 'burden of lifestyle' diseases, including atherosclerosis, type-2 diabetes, chronic kidney disease and vascular calcification; all of which possess signs of early vascular ageing.\ud \ud Nuclear factor erythroid 2-related factor 2 (Nrf2), termed the master regulator of antioxidant responses, is a transcription factor found to be frequently dysregulated in conditions characterized by oxidative stress and inflammation. Recent evidence suggests that activation of Nrf2 may be beneficial in protecting against vascular senescence and calcification. Both natural and synthetic Nrf2 agonists have been introduced as promising drug classes in different phases of clinical trials. However, overexpression of the Nrf2 pathway has also been linked to tumorigenesis, which highlights the requirement for further understanding of pathways involving Nrf2 activity, especially in the context of cellular senescence and vascular calcification.\ud \ud Therefore, comprehensive translational pre-clinical and clinical studies addressing the targeting capabilities of Nrf2 agonists are urgently required. The present review discusses the impact of Nrf2 in senescence and calcification in early vascular ageing, with focus on the potential clinical implications of Nrf2 agonists and non-pharmacological Nrf2 therapeutics.

Ageing is a process of decline in physiological function and capability over time. It is an anticipated major burden on societal health-care costs due to an increasingly aged global population. Accelerated biological ageing is a feature of age-related morbidities, which also appear to share common underpinning features, including low-grade persistent inflammation, phosphate toxicity, diminished Nrf2 activity, a depleted metabolic capability, depressed mitochondrial biogenesis and a low diversity gut microbiome. Social, psychological, lifestyle and nutritional risk factors can all influence the trajectory of age-related health, as part of an individual's exposome, which reflects the interplay between the genome and the environment. This is manifest as allostatic (over)load reflecting the burden of lifestyle/disease at both a physiological and molecular level. In particular, age-related genomic methylation levels and inflammatory status reflect exposome differences. These features may be mediated by changes in microbial diversity. This can drive the generation of pro-inflammatory factors, such as TMAO, implicated in the ‘diseasome’ of ageing. Additionally, it can be influenced by the ‘foodome’, via nutritional differences affecting the availability of methyl donors required for maintenance of the epigenome and by the provision of nutritionally derived Nrf2 agonists. Both these factors influence age-related physiological resilience and health. This offers novel insights into possible interventions to improve health span, including a rage of emerging senotherapies and simple modifications of the nutritional and environmental exposome. In essence, the emerging strategy is to treat ageing processes common to the diseasome of ageing itself and thus preempt the development or progression of a range of age-related morbidities.

The psychologist’s role in rehabilitation settings includes supporting both team formulation and training (e.g. New Ways of Working, 2007). This article summarises our attempts to embed formulation within a year-long training programme in a community rehabilitation setting.

There is significant interest among patients and providers in using cannabis (marijuana) and its derivatives to treat a number of chronic illnesses, including inflammatory bowel disease. Despite the Schedule I classification of cannabis by the federal government, state governments have sought ways to make cannabis available for specific medical conditions, and some states have legalized cannabis outright. This white paper summarizes the preclinical data, clinical data, safety data, and the regulatory landscape as they apply to medical cannabis use in inflammatory bowel disease. Animal models of cannabinoid chemistry and physiology give evidence of anti-inflammatory, antidiarrheal, and nociceptive-limiting properties. Human studies have found benefit in controlling symptoms and improving quality of life, but no studies have established true disease modification given the absent improvement in biomarker profiles or endoscopic healing. Finally, this review describes the legal, regulatory, and practical hurdles to studying the risks and benefits of medical cannabis in the United States. 10.1093/ibd/izy319_video1 izy319.video1 5852852028001

Farm animals have been identified as reservoirs of Clostridium difficile PCR-ribotype 078 (RT078). Since 2005, the incidence of human clinical cases (frequently severe), with this genotype has increased. We aimed to understand this change, by studying the recent evolutionary history of RT078. Phylogenetic analysis of international genomes (isolates from 2006–2014) revealed several recent clonal expansions. A common ancestor of each expansion had independently acquired different alleles of the tetracycline resistance gene tetM. Consequently, an unusually high proportion of RT078 genomes were tetM positive (76.5%). Additional tetracycline resistance determinants were also identified, some for the first time in C. difficile (efflux pump tet40). Each tetM-clonal expansion lacked geographic structure, indicating rapid international spread. Resistance determinants for C. difficile-infection-triggering antimicrobials including fluoroquinolones and clindamycin were comparatively rare in RT078. Tetracyclines are used intensively in agriculture; this selective pressure, plus rapid spread via the food-chain may explain the increased RT078 prevalence in humans.

e18322 Background: Though patients (pts) with gynecological cancer are at higher risk of MBO, clinical management is not well defined. We implemented a coordinated team approach to evaluate MBO at Princess Margaret Cancer Centre. The Princess Margaret Cancer Centre inter-professional MBO management program includes nurse led ambulatory symptom management, inpatient treatment algorithm, patient directed bowel management education & MCCs. This study evaluates the utility of MBO MCC on clinical decision making in gynecologic oncology. Methods: Monthly MBO MCCs are conducted to discuss complex clinical management issues. A clinical summary is presented prior to the discussion with each case incorporating radiology review followed by interdisciplinary discussion. In this study, the initial management plan was compared to post-MCC consensus. A change in plan was defined as a consensus plan different from the pre-MCC plan or no definite plan prior to MCC. Barriers to implementation of the consensus were analyzed. Results: From December 2016 to November 2018, 90 pts were discussed in 22 MCCs. Of these, 60 had high grade serous ovarian carcinoma (67%) & 64 had small bowel obstruction (71%). Discussion in MCCs lead to a change in management plan in 49 cases(54%). These changes included recommendations for palliative surgery (25%) or radiation (10%), interventional radiology (23%), pharmacologic management alone (14%), imaging studies (4%) & total parenteral nutrition (TPN) (4%). Chemotherapy continuation, break or regimen changes were recommended in 20%. MCC consensus plan could not be implemented in 11 cases (23%). The barriers were refusal of surgery (8%), interventional radiology procedures (2%), TPN (4%) by patients, functional decline (6%) & inability to create a colostomy due to dense adhesions (2%). During MCC referrals to the dietitian & palliative care team were planned for 16 (18%) & 22 (24%) pts respectively. Conclusions: Interdisciplinary MBO MCCs have a significant impact on decision making in complex MBO cases. Radiology review & group discussion facilitates greater clarity in formulation of a management plan.