Enhancing practitioners’ confidence in recruitment and consent in the EcLiPSE trial: A mixed-method evaluation of site training – a Paediatric Emergency Research in the United Kingdom and Ireland (PERUKI) study

Background: EcLiPSE (Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children) is a randomised controlled trial (RCT) in the United Kingdom. Challenges to success include the need to immediately administer an intervention without informed consent and changes in staffing during trial conduct, mainly due to physician rotations. Using literature on parents' perspectives and research without prior consent (RWPC) guidance, we developed an interactive training package (including videos, simulation and question and answer sessions) and evaluated its dissemination and impact upon on practitioners' confidence in recruitment and consent. Methods: Questionnaires were administered before and immediately after training followed by telephone interviews (mean 11 months later), focus groups (mean 14 months later) and an online questionnaire (8 months before trial closure).Results: One hundred and twenty-five practitioners from 26/30 (87%) participating hospitals completed a questionnaire before and after training. We conducted 10 interviews and six focus groups (comprising 36 practitioners); 199 practitioners working in all recruiting hospitals completed the online questionnaire. Before training, practitioners were concerned about recruitment and consent. Confidence increased after training for explaining (all scale 0-5, 95% CIs above 0 and p values < 0.05): the study (66% improved mean score before 3.28 and after 4.52), randomisation (47% improvement, 3.86 to 4.63), RWPC (72% improvement, 2.98 to 4.39), and addressing parents' objections to randomisation (51% improvement, 3.37 to 4.25). Practitioners rated highly the content and clarity of the training, which was successfully disseminated. Some concerns about staff availability for training and consent discussions remained.Conclusions: Training improved practitioners' confidence in recruitment and RWPC. Our findings highlight the value of using parents' perspectives to inform training and to engage practitioners in trials that are at high risk of being too challenging to conduct

Field Report: Anna Plains and Roebuck Bay Benthic Invertebrate Mapping 2016

This project has been funded by the Department of Parks and Wildlife partnershipwith BHP Billiton “Eighty Mile Beach and Walyarta Conservation Program”, with in-kind support from NIOZ and Wetland Research &amp; ManagementThis report was produced at the Broome Bird Observatory in late October 2016.Abstract1. This is a report on repeat surveys on the state of the benthic invertebrates at two internationally important areas of intertidal mudflats in northwest Australia (Roebuck Bay and Eighty Mile Beach) during October 2016. In the period 6-19 October 2016, we mapped the invertebrate macrobenthic animals (those retained by a 1 mm sieve) at the main intertidal sites of West Kimberley, WA: Eighty Mile Beach and Roebuck Bay. We revisited almost the entire intertidal area along Eighty Mile Beach that was ‘benthically’ mapped in October 1999. The benthic animals of the northern mudflats of Roebuck Bay had been mapped in 1997, 2000, 2002, and 2006; we revisited as many as possible of these previously established sampling stations along the northern shore.2. Our team comprised close to 100 participants with greatly varying levels of experience, though similarly high motivation and enthusiasm. At Eighty Mile Beach we visited 816 sampling stations laid out in a grid of 200 m intersections over 7 separate areas along ca. 75 km of beach (from 10 km north of the Anna Plains Station beach access to 65 km south). In the northern part of Roebuck Bay, we visited 534 sampling stations also laid out in a grid with 200 m intersections (but with distance of 400 m in the southeast). We made notes on the surface features on the mud, including the presence or absence of seagrass and various macrofauna. In the course of digging up, sieving, and sorting the mud samples from all stations, we identified and measured 32,500 individual invertebrates. We tried to identify all animals groups up to the level of species if possible, all on the basis of morphological differences. These species were often given field names, as time and means (literature or access to internet) did not allow us to always attach a proper scientific name. In addition, it is very likely that some of the species are still undescribed. Animals were preserved on ethanol for a more thorough scientific identification at a later date.3. This time we surveyed two very distinct sections of the West Kimberley coast. Roebuck Bay represents a true embayment that is semi-enclosed by mangroves along the eastern, and some of the western shores, and by cliff and pindan woodlands in the north. Eighty Mile Beach stretches over 200 km along the open Indian Ocean facing northwest. In this environment, the intertidal mud- and sandflat area stretches from 1-5 km wide from shore to sea and is enclosed by sand dunes and a few mangroves. Despite the two systems being very important as nonbreeding areas for the same species of long-distance migrant shorebirds, their geomorphology and ecology are very distinct.4. At both areas the biodiversity of benthic animals was very high compared with other intertidal soft sediment areas across in the world. In Roebuck Bay, 368 species were found, and at Eighty Mile Beach 156 species, providing a total of 433 species/taxa. The most diverse group were the Polychaeta with 167 species, followed by Crustacea (74), Bivalvia (59), Gastropoda (59), and Echinodermata (35). All other groups total less than 12 species.5. The two areas have 92 species in common, which in the case of Eighty Mile Beach means that 60% of the species also occur in Roebuck Bay. Major groups not found at Eighty Mile Beach were Asteroidea, Brachiopoda, Hirudinea, Oligochaeta, Platyhelminthes, Polyplacophora, and Pycnogonida. Most of these groups were also rare in Roebuck Bay, but the absence of Brachiopoda (lamp-shells) and Pycnogonida (seaspiders) at Eighty Mile Beach came as a surprise. Some species, including two species of Spionidae (Polychaeta) common at Eighty Mile Beach were either absent or extremely rare at Roebuck Bay. Furthermore, a small seacucumber with dark coloured spots all over its body, another larger seacucumber Paracaudina chilensis, two bivalve species of the genus Tellina, and two species of anemones were not found in Roebuck Bay. Yet, Roebuck Bay had many more species (277) not found at Eighty Mile Beach, the most common of these was the relatively large bivalve Tellina piratica, followed by the smooth tusk shell (Laevidentalium lubricatum), and the polychaete family Sternaspidae.6. The large difference in biodiversity between Roebuck Bay and Eighty Mile Beach may be caused by different factors. Roebuck Bay has a greater variety of sedimentary habitats than Eighty Mile Beach. Eighty Mile Beach is completely exposed to the waves of Indian Ocean, while Roebuck Bay is protected by the peninsula on which Broome is situated. Therefore, notorious ‘ecosystem engineers’ such as the seagrasses occur quite extensively on the intertidal area of Roebuck Bay, but are not found at Eighty Mile Beach. These seagrass mats of Halodula uninervis and Halophila ovalis form special habitat for e.g. the little snail Smaragdia souverbiana. The influence of Broome city by episodic sewage and fertilizer releases, of which blooms of the cyanobacteria Lyngbya are an indication, can may well have a negative influence; opportunistic widespread species other than Lyngbya may of course benefit from the additional nutrient inputs.7. Local communities and the land-owners actively participated in both expeditions. Several DPAW ranger groups (Yawuru, Karajarri and Nyangumarta) joined the sampling and also aided in the identification of species. Angela Rossen (WAMSI) spearheaded a biodiversity project that involved pupils from Cable Beach Primary School. We believe that we have raised wide awareness and generated considerable enthusiasm for the ecology of a unique contribution of northwest Australia to the world.8. Based on their outstanding universal values, we recommend that the WA government consider an application of the joint marine reserves of Eighty Mile Beach and Roebuck Bay for World Heritage Status, thus joining China and South Korea in acknowledging and protecting this shared heritage.<br/

The Local Politics of Public Action: Relationships, Bargains and the Question of ‘Impact”

The concluding contribution to this IDS Bulletin draws together the themes and findings from the eight country case studies. It reflects on the choice of the framing notion of ‘public action’ as distinct from a focus on ‘civil society’, as an alternative and more appropriate frame of reference for the hybrid forms of change in local governance witnessed through these cases. Three main wider contributions of the research are identified. First, as action research, some of the cases offer fresh perspectives on processes of change, often from the valuable perspectives of insiders or engaged practitioners. Second, the cases collectively provide striking new insights into how relationships are built to bolster alliances, strike bargains, and develop trust between actors engaged in local governance reform. Third, the article draws together the case study findings to develop a working typology of the impacts of local democratic governance reform on poverty, inequality and exclusion

Field Report: Anna Plains and Roebuck Bay Benthic Invertebrate Mapping 2016

This project has been funded by the Department of Parks and Wildlife partnershipwith BHP Billiton “Eighty Mile Beach and Walyarta Conservation Program”, with in-kind support from NIOZ and Wetland Research &amp; ManagementThis report was produced at the Broome Bird Observatory in late October 2016.Abstract1. This is a report on repeat surveys on the state of the benthic invertebrates at two internationally important areas of intertidal mudflats in northwest Australia (Roebuck Bay and Eighty Mile Beach) during October 2016. In the period 6-19 October 2016, we mapped the invertebrate macrobenthic animals (those retained by a 1 mm sieve) at the main intertidal sites of West Kimberley, WA: Eighty Mile Beach and Roebuck Bay. We revisited almost the entire intertidal area along Eighty Mile Beach that was ‘benthically’ mapped in October 1999. The benthic animals of the northern mudflats of Roebuck Bay had been mapped in 1997, 2000, 2002, and 2006; we revisited as many as possible of these previously established sampling stations along the northern shore.2. Our team comprised close to 100 participants with greatly varying levels of experience, though similarly high motivation and enthusiasm. At Eighty Mile Beach we visited 816 sampling stations laid out in a grid of 200 m intersections over 7 separate areas along ca. 75 km of beach (from 10 km north of the Anna Plains Station beach access to 65 km south). In the northern part of Roebuck Bay, we visited 534 sampling stations also laid out in a grid with 200 m intersections (but with distance of 400 m in the southeast). We made notes on the surface features on the mud, including the presence or absence of seagrass and various macrofauna. In the course of digging up, sieving, and sorting the mud samples from all stations, we identified and measured 32,500 individual invertebrates. We tried to identify all animals groups up to the level of species if possible, all on the basis of morphological differences. These species were often given field names, as time and means (literature or access to internet) did not allow us to always attach a proper scientific name. In addition, it is very likely that some of the species are still undescribed. Animals were preserved on ethanol for a more thorough scientific identification at a later date.3. This time we surveyed two very distinct sections of the West Kimberley coast. Roebuck Bay represents a true embayment that is semi-enclosed by mangroves along the eastern, and some of the western shores, and by cliff and pindan woodlands in the north. Eighty Mile Beach stretches over 200 km along the open Indian Ocean facing northwest. In this environment, the intertidal mud- and sandflat area stretches from 1-5 km wide from shore to sea and is enclosed by sand dunes and a few mangroves. Despite the two systems being very important as nonbreeding areas for the same species of long-distance migrant shorebirds, their geomorphology and ecology are very distinct.4. At both areas the biodiversity of benthic animals was very high compared with other intertidal soft sediment areas across in the world. In Roebuck Bay, 368 species were found, and at Eighty Mile Beach 156 species, providing a total of 433 species/taxa. The most diverse group were the Polychaeta with 167 species, followed by Crustacea (74), Bivalvia (59), Gastropoda (59), and Echinodermata (35). All other groups total less than 12 species.5. The two areas have 92 species in common, which in the case of Eighty Mile Beach means that 60% of the species also occur in Roebuck Bay. Major groups not found at Eighty Mile Beach were Asteroidea, Brachiopoda, Hirudinea, Oligochaeta, Platyhelminthes, Polyplacophora, and Pycnogonida. Most of these groups were also rare in Roebuck Bay, but the absence of Brachiopoda (lamp-shells) and Pycnogonida (seaspiders) at Eighty Mile Beach came as a surprise. Some species, including two species of Spionidae (Polychaeta) common at Eighty Mile Beach were either absent or extremely rare at Roebuck Bay. Furthermore, a small seacucumber with dark coloured spots all over its body, another larger seacucumber Paracaudina chilensis, two bivalve species of the genus Tellina, and two species of anemones were not found in Roebuck Bay. Yet, Roebuck Bay had many more species (277) not found at Eighty Mile Beach, the most common of these was the relatively large bivalve Tellina piratica, followed by the smooth tusk shell (Laevidentalium lubricatum), and the polychaete family Sternaspidae.6. The large difference in biodiversity between Roebuck Bay and Eighty Mile Beach may be caused by different factors. Roebuck Bay has a greater variety of sedimentary habitats than Eighty Mile Beach. Eighty Mile Beach is completely exposed to the waves of Indian Ocean, while Roebuck Bay is protected by the peninsula on which Broome is situated. Therefore, notorious ‘ecosystem engineers’ such as the seagrasses occur quite extensively on the intertidal area of Roebuck Bay, but are not found at Eighty Mile Beach. These seagrass mats of Halodula uninervis and Halophila ovalis form special habitat for e.g. the little snail Smaragdia souverbiana. The influence of Broome city by episodic sewage and fertilizer releases, of which blooms of the cyanobacteria Lyngbya are an indication, can may well have a negative influence; opportunistic widespread species other than Lyngbya may of course benefit from the additional nutrient inputs.7. Local communities and the land-owners actively participated in both expeditions. Several DPAW ranger groups (Yawuru, Karajarri and Nyangumarta) joined the sampling and also aided in the identification of species. Angela Rossen (WAMSI) spearheaded a biodiversity project that involved pupils from Cable Beach Primary School. We believe that we have raised wide awareness and generated considerable enthusiasm for the ecology of a unique contribution of northwest Australia to the world.8. Based on their outstanding universal values, we recommend that the WA government consider an application of the joint marine reserves of Eighty Mile Beach and Roebuck Bay for World Heritage Status, thus joining China and South Korea in acknowledging and protecting this shared heritage.<br/

Seven-step framework to enhance practitioner explanations and parental understandings of research without prior consent in paediatric emergency and critical care trials

Background: Alternatives to prospective informed consent enable the conduct of paediatric emergency and critical care trials. Research without prior consent (RWPC) involves practitioners approaching parents after an intervention has been given and seeking consent for their child to continue in the trial. As part of an embedded study in the 'Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children' (EcLiPSE) trial, we explored how practitioners described the trial and RWPC during recruitment discussions, and how well this information was understood by parents. We aimed to develop a framework to assist trial conversations in future paediatric emergency and critical care trials using RWPC. Methods: Qualitative methods embedded within the EcLiPSE trial processes, including audiorecorded practitioner-parent trial discussions and telephone interviews with parents. We analysed data using thematic analysis, drawing on the Realpe et al (2016) model for recruitment to trials. Results: We analysed 76 recorded trial discussions and conducted 30 parent telephone interviews. For 19 parents, we had recorded trial discussion and interview data, which were matched for analysis. Parental understanding of the EcLiPSE trial was enhanced when practitioners: provided a comprehensive description of trial aims; explained the reasons for RWPC; discussed uncertainty about which intervention was best; provided a balanced description of trial intervention; provided a clear explanation about randomisation and provided an opportunity for questions. We present a seven-step framework to assist recruitment practice in trials involving RWPC. Conclusion: This study provides a framework to enhance recruitment practice and parental understanding in paediatric emergency and critical care trials involving RWPC. Further testing of this framework is required

Adalimumab in combination with methotrexate for refractory uveitis associated with juvenile idiopathic arthritis: a RCT

Abstract Background Children with juvenile idiopathic arthritis (JIA) are at risk of uveitis. The role of adalimumab (Humira®; AbbVie Inc., Ludwigshafen, Germany) in the management of uveitis in children needs to be determined. Objective To compare the efficacy, safety and cost-effectiveness of adalimumab in combination with methotrexate (MTX) versus placebo with MTX alone, with regard to controlling disease activity in refractory uveitis associated with JIA. Design This was a randomised (applying a ratio of 2 : 1 in favour of adalimumab), double-blind, placebo-controlled, multicentre parallel-group trial with an integrated economic evaluation. A central web-based system used computer-generated tables to allocate treatments. A cost–utility analysis based on visual acuity was conducted and a 10-year extrapolation by Markov modelling was also carried out. Setting The setting was tertiary care centres throughout the UK. Participants Patients aged 2–18 years inclusive, with persistently active JIA-associated uveitis (despite optimised MTX treatment for at least 12 weeks). Interventions All participants received a stable dose of MTX and either adalimumab (20 mg/0.8 ml for patients weighing < 30 kg or 40 mg/0.8 ml for patients weighing ≥ 30 kg by subcutaneous injection every 2 weeks based on body weight) or a placebo (0.8 ml as appropriate according to body weight by subcutaneous injection every 2 weeks) for up to 18 months. A follow-up appointment was arranged at 6 months. Main outcome measures Primary outcome – time to treatment failure [multicomponent score as defined by set criteria based on the Standardisation of Uveitis Nomenclature (SUN) criteria]. Economic outcome – incremental cost per quality-adjusted life-year (QALY) gained from the perspective of the NHS in England and Personal Social Services providers. Full details of secondary outcomes are provided in the study protocol. Results A total of 90 participants were randomised (adalimumab, n = 60; placebo, n = 30). There were 14 (23%) treatment failures in the adalimumab group and 17 (57%) in the placebo group. The analysis of the data from the double-blind phase of the trial showed that the hazard risk (HR) of treatment failure was significantly reduced, by 75%, for participants in the adalimumab group (HR 0.25, 95% confidence interval 0.12 to 0.51; p < 0.0001 from log-rank test). The cost-effectiveness of adalimumab plus MTX was £129,025 per QALY gained. Adalimumab-treated participants had a much higher incidence of adverse and serious adverse events. Conclusions Adalimumab in combination with MTX is safe and effective in the management of JIA-associated uveitis. However, the likelihood of cost-effectiveness is < 1% at the £30,000-per-QALY threshold. Future work A clinical trial is required to define the most effective time to stop therapy. Prognostic biomarkers of early and complete response should also be identified

Emergency treatment with levetiracetam or phenytoin in status epilepticus in children-the EcLiPSE study: Study protocol for a randomised controlled trial

© The Author(s). 2017. Background: Convulsive status epilepticus (CSE) is the most common life-threatening neurological emergency in childhood. These children are also at risk of significant morbidity, with acute and chronic impact on the family and the health and social care systems. The current recommended first-choice, second-line treatment in children aged 6 months and above is intravenous phenytoin (fosphenytoin in the USA), although there is a lack of evidence for its use and it is associated with significant side effects. Emerging evidence suggests that intravenous levetiracetam may be effective as a second-line agent for CSE, and fewer adverse effects have been described. This trial therefore aims to determine whether intravenous phenytoin or levetiracetam is more effective, and safer, in treating childhood CSE. Methods/design: This is a phase IV, multi-centre, parallel group, randomised controlled, open-label trial. Following treatment for CSE with first-line treatment, children with ongoing seizures are randomised to receive either phenytoin (20 mg/kg, maximum 2 g) or levetiracetam (40 mg/kg, maximum 2.5 g) intravenously. The primary outcome measure is the cessation of all visible signs of CSE as determined by the treating clinician. Secondary outcome measures include the need for further anti-seizure medications or rapid sequence induction for ongoing CSE, admission to critical care areas, and serious adverse reactions. Patients are recruited without prior consent, with deferred consent sought at an appropriate time for the family. The primary analysis will be by intention-to-treat. The primary outcome is a time to event outcome and a sample size of 140 participants in each group will have 80% power to detect an increase in CSE cessation rates from 60% to 75%. Our total sample size of 308 randomised and treated participants will allow for 10% loss to follow-up. Discussion: This clinical trial will determine whether phenytoin or levetiracetam is more effective as an intravenous second-line agent for CSE, and provide evidence for management recommendations. In addition, this trial will also provide data on which of these therapies is safer in this setting

Field Report: Anna Plains and Roebuck Bay Benthic Invertebrate Mapping 2016

This project has been funded by the Department of Parks and Wildlife partnership with BHP Billiton “Eighty Mile Beach and Walyarta Conservation Program”, with in-kind support from NIOZ and Wetland Research & Management This report was produced at the Broome Bird Observatory in late October 2016. Abstract 1. This is a report on repeat surveys on the state of the benthic invertebrates at two internationally important areas of intertidal mudflats in northwest Australia (Roebuck Bay and Eighty Mile Beach) during October 2016. In the period 6-19 October 2016, we mapped the invertebrate macrobenthic animals (those retained by a 1 mm sieve) at the main intertidal sites of West Kimberley, WA: Eighty Mile Beach and Roebuck Bay. We revisited almost the entire intertidal area along Eighty Mile Beach that was ‘benthically’ mapped in October 1999. The benthic animals of the northern mudflats of Roebuck Bay had been mapped in 1997, 2000, 2002, and 2006; we revisited as many as possible of these previously established sampling stations along the northern shore. 2. Our team comprised close to 100 participants with greatly varying levels of experience, though similarly high motivation and enthusiasm. At Eighty Mile Beach we visited 816 sampling stations laid out in a grid of 200 m intersections over 7 separate areas along ca. 75 km of beach (from 10 km north of the Anna Plains Station beach access to 65 km south). In the northern part of Roebuck Bay, we visited 534 sampling stations also laid out in a grid with 200 m intersections (but with distance of 400 m in the southeast). We made notes on the surface features on the mud, including the presence or absence of seagrass and various macrofauna. In the course of digging up, sieving, and sorting the mud samples from all stations, we identified and measured 32,500 individual invertebrates. We tried to identify all animals groups up to the level of species if possible, all on the basis of morphological differences. These species were often given field names, as time and means (literature or access to internet) did not allow us to always attach a proper scientific name. In addition, it is very likely that some of the species are still undescribed. Animals were preserved on ethanol for a more thorough scientific identification at a later date. 3. This time we surveyed two very distinct sections of the West Kimberley coast. Roebuck Bay represents a true embayment that is semi-enclosed by mangroves along the eastern, and some of the western shores, and by cliff and pindan woodlands in the north. Eighty Mile Beach stretches over 200 km along the open Indian Ocean facing northwest. In this environment, the intertidal mud- and sandflat area stretches from 1-5 km wide from shore to sea and is enclosed by sand dunes and a few mangroves. Despite the two systems being very important as nonbreeding areas for the same species of long-distance migrant shorebirds, their geomorphology and ecology are very distinct. 4. At both areas the biodiversity of benthic animals was very high compared with other intertidal soft sediment areas across in the world. In Roebuck Bay, 368 species were found, and at Eighty Mile Beach 156 species, providing a total of 433 species/taxa. The most diverse group were the Polychaeta with 167 species, followed by Crustacea (74), Bivalvia (59), Gastropoda (59), and Echinodermata (35). All other groups total less than 12 species. 5. The two areas have 92 species in common, which in the case of Eighty Mile Beach means that 60% of the species also occur in Roebuck Bay. Major groups not found at Eighty Mile Beach were Asteroidea, Brachiopoda, Hirudinea, Oligochaeta, Platyhelminthes, Polyplacophora, and Pycnogonida. Most of these groups were also rare in Roebuck Bay, but the absence of Brachiopoda (lamp-shells) and Pycnogonida (seaspiders) at Eighty Mile Beach came as a surprise. Some species, including two species of Spionidae (Polychaeta) common at Eighty Mile Beach were either absent or extremely rare at Roebuck Bay. Furthermore, a small seacucumber with dark coloured spots all over its body, another larger seacucumber Paracaudina chilensis, two bivalve species of the genus Tellina, and two species of anemones were not found in Roebuck Bay. Yet, Roebuck Bay had many more species (277) not found at Eighty Mile Beach, the most common of these was the relatively large bivalve Tellina piratica, followed by the smooth tusk shell (Laevidentalium lubricatum), and the polychaete family Sternaspidae. 6. The large difference in biodiversity between Roebuck Bay and Eighty Mile Beach may be caused by different factors. Roebuck Bay has a greater variety of sedimentary habitats than Eighty Mile Beach. Eighty Mile Beach is completely exposed to the waves of Indian Ocean, while Roebuck Bay is protected by the peninsula on which Broome is situated. Therefore, notorious ‘ecosystem engineers’ such as the seagrasses occur quite extensively on the intertidal area of Roebuck Bay, but are not found at Eighty Mile Beach. These seagrass mats of Halodula uninervis and Halophila ovalis form special habitat for e.g. the little snail Smaragdia souverbiana. The influence of Broome city by episodic sewage and fertilizer releases, of which blooms of the cyanobacteria Lyngbya are an indication, can may well have a negative influence; opportunistic widespread species other than Lyngbya may of course benefit from the additional nutrient inputs. 7. Local communities and the land-owners actively participated in both expeditions. Several DPAW ranger groups (Yawuru, Karajarri and Nyangumarta) joined the sampling and also aided in the identification of species. Angela Rossen (WAMSI) spearheaded a biodiversity project that involved pupils from Cable Beach Primary School. We believe that we have raised wide awareness and generated considerable enthusiasm for the ecology of a unique contribution of northwest Australia to the world. 8. Based on their outstanding universal values, we recommend that the WA government consider an application of the joint marine reserves of Eighty Mile Beach and Roebuck Bay for World Heritage Status, thus joining China and South Korea in acknowledging and protecting this shared heritage