A significant statement: new outlooks on treatment documentation

Values-based conservation is an increasingly dominant theme in heritage conservation theory. It is less routine in the application of object conservation practice, where emphasis on the physical fabric of heritage prevails. Materials-based approaches pivot conservation decisions on assessments of object condition. Values-based approaches posit that conservation should seek to sustain and enhance heritage significance rather than arrest physical change. A values-based approach is also one where the value-judgements underlying conservation decisions are made explicit. To reflect this, a new treatment documentation format has been developed at the UCL Institute of Archaeology. The documentation procedure shifts the focal point from condition assessments to statements of significance. Within the professional setting, similar new documentation is being developed for light-based artworks at Glasgow Museums. Ultimately, using a value-based treatment report, the conservator can be aware of the reasoning behind treatment choices and be better equipped to make decisions that reflect an object’s values

Could Public Restrooms Be an Environment for Bacterial Resistomes?

PMCID: PMC3547874This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

When Loss is More: From Managed Decline to Adaptive Release

This is the final version. Available on open access from Routledge via the DOI in this recordWithin the heritage sector there is widespread recognition that the accelerating effects of climate and other changes will necessitate reconsideration of the care of at-risk places and properties. Heritage organisations and agencies are developing new ways to identify and measure future threats, and to prioritise resources accordingly. For some designated assets, it is becoming clear, it may be necessary to manage processes of decline and transformation. Drawing on insights gathered from conversations with natural and historic environment practitioners and regulators, this paper highlights current practice and policy around managed decline, with a focus on the English context. In seeking to address some of the limitations of current approaches, this paper introduces a new conceptual framework: adaptive release. Adaptive release, as presented here, reflects a decision to accommodate the dynamic transformation of a heritage asset and its associated values and significance, with reference to wider landscape settings. The focus is on iterative management over extended timeframes, involving some relinquishment of control and a commitment to ongoing monitoring and interpretation. The concept of adaptive release is presented provisionally, rather than prescriptively, to expand the range of options available to natural and historic environment professionals in responding to inevitable change.Arts and Humanities Research Council (AHRC

Methadone adverse reaction presenting with large increase in plasma methadone binding: a case series

<p>Abstract</p> <p>Introduction</p> <p>The use of methadone as an analgesic is on the increase, but it is widely recognized that the goal of predictable and reproducible dosing is confounded by considerable variability in methadone pharmacokinetics, and unpredictable side effects that include sedation, respiratory depression and cardiac arrhythmias. The mechanisms underlying these unpredictable effects are frequently unclear. Here, to the best of our knowledge we present the first report of an association between accidental methadone overexposure and increased plasma protein binding, a new potential mechanism for drug interactions with methadone.</p> <p>Case presentation</p> <p>We describe here the cases of two patients who experienced markedly different responses to the same dose of methadone during co-administration of letrozole. Both patients were post-menopausal Caucasian women who were among healthy volunteers participating in a clinical trial. Under the trial protocol both patients received 6 mg of intravenous methadone before and then after taking letrozole for seven days. One woman (aged 59) experienced symptoms consistent with opiate overexposure after the second dose of methadone that were reversed by naloxone, while the other (aged 49) did not. To understand the etiology of this event, we measured methadone pharmacokinetics in both patients. In our affected patient only, a fourfold to eightfold increase in methadone plasma concentrations after letrozole treatment was observed. Detailed pharmacokinetic analysis indicated no change in metabolism or renal elimination in our patient, but the percentage of unbound methadone in the plasma decreased 3.7-fold. As a result, the volume of distribution of methadone decreased approximately fourfold. The increased plasma binding in our affected patient was consistent with observed increases in plasma protein concentrations.</p> <p>Conclusions</p> <p>The marked increase in the total plasma methadone concentration observed in our patient, and the enhanced pharmacodynamic effect, appear primarily due to a reduced volume of distribution. The extent of plasma methadone binding may help to explain the unpredictability of its pharmacokinetics. Changes in volume of distribution due to plasma binding may represent important causes of clinically meaningful drug interactions.</p

Views on a brief mindfulness intervention among patients with long-term illness.

BACKGROUND: Chronic illness is the leading cause of death in the UK and worldwide. Psychological therapies to support self-management have been shown to play an important role in helping those with chronic illness cope; more recently, the therapeutic benefits of mindfulness approaches have become evident for managing depression and other distressing emotions. Brief guided mindfulness interventions, are more convenient than intensive traditional programmes requiring regular attendance but have been less explored. This study assessed views on a brief (i.e., 10 min) mindfulness intervention for those with specific long-term illnesses. METHODS: Semi-structured interviews and focus groups were conducted with chronic illness patient groups (i.e., chronic obstructive pulmonary disease, chronic pain and cardiovascular disease), designed to capture the acceptability and feasibility of the intervention. The interviews were conducted after use of a mindfulness based audio in clinic and, one week later, after use in the patient's own environment. Interviews were recorded, transcribed and analysed using thematic analysis. RESULTS: In total, a combination of 18 interviews and focus groups were conducted among 14 patients. Recruitment was most successful with chronic pain patients. All patients reported benefits such as feelings of relaxation and improved coping with symptoms. While the wording and content of the audio were generally well received, it was suggested that the length could be increased, as it felt rushed, and that more guidance about the purpose of mindfulness, and when to use it, was needed. CONCLUSIONS: A brief mindfulness intervention was well accepted among patients with long-term illness. The intervention may benefit by being lengthened and by offering further guidance on its use

Temporal Patterns of Medications Dispensed to Children and Adolescents in a National Insured Population

This study aimed to comprehensively describe prevalence and temporal dispensing patterns for medications prescribed to children and adolescents in the United States. Participants were 1.6 million children (49% female) under 18 years old enrolled in a nation-wide, employer-provided insurance plan. All medication claims from 1999–2006 were reviewed retrospectively. Drugs were assigned to 16 broad therapeutic categories. Effects of trend over time, seasonality, age and gender on overall and within category prevalence were examined. Results: Mean monthly prevalence for dispensed medications was 23.5% (range 19.4–27.5), with highest rates in winter and lowest in July. The age group with the highest prevalence was one-year-old children. On average each month, 17.1% of all children were dispensed a single drug and 6.4% were dispensed two or more. Over time, prevalence for two or more drugs did not change, but the proportion of children dispensed a single drug decreased (slope -.02%, p = .001). Overall, boys had higher monthly rates than girls (average difference 0.9%, p = .002). However, differences by gender were greatest during middle childhood, especially for respiratory and central nervous system agents. Contraceptives accounted for a large proportion of dispensed medication to older teenage girls. Rates for the drugs with the highest prevalence in this study were moderately correlated (average Pearson r.66) with those from a previously published national survey. Conclusion: On average, nearly one quarter of a population of insured children in the United States was dispensed medication each month. This rate decreased somewhat over time, primarily because proportionally fewer children were dispensed a single medication. The rate for two or more drugs dispensed simultaneously remained steady

Heritage Futures - Comparative Approaches to Natural and Cultural Heritage Practices

This is the final version. Available on open access from UCL Press via the DOI in this recordWe present the book as a co-authored monograph because we acknowledge the collective contributions to the arguments developed within it, and the collaborative nature of the work. This has in itself been an experiment in finding a format in which diverse voices and views could productively speak to one another, while also acknowledging and foregrounding the diversity and range of different views, academic traditions and writing styles of contributors. As principal investigator, Harrison acted as the lead and coordinating author of the book, taking overall responsibilities for its editing and production. The co-investigators (DeSilvey, Holtorf, Macdonald) shared with Harrison editorial responsibilities for the individual thematic parts they each led, and for shaping the intellectual agenda of the book as a whole. However, we also felt it important to indicate the main authors of individual chapters within the book, to make clear specific contributions to the text and its arguments, and to highlight which named individuals were responsible for the empirical work that underpins them. Preservation of natural and cultural heritage is often said to be something that is done for the future, or on behalf of future generations, but the precise relationship of such practices to the future is rarely reflected upon. Heritage Futures draws on research undertaken over four years by an interdisciplinary, international team of 16 researchers and more than 25 partner organisations to explore the role of heritage and heritage-like practices in building future worlds. Engaging broad themes such as diversity, transformation, profusion and uncertainty, Heritage Futures aims to understand how a range of conservation and preservation practices across a number of countries assemble and resource different kinds of futures, and the possibilities that emerge from such collaborative research for alternative approaches to heritage in the Anthropocene. Case studies include the cryopreservation of endangered DNA in frozen zoos, nuclear waste management, seed biobanking, landscape rewilding, social history collecting, space messaging, endangered language documentation, built and natural heritage management, domestic keeping and discarding practices, and world heritage site management.Arts and Humanities Research Council (AHRC

People's interest in brain health testing: Findings from an international, online cross-sectional survey

Brain health entails mental wellbeing and cognitive health in the absence of brain disorders. The past decade has seen an explosion of tests, cognitive and biological, to predict various brain conditions, such as Alzheimer's Disease. In line with these current developments, we investigated people's willingness and reasons to—or not to—take a hypothetical brain health test to learn about risk of developing a brain disease, in a cross-sectional multilanguage online survey. The survey was part of the Global Brain Health Survey, open to the public from 4th June 2019 to 31st August 2020. Respondents were largely recruited via European brain councils and research organizations. 27,590 people responded aged 18 years or older and were predominantly women (71%), middle-aged or older (>40 years; 83%), and highly educated (69%). Responses were analyzed to explore the relationship between demographic variables and responses. Results: We found high public interest in brain health testing: over 91% would definitely or probably take a brain health test and 86% would do so even if it gave information about a disease that cannot be treated or prevented. The main reason for taking a test was the ability to respond if one was found to be at risk of brain disease, such as changing lifestyle, seeking counseling or starting treatment. Higher interest in brain health testing was found in men, respondents with lower education levels and those with poor self-reported cognitive health. Conclusion: High public interest in brain health and brain health testing in certain segments of society, coupled with an increase of commercial tests entering the market, is likely to put pressure on public health systems to inform the public about brain health testing in years to come.publishedVersio