If We Had a Prologue: Lessons From a System Migration

This paper is a reflection on a library system migration project from two project managers at two different campuses. The authors discuss challenges encountered, approaches taken, priorities established, and perhaps most importantly, what each would do differently with the benefit of hindsight. For those who are preparing to undertake a system migration, this paper will offer guidance and advice

Achieving Teaching, Scholarship, and Service through Community Engagement

Occupational therapy faculty currently face enormous challenges in meeting teaching load expectations, while also under pressure to participate in scholarly projects and to make administrative and service contributions. Community engagement projects may provide opportunities for faculty to effectively and efficiently meet the goals in each of these areas while imparting benefits to students and community partners as well. Faculty at the Department of Occupational Therapy (OT) at Virginia Commonwealth University (VCU) embraced this idea as consistent with the university’s mission and strategic plan, and recognized its benefits in assisting faculty to meet workload demands. Four community partnerships reflecting the range and diversity of populations currently involved are highlighted: the Children’s Museum of Richmond, Rebuilding Together-Richmond, the William Nelson Bland Literacy Center, and Gateway Homes of Richmond. The developmental process and resulting benefits are described for each of these partnerships, and the paper concludes with lessons learned from these collaborative efforts. From these examples, it appears important to be proactive about developing community partnerships and realistic about the challenges of collaboration, but also to be aware of the role community engagement plays in creatively blending the potentially conflicting demands on faculty time

Defining Mechanisms of Recurrence Following Apical Prolapse Repair Based on Imaging Criteria

BackgroundProlapse recurrence after transvaginal surgical repair is common; however, its mechanisms are ill-defined. A thorough understanding of how and why prolapse repairs fail is needed to address their high rate of anatomic recurrence and to develop novel therapies to overcome defined deficiencies.ObjectiveThis study aimed to identify mechanisms and contributors of anatomic recurrence after vaginal hysterectomy with uterosacral ligament suspension (native tissue repair) vs transvaginal mesh (VM) hysteropexy surgery for uterovaginal prolapse.Study designThis multicenter study was conducted in a subset of participants in a randomized clinical trial by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. Overall, 94 women with uterovaginal prolapse treated via native tissue repair (n=48) or VM hysteropexy (n=46) underwent pelvic magnetic resonance imaging at rest, maximal strain, and poststrain rest (recovery) 30 to 42 months after surgery. Participants who desired reoperation before 30 to 42 months were imaged earlier to assess the impact of the index surgery. Using a novel 3-dimensional pelvic coordinate system, coregistered midsagittal images were obtained to assess study outcomes. Magnetic resonance imaging-based anatomic recurrence (failure) was defined as prolapse beyond the hymen. The primary outcome was the mechanism of failure (apical descent vs anterior vaginal wall elongation), including the frequency and site of failure. Secondary outcomes included displacement of the vaginal apex and perineal body and change in the length of the anterior wall, posterior wall, vaginal perimeter, and introitus of the vagina from rest to strain and rest to recovery. Group differences in the mechanism, frequency, and site of failure were assessed using the Fisher exact tests, and secondary outcomes were compared using Wilcoxon rank-sum tests.ResultsOf the 88 participants analyzed, 37 (42%) had recurrent prolapse (VM hysteropexy, 13 of 45 [29%]; native tissue repair, 24 of 43 [56%]). The most common site of failure was the anterior compartment (VM hysteropexy, 38%; native tissue repair, 92%). The primary mechanism of recurrence was apical descent (VM hysteropexy, 85%; native tissue repair, 67%). From rest to strain, failures (vs successes) had greater inferior displacement of the vaginal apex (difference, -12 mm; 95% confidence interval, -19 to -6) and perineal body (difference, -7 mm; 95% confidence interval, -11 to -4) and elongation of the anterior vaginal wall (difference, 12 mm; 95% confidence interval, 8-16) and vaginal introitus (difference, 11 mm; 95% confidence interval, 7-15).ConclusionThe primary mechanism of prolapse recurrence following vaginal hysterectomy with uterosacral ligament suspension or VM hysteropexy was apical descent. In addition, greater inferior descent of the vaginal apex and perineal body, lengthening of the anterior vaginal wall, and increased size of the vaginal introitus with strain were associated with anatomic failure. Further studies are needed to provide additional insight into the mechanism by which these factors contribute to anatomic failure

Mainstreaming African Diasporic Foodways When Academia Is Not Enough

More than a decade after Britain's bicentennial commemoration of the 1807 Abolition Act to end the Transatlantic Slave Trade, Scotland still struggles to reconcile her colonial past. Unlike in North America, historical archaeology centered on the history and legacy of the transatlantic slave trade is still highly marginalized in British academia. Furthermore, Scotland's roles in slave-based economies is only recently being considered a relevant area of historical studies. This paper emerges from my evolving perspective as a Black American scholar and resident in the United Kingdom, as I strive to create intellectual spaces in and outside of academia. Through civic engagement, I use my work on African diasporic foodways in the French Caribbean to link with a similar material basis of resistance in the British Caribbean and engage British audiences whose connections to Atlantic slavery are yet to be fully recognized