The Carlisle Site (41WD46), a Middle Caddoan Occupation on the Sabine River, Wood County, Texas

The Carlisle site (41WD46) is located on the Sabine River near its confluence with Lake Fork Creek in the Upper Sabine River Basin. As defined by Perttula, the Upper Sabine River Basin includes the area from the headwaters of the Sabine River to the mouths of Cherokee Bayou and Hatley Creek at the western edge of the Sabine Uplift. Lake Fork Creek is one of several large south-southeastward flowing streams within the Upper Sabine River Basin. The town of Mineola is approximately 13 kilometers (km) west of the Carlisle site. The site is situated at the tip of an upland projection overlooking the Sabine River floodplain, but extends into the floodplain to within ca 30 meters of the river bank. The Lake Fork Creek channel is approximately one km east of the site. While the site was an improved pasture for many years prior to 1975 and to the present, it had been previously cultivated. In fact, this cultivation may have contributed to its initial identification in the early 1930s, as well as its subsequent partial burial. The upland sandy soils derive from the Queen City Formation, and these are highly susceptible to erosion and colluvial downwasting. Colluvial deposition seems to have been a prominent factor in the burial of cultural materials along valley margins and lower footslopes elsewhere in the Upper Sabine Basin, and the site\u27s topographic position suggests that both alluvial and colluvial deposition is responsible for the burial of the floodplain cultural deposits at the Carlisle site

The M. W. Burks Site (41WD52): A Late Caddo Hamlet in Wood County, Texas

While attempting to locate and evaluate prehistoric Caddo archaeological sites in the Dry Creek watershed, Wood County, Texas, that had been originally recorded by A. T. Jackson and M. M. Reese in 1930, the M. W. Burks site (41WD52) was discovered by James E. Bruseth and Bob D. Skiles in June 1977. The site is in the Forest Hill community, about 5 km north of Quitman, Texas, in the East Texas Pineywoods and Gulf Coastal Plain. It is on a small rise in the uplands overlooking a small intermittent drainage that is an unnamed tributary of Little Dry Creek. The landowner, Mr. M. W. Burks, had resided in this part of Wood County since the 1920s, and recalled where A. T. Jackson and crew had spent time excavating the J. H. Reese (41WD2) site. He mentioned that while putting in a fence on his property in the early 1960s, adjacent to the property where the Reese site is located, he had found some pottery sherds in one of the post holes. Bruseth and Skiles placed a small shovel test next to this fence post hole, and a large articulated red-slipped Ripley Engraved carinated bowl was encountered at 65 em below the surface (bs) in tan sand E-horizon deposits. This find demonstrated that the Burks site contained both intact archaeological deposits as well as an apparently undisturbed Late Caddo Titus phase burial or cemetery. Bruseth, Skiles, and Perttula followed up this work with more intensive investigations in the spring and fall of 1978. This research was carried on as an adjunct to the ongoing (and final season of) archaeological work being conducted by Bruseth and Perttula at Lake Fork Reservoir on Lake Fork Creek, a few miles to the west of the Burks site. Our purpose in carrying out archaeological research at the Burks site was to examine in more detail the spatial character of a Late Caddo Titus phase settlement, and also obtain information on the material culture remains (especially the ceramics) made and used by the Caddo peoples that lived at the Burks site some 400-500 years ago

Archeological Investigations at the Hudnall-Pirtle Site (41RK4) An Early Caddo Mound Center in Northeast Texas

The Hudnall-Pirtle site (41RK4) is situated on a large T-1 alluvial terrace of the Sabine River in northern Rusk County in Texas. This area of the state, commonly called Northeast Texas, is part of the Southern Gulf Coastal Plain, a relatively level, sloping plain formed by the pre-Pleistocene embayment of the Gulf of Mexico. From a biogeographical perspective, the site is located in the Oak-Hickory-Pine forest of eastern Texas, otherwise known as the Pineywoods. This area represents the western extension of the southern coniferous forests and is dominated by shortleaf and loblolly pine trees. Hardwood trees, including various oaks, hickory, elm, and gum, are the dominant vegetation in the floodplains of rivers and major creeks in Northeast Texas

ALCOA #1 (41AN87): A Frankston Phase Settlement along Mound Prairie Creek, Anderson County, Texas

The ALCOA #1 (41AN87) site is a Frankston Phase (ca. A.D. 1400-1650) site located on a high alluvial terrace of Mound Prairie Creek, about seven kilometers northeast of Palestine, Texas. Mound Prairie Creek, a perennial stream, flows southeast to east across the county and drains into the Neches River. The site is approximately 10 meters above the Mound Prairie Creek floodplain, and the creek channel is 300 meters to the south. Although the investigations at the site have been rather limited to date, it appears that the ALCOA #1 site is a single component Frankston Phase homestead, or possibly a small hamlet. Other Frankston phase sites are known on Mound Prairie Creek, Hurricane Creek, Walnut Creek, and Brushy Creek, all Neches River tributaries, and the possibility exists that these may be part of a larger related Caddo community and settlement system

Following the funding trail: Financing, nurses and teamwork in Australian general practice

Contains fulltext : 97927.pdf (publisher's version ) (Open Access)BACKGROUND: Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. METHODS: This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36), doctors (n = 24), and managers (n = 22), structured observation of the practice nurse (51 hours of observation), and detailed case studies of the change process in the seven year-long studies. RESULTS: Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. CONCLUSIONS: Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice

Archaeological Investigations at Five Prehistoric Sites at Lewisville Lake, Denton County, Texas

This report describes the results of excavations performed by the Institute of Applied Sciences at the Lewisville Lake project, Denton County, Texas

A spatial analysis of the expanding roles of nurses in general practice

<p>Abstract</p> <p>Background</p> <p>Changes to the workforce and organisation of general practice are occurring rapidly in response to the Australian health care reform agenda, and the changing nature of the medical profession. In particular, the last five years has seen the rapid introduction and expansion of a nursing workforce in Australian general practices. This potentially creates pressures on current infrastructure in general practice.</p> <p>Method</p> <p>This study used a mixed methods, ‘rapid appraisal’ approach involving observation, photographs, and interviews.</p> <p>Results</p> <p>Nurses utilise space differently to GPs, and this is part of the diversity they bring to the general practice environment. At the same time their roles are partly shaped by the ways space is constructed in general practices.</p> <p>Conclusion</p> <p>The fluidity of nursing roles in general practice suggests that nurses require a versatile space in which to maximize their role and contribution to the general practice team.</p

Diagnostic approach to the evaluation of myeloid malignancies following CAR T-cell therapy in B-cell acute lymphoblastic leukemia.

Immunotherapeutic strategies targeting B-cell acute lymphoblastic leukemia (B-ALL) effectively induce remission; however, disease recurrence remains a challenge. Due to the potential for antigen loss, antigen diminution, lineage switch or development of a secondary or treatment-related malignancy, the phenotype and manifestation of subsequent leukemia may be elusive. We report on two patients with multiply relapsed/refractory B-ALL who, following chimeric antigen receptor T-cell therapy, developed myeloid malignancies. In the first case, a myeloid sarcoma developed in a patient with a history of myelodysplastic syndrome. In the second case, two distinct events occurred. The first event represented a donor-derived myelodysplastic syndrome with monosomy 7 in a patient with a prior hematopoietic stem cell transplantation. This patient went on to present with lineage switch of her original B-ALL to ambiguous lineage T/myeloid acute leukemia. With the rapidly evolving field of novel immunotherapeutic strategies, evaluation of relapse and/or subsequent neoplasms is becoming increasingly more complex. By virtue of these uniquely complex cases, we provide a framework for the evaluation of relapse or evolution of a subsequent malignancy following antigen-targeted immunotherapy