Academic literature on the topic 'Johnson Collection (Spartanburg, S.C.)'

The major aim of the present study is to find connections between global-mindedness and some important factors such as gender and level of proficiency. To this end, 182 language learners, 92 females and 90 males, participated in the study. These students were selected and categorized based on one-stage cluster sampling from 16 branches of different language centers, namely Safiran, Shoukoh, and Kish. The main phase of the study was conducted through the use of Google Docs platform that provides the researchers with the well-organized data. Language learners were asked to answer all the demographic information by considering their anonymity during the process of data collection. The result of the study, through t-test, showed that there was a significant difference between male and female language learners regarding their level of global-mindedness. The result also showed that the level of proficiency of the female language learners does not influence their level of global-mindedness. References Byram, M., Zarate, G., & Neuner, G. (1997). Sociocultural competence in languagelearning and teaching: Studies towards a common European framework of reference forlanguage learning and teaching. Strasbourg, France: Council of Europe. Deardorff, D. K. (2011). Assessing intercultural competence. New Directions forInstitutional Research, 149, 65–79. DeMello, M. A. (2011). The impact of study tours in developing global-mindedness amongPK-12 educators in Southeastern Massachusetts (Doctoral dissertation, NortheasternUniversity, Boston) Duckworth, R. L., Levy, L. W., & Levy, J. (2005). Present and future teachers of theworld’s children How internationally-minded are they?. Journal of Research inInternational Education, 4(3), 279–311. Earley, P. C. and Ang, S. (2003). Cultural Intelligence: An Analysis of IndividualInteractions Across Cultures. Palo Alto (CA): Stanford University Press. Fantini, A. E. (2009), Assessing Intercultural Competence: Issues and Tools. In Deardorff,D. K. (ed.), The SAGE Handbook of Intercultural Competence. Thousand Oaks (CA):Sage, 456–476. FitzGerald, H. (2003). How Different Are We? Spoken Discourse in InterculturalCommunication. Clevedon – Buffalo – Toronto – Sydney: Multilingual Matters Ltd. Gaudelli, W. (2003). World class: Teaching and learning in global times. Mahwah, NJ:Erlbaum. Giddens, A. (1991) Modernity and Self-Identity. Cambridge: Polity. Gillian, K. J. (1995). A measure of global-mindedness at the University of NorthernColorado: An assessment of students, faculty, and administrators (Doctoral dissertation,University of Northern Colorado, 1995). Dissertation Abstracts International, 5,08. Hett, E. J. (1993). The development of an instrument to measure global-mindedness(Doctoral dissertation, University of San Diego). Hill, I. (2007). International education as developed by the International BaccalaureateOrganization. The SAGE handbook of research in international education, 25–37. Johnson, J. P., Lenartowicz, T., & Apud, S. (2006). Cross-cultural competence ininternational business: Toward a definition and a model. Journal of International BusinessStudies, 37(4), 525–543. Kehl, K., & Morris, J. (2007). Differences in global mindedness between short-term andsemester-long study abroad participants at selected private universities. Frontiers: TheInterdisciplinary Journal of Study Abroad, 15(1), 67–79. Lakoff, R. (1973). Language and woman's place. Language in society, 2(01), 45–79. Muller, G. C. (2012). Exploring characteristics of international schools that promoteinternational-mindedness (Doctoral dissertation, Teachers College, Columbia University). Olsen, M.E., Lodwick, D.G., & Dunlap, R.E. (1992). Viewing the World Ecologically.Boulder: Westview. Sampson, D. L., & Smith, H. P. (1957). A scale to measure world-minded attitudes. TheJournal of Social Psychology, 45(1), 99–106. Sercu, L. e.a. (2005). Foreign Language Teachers and Intercultural Competence. AnInternational investigation. Clevedon–Buffalo–Toronto: Multilingual Matters Ltd. Smallman, S. C., & Brown, K. (2011). Introduction to international & global studies.Chapel Hill: University of North Carolina Press. Wardhaugh, R. (1992). An Introduction to Sociolinguistics. USA: Blackwell PublishersLtd. Zhai, L., & Scheer, S. (2004). Global perspectives and attitudes toward cultural diversityamong summer agriculture students at the Ohio State University. Journal of AgriculturalEducation, 45(2), 39–51.

This research aimed to map the quality curriculum used of kindergartens in Jakarta. The mapping curriculum was done by looking at the suitability curriculum with the stages of child development, needs of children, using the child-centered learning process, and taking ad-vantage of technological development. Subjects were 32 kindergarten institutions in Jakarta (North Jakarta and Jakarta Central), from 14 districts. Kindergarten institutions selected by representing every district. In collecting data, the researchers conducted an analysis content of curriculum and interview with respondents and informants in kindergarten institutions ei-ther principals or teachers in schools who selected as samples. The research team conducted a meeting to gather information that recorded as a result of observation and described in-depth interviews in the diary of researchers — the data collected from 16 kindergartens that are willing to research subject. The data consisted of curriculum documents, curriculum evaluation instruments and interviews’ result that analyzed qualitatively from the beginning of the data collection process including data reduction, data presentation, and conclusion. Keyword: Content, Curriculum, Evaluation, Kindergarten References Burchinal, M. (2018). Measuring Early Care and Education Quality. Child Development Perspectives, 12(1), 3–9. https://doi.org/10.1111/cdep.12260 Dhieni, N., & Utami, A. D. (2013). Evaluasi Konten Kurikulum Taman Kanak-Kanak di DKI Jakarta Tahun ke 1 dari rencana 3 tahun. Jakarta: FIP press. Dodge, D. T. (2004). Early Childhood Curriculum Models Why What and How Programs Use them. Exchange Organizational Behavior Teaching Journal, (February), 71–75. Eliason, C., & Jenkins, L. (2008). A Practical Guide to Early Childhood Curriculum 8th. New Jersey: Pearson Prentice Hall. Fox-turnbull, W. (2007). Implementing Digital Technology in The New Zealand Curriculum. Gestwicki, C. (2007). Developmentally Appropriate Practice Curriculum, and Development in Early Education 3rd Ed. New York: Thomson Delmar. Hainstock, E. G. (2002). Montessori untuk Prasekolah. Jakarta: Pustaka Delapratasa. Hasan, S. H. (2008). Evaluasi Kurikulum. (U. & R. Rosdakarya, Ed.). Bandung. Haslip, M. J., & Gullo, D. F. (2018). The Changing Landscape of Early Childhood Education: Implications for Policy and Practice. Early Childhood Education Journal, 46(3), 249–264. https://doi.org/10.1007/s10643-017-0865-7 Jackman, H. L. (2012). Early Education Curriculum: A Child’s Connection to the World Fifth Edition. Belmont: Wadsworth: Cengage Learning. Jacman, H. (2012). Early Education Curriculum. Pedagogical Development Unit, (FEBRUARY 2011), 163. Retrieved from https://www.eursc.eu/Syllabuses/2011-01-D-15-en-4.pdf Kostelnik, M. J., Soderman, A. K., & P, A. (2007). Whiren, Developmentally Appro-priate Curriculum: Best Practices in Early Childhood Education 4th. New Jersey: Pearson Prentice Hall. Mak, B., Keung, C., & Cheung, A. (2018). Analyzing Curriculum Orientations of Kindergarten Curriculum. In Teacher Education, Learning Innovation and Accountability, (pp. 135–153). Singapore: Springer Singapore. https://doi.org/10.1007/978-981-13-2026-2 Odom, S. L., Butera, G., Diamond, K. E., Hanson, M. J., Horn, E., Lieber, J., … Marquis, J. (2019). Efficacy of a Comprehensive Early Childhood Curriculum to Enhance Children’s Success. Topics in Early Childhood Special Education. https://doi.org/10.1177/0271121419827654 Plowman, L., Stephen, C., & Mcpake, J. (2010). Growing Up with Technology (pp. 1–169). London and New York: Routledge. Roopnarine, J. L., & Johnson, J. E. (2005). Approaches to Early Childhood Education 4th Ed,. New Jersey: Pearson Prentice Hall. Sarama, J., & Clements, D. H. (2019). From Cognition to Curriculum to Scale. Cognitive Foundations for Improving Mathematical Learning. https://doi.org/10.1016/b978-0-12-815952-1.00006-2 Wood, E., & Hedges, H. (2016). Curriculum in early childhood education: critical questions about content, coherence, and control. Curriculum Journal, 27(3), 387–405. https://doi.org/10.1080/09585176.2015.1129981 Yang, W., & Li, H. (2019). Changing culture, changing curriculum: a case study of early childhood curriculum innovations in two Chinese kindergartens. Curriculum Journal, 0(0), 1–19. https://doi.org/10.1080/09585176.2019.1568269

The rapid development of technology makes it easier for mothers to provide stimulation related to growth and development using gadgets. However, parental knowledge is needed about the safe limits of using a gadget in early childhood. This study aims to determine the perspective and behavior of mothers about the use of gadgets in toddlers. The method used is quantitative research with a cross-sectional approach. The participants of this study were thirty-one mothers who have early childhood and who are empowering family welfare. The inclusion criteria were mothers who agreed to be respondents, the exclusion criteria for mothers who did not have gadgets. This study uses a questionnaire measurement instrument for data collection. Data analysis was performed univariate and bivariate using the chi-square test. The results of the study concluded that the mother's knowledge regarding the safety of using a gadget was still lacking, with a value of around 54.8%, while the mother's behavior related to the same thing was better, which was around 58.1%. The relationship test shows that there is a strong enough relationship between maternal knowledge and maternal behavior in introducing or using gadgets in toddlers. Keywords: Early Childhood, Mother Perspective, Gadget Safeness References Appel, M. (2012). Are heavy users of computer games and social media more computer literate? Computers and Education, 59(4), 1339–1349. https://doi.org/10.1016/j.compedu.2012.06.004 Bandura, A. (1977). Social learning theory. Prentice-Hall. Cingel, D. P., & Krcmar, M. (2013). Predicting Media Use in Very Young Children: The Role of Demographics and Parent Attitudes. Communication Studies, 64(4), 374–394. https://doi.org/10.1080/10510974.2013.770408 Connell, S. L., Lauricella, A. R., & Wartella, E. (2015). Parental Co-Use of Media Technology with their Young Children in the USA. Journal OfChildren and Media, 9(1), 5–21. https://doi.org/10.1080/17482798.2015.997440 Haines, J., O’Brien, A., McDonald, J., Goldman, R. E., Evans-Schmidt, M., Price, S., King, S., Sherry, B., & Taveras, E. M. (2013). Television Viewing and Televisions in Bedrooms: Perceptions of Racial/Ethnic Minority Parents of Young Children. Journal of Child and Family Studies, 22(6), 749–756. https://doi.org/10.1007/s10826-012-9629-6 Jones, I., & Park, Y. (2015). Virtual worlds: Young children using the internet. Young children and families in the information age. Educating the young child (Advances in theory and research, implications for practice) (I. K. Heider & J. M. Renck (eds.); Volume 10). Springer. Lauricella, A. R., Wartella, E., & Rideout, V. J. (2015). Young children’s screen time: The complex role of parent and child factors. Journal of Applied Developmental Psychology, 36, 11–17. https://doi.org/10.1016/j.appdev.2014.12.001 Livingstone, S, Görzig, A., & Ólafsson, K. (2011). Disadvantaged children and online risk. http://eprints.lse.ac.uk/39385/ Livingstone, Sonia, Mascheroni, G., Dreier, M., Chaudron, S., & Lagae, K. (2015). How parents of young children manage digital devices at home: The role of income, education and parental style (Issue September). Livingstone, Sonia, Ólafsson, K., Helsper, E. J., Lupiáñez-Villanueva, F., Veltri, G. A., & Folkvord, F. (2017). Maximizing Opportunities and Minimizing Risks for Children Online: The Role of Digital Skills in Emerging Strategies of Parental Mediation. Journal of Communication, 67(1), 82–105. https://doi.org/10.1111/jcom.12277 M, S. (2017). The Impact of using Gadgets on Children. Journal of Depression and Anxiety, 07(01), 1–3. https://doi.org/10.4172/2167-1044.1000296 Marsh, J., Hannon, P., Lewis, M., & Ritchie, L. (2017). Young children’s initiation into family literacy practices in the digital age. Journal of Early Childhood Research, 15(1), 47–60. https://doi.org/10.1177/1476718X15582095 Mifsud, C. L., & Petrova, R. (2017). Young Children (0-8) and Digital Technology. In JRC Science and Policies Reports. Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0–3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years, 36(3), 227–241. https://doi.org/10.1080/09575146.2016.1161601 Nikken, P. (2017). Implications of low or high media use among parents for young children’s media use. Cyberpsychology, 11(3 Special Issue). https://doi.org/10.5817/CP2017-3-1 Nikken, P., & de Haan, J. (2015). Guiding young children’s internet use at home: Problems that parents experience in their parental mediation and the need for parenting support. Cyberpsychology, 9(1). https://doi.org/10.5817/CP2015-1-3 Piotrowski, J. (2017). Media exposure during infancy and early childhood: The effect of content and context on learning and development. In I. R. Barr & D. Linebarger (Eds.), The parental media mediation context of young children’s media use.(pp. 205–219). Springer International Publishing. Plowman, L., Stevenson, O., Stephen, C., & McPake, J. (2012). Preschool children’s learning with technology at home. Computers and Education, 59(1), 30–37. https://doi.org/10.1016/j.compedu.2011.11.014 Rasmussen, E. E., Shafer, A., Colwell, M. J., White, S., Punyanunt-Carter, N., Densley, R. L., & Wright, H. (2016). Relation between active mediation, exposure to Daniel Tiger’s Neighborhood, and US preschoolers’ social and emotional development. Journal of Children and Media, 10(4), 443–461. https://doi.org/10.1080/17482798.2016.1203806 Smahelova, M., Juhová, D., Cermak, I., & Smahel, D. (2017). Mediation of young children’s digital technology use: The parents’ perspective. Cyberpsychology, 11(3 Special Issue). https://doi.org/10.5817/CP2017-3-4 Troseth, G. L., Strouse, G. A., & Russo Johnson, C. E. (2017). Early Digital Literacy: Learning to Watch, Watching to Learn. In Cognitive Development in Digital Contexts. Elsevier Inc. https://doi.org/10.1016/B978-0-12-809481-5.00002-X Vaala, S. E. (2014). The Nature and Predictive Value of Mothers’ Beliefs Regarding Infants’ and Toddlers’ TV/Video Viewing: Applying the Integrative Model of Behavioral Prediction. Media Psychology, 17(3), 282–310. https://doi.org/10.1080/15213269.2013.872995 Zaman, B., & Mifsud, C. L. (2017). Editorial: Young children’s use of digital media and parental mediation. Cyberpsychology, 11(3 Special Issue), 9. https://doi.org/10.5817/CP2017-3-xx

Covid-19 has changed the learning process from class attendance to distance learning using the Internet. Early childhood education is threatened to enter into the lost generation, due to distance learning, which causes confusion for teachers and parents to be able to provide the best stimulation for them. Therefore, the Indonesian government made a new policy on online learning. The objectives of this research are to find how effective at online learning policy formulation, how productive it is in policy implementation, and what are the obstacles of the implementation at Early-Childhood Education (ECE). This qualitative research uses a mixed method approach with an iterative analysis design, conducted in Central Java Province in 35 districts / cities with 1,899 respondents. Data collection techniques with open-closed questionnaires, study from 15 documentation, and in-depth interviews. Data analysis uses quantitative-qualitative software Nvivo12+, with Miles and Huberman models. The results showed the policy formulation of online learning at ECE has been effective. However, the implementation of online learning policy at ECE still takes a lot of effort to become more powerful in preventing a decline in learning. There are five obstacles in in applying this in the field, namely the ability of teachers, the ability of parents, economic capability, facility constraints, and pedagogical constraints. Keywords: Online Learning Policy; Children Engagement; Learning Management System References Allen, I. E., Seaman, J. (2013). Changing course: Ten years of tracking online education in the United States. ERIC, ISBN 0984028838. Asilestari, P. (2016). Komputer Interaktif sebagai Media Pengajaran Bahasa Inggris pada Anak Usia Dini. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 2, n. 1, p. 55-62. Association, I. I. S. P. (2018). Penetrasi & Profil Perialku Pengguna Internet Indonesia. Coates, H. (2006). Student engagement in campus-based and online education: University connections. Routledge, ISBN 1134161530. Ha, Young. & Im, Hyunjoo. (2020). The Role of an Interactive Visual Learning Tool and its Personalizability in Online Learning: Flow Experience. Online Learning, 24, n. 1. Harjanto, T. & Sumunar, D. S. E. W. (2018). Tantangan Dan Peluang Pembelajaran Dalam Jaringan: Studi Kasus Implementas Elok (E-Learning: Open For Knowledge Sharing) Pada Mahasiswa Profesi Ners. Jurnal Keperawatan Respati Yogyakarta, 5, p. 24-28. Imron, A. (1995). Kebijaksanaan pendidikan di Indonesia: Proses, produk dan masa depannya. Bumi Aksara, ISBN 9795262319. Inoue, Y. (2007). Online education for lifelong learning. IGI Global, ISBN 1599043211. Irma, C. N., Nisa, K. & Sururiyah, S. K. (2019). Keterlibatan Orang Tua dalam Pendidikan Anak Usia Dini di TK Masyithoh 1 Purworejo. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 3, n. 1, p. 214-224. Jebba, A. M. & Umaru, N. N. (2019). The role of social media in reshaping the academic activities of vocational and technical education lecturers in Nigeria. Int. J. Eval. & Res. Educ. Vol, 8, n. 4, p. 735-741. Johnson, K. & Manning, S. (2010). Online education for dummies. Canada: John Wiley & Sons Publishing ISBN 0470536209. Juwah, C. (2006). Interactions in online education: Implications for theory and practice. Routledge, ISBN 1134247494. Kemendikbud. (2020). Surat Edaran Nomor 4 Tahun 2020 Tentang Pelaksanaan Kebijakan Pendidikan Dalam Masa Darurat Penyebaran Corona Virus Disease (Covid-19). Kong, S. C., Chan, T.-W., Griffin, P. & Hoppe, U. et al. (2014). E-learning in school education in the coming 10 years for developing 21st century skills: Critical research issues and policy implications. Journal of Educational Technology & Society, 17, n. 1, p. 70-78. Kwon, J. B., Debruler, K. & Kennedy, K. (2019). A Snapshot of Successful K-12 Online Learning: Focused on the 2015-16 Academic Year in Michigan. Journal of Online Learning Research, 5, n. 2, p. 199-225. Layne, M., Boston, W. E. & Ice, P. (2013). A longitudinal study of online learners: Shoppers, swirlers, stoppers, and succeeders as a function of demographic characteristics. Online Journal of Distance Learning Administration, 16, n. 2, p. 1-12. Lynch, M. M. (2002). The online educator: A guide to creating the virtual classroom. Routledge, ISBN 1134542542. Novianti, R. & Garzia, M. (2020). Penggunaan Gadget Pada Anak; Tantangan Baru Orang Tua Milenial. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 4, n. 2. Nugroho, R. (2008). Kebijakan Pendidikan: Pengantar untuk Memahami Kebijakan Pendidikan Sebagai Kebijakan Publik. Yogyakarta: Pustaka Pelajar. Nugroho, R. (2017). Public Policy: Dinamika Kebijakan, Analisis Kebijakan, dan Manajemen Politik Kebijakan Publik. Jakarta: Elex Media Komputindo. Palloff, R. M. & Pratt, K. (2002). Lessons from the cyberspace classroom: The realities of online teaching. California: John Wiley & Sons Publishing, ISBN 0787959960. Pangondian, R. A., Santosa, P. I. & Nugroho, E. (2019). Faktor-Faktor Yang Mempengaruhi Kesuksesan Pembelajaran Daring Dalam Revolusi Industri 4.0. Panjaitan, N. Q.; Yetti, E. & Nurani, Y. (2020). Pengaruh Media Pembelajaran Digital Animasi dan Kepercayaan Diri terhadap Hasil Belajar Pendidikan Agama Islam Anak. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 4, n. 2, p. 588-596. Pebriana, P. H. (2017). Analisis penggunaan gadget terhadap kemampuan interaksi sosial pada anak usia dini. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 1, n. 1, p. 1-11. Pertiwi, W. K. (2020). Penetrasi Internet di Indonesia Capai 64 Persen. https://tekno.kompas.com/read/2020/02/20/14090017/penetrasi-internet-di-indonesia-capai-64-persen. Ramadhan, B. (2020). Ini Data Pengguna Internet Di Seluruh Dunia Tahun 2020. Jakarta https://teknoia.com/data-pengguna-internet-dunia-ac03abc7476. Roach, V. & Lemasters, L. (2006). Satisfaction with online learning: A comparative descriptive study. Journal of Interactive Online Learning, 5, n. 3, p. 317-332. Rohita, R. (2020). The Ability of Ece Teachers to Use ICT in The Industrial Revolution 4.0. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 4, n. 2, p. 502-511. Rostaminezhad, M., Mozayani, N., Norozi, D. & Iziy, M. (2013). Factors related to e-learner dropout: Case study of IUST elearning center. Procedia-Social and Behavioral Sciences, 83, p. 522-527. Sari, K. M. & Setiawan, H. (2020). Kompetensi Pedagogik Guru dalam Melaksanakan Penilaian Pembelajaran Anak Usia Dini. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 4, n. 2, p. 900-912. Seok, S. & Dacosta, B. (2020). Relationships Between Young South Koreans’ Online Activities and Their Risk of Exploitation. Journal of Online Learning Research, 6, n. 1, p. 77-101. Setyaji, A., Iskak, A., Sukmaningrum, R. & Hawa, F. (2015). Komputer Interaktif Sebagai Media Pengajaran Bahasa Inggris Pada Anak Usia Dini. E-Dimas: Jurnal Pengabdian kepada Masyarakat, 6, n. 1, p. 1-12. Sharoff, L. (2019). Creative and Innovative Online Teaching Strategies: Facilitation for Active Participation. Journal of Educators Online, 16, n. 2, p. n2. Suhartanto, H. (2010). Survei 2009: Mutu Situs E-Learning Sekolah Indonesia Masih Sangat Minim. Jurnal Sistem Informasi,6, n. 1, p. 80-83. Sum, T. A. & Taran, E. G. M. (2020). Kompetensi Pedagogik Guru PAUD dalam Perencanaan dan Pelaksanaan Pembelajaran. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 4, n. 2. Swan, K. (2003). Learning effectiveness online: What the research tells us. p.13-47. Taufik, A., Apendi, T., Saidi, S. & Istiarsono, Z. (2019). Parental Perspectives on the Excellence of Computer Learning Media in Early Childhood Education. Jurnal Pendidikan Usia Dini, 13, n. 2, p. 356-370. Tilaar, H.; Nugroho, R. (2009). Kebijakan Pendidikan: Pengantar untuk Memahami Kebijakan Pendidikan dan Kebijakan Pendidikan sebagai Kebijakan Publik. Yogyakarta: Pustaka Pelajar. Ulya, S. I. (2019). Analisis Penggunaan Gedget Terhadap Kemampuan Interaksi Sosial Dan Komunikasi Pada Anak Usia Dini. 89-96. Vonderwell, S. & Zachariah, S. (2005). Factors that influence participation in online learning. Journal of Research on Technology in education, 38, n. 2, p. 213-230. Wang, Q., Zhu, Z., Chen, L. & Yan, H. (2009). E‐learning in China. Campus-Wide Information Systems. Winter, J., Cotton, D., Gavin, J. & Yorke, J. D. (2010). Effective e-learning? Multi-tasking, distractions and boundary management by graduate students in an online environment. ALT-J, 18, n. 1, p. 71-83. Yu, E. (2020). Student-Inspired Optimal Design of Online Learning for Generation Z. Journal of Educators Online, 17, n. 1, p. n1. Zaini, M. & Soenarto, S. (2019). Persepsi Orangtua terhadap Hadirnya Era Teknologi Digital di Kalangan Anak Usia Dini. Jurnal Obsesi: Jurnal Pendidikan Anak Usia Dini, 3, n. 1, p. 254-264.

Background:Upadacitinib (UPA), an oral Janus kinase inhibitor (JAKi), has demonstrated efficacy in the phase 3 SELECT clinical program, conducted across a range of patients (pts) with rheumatoid arthritis (RA).1–6 Real-world data for UPA, including in pts previously treated with a JAKi, have not yet been reported since global approvals beginning in 2019.Objectives:To assess the characteristics of US-based pts receiving UPA and its effectiveness in clinical practice at 3 months.Methods:This observational study included US-based pts from the United Rheumatology Normalized Integrated Community Evidence (UR-NICE) database who initiated UPA 15 mg once daily from FDA approval (August 2019) to July 31, 2020 and had ≥6-month pre-baseline data available. Effectiveness was assessed in pts with a reported Clinical Disease Activity Index (CDAI) score at 3 months after UPA initiation and included proportions of pts achieving CDAI remission (≤2.8), CDAI low disease activity (≤10), other disease activity measures, and pt-reported outcomes. A subgroup analysis assessed UPA effectiveness in pts with or without prior tofacitinib (TOFA) treatment.Results:This analysis included 252 pts treated with UPA 15 mg, of whom 98 (38.9%) received UPA monotherapy and 154 (61.1%) received UPA combined with conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs). 64.3% of pts were from the Southern region of the USA. 86.1%, 72.2%, and 47.6% of pts had been previously treated with csDMARDs, biologic DMARDs, and JAKis, respectively. Baseline characteristics were largely similar between UPA monotherapy and combination therapy groups and those with or without prior TOFA treatment (Table 1). Pts with prior TOFA treatment had a longer duration of RA since diagnosis and higher steroid use versus those without. UPA 15 mg improved disease activity scores (including CDAI) and pt-reported outcomes (including physical function and pain) after 3 months of treatment (Figure 1). Similar effectiveness was observed with UPA 15 mg in pts with or without prior TOFA treatment.Conclusion:In the UR-NICE real-world database of US-based pts, improvements in clinical and pt-reported outcomes were observed at 3 months in UPA-treated pts with RA, including those with or without prior TOFA treatment, despite the treatment-refractory population included in this dataset.References:[1]Burmester GR, et al. Lancet 2018;391:2503–12.[2]Smolen JS, et al. Lancet 2019;393:2303–11.[3]Fleischmann R, et al. Arthritis Rheumatol 2019;71:1788–800.[4]Genovese MC, et al. Lancet 2018;391:2513–24.[5]van Vollenhoven R, et al. Arthritis Rheumatol 2020;72:1607–20.[6]Rubbert-Roth A, et al. N Engl J Med 2020;383:1511–21.Table 1.Baseline characteristicsn (%), unless otherwise statedFull analysis set(n=252)Pts with prior TOFA treatment(n=113)Pts without prior TOFA treatment (n=139)Mean (SD) exposure, days219.7 (112.1)215.7 (116.7)222.9 (108.5)Female199 (79.0)85 (75.2)114 (82.0)Age ≥65 years75 (29.8)34 (30.1)41 (29.5)Oral steroid use140 (55.6)70 (61.9)70 (50.4)Prior csDMARDs217 (86.1)102 (90.3)115 (82.7)Prior TOFA113 (44.8)113 (100.0)0Prior biologic DMARDs182 (72.2)86 (76.1)96 (69.1)Tumor necrosis factor inhibitor147 (58.3)66 (58.4)81 (58.3)Interleukin-6 receptor inhibitor87 (34.5)47 (41.6)40 (28.8)nMean (SD)nMean (SD)nMean (SD)Duration of RA diagnosis, years1884.0 (3.0)895.1 (2.9)993.1 (2.8)Methotrexate dose, mg/week8817.0 (5.1)2817.8 (5.0)6016.6 (5.2)SJC282394.8 (5.7)1084.5 (5.0)1315.0 (6.2)TJC282376.5 (6.7)1076.5 (6.8)1306.5 (6.6)CDAI22520.4 (13.4)10520.2 (13.5)12020.6 (13.3)Routine assessment of patient index data 31654.2 (2.3)724.2 (2.4)934.3 (2.2)Disease Activity Score in 28 joints based on C-reactive protein1673.9 (1.5)833.9 (1.5)843.9 (1.5)Health Assessment Questionnaire-Disability Index1702.5 (2.1)742.4 (2.2)962.5 (2.1)Pain(0–10)22956.5 (28.5)10456.9 (29.3)12556.1 (28.0)SD, standard deviation; S/TJC, swollen/tender joint countAcknowledgements:AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Hilary Wong, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.Disclosure of Interests:Allan Gibofsky Shareholder of: AbbVie, Amgen, Johnson & Johnson, and Pfizer, Consultant of: AbbVie, Celgene, Eli Lilly, Flexion, Pfizer, Relburn Pharma, and Samumed. Paid consultant with investment analysts on behalf of the Gerson Lehrman Group, Bhavna Dhillon Shareholder of: May own stock or options in United Rheumatology, Employee of: United Rheumatology, Mark E. Pearson Shareholder of: May own AbbVie stock or options, Namita Tundia Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Yanna Song Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Kendall Dunlap Shareholder of: May own stocks or shares in AbbVie, Employee of: AbbVie, Grace Wright Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Exagen, Myriad Autoimmune, Novartis, Sanofi/Regeneron, UCB, and Vindico, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Exagen, Gilead, Janssen, Myriad Autoimmune, Novartis, Pfizer, Sanofi/Regeneron, and UCB, Employee of: President and Founder of the Association of Women in Rheumatology

Johnson, K. H., Maughan, E., Bergren, M. D., Wolfe, L. C., Cole, M., & Watts, H. E. S. (2017). What’s Up With Step Up!? Year 2! NASN, 32(2), 100-105. (DOI: 10.1177/1942602X17691808) In the March 2017 issue of NASN, the following abstract and keywords were not included in the manuscript. This has been updated in the online issue: Step Up & Be Counted! (Step Up!) is a joint initiative of the National Association of School Nurses (NASN) and the National Association of State School Nurse Consultants (NASSNC). The aim of Step Up! is for all school nurses across the nation to collect and submit specific, uniform data points for all their students. The program was initiated in 2014. In the second year of data collection, 2015-16, school nurses from more states contributed data, and many states reported on a larger number of school nurses reporting data. This article reports the progress we have made in data collection and reporting in year two. Keywords: Step Up & Be Counted!; National data set; Data collection; Informatics; School nursing

augmentvb [ɔːgˈmɛnt]1. to make or become greater in number, amount, strength, etc.; increase2. Music: to increase (a major or perfect interval) by a semitone (Collins English Dictionary 107) Almost everything associated with Robert Johnson has been subject to some form of augmentation. His talent as a musician and songwriter has been embroidered by myth-making. Johnson’s few remaining artefacts—his photographic images, his grave site, other physical records of his existence—have attained the status of reliquary. Even the integrity of his forty-two surviving recordings is now challenged by audiophiles who posit they were musically and sonically augmented by speeding up—increasing the tempo and pitch. This article documents the promulgation of myth in the life and music of Robert Johnson. His disputed photographic images are cited as archetypal contested artefacts, augmented both by false claims and genuine new discoveries—some of which suggest Johnson’s cultural magnetism is so compelling that even items only tenuously connected to his work draw significant attention. Current challenges to the musical integrity of Johnson’s original recordings, that they were “augmented” in order to raise the tempo, are presented as exemplars of our on-going fascination with his life and work. Part literature review, part investigative history, it uses the phenomenon of augmentation as a prism to shed new light on this enigmatic figure. Johnson’s obscurity during his lifetime, and for twenty-three years after his demise in 1938, offered little indication of his future status as a musical legend: “As far as the evolution of black music goes, Robert Johnson was an extremely minor figure, and very little that happened in the decades following his death would have been affected if he had never played a note” (Wald, Escaping xv). Such anonymity allowed those who first wrote about his music to embrace and propagate the myths that grew around this troubled character and his apparently “supernatural” genius. Johnson’s first press notice, from a pseudonymous John Hammond writing in The New Masses in 1937, spoke of a mysterious character from “deepest Mississippi” who “makes Leadbelly sound like an accomplished poseur” (Prial 111). The following year Hammond eulogised the singer in profoundly romantic terms: “It still knocks me over when I think of how lucky it is that a talent like his ever found its way to phonograph records […] Johnson died last week at precisely the moment when Vocalion scouts finally reached him and told him that he was booked to appear at Carnegie Hall” (19). The visceral awe experienced by subsequent generations of Johnson aficionados seems inspired by the remarkable capacity of his recordings to transcend space and time, reaching far beyond their immediate intended audience. “Johnson’s music changed the way the world looked to me,” wrote Greil Marcus, “I could listen to nothing else for months.” The music’s impact originates, at least in part, from the ambiguity of its origins: “I have the feeling, at times, that the reason Johnson has remained so elusive is that no one has been willing to take him at his word” (27-8). Three decades later Bob Dylan expressed similar sentiments over seven detailed pages of Chronicles: From the first note the vibrations from the loudspeaker made my hair stand up … it felt like a ghost had come into the room, a fearsome apparition …When he sings about icicles hanging on a tree it gives me the chills, or about milk turning blue … it made me nauseous and I wondered how he did that … It’s hard to imagine sharecroppers or plantation field hands at hop joints, relating to songs like these. You have to wonder if Johnson was playing for an audience that only he could see, one off in the future. (282-4) Such ready invocation of the supernatural bears witness to the profundity and resilience of the “lost bluesman” as a romantic trope. Barry Lee Pearson and Bill McCulloch have produced a painstaking genealogy of such a-historical misrepresentation. Early contributors include Rudi Blesch, Samuel B Charters, Frank Driggs’ liner notes for Johnson’s King of the Delta Blues Singers collection, and critic Pete Welding’s prolific 1960s output. Even comparatively recent researchers who ostensibly sought to demystify the legend couldn’t help but embellish the narrative. “It is undeniable that Johnson was fascinated with and probably obsessed by supernatural imagery,” asserted Robert Palmer (127). For Peter Guralnick his best songs articulate “the debt that must be paid for art and the Faustian bargain that Johnson sees at its core” (43). Contemporary scholarship from Pearson and McCulloch, James Banninghof, Charles Ford, and Elijah Wald has scrutinised Johnson’s life and work on a more evidential basis. This process has been likened to assembling a complicated jigsaw where half the pieces are missing: The Mississippi Delta has been practically turned upside down in the search for records of Robert Johnson. So far only marriage application signatures, two photos, a death certificate, a disputed death note, a few scattered school documents and conflicting oral histories of the man exist. Nothing more. (Graves 47) Such material is scrappy and unreliable. Johnson’s marriage licenses and his school records suggest contradictory dates of birth (Freeland 49). His death certificate mistakes his age—we now know that Johnson inadvertently founded another rock myth, the “27 Club” which includes fellow guitarists Brian Jones, Jimi Hendrix and Kurt Cobain (Wolkewitz et al., Segalstad and Hunter)—and incorrectly states he was single when he was twice widowed. A second contemporary research strand focuses on the mythmaking process itself. For Eric Rothenbuhler the appeal of Johnson’s recordings lies in his unique “for-the-record” aesthetic, that foreshadowed playing and song writing standards not widely realised until the 1960s. For Patricia Schroeder Johnson’s legend reveals far more about the story-tellers than it does the source—which over time has become “an empty center around which multiple interpretations, assorted viewpoints, and a variety of discourses swirl” (3). Some accounts of Johnson’s life seem entirely coloured by their authors’ cultural preconceptions. The most enduring myth, Johnson’s “crossroads” encounter with the Devil, is commonly redrawn according to the predilections of those telling the tale. That this story really belongs to bluesman Tommy Johnson has been known for over four decades (Evans 22), yet it was mistakenly attributed to Robert as recently as 1999 in French blues magazine Soul Bag (Pearson and McCulloch 92-3). Such errors are, thankfully, becoming less common. While the movie Crossroads (1986) brazenly appropriated Tommy’s story, the young walking bluesman in Oh, Brother, Where Art Thou? (2000) faithfully proclaims his authentic identity: “Thanks for the lift, sir. My name's Tommy. Tommy Johnson […] I had to be at that crossroads last midnight. Sell my soul to the devil.” Nevertheless the “supernatural” constituent of Johnson’s legend remains an irresistible framing device. It inspired evocative footage in Peter Meyer’s Can’t You Hear the Wind Howl? The Life and Music of Robert Johnson (1998). Even the liner notes to the definitive Sony Music Robert Johnson: The Centennial Edition celebrate and reclaim his myth: nothing about this musician is more famous than the word-of-mouth accounts of him selling his soul to the devil at a midnight crossroads in exchange for his singular mastery of blues guitar. It has become fashionable to downplay or dismiss this account nowadays, but the most likely source of the tale is Johnson himself, and the best efforts of scholars to present this artist in ordinary, human terms have done little to cut through the mystique and mystery that surround him. Repackaged versions of Johnson’s recordings became available via Amazon.co.uk and Spotify when they fell out of copyright in the United Kingdom. Predictable titles such as Contracted to the Devil, Hellbound, Me and the Devil Blues, and Up Jumped the Devil along with their distinctive “crossroads” artwork continue to demonstrate the durability of this myth [1]. Ironically, Johnson’s recordings were made during an era when one-off exhibited artworks (such as his individual performances of music) first became reproducible products. Walter Benjamin famously described the impact of this development: that which withers in the age of mechanical reproduction is the aura of the work of art […] the technique of reproduction detaches the reproduced object from the domain of tradition. By making many reproductions it substitutes a plurality of copies for a unique existence. (7) Marybeth Hamilton drew on Benjamin in her exploration of white folklorists’ efforts to document authentic pre-modern blues culture. Such individuals sought to preserve the intensity of the uncorrupted and untutored black voice before its authenticity and uniqueness could be tarnished by widespread mechanical reproduction. Two artefacts central to Johnson’s myth, his photographs and his recorded output, will now be considered in that context. In 1973 researcher Stephen LaVere located two pictures in the possession of his half–sister Carrie Thompson. The first, a cheap “dime store” self portrait taken in the equivalent of a modern photo booth, shows Johnson around a year into his life as a walking bluesman. The second, taken in the Hooks Bros. studio in Beale Street, Memphis, portrays a dapper and smiling musician on the eve of his short career as a Vocalion recording artist [2]. Neither was published for over a decade after their “discovery” due to fears of litigation from a competing researcher. A third photograph remains unpublished, still owned by Johnson’s family: The man has short nappy hair; he is slight, one foot is raised, and he is up on his toes as though stretching for height. There is a sharp crease in his pants, and a handkerchief protrudes from his breast pocket […] His eyes are deep-set, reserved, and his expression forms a half-smile, there seems to be a gentleness about him, his fingers are extraordinarily long and delicate, his head is tilted to one side. (Guralnick 67) Recently a fourth portrait appeared, seemingly out of nowhere, in Vanity Fair. Vintage guitar seller Steven Schein discovered a sepia photograph labelled “Old Snapshot Blues Guitar B. B. King???” [sic] while browsing Ebay and purchased it for $2,200. Johnson’s son positively identified the image, and a Houston Police Department forensic artist employed face recognition technology to confirm that “all the features are consistent if not identical” (DiGiacomo 2008). The provenance of this photograph remains disputed, however. Johnson’s guitar appears overly distressed for what would at the time be a new model, while his clothes reflect an inappropriate style for the period (Graves). Another contested “Johnson” image found on four seconds of silent film showed a walking bluesman playing outside a small town cinema in Ruleville, Mississippi. It inspired Bob Dylan to wax lyrical in Chronicles: “You can see that really is Robert Johnson, has to be – couldn’t be anyone else. He’s playing with huge, spiderlike hands and they magically move over the strings of his guitar” (287). However it had already been proved that this figure couldn’t be Johnson, because the background movie poster shows a film released three years after the musician’s death. The temptation to wish such items genuine is clearly a difficult one to overcome: “even things that might have been Robert Johnson now leave an afterglow” (Schroeder 154, my italics). Johnson’s recordings, so carefully preserved by Hammond and other researchers, might offer tangible and inviolate primary source material. Yet these also now face a serious challenge: they run too rapidly by a factor of up to 15 per cent (Gibbens; Wilde). Speeding up music allowed early producers to increase a song’s vibrancy and fit longer takes on to their restricted media. By slowing the recording tempo, master discs provided a “mother” print that would cause all subsequent pressings to play unnaturally quickly when reproduced. Robert Johnson worked for half a decade as a walking blues musician without restrictions on the length of his songs before recording with producer Don Law and engineer Vincent Liebler in San Antonio (1936) and Dallas (1937). Longer compositions were reworked for these sessions, re-arranging and edited out verses (Wald, Escaping). It is also conceivable that they were purposefully, or even accidentally, sped up. (The tempo consistency of machines used in early field recordings across the South has often been questioned, as many played too fast or slow (Morris).) Slowed-down versions of Johnson’s songs from contributors such as Angus Blackthorne and Ron Talley now proliferate on YouTube. The debate has fuelled detailed discussion in online blogs, where some contributors to specialist audio technology forums have attempted to decode a faintly detectable background hum using spectrum analysers. If the frequency of the alternating current that powered Law and Liebler’s machine could be established at 50 or 60 Hz it might provide evidence of possible tempo variation. A peak at 51.4 Hz, one contributor argues, suggests “the recordings are 2.8 per cent fast, about half a semitone” (Blischke). Such “augmentation” has yet to be fully explored in academic literature. Graves describes the discussion as “compelling and intriguing” in his endnotes, concluding “there are many pros and cons to the argument and, indeed, many recordings over the years have been speeded up to make them seem livelier” (124). Wald ("Robert Johnson") provides a compelling and detailed counter-thesis on his website, although he does acknowledge inconsistencies in pitch among alternate master takes of some recordings. No-one who actually saw Robert Johnson perform ever called attention to potential discrepancies between the pitch of his natural and recorded voice. David “Honeyboy” Edwards, Robert Lockwood Jr. and Johnny Shines were all interviewed repeatedly by documentarians and researchers, but none ever raised the issue. Conversely Johnson’s former girlfriend Willie Mae Powell was visibly affected by the familiarity in his voice on hearing his recording of the tune Johnson wrote for her, “Love in Vain”, in Chris Hunt’s The Search for Robert Johnson (1991). Clues might also lie in the natural tonality of Johnson’s instrument. Delta bluesmen who shared Johnson’s repertoire and played slide guitar in his style commonly used a tuning of open G (D-G-D-G-B-G). Colloquially known as “Spanish” (Gordon 2002, 38-42) it offers a natural home key of G major for slide guitar. We might therefore expect Johnson’s recordings to revolve around the tonic (G) or its dominant (D) -however almost all of his songs are a full tone higher, in the key of A or its dominant E. (The only exceptions are “They’re Red Hot” and “From Four Till Late” in C, and “Love in Vain” in G.) A pitch increase such as this might be consistent with an increase in the speed of these recordings. Although an alternative explanation might be that Johnson tuned his strings particularly tightly, which would benefit his slide playing but also make fingering notes and chords less comfortable. Yet another is that he used a capo to raise the key of his instrument and was capable of performing difficult lead parts in relatively high fret positions on the neck of an acoustic guitar. This is accepted by Scott Ainslie and Dave Whitehill in their authoritative volume of transcriptions At the Crossroads (11). The photo booth self portrait of Johnson also clearly shows a capo at the second fret—which would indeed raise open G to open A (in concert pitch). The most persuasive reasoning against speed tampering runs parallel to the argument laid out earlier in this piece, previous iterations of the Johnson myth have superimposed their own circumstances and ignored the context and reality of the protagonist’s lived experience. As Wald argues, our assumptions of what we think Johnson ought to sound like have little bearing on what he actually sounded like. It is a compelling point. When Son House, Skip James, Bukka White, and other surviving bluesmen were “rediscovered” during the 1960s urban folk revival of North America and Europe they were old men with deep and resonant voices. Johnson’s falsetto vocalisations do not, therefore, accord with the commonly accepted sound of an authentic blues artist. Yet Johnson was in his mid-twenties in 1936 and 1937; a young man heavily influenced by the success of other high pitched male blues singers of his era. people argue that what is better about the sound is that the slower, lower Johnson sounds more like Son House. Now, House was a major influence on Johnson, but by the time Johnson recorded he was not trying to sound like House—an older player who had been unsuccessful on records—but rather like Leroy Carr, Casey Bill Weldon, Kokomo Arnold, Lonnie Johnson, and Peetie Wheatstraw, who were the big blues recording stars in the mid–1930s, and whose vocal styles he imitated on most of his records. (For example, the ooh-well-well falsetto yodel he often used was imitated from Wheatstraw and Weldon.) These singers tended to have higher, smoother voices than House—exactly the sound that Johnson seems to have been going for, and that the House fans dislike. So their whole argument is based on the fact that they prefer the older Delta sound to the mainstream popular blues sound of the 1930s—or, to put it differently, that their tastes are different from Johnson’s own tastes at the moment he was recording. (Wald, "Robert Johnson") Few media can capture an audible moment entirely accurately, and the idea of engineering a faithful reproduction of an original performance is also only one element of the rationale for any recording. Commercial engineers often aim to represent the emotion of a musical moment, rather than its totality. John and Alan Lomax may have worked as documentarians, preserving sound as faithfully as possible for the benefit of future generations on behalf of the Library of Congress. Law and Liebler, however, were producing exciting and profitable commercial products for a financial gain. Paradoxically, then, whatever the “real” Robert Johnson sounded like (deeper voice, no mesmeric falsetto, not such an extraordinarily adept guitar player, never met the Devil … and so on) the mythical figure who “sold his soul at the crossroads” and shipped millions of albums after his death may, on that basis, be equally as authentic as the original. Schroeder draws on Mikhail Bakhtin to comment on such vacant yet hotly contested spaces around the Johnson myth. For Bakhtin, literary texts are ascribed new meanings by consecutive generations as they absorb and respond to them. Every age re–accentuates in its own way the works of its most immediate past. The historical life of classic works is in fact the uninterrupted process of their social and ideological re–accentuation [of] ever newer aspects of meaning; their semantic content literally continues to grow, to further create out of itself. (421) In this respect Johnson’s legend is a “classic work”, entirely removed from its historical life, a free floating form re-contextualised and reinterpreted by successive generations in order to make sense of their own cultural predilections (Schroeder 57). As Graves observes, “since Robert Johnson’s death there has seemed to be a mathematical equation of sorts at play: the less truth we have, the more myth we get” (113). The threads connecting his real and mythical identity seem so comprehensively intertwined that only the most assiduous scholars are capable of disentanglement. Johnson’s life and work seem destined to remain augmented and contested for as long as people want to play guitar, and others want to listen to them. Notes[1] Actually the dominant theme of Johnson’s songs is not “the supernatural” it is his inveterate womanising. Almost all Johnson’s lyrics employ creative metaphors to depict troubled relationships. Some even include vivid images of domestic abuse. In “Stop Breakin’ Down Blues” a woman threatens him with a gun. In “32–20 Blues” he discusses the most effective calibre of weapon to shoot his partner and “cut her half in two.” In “Me and the Devil Blues” Johnson promises “to beat my woman until I get satisfied”. However in The Lady and Mrs Johnson five-time W. C. Handy award winner Rory Block re-wrote these words to befit her own cultural agenda, inverting the original sentiment as: “I got to love my baby ‘til I get satisfied”.[2] The Gibson L-1 guitar featured in Johnson’s Hooks Bros. portrait briefly became another contested artefact when it appeared in the catalogue of a New York State memorabilia dealership in 2006 with an asking price of $6,000,000. The Australian owner had apparently purchased the instrument forty years earlier under the impression it was bona fide, although photographic comparison technology showed that it couldn’t be genuine and the item was withdrawn. “Had it been real, I would have been able to sell it several times over,” Gary Zimet from MIT Memorabilia told me in an interview for Guitarist Magazine at the time, “a unique item like that will only ever increase in value” (Stewart 2010). References Ainslie, Scott, and Dave Whitehall. Robert Johnson: At the Crossroads – The Authoritative Guitar Transcriptions. Milwaukee: Hal Leonard Publishing, 1992. Bakhtin, Mikhail M. The Dialogic Imagination. Austin: University of Texas Press, 1982. Banks, Russell. “The Devil and Robert Johnson – Robert Johnson: The Complete Recordings.” The New Republic 204.17 (1991): 27-30. Banninghof, James. “Some Ramblings on Robert Johnson’s Mind: Critical Analysis and Aesthetic in Delta Blues.” American Music 15/2 (1997): 137-158. 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Crossroads: The Life and Afterlife of Blues Legend Robert Johnson. Spokane: Demers Books, 2008. Guralnick, Peter. Searching for Robert Johnson: The Life and Legend of the "King of the Delta Blues Singers". London: Plume, 1998. Hamilton, Marybeth. In Search of the Blues: Black Voices, White Visions. London: Jonathan Cape, 2007. Hammond, John. From Spirituals to Swing (Dedicated to Bessie Smith). New York: The New Masses, 1938. Johnson, Robert. “Hellbound.” Amazon.co.uk 2011. 1 Aug. 2013 ‹http://www.amazon.co.uk/Hellbound/dp/B0063S8Y4C/ref=sr_1_cc_2?s=aps&ie=UTF8&qid=1376605065&sr=1-2-catcorr&keywords=robert+johnson+hellbound›. ———. “Contracted to the Devil.” Amazon.co.uk 2002. 1 Aug. 2013. ‹http://www.amazon.co.uk/Contracted-The-Devil-Robert-Johnson/dp/B00006F1L4/ref=sr_1_cc_1?s=aps&ie=UTF8&qid=1376830351&sr=1-1-catcorr&keywords=Contracted+to+The+Devil›. ———. King of the Delta Blues Singers. Columbia Records CL1654, 1961. ———. “Me and the Devil Blues.” Amazon.co.uk 2003. 1 Aug. 2013 ‹http://www.amazon.co.uk/Me-Devil-Blues-Robert-Johnson/dp/B00008SH7O/ref=sr_1_16?s=music&ie=UTF8&qid=1376604807&sr=1-16&keywords=robert+johnson›. ———. “The High Price of Soul.” Amazon.co.uk 2007. 1 Aug. 2013 ‹http://www.amazon.co.uk/High-Price-Soul-Robert-Johnson/dp/B000LC582C/ref=sr_1_39?s=music&ie=UTF8&qid=1376604863&sr=1-39&keywords=robert+johnson›. ———. “Up Jumped the Devil.” Amazon.co.uk 2005. 1 Aug. 2013 ‹http://www.amazon.co.uk/Up-Jumped-Devil-Robert-Johnson/dp/B000B57SL8/ref=sr_1_2?s=music&ie=UTF8&qid=1376829917&sr=1-2&keywords=Up+Jumped+The+Devil›. Marcus, Greil. Mystery Train: Images of America in Rock ‘n’ Roll Music. London: Plume, 1997. Morris, Christopher. “Phonograph Blues: Robert Johnson Mastered at Wrong Speed?” Variety 2010. 1 Aug. 2013 ‹http://www.varietysoundcheck.com/2010/05/phonograph-blues-robert-johnson-mastered-at-wrong-speed.html›. Oh, Brother, Where Art Thou? DVD. Universal Pictures, 2000. Palmer, Robert. Deep Blues: A Musical and Cultural History from the Mississippi Delta to Chicago’s South Side to the World. London: Penguin Books, 1981. Pearson, Barry Lee, and Bill McCulloch. Robert Johnson: Lost and Found. Chicago: University of Illinois Press, 2003. Prial, Dunstan. The Producer: John Hammond and the Soul of American Music. New York: Farrar, Straus and Giroux, 2006. Rothenbuhler, Eric W. “For–the–Record Aesthetics and Robert Johnson’s Blues Style as a Product of Recorded Culture.” Popular Music 26.1 (2007): 65-81. Rothenbuhler, Eric W. “Myth and Collective Memory in the Case of Robert Johnson.” Critical Studies in Media Communication 24.3 (2007): 189-205. Schroeder, Patricia. Robert Johnson, Mythmaking and Contemporary American Culture (Music in American Life). Chicago: University of Illinois Press, 2004. Segalstad, Eric, and Josh Hunter. The 27s: The Greatest Myth of Rock and Roll. Berkeley: North Atlantic Books, 2009. Stewart, Jon. “Rock Climbing: Jon Stewart Concludes His Investigation of the Myths behind Robert Johnson.” Guitarist Magazine 327 (2010): 34. The Search for Robert Johnson. DVD. Sony Pictures, 1991. Talley, Ron. “Robert Johnson, 'Sweet Home Chicago', as It REALLY Sounded...” YouTube.com 2012. 1 Aug. 2013. ‹http://www.youtube.com/watch?v=LCHod3_yEWQ›. Wald, Elijah. Escaping the Delta: Robert Johnson and the Invention of the Blues. London: HarperCollins, 2005. ———. The Robert Johnson Speed Recording Controversy. Elijah Wald — Writer, Musician 2012. 1 Aug. 2013. ‹http://www.elijahwald.com/johnsonspeed.html›. Wilde, John . “Robert Johnson Revelation Tells Us to Put the Brakes on the Blues: We've Been Listening to the Immortal 'King of the Delta Blues' at the Wrong Speed, But Now We Can Hear Him as He Intended.” The Guardian 2010. 1 Aug. 2013 ‹http://www.theguardian.com/music/musicblog/2010/may/27/robert-johnson-blues›. Wolkewitz, M., A. Allignol, N. Graves, and A.G. Barnett. “Is 27 Really a Dangerous Age for Famous Musicians? Retrospective Cohort Study.” British Medical Journal 343 (2011): d7799. 1 Aug. 2013 ‹http://www.bmj.com/content/343/bmj.d7799›.

Across Europe there is a push for strengthening research-based higher education (Fung et.al, 2017). As a pedagogical driven approach, research-based education aims at making students across all levels learn through enquiry and discovery (eg. Cleaver et al., 2017). Core competencies addressed are scientific and critical thinking skills, and skills in scholarly and interdisciplinary communication. At the University of Oslo, the reinforcement of research-based education is manifest in a recent large-scale initiative. The initiative implies that we must build quality in teaching and learning through partnership across and beyond the communities of our university. How can a library in higher education contribute to research-basededucation? This presentation illuminates three interrelated cases from The University of Oslo Library. They exemplify how libraries can involve students, librarians and their patrons when the aim is to develop innovative education. Together the cases prompt discussions about the methods used to include different actors’ perspectives in current development of learning and teaching design. The three cases highlight the current state of a long-term movement of our libraries away from librarycentered approaches and towards user and co-creation centered approaches. The methods described respond to the current call for partnership in building enquiry-based learning experiences. The first case is our staff-development program. Established a decade ago the program focuses on developing a shared understanding of information literacy and pedagogical theories. The program is one element in our effort to change focus from education as a private concern to corporate responsibility. The aim is to make pedagogical competencies a matter of shared knowledge and culture. The second case presents course design and the methods used to include the perspectives of students, fellow librarians and faculty. Project methodology from informatics has contributed to teambuilding and collaboration among library staff. It has also facilitated feedback from students, faculty and fellow librarians. The result is a revision of courses to students from BA to PHD levels, now with an emphasis on research-based education and active learning. The last case describes the development of physical and digital learning spaces at the university libraries. Technology has opened for a change in the way students collaborate, learn and study. A project based approach that apply user centered design and user experience have contributed to the collection of information from students and employees aimed at enhancing and developing library space to enhance learning experiences. Together our three cases tell a story about cultural change within our libraries, about implementation by involvement of different people and perspectives, and about the balancing of specialized expertise with shared vocabularies. ReferencesFung, D., Besters-Dilger, J., & Van der Vaart, R. (2017). Excellent education in research-rich universities. [Position Paper] League of European Universities (LERU). https://www.leru.org/files/ExcellentEducation-in-Research-Rich-Universities-Full-paper.pdf Cleaver, E., Wills, D., Gormally, S., Grey, D., Johnson, C., & Rippingale, J. (2017). Connecting research and teaching through curricular and pedagogic design: from theory to practice in disciplinary approaches to connecting the higher education curriculum. In: Carnell, B & Fung, D, (eds.) Developing the Higher Education Curriculum: Research-based Education in Practice. London, UCL Press, pp. 145-159

Background: Reperfusion following ischemia can lead to more injuries than ischemia itself especially in diabetic patients. The aim of this study was to evaluate the effect of dexmedetomidine on ischemia-reperfusion injury (IRI) in rats with have hepatic IRI and diabetes mellitus. Methodology: Twenty-eight Wistar Albino rats were randomised into four groups as control (C), diabetic (DC), diabetic with hepatic ischemia-reperfusion injury (DIR), and diabetic but administered dexmedetomidine followed by hepatic IRI (DIRD) groups. Hepatic tissue samples were evaluated histopathologically by semiquantitative methods. Malondialdehyde (MDA), superoxide dismutase (SOD), glutathion s-transpherase (GST), and catalase (CAT) enzyme levels were investigated in liver and kidney tissues as oxidative state parameters. Results: In Group DIR; hepatocyte degeneration, sinusoidal dilatation, pycnotic nucleus, and necrotic cells were found to be more in rat hepatic tissue; while mononuclear cell infiltration was higher in the parenchyme. MDA levels were significantly lower; but SOD levels were significantly higher in Group DIRD with regard to Group DIR. In the IRI induced diabetic rats’ hepatic and nephrotic tissues MDA levels, showing oxidative injury, were found to be lower. SOD levels, showing early antioxidant activity, were higher. Conclusion: The enzymatic findings of our study together with the hepatic histopathology indicate that dexmedetomidine has a potential role to decrease IRI. Key words: Hepatic ischemia reperfusion injury; Diabetes mellitus; Dexmedetomidine; Rat; MDA; SOD Citation: Sezen SC, Işık B, Bilge M, Arslan M, Çomu FM, Öztürk L, Kesimci E, Kavutçu M. Effect of dexmedetomidine on ischemia-reperfusion injury of liver and kidney tissues in experimental diabetes and hepatic ischemia-reperfusion injury induced rats. Anaesth Pain & Intensive Care 2016;20(2):143-149 Received: 21 November 2015; Reviewed: 10, 24 December 2015, 9, 10 June 2016; Corrected: 12 December 2015; Accepted: 10 June 2016 INTRODUCTİON Perioperative acute tissue injury induced by ischemia-reperfusion is a comman clinical event caused by reduced blood supply to the tissue being compromised during major surgery. Ischemia leads to cellular injury by depleting cellular energy deposits and resulting in accumulation of toxic metabolites. The reperfusion of tissues that have remained in ischemic conditions causes even more damage.1 Furthermore hepatic ischemia-reperfusion injury (IRI) demonstrates a strong relationship with peri-operative acute kidney injury.2 The etiology of diabetic complications is strongly associated with increased oxidative stress (OS). Diabetic patients are known to have a high risk of developing OS or IRI which results with tissue failure.3 The most important role in ischemia and reperfusion is played by free oxygen radicals.1 In diabetes, characterized by hyperglycemia, even more free oxygen radicals are produced due to oxidation of glucose and glycosylation of proteins.3 The structures which are most sensitive to free oxygen radicals in the cells are membrane lipids, proteins, nucleic acids and deoxyribonucleic acids.1 It has been reported that endogenous antioxidant enzymes [superoxide dismutase (SOD), glutathion s-transpherase (GST), catalase (CAT)] play an important role to alleviate IRI.4-8 Also some pharmacological agents have certain effects on IRI.1 The anesthetic agents influence endogenous antioxidant systems and free oxygen radical formation.9-12 Dexmedetomidine is a selective α-2 adrenoceptor agonist agent. It has been described as a useful and safe adjunct in many clinical applications. It has been found that it may increase urine output by considerably redistributing cardiac output, inhibiting vasopressin secretion and maintaining renal blood flow and glomerular filtration. Previous studies demonstrated that dexmedetomidine provides protection against renal, focal cerebral, cardiac, testicular, and tourniquet-induced IRI.13-18 Arslan et al observed that dexmedetomidine protected against lipid peroxidation and cellular membrane alterations in hepatic IRI, when given before induction of ischemia.17 Si et al18 demonstrated that dexmedetomidine treatment results in a partial but significant attenuation of renal demage induced by IRI through the inactivation of JAK/STAT signaling pathway in an in vivo model. The efficacy of the dexmedetomidine for IRI in diabetic patient is not resarched yet. The purpose of this experimental study was to evaluate the biochemical and histological effects of dexmedetomidine on hepatic IRI in diabetic rat’s hepatic and renal tissue. METHODOLOGY Animals and Experimental Protocol: This study was conducted in the Physiology Laboratory of Kirikkale University upon the consent of the Experimental Animals Ethics Committee of Kirikkale University. All of the procedures were performed according to the accepted standards of the Guide for the Care and Use of Laboratory Animals. In the study, 28 male Wistar Albino rats, weighing between 250 and 300 g, raised under the same environmental conditions, were used. The rats were kept under 20-21 oC at cycles of 12-hour daylight and 12-hour darkness and had free access to food until 2 hours before the anesthesia procedure. The animals were randomly separated into four groups, each containing 7 rats. Diabetes was induced by a single intraperitoneal injection of streptozotocin (Sigma Chemical, St. Louis, MO, USA) at a dose of 65 mg/kg body weight. The blood glucose levels were measured at 72 hrs following this injection. Rats were classified as diabetic if their fasting blood glucose (FBG) levels exceeded 250 mg/dl, and only animals with FBGs of > 250 mg/dl were included in the diabetic groups (dia­betes only, diabetes plus ischemia-reperfusion and diabetes plus dexmedetomidine-ischemia-reperfusion). The rats were kept alive 4 weeks after streptozotocin injection to allow development of chronic dia­betes before they were exposed to ischemia-reperfusion.(19) The rats were weighed before the study. Rats were anesthetized with intraperitoneal ketamine 100 mg/kg. The chest and abdomen were shaved and each animal was fixed in a supine position on the operating table. The abdomen was cleaned with 1% polyvinyl iodine and when dry, the operating field was covered with a sterile drape and median laparotomy was performed. There were four experimental groups (Group C (sham-control; n = 7), (Group DC (diabetes-sham-control; n = 7), Group DIR (diabetes-ischemia-reperfusion; n = 7), and Group DIRD (diabetes-ischemia-reperfusion-dexmedetomidine; n = 7). Sham operation was performed on the rats in Group C and Group DC. The sham operation consisted of mobilization of the hepatic pedicle only. The rats in this group were sacrificed 90 min after the procedure. Hepatic I/R injury was induced in Groups DIR and DIRD respectively with hepatic pedicle clamping using a vascular clamp as in the previous study of Arslan et al.(17) After an ischemic period of 45 min, the vascular clamp was removed. A reperfusion period was maintained for 45 min. In Group DIRD, dexmedetomidine hydrochloride 100 μg/kg, (Precedex 100 μg/2 ml, Abbott®, Abbott Laboratory, North Chicago, Illinois, USA) was administrated via intraperitoneal route 30 minutes before surgery. All the rats were given ketamine 100 mg/kg intraperitoneally and intracardiac blood samples were obtained. Preserving the tissue integrity by avoiding trauma, liver and renal biopsy samples were obtained. Biochemical Analysis: The liver and renal tissues were first washed with cold deionized water to discard blood contamination and then homogenized in a homogenizer. Measurements on cell contest require an initial preparation of the tissues. The preparation procedure may involve grinding of the tissue in a ground glass tissue blender using a rotor driven by a simple electric motor. The homogenizer as a tissue blender similar to the typical kitchen blender is used to emulsify and pulverize the tissue (Heidolph Instruments GMBH & CO KGDiax 900 Germany®) at 1000 U for about 3 min. After centrifugation at 10,000 g for about 60 min, the upper clear layer was taken. MDA levels were determined using the method of Van Ye et al,(20) based on the reaction of MDA with thiobarbituric acid (TBA). In the TBA test reaction, MDA and TBA react in acid pH to form a pink pigment with an absorption maximum at 532 nm. Arbitrary values obtained were compared with a series of standard solutions (1,1,3,3-tetraethoxypropane). Results were expressed as nmol/mg.protein. Part of the homogenate was extracted in ethanol/chloroform mixture (5/3 v/v) to discard the lipid fraction, which caused interferences in the activity measurements of T-SOD, CAT and GST activities. After centrifugation at 10.000 x g for 60 min, the upper clear layer was removed and used for the T-SOD, CAT, GST enzyme activity measurement by methods as described by Durak et al21, Aebi22 and Habig et al23 respectively. One unit of SOD activity was defined as the enzyme protein amount causing 50% inhibition in NBTH2 reduction rate and result were expressed in U/mg protein. The CAT activity method is based on the measurement of absorbance decrease due to H2O2 consumption at 240 nm. The GST activity method is based on the measurement of absorbance changes at 340 nm due to formation of GSH-CDNB complex. Histological determinations: Semiquantitative evaluation technique used by Abdel-Wahhab et al(24) was applied for interpreting the structural changes investigated in hepatic tissues of control and research groups. According to this, (-) (negative point) represents no structural change, while (+) (one positive point) represents mild, (++) (two positive points) medium and (+++) (three positive points) represents severe structural changes. Statistical analysis: The Statistical Package for the Social Sciences (SPSS, Chicago, IL, USA) 20.0 softwre was used for the statistical analysis. Variations in oxidative state parameters, and histopathological examination between study groups were assessed using the Kruskal-Wallis test. The Bonferroni-adjusted Mann-Whitney U-test was used after significant Kruskal-Wallis to determine which groups differed from the others. Results were expressed as mean ± standard deviation (Mean ± SD). Statistical significance was set at a p value < 0.05 for all analyses. RESULTS There was statistically significant difference observed between the groups with respect to findings from the histological changes in the rat liver tissue (hepatocyte degeneration, sinüsoidal dilatation, pycnotic nucleus, prenecrotic cell) determined by light microscopy according to semiquantitative evaluation techniques (p < 0.0001). In Group DIR, hepatocyte degeneration was significantly high compared to Group C, Group DC and Group DIRD (p < 0.0001, p < 0.0001, p = 0.002, respectively), (Table 1, Figure 1-4). Similarly, sinüsoidal dilatation was significantly higher in Group DIR (p < 0.0001, p = 0.004, p = 0.015, respectively). Although, pcynotic nucleus was decreased in Group DIRD, it did not make a significant difference in comparison to Group DIR (p = 0.053), (Table 1, Figure 1-4). The prenecrotic cells were significantly increased in Group DIR, with respect to Group C, Group DC and Group DIRD (p < 0.0001, p = 0.004, p < 0.0001, respectively), (Table 1, Figure 1-4). Table 1. The comparison of histological changes in rat hepatic tissue [Mean ± SD)] p**: Statistical significance was set at a p value < 0.05 for Kruskal-Wallis test *p < 0.05: When compared with Group DIR Figure 1: Light microscopic view of hepatic tissue of Group C (control). VC: vena centralis, *: sinusoids. ®: hepatocytes, k: Kupffer cells, G: glycogen granules, mc: minimal cellular changes, Hematoxilen & Eosin x 40 Figure 2: Light-microscopic view of hepatic tissue of Group DC (diabetes mellitus control) (G: Glycogen granules increased in number, (VC: vena centralis, *:sinusoids. ®:hepatocytes, k:Kupffer cells, G: glycogen granules, mc: minimal cellular changes; Hematoxylin & Eosin x 40) Figure 3: Light-microscopic view of hepatic tissue of Group DIR (Diabetes Mellitus and ischemia-reperfusion) (VC: vena centralis, (H) degenerative and hydrophic hepatocytes, (dej) vena centralis degeneration (centrolobar injury) (*): sinusoid dilatation. (←) pycnotic and hyperchromatic nuclei, MNL: mononuclear cell infiltration, (¯) congestion, K: Kupffer cell hyperplasia, (­) vacuolar degeneration (Hematoxylin & Eosin x 40) Figure 4: Light-microscopic view of hepatic tissue of Group DIRD (Diabetes Mellitus and ischemia-reperfusion together with dexmedetomidine applied group) (VC: vena centralis, (MNL) mononuclear cell infiltration, (dej) hydrophilic degeneration in hepatocytes around vena centralis, (conj) congestion, G: glycogen granules, (←) pycnotic and hyperchromatic nuclei, sinusoid dilatation (*) (Hematoxylin & Eosin x 40) Besides, in liver tissue parenchyma, MN cellular infiltration was a light microscopic finding; and showed significant changes among the groups (p < 0.0001). This was significantly higher in Group DIR, compared to Group C, DC, and DIRD (p < 0.0001, p=0.007, p = 0.007, respectively), (Table 1, Figure 1-4). The enzymatic activity of MDA, SOD and GST in hepatic tissues showed significant differences among the groups [(p = 0.019), (p = 0.034). (p = 0.008) respectively]. MDA enzyme activity was significantly incresed in Group DIR, according to Group C and Group DIRD (p = 0.011, p = 0.016, respectively), (Table 2). In Group DIR SOD enzyme activity was lower with respect to Group C and Group DIRD (p = 0.010, p = 0.038, respectively), (Table 2). The GST enzyme activity was significantly higher in Group DIR, when compared to Group C, DC and DIRD (p = 0.007, p = 0.038, p = 0.039, respectively), (Table 2). Table 2. Oxidative state parameters in rat hepatic tissue [Mean ± SD] p**: Statistical significance was set at a p value < 0.05 for Kruskal-Wallis test *p < 0.05: When compared with Group DIR The enzymatic activity of MDA, SOD in renal tissues, showed significant differences among the groups [(p < 0.0001), (p = 0.008) respectively ]. MDA enzyme activity was significantly incresed in Group DIR, according to Group C and Group DIRD (p < 0.0001, p < 0.0001, respectively). Also MDA enzyme activity level was significantly increased in Group DC, in comparison to Group C and Group DIRD (p = 0.003, p = 0.001, respectively), (Table 3). In Group DIR SOD enzyme activity was lower with respect to Group C and Group DIRD (p = 0.032, p = 0.013, respectively), (Table 3). The GST enzyme activity was significantly higher in Group DIR than the other three groups, however; CAT levels were similar among the groups (Table 3). Table 3: Oxidative state parameters in rat nephrotic tissue [Mean ± SD)] p**: Statistical significance was set at a p value < 0.05 for Kruskal-Wallis test *p < 0.05: When compared with Group DIR DISCUSSION In this study, we have reported the protective effect of dexmedetomidine in experimental hepatic and renal IRI model in the rat by investigating the MDA and SOD levels biochemically. Besides, hepatic histopathological findings also supported our report. Ischemic damage may occur with trauma, hemorrhagic shock, and some surgical interventions, mainly hepatic and renal resections. Reperfusion following ischemia results in even more injury than ischemia itself. IRI is an inflammatory response accompanied by free radical formation, leucocyte migration and activation, sinusoidal endothelial cellular damage, deteoriated microcirculation and coagulation and complement system activation.1 We also detected injury in hepatic and renal tissue caused by reperfusion following ischemia in liver. Experimental and clinical evidence indicates that OS is involved in both the pathogenesis and the complications of diabetes mellitus.25,26 Diabetes mellitus is a serious risk factor for the development of renal and cardiovascular disease. It is also related to fatty changes in the liver.27 Diabetes-related organ damage seems to be the result of multiple mechanisms. Diabetes has been associated with increased free radical reactions and oxidant tissue damage in STZ-induced diabetic rats and also in patients.26Oxidative stress has been implicated in the destruction of pancreatic β-cells28 and could largely contribute to the oxidant tissue damage associated with chronic hyperglycemia.29 A number of reports have shown that antioxidants can attenuate the complications of diabetes in patients30 and in experimental models.28,31 This study demonstrated that diabetes causes a tendency to increase the IRI. There is a lot of investigations related to the pharmacological agents or food supplements applied for decreasing OS and IRI. Antioxidant agents paly an important role in IRI by effecting antioxidant system or lessening the formation of ROS. It has been reported that anesthetic agents too, are effective in oxidative stress.1 During surgical interventions, it seems rational to get benefit from anesthetic agents in prevention of OS caused by IRI instead of using other agents. It has been declared that; dexmedetomidine; as an α-2 agonist with sedative, hypnotic properties; is important in prevention of renal, focal, cerebral, cardiac, testicular and tourniquet-induced IRI.13-18 On the other hand Bostankolu et al. concluded that dexmedetomidine did not have an additional protective role for tournique induced IRI during routine general anesthesia.32 In this study; we have shown that dexmedetomidine has a reducing effect in IRI in diabetic rats. Some biochemical tests and histopathological evaluations are applied for bringing up oxidative stress and IRI in the tissues. Reactive oxygen species (ROS) that appear with reperfusion injury damage cellular structures through the process of the lipid peroxidation of cellular membranes and yield toxic metabolites such as MDA.33 As an important intermidiate product in lipid peroxidation, MDA is used as a sensitive marker of IRI.34 ROS-induced tissue injury is triggered by various defense mechanisms.35 The first defence mechanisms include the antioxidant enzymes of SOD, CAT, and GPx. These endogenous antioxidants are the first lines of defence against oxidative stres and act by scavenging potentially damaging free radical moieties.36 There is a balance between ROS and the scavenging capacity of antioxidant enzymes.1-8 In this study, for evaluation of oxidative damage and antioxidant activity, MDS, SOD, GST and CAT levels were determined in liver and kidney tissues. MDA levels in hepatic and renal tissues were higher in Group DIR compared to Group C and Group DIRD. GST levels were higher in Group DIR compared to all the other three groups. When the groups were arranged from highest to lowest order, with respect to CAT levels, the order was; Group DIR, Group DIRD, Group DC and Group C. However, the difference was not significant. The acute phase reactant MDA, as a marker of OS, was found to be high in Group DIR and low in Group DIRD. This could be interpreted as the presence of protective effect of dexmedetomidine in IRI. IRI developing in splanchnic area causes injury also in the other organs.35 Leithead et al showed that clinically significant hepatic IRI demonstrates a strong relationship with peri-operative acute kidney injury.2 In our experimental research that showed correlation to that of research by Leithead et al. After hepatic IRI in diabetic rats renal OS marker MDA levels were significantly more in Group DIR than Group DIRD. In our study, we observed histopathological changes in the ischemic liver tissue and alterations in the level of MDA, SOD, GST and CAT levels which are OS markers. Histopathological changes of the liver tissues are hepatocyt degeneration, sinusoidal dilatation, nuclear picnosis, celluler necrosis, mononuclear cell infiltrationat paranchimal tissue. These histopathological injury scores were significantly lower in the Group DIRD than those in group DIR. LIMITATION Study limitation is there was no negative control group, as this type of surgical intervention is not possible in rats without anesthesia. CONCLUSION The enzymatic findings of our study together with the hepatic histopathology indicate that dexmedetomidine has a potential role to decrease ischemia-reperfusion injury. Conflict of interest and funding: The authors have not received any funding or benefits from industry or elsewhere to conduct this study. 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This article investigates the possibilities for understanding waste as a resource, with a particular focus on understanding food waste as a food resource. It considers the popular yeast spread Vegemite within this frame. The spread’s origins in waste product, and how it has achieved and sustained its status as a popular symbol of Australia despite half a century of Australian gastro-multiculturalism and a marked public resistance to other recycling and reuse of food products, have not yet been a focus of study. The process of producing Vegemite from waste would seem to align with contemporary moves towards recycling food waste, and ensuring environmental sustainability and food security, yet even during times of austerity and environmental concern this has not provided the company with a viable marketing strategy. Instead, advertising copywriting and a recurrent cycle of product memorialisation have created a superbrand through focusing on Vegemite’s nutrient and nostalgic value.John Scanlan notes that producing waste is a core feature of modern life, and what we dispose of as surplus to our requirements—whether this comprises material objects or more abstract products such as knowledge—reveals much about our society. In observing this, Scanlan asks us to consider the quite radical idea that waste is central to everything of significance to us: the “possibility that the surprising core of all we value results from (and creates even more) garbage (both the material and the metaphorical)” (9). Others have noted the ambivalent relationship we have with the waste we produce. C. T. Anderson notes that we are both creator and agent of its disposal. It is our ambivalence towards waste, coupled with its ubiquity, that allows waste materials to be described so variously: negatively as garbage, trash and rubbish, or more positively as by-products, leftovers, offcuts, trimmings, and recycled.This ambivalence is also crucial to understanding the affectionate relationship the Australian public have with Vegemite, a relationship that appears to exist in spite of the product’s unpalatable origins in waste. A study of Vegemite reveals that consumers can be comfortable with waste, even to the point of eating recycled waste, as long as that fact remains hidden and unmentioned. In Vegemite’s case not only has the product’s connection to waste been rendered invisible, it has been largely kept out of sight despite considerable media and other attention focusing on the product. Recycling Food Waste into Food ProductRecent work such as Elizabeth Royte’s Garbage Land and Tristram Stuart’s Waste make waste uncomfortably visible, outlining how much waste, and food waste in particular, the Western world generates and how profligately this is disposed of. Their aim is clear: a call to less extravagant and more sustainable practices. The relatively recent interest in reducing our food waste has, of course, introduced more complexity into a simple linear movement from the creation of a food product, to its acquisition or purchase, and then to its consumption and/or its disposal. Moreover, the recycling, reuse and repurposing of what has previously been discarded as waste is reconfiguring the whole idea of what waste is, as well as what value it has. The initiatives that seem to offer the most promise are those that reconfigure the way waste is understood. However, it is not only the process of transforming waste from an abject nuisance into a valued product that is central here. It is also necessary to reconfigure people’s acculturated perceptions of, and reactions to waste. Food waste is generated during all stages of the food cycle: while the raw materials are being grown; while these are being processed; when the resulting food products are being sold; when they are prepared in the home or other kitchen; and when they are only partly consumed. Until recently, the food industry in the West almost universally produced large volumes of solid and liquid waste that not only posed problems of disposal and pollution for the companies involved, but also represented a reckless squandering of total food resources in terms of both nutrient content and valuable biomass for society at large. While this is currently changing, albeit slowly, the by-products of food processing were, and often are, dumped (Stuart). In best-case scenarios, various gardening, farming and industrial processes gather household and commercial food waste for use as animal feed or as components in fertilisers (Delgado et al; Wang et al). This might, on the surface, appear a responsible application of waste, yet the reality is that such food waste often includes perfectly good fruit and vegetables that are not quite the required size, shape or colour, meat trimmings and products (such as offal) that are completely edible but extraneous to processing need, and other high grade product that does not meet certain specifications—such as the mountains of bread crusts sandwich producers discard (Hickman), or food that is still edible but past its ‘sell by date.’ In the last few years, however, mounting public awareness over the issues of world hunger, resource conservation, and the environmental and economic costs associated with food waste has accelerated efforts to make sustainable use of available food supplies and to more efficiently recycle, recover and utilise such needlessly wasted food product. This has fed into and led to multiple new policies, instances of research into, and resultant methods for waste handling and treatment (Laufenberg et al). Most straightforwardly, this involves the use or sale of offcuts, trimmings and unwanted ingredients that are “often of prime quality and are only rejected from the production line as a result of standardisation requirements or retailer specification” from one process for use in another, in such processed foods as soups, baby food or fast food products (Henningsson et al. 505). At a higher level, such recycling seeks to reclaim any reusable substances of significant food value from what could otherwise be thought of as a non-usable waste product. Enacting this is largely dependent on two elements: an available technology and being able to obtain a price or other value for the resultant product that makes the process worthwhile for the recycler to engage in it (Laufenberg et al). An example of the latter is the use of dehydrated restaurant food waste as a feedstuff for finishing pigs, a reuse process with added value for all involved as this process produces both a nutritious food substance as well as a viable way of disposing of restaurant waste (Myer et al). In Japan, laws regarding food waste recycling, which are separate from those governing other organic waste, are ensuring that at least some of food waste is being converted into animal feed, especially for the pigs who are destined for human tables (Stuart). Other recycling/reuse is more complex and involves more lateral thinking, with the by-products from some food processing able to be utilised, for instance, in the production of dyes, toiletries and cosmetics (Henningsson et al), although many argue for the privileging of food production in the recycling of foodstuffs.Brewing is one such process that has been in the reuse spotlight recently as large companies seek to minimise their waste product so as to be able to market their processes as sustainable. In 2009, for example, the giant Foster’s Group (with over 150 brands of beer, wine, spirits and ciders) proudly claimed that it recycled or reused some 91.23% of 171,000 tonnes of operational waste, with only 8.77% of this going to landfill (Foster’s Group). The treatment and recycling of the massive amounts of water used for brewing, rinsing and cooling purposes (Braeken et al.; Fillaudeaua et al.) is of significant interest, and is leading to research into areas as diverse as the development microbial fuel cells—where added bacteria consume the water-soluble brewing wastes, thereby cleaning the water as well as releasing chemical energy that is then converted into electricity (Lagan)—to using nutrient-rich wastewater as the carbon source for creating bioplastics (Yu et al.).In order for the waste-recycling-reuse loop to be closed in the best way for securing food supplies, any new product salvaged and created from food waste has to be both usable, and used, as food (Stuart)—and preferably as a food source for people to consume. There is, however, considerable consumer resistance to such reuse. Resistance to reusing recycled water in Australia has been documented by the CSIRO, which identified negative consumer perception as one of the two primary impediments to water reuse, the other being the fundamental economics of the process (MacDonald & Dyack). This consumer aversion operates even in times of severe water shortages, and despite proof of the cleanliness and safety of the resulting treated water. There was higher consumer acceptance levels for using stormwater rather than recycled water, despite the treated stormwater being shown to have higher concentrations of contaminants (MacDonald & Dyack). This reveals the extent of public resistance to the potential consumption of recycled waste product when it is labelled as such, even when this consumption appears to benefit that public. Vegemite: From Waste Product to Australian IconIn this context, the savoury yeast spread Vegemite provides an example of how food processing waste can be repurposed into a new food product that can gain a high level of consumer acceptability. It has been able to retain this status despite half a century of Australian gastronomic multiculturalism and the wide embrace of a much broader range of foodstuffs. Indeed, Vegemite is so ubiquitous in Australian foodways that it is recognised as an international superbrand, a standing it has been able to maintain despite most consumers from outside Australasia finding it unpalatable (Rozin & Siegal). However, Vegemite’s long product history is one in which its origin as recycled waste has been omitted, or at the very least, consistently marginalised.Vegemite’s history as a consumer product is narrated in a number of accounts, including one on the Kraft website, where the apocryphal and actual blend. What all these narratives agree on is that in the early 1920s Fred Walker—of Fred Walker and Company, Melbourne, canners of meat for export and Australian manufacturers of Bonox branded beef stock beverage—asked his company chemist to emulate Marmite yeast extract (Farrer). The imitation product was based, as was Marmite, on the residue from spent brewer’s yeast. This waste was initially sourced from Melbourne-based Carlton & United Breweries, and flavoured with vegetables, spices and salt (Creswell & Trenoweth). Today, the yeast left after Foster Group’s Australian commercial beer making processes is collected, put through a sieve to remove hop resins, washed to remove any bitterness, then mixed with warm water. The yeast dies from the lack of nutrients in this environment, and enzymes then break down the yeast proteins with the effect that vitamins and minerals are released into the resulting solution. Using centrifugal force, the yeast cell walls are removed, leaving behind a nutrient-rich brown liquid, which is then concentrated into a dark, thick paste using a vacuum process. This is seasoned with significant amounts of salt—although less today than before—and flavoured with vegetable extracts (Richardson).Given its popularity—Vegemite was found in 2009 to be the third most popular brand in Australia (Brand Asset Consulting)—it is unsurprising to find that the product has a significant history as an object of study in popular culture (Fiske et al; White), as a marker of national identity (Ivory; Renne; Rozin & Siegal; Richardson; Harper & White) and as an iconic Australian food, brand and product (Cozzolino; Luck; Khamis; Symons). Jars, packaging and product advertising are collected by Australian institutions such as Sydney’s Powerhouse Museum and the National Museum of Australia in Canberra, and are regularly included in permanent and travelling exhibitions profiling Australian brands and investigating how a sense of national identity is expressed through identification with these brands. All of this significant study largely focuses on how, when and by whom the product has been taken up, and how it has been consumed, rather than its links to waste, and what this circumstance could add to current thinking about recycling of food waste into other food products.It is worth noting that Vegemite was not an initial success in the Australian marketplace, but this does not seem due to an adverse public perception to waste. Indeed, when it was first produced it was in imitation of an already popular product well-known to be made from brewery by-products, hence this origin was not an issue. It was also introduced during a time when consumer relationships to waste were quite unlike today, and thrifty re-use of was a common feature of household behaviour. Despite a national competition mounted to name the product (Richardson), Marmite continued to attract more purchasers after Vegemite’s launch in 1923, so much so that in 1928, in an attempt to differentiate itself from Marmite, Vegemite was renamed “Parwill—the all Australian product” (punning on the idea that “Ma-might” but “Pa-will”) (White 16). When this campaign was unsuccessful, the original, consumer-suggested name was reinstated, but sales still lagged behind its UK-owned prototype. It was only after remaining in production for more than a decade, and after two successful marketing campaigns in the second half of the 1930s that the Vegemite brand gained some market traction. The first of these was in 1935 and 1936, when a free jar of Vegemite was offered with every sale of an item from the relatively extensive Kraft-Walker product list (after Walker’s company merged with Kraft) (White). The second was an attention-grabbing contest held in 1937, which invited consumers to compose Vegemite-inspired limericks. However, it was not the nature of the product itself or even the task set by the competition which captured mass attention, but the prize of a desirable, exotic and valuable imported Pontiac car (Richardson 61; Superbrands).Since that time, multinational media company, J Walter Thompson (now rebranded as JWT) has continued to manage Vegemite’s marketing. JWT’s marketing has never looked to Vegemite’s status as a thrifty recycler of waste as a viable marketing strategy, even in periods of austerity (such as the Depression years and the Second World War) or in more recent times of environmental concern. Instead, advertising copywriting and a recurrent cycle of cultural/media memorialisation have created a superbrand by focusing on two factors: its nutrient value and, as the brand became more established, its status as national icon. Throughout the regular noting and celebration of anniversaries of its initial invention and launch, with various commemorative events and products marking each of these product ‘birthdays,’ Vegemite’s status as recycled waste product has never been more than mentioned. Even when its 60th anniversary was marked in 1983 with the laying of a permanent plaque in Kerferd Road, South Melbourne, opposite Walker’s original factory, there was only the most passing reference to how, and from what, the product manufactured at the site was made. This remained the case when the site itself was prioritised for heritage listing almost twenty years later in 2001 (City of Port Phillip).Shying away from the reality of this successful example of recycling food waste into food was still the case in 1990, when Kraft Foods held a nationwide public campaign to recover past styles of Vegemite containers and packaging, and then donated their collection to Powerhouse Museum. The Powerhouse then held an exhibition of the receptacles and the historical promotional material in 1991, tracing the development of the product’s presentation (Powerhouse Museum), an occasion that dovetailed with other nostalgic commemorative activities around the product’s 70th birthday. Although the production process was noted in the exhibition, it is noteworthy that the possibilities for recycling a number of the styles of jars, as either containers with reusable lids or as drinking glasses, were given considerably more notice than the product’s origins as a recycled product. By this time, it seems, Vegemite had become so incorporated into Australian popular memory as a product in its own right, and with such a rich nostalgic history, that its origins were no longer of any significant interest or relevance.This disregard continued in the commemorative volume, The Vegemite Cookbook. With some ninety recipes and recipe ideas, the collection contains an almost unimaginably wide range of ways to use Vegemite as an ingredient. There are recipes on how to make the definitive Vegemite toast soldiers and Vegemite crumpets, as well as adaptations of foreign cuisines including pastas and risottos, stroganoffs, tacos, chilli con carne, frijole dip, marinated beef “souvlaki style,” “Indian-style” chicken wings, curries, Asian stir-fries, Indonesian gado-gado and a number of Chinese inspired dishes. Although the cookbook includes a timeline of product history illustrated with images from the major advertising campaigns that runs across 30 pages of the book, this timeline history emphasises the technological achievement of Vegemite’s creation, as opposed to the matter from which it orginated: “In a Spartan room in Albert Park Melbourne, 20 year-old food technologist Cyril P. Callister employed by Fred Walker, conducted initial experiments with yeast. His workplace was neither kitchen nor laboratory. … It was not long before this rather ordinary room yielded an extra-ordinary substance” (2). The Big Vegemite Party Book, described on its cover as “a great book for the Vegemite fan … with lots of old advertisements from magazines and newspapers,” is even more openly nostalgic, but similarly includes very little regarding Vegemite’s obviously potentially unpalatable genesis in waste.Such commemorations have continued into the new century, each one becoming more self-referential and more obviously a marketing strategy. In 2003, Vegemite celebrated its 80th birthday with the launch of the “Spread the Smile” campaign, seeking to record the childhood reminisces of adults who loved Vegemite. After this, the commemorative anniversaries broke free from even the date of its original invention and launch, and began to celebrate other major dates in the product’s life. In this way, Kraft made major news headlines when it announced that it was trying to locate the children who featured in the 1954 “Happy little Vegemites” campaign as part of the company’s celebrations of the 50th anniversary of the television advertisement. In October 2006, these once child actors joined a number of past and current Kraft employees to celebrate the supposed production of the one-billionth jar of Vegemite (Rood, "Vegemite Spreads" & "Vegemite Toasts") but, once again, little about the actual production process was discussed. In 2007, the then iconic marching band image was resituated into a contemporary setting—presumably to mobilise both the original messages (nutritious wholesomeness in an Australian domestic context) as well as its heritage appeal. Despite the real interest at this time in recycling and waste reduction, the silence over Vegemite’s status as recycled, repurposed food waste product continued.Concluding Remarks: Towards Considering Waste as a ResourceIn most parts of the Western world, including Australia, food waste is formally (in policy) and informally (by consumers) classified, disposed of, or otherwise treated alongside garden waste and other organic materials. Disposal by individuals, industry or local governments includes a range of options, from dumping to composting or breaking down in anaerobic digestion systems into materials for fertiliser, with food waste given no special status or priority. Despite current concerns regarding the security of food supplies in the West and decades of recognising that there are sections of all societies where people do not have enough to eat, it seems that recycling food waste into food that people can consume remains one of the last and least palatable solutions to these problems. This brief study of Vegemite has attempted to show how, despite the growing interest in recycling and sustainability, the focus in both the marketing of, and public interest in, this iconic and popular product appears to remain rooted in Vegemite’s nutrient and nostalgic value and its status as a brand, and firmly away from any suggestion of innovative and prudent reuse of waste product. 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