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After five years of looking closely through his camera at a small beach, David Batchelder no longer sees the shores as we know them. His vision now is of a private reality within the tideland. In Tideland, Batchelder invites you to join him in his visual journey into a tideland like none that has yet been photographed. Batchelder uses the camera, not to picture more clearly that which we already know, but to discover and capture the unsung beauty of our sand. He shares with us an inexplicable, ambiguous, imaginative and odd world of magical visions - landscapes, spaces, creatures and curious objects, disfigured and eroded by the ocean. Although Batchelder uses digital processes, his approach to creative camera work has its origin very much in the era of film, using a digital camera and Photoshop as one would have used a film camera and a darkroom. David Campany's essay introduces Batchelder's tideland world where the viewer's imagination and memory take over and, you too, leave the beach as you now know it. In the 1960s, David Batchelder received an MA and MFA in photography from the University of Iowa studying under John Schulze. He taught photography at Smith College, Amherst College, Boston University, Dartmouth College, and Plymouth State College. His early photographs were exhibited widely, published in Aperture magazine, and can be admired in the following collections: Addison Gallery of American Art, Fogg Museum, George Eastman House, Michigan Institute of Technology, Smith College, Bowdoin College, Institute of Contemporary Art, Boston, Museum of Fine Arts, Boston, Museum of Fine Arts, Houston, Hood Museum, and Dartmouth College. Batchelder stopped making creative photographs in 1984 and resumed when the Tidelands caught his eye. Ninety photographs from Tideland were exhibited at the City Gallery at Waterfront Park, Charleston, South Carolina in 2014.

Abstract Background Screening in primary care for unmet individual social needs (e.g., housing instability, food insecurity, unemployment, social isolation) is critical to addressing their deleterious effects on patients’ health outcomes. To our knowledge, this is the first study to apply an implementation science framework to identify implementation factors and best practices for social needs screening and response. Methods Guided by the Health Equity Implementation Framework (HEIF), we collected qualitative data from clinicians and patients to evaluate barriers and facilitators to implementing the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE), a standardized social needs screening and response protocol, in a federally qualified health center. Eligible patients who received the PRAPARE as a standard of care were invited to participate in semi-structured interviews. We also obtained front-line clinician perspectives in a semi-structured focus group. HEIF domains informed a directed content analysis. Results Patients and clinicians (i.e., case managers) reported implementation barriers and facilitators across multiple domains (e.g., clinical encounters, patient and provider factors, inner context, outer context, and societal influence). Implementation barriers included structural and policy level determinants related to resource availability, discrimination, and administrative burden. Facilitators included evidence-based clinical techniques for shared decision making (e.g., motivational interviewing), team-based staffing models, and beliefs related to alignment of the PRAPARE with patient-centered care. We found high levels of patient acceptability and opportunities for adaptation to increase equitable adoption and reach. Conclusion Our results provide practical insight into the implementation of the PRAPARE or similar social needs screening and response protocols in primary care at the individual encounter, organizational, community, and societal levels. Future research should focus on developing discrete implementation strategies to promote social needs screening and response, and associated multisector care coordination to improve health outcomes and equity for vulnerable and marginalized patient populations.

Evidence-based approaches promoting patient engagement and chronic illness self-management include peer support, shared decision-making, and education. Designed based on these components, Taking Charge of My Life and Health (TCMLH) is a group-based, ‘Whole Person’ care program promoting mental and physical self-care and patient empowerment. Despite evidence of effectiveness, little is known about implementation for TCMLH and similar programs. In this first-of-its-kind, multi-methods evaluation conducted between 2015–2020, we report on implementation strategies and intervention adaptations with a contextual analysis to describe TCMLH translational efforts in Veterans Health Administration (VHA) facilities across the United States. Quantitative and qualitative data were collected via listening sessions with TCMLH facilitators, open-ended survey responses from facilitators, and quarterly reports from clinical implementation sites. We used the Consolidated Framework for Implementation Research (CFIR) to analyze, interpret, and organize qualitative findings, and descriptive statistics to analyze quantitative data. Most TCMLH programs (58%) were adapted from the original format, including changes to the modality, duration, or frequency of sessions. Findings suggest these adaptations occurred in response to barriers including space, staffing constraints, and participant recruitment. Overall, findings highlight practical insights for improving the implementation of TCMLH, including recommendations for additional adaptations and tailored implementation strategies to promote its reach.

A primary focus of the US Global Ocean Ecosystem Dynamics (GLOBEC) program was to identify the mechanisms of ecosystem response to largescale climate forcing under the assumption that bottom-up forcing controls a large fraction of marine ecosystem variability. At the beginning of GLOBEC, the prevailing bottom-up forcing hypothesis was that climate-induced changes in vertical transport modulated nutrient supply and surface primary productivity, which in turn affected the lower trophic levels (e.g., zooplankton) and higher trophic levels (e.g., fish) through the trophic cascade. Although upwelling dynamics were confirmed to be an important driver of ecosystem variability in GLOBEC studies, the use of eddyresolving regional-scale ocean circulation models combined with field observations revealed that horizontal advection is an equally important driver of marine ecosystem variability. Through a synthesis of studies from the four US GLOBEC regions (Gulf of Alaska, Northern California Current, Northwest Atlantic, and Southern Ocean), a new horizontal-advection bottom-up forcing paradigm emerges in which large-scale climate forcing drives regional changes in alongshore and cross-shelf ocean transport that directly impact ecosystem functions (e.g., productivity, species composition, spatial connectivity). The horizontal advection bottom-up forcing paradigm expands the mechanistic pathways through which climate variability and climate change impact the marine ecosystem. In particular, these results highlight the need for future studies to resolve and understand the role of mesoscale and submesoscale transport processes and their relationship to climate.

Ribosome biogenesis is a canonical hallmark of cell growth and proliferation. Here we show that execution of Epithelial-to-Mesenchymal Transition (EMT), a migratory cellular program associated with development and tumor metastasis, is fueled by upregulation of ribosome biogenesis during G1/S arrest. This unexpected EMT feature is independent of species and initiating signal, and is accompanied by release of the repressive nucleolar chromatin remodeling complex (NoRC) from rDNA, together with recruitment of the EMT-driving transcription factor Snai1 (Snail1), RNA Polymerase I (Pol I) and the Upstream Binding Factor (UBF). EMT-associated ribosome biogenesis is also coincident with increased nucleolar recruitment of Rictor, an essential component of the EMT-promoting mammalian target of rapamycin complex 2 (mTORC2). Inhibition of rRNA synthesis in vivo differentiates primary tumors to a benign, Estrogen Receptor-alpha (ERα) positive, Rictor-negative phenotype and reduces metastasis. These findings implicate the EMT-associated ribosome biogenesis program with cellular plasticity, de-differentiation, cancer progression and metastatic disease.