Exploring the Materials and Condition of 20th-Century Dolls in Zoe Leonard's Mouth Open, Teeth Showing 2000.

Systematic condition and analytical surveys were carried out on Zoe Leonard's (b. 1961) Mouth Open, Teeth Showing 2000, an installation artwork in Tate's collection consisting of 162 children's dolls. The dolls were manufactured at various points within the 20th century and encompass several potentially problematic synthetic polymers found in modern and contemporary museum collections. To explore the doll materials and conservation condition, a multi-analytical approach was used to identify key synthetic polymer types and additives present, including portable and bench analytical techniques. Challenging degradation phenomena associated with different types of doll have been discussed and related to their material composition, which has helped our understanding of the conservation challenges inherent to this contemporary artwork.

The stability of paintings and the molecular structure of the oil paint polymeric network.

A molecular-level understanding of the structure of the polymeric network formed upon the curing of air-drying artists' oil paints still represents a challenge. In this study we used a set of analytical methodologies classically employed for the characterisation of a paint film-based on infrared spectroscopy and mass spectrometry-in combination with solid state NMR (SSNMR), to characterise model paint layers which present different behaviours towards surface cleaning with water, a commonly applied procedure in art conservation. The study demonstrates, with the fundamental contribution of SSNMR, a relationship between the painting stability and the chemical structure of the polymeric network. In particular, it is demonstrated for the first time that a low degree of cross-linking in combination with a high degree of oxidation of the polymeric network render the oil paint layer sensitive to water.

Conservation Issues of Modern Oil Paintings: A Molecular Model on Paint Curing.

The 20th and 21st century oil paintings are presenting a range of challenging conservation problems that can be distinctly different from those noted in paintings from previous centuries. These include the formation of vulnerable surface "skins" of medium and exudates on paint surfaces, efflorescence, unpredictable water and solvent sensitivity, and incidence of paint dripping which can occur within a few years after the paintings were completed. Physicochemical studies of modern oil paints and paintings in recent years have identified a range of possible causal factors for the noted sensitivity of painting surfaces to water and protic solvents, including the formation of water-soluble inorganic salts and/or the accumulation of diacids at the paint surface, which are oxidation products of the oil binder. Other studies have investigated the relationship between water sensitivity and the degree of hydrolysis of the binder, the proportions of free fatty and dicarboxylic acids formed, as well as the relative content of free metal soaps. Thus far, data indicate that the qualitative and quantitative composition of the nonpolymerized fractions of the oil binder cannot be solely or directly related to the solvent sensitivity of the paint film. Conclusions therefore indicate that the polymeric network, formed upon the curing of the oil, plays a fundamental role, suggesting that water sensitivity, at least in some cases, may be related to the poor development and/or polar nature of the formed polymeric network rather than the composition of the nonpolymerized fractions. Poorly developed polymeric networks, in combination with the migration of polar fractions, i.e., dicarboxylic and hydroxylated fatty acids toward the paint surface, can be related to other degradation phenomena, including the separation and migration of the paint binder which can lead to the presence of observable skins of medium as well as the more alarming phenomenon of liquefying or dripping oil paints. It is thus crucial to understand the molecular composition of these paints and their physicochemical behavior to aid the further development of appropriate conservation and preservation strategies, as the risks currently associated with surface cleaning treatments and other conservation procedures can be unacceptably high. This Account reviews the relationships between the degradation phenomena associated with modern oil paintings and the chemical composition of the oil binder and proposes a molecular model for the development of water sensitivity and other noted degradation phenomena. It is suggested that water sensitivity (and possibly other degradation phenomena) is a consequence of processes that take place upon curing, and in particular to the rate of formation and decomposition of alkoxyl and peroxyl radicals. These reactions are strongly dependent on the type of oil present, the ambient environmental conditions, and the chemical and physical nature of the pigments and additives present in the paint formulation. When the curing environment is oxidizing, the chemistry of peroxyl radicals dominates the reaction pathways, and oxidative decomposition of the paint film overwhelms cross-linking reactions.

The role of the polymeric network in the water sensitivity of modern oil paints.

Spectroscopic and mass spectrometric analytical techniques were used to characterise two naturally aged Winsor & Newton (W&N) Winsor Green (phthalocyanine green, PG7) artists' oil colour paint swatches dating to 1993 and 2003. Infrared and Energy Dispersive X-ray (EDX) analysis indicated that the swatches were of closely similar composition, yet the swatch from 2003 was water-sensitive whilst the swatch from 1993 was not. Water-sensitivity is a conservation challenge associated with significant numbers of modern oil paintings and this study aimed to further develop our understanding of the molecular causes of water sensitivity. SEM elemental mapping of samples taken from both swatches provided no indication for the formation of epsomite - a known cause of water sensitivity in some modern oil paintings. Liquid chromatography coupled with mass spectrometry (HPLC-MS) and gas chromatography coupled with mass spectrometry (GC-MS) also revealed very similar qualitative-quantitative composition in terms of unbound and esterified medium fractions. The polymeric network was investigated using analytical pyrolysis. A combination of flash pyrolysis coupled with gas chromatography mass spectrometry (Py-GC-MS) together with evolved gas analysis mass spectrometry (EGA-MS) revealed that the polymeric material was relatively more abundant in the non-water-sensitive paint. This is the first multi-analytical study that has demonstrated a correlation between water-sensitivity and the degree of polymerisation of the oil medium; independent of other known causes of water-sensitivity.

A molecular study of modern oil paintings: investigating the role of dicarboxylic acids in the water sensitivity of modern oil paints.

The 20th century has seen a significant evolution in artists' paint formulation and technology which is likely to relate to the new conservation challenges frequently presented by modern oil paintings, including unpredictable water- and solvent-sensitivity. This study examined the molecular causes and mechanisms behind these types of modern oil paint vulnerability. Research performed up to now has suggested a correlation between the occurrence of water sensitivity and the presence of relatively high amounts of extractable free dicarboxylic acids. To explore this further, as well as the influence of paint formulation, a set of model paint samples, produced in 2006 using commercial tube paints to which known amounts of additives were added, were analysed. The samples were tested for water sensitivity by aqueous swabbing and characterised using transmission Fourier Transform-Infra Red spectroscopy (FTIR) to determine the molecular composition of the main paint constituents, High Performance Liquid Chromatography-Mass Spectrometry (HPLC-MS), to identify the type(s) of drying oils used as binders, and Gas Chromatography-Mass Spectrometry (GC-MS) using a recently developed analytical procedure that can discriminate and quantify free fatty and dicarboxylic acids, as well as their corresponding metal soaps (carboxylates of fatty and dicarboxylic acids). The results indicated that the addition of small amounts of additives can influence the water sensitivity of an oil paint, as well as its molecular composition. Additionally the nature of the ionomeric/polymeric network appears to be a significant determining factor in the development of water sensitivity.

Information-seeking styles among cancer patients before and after treatment by demographics and use of information sources.

The type and quantity of information needed varies between patients who actively seek information and those who tend to avoid information.We analyzed data from a longitudinal study of adult cancer patients from outpatient clinics for whom information needs and behaviors were assessed by survey before and after treatment. We evaluated the relationships between information-seeking style (active, moderately active, and passive styles) and demographics, cancer type, and health status for the pretreatment and posttreatment periods and overall. The generalized estimating equations (GEE) approach was used to model the log odds of more active to more passive information-seeking preferences taking into consideration both the pretreatment and posttreatment periods. Analyses included 731 case participants, including female breast cancer patients (51%), male genitourinary cancer patients (18%), and lung cancer patients of both sexes (10%). At pretreatment, 17% reported an active information-seeking style, 69% were moderately active, and 14% were passive. During this period, 19% of those with at least some college education reported being very active compared with 14% of those with less education. With adjustment for all other covariates, male genitourinary and lung cancer patients had a higher odds of having a more active information-seeking style in the pretreatment than in the posttreatment period, with an odds of 4.5 (95% confidence interval [CI]: 2.4-8.4) and 5.4 (95% CI: 2.7-10.6), respectively. Controlling for all covariates, breast cancer patients had 1.5 (95% CI: 1.0-2.1) times higher odds of being more active in seeking information than other patients. Public health researchers and clinicians must work together to develop the most effective strategy for meeting the informational needs of these patients before and after treatment.

The menopause: effects on the pelvic floor, symptoms and treatment options.

This article discusses the effects of age and the menopause on the pelvic floor, subsequent risks of urogynaecological dysfunction, symptoms of this dysfunction and treatment options.

Cancer outcomes research in a rural area: a multi-institution partnership model.

Whereas, most cancer research data come from high-profile academic centers, little is known about the outcomes of cancer care in rural communities. We summarize the experience of building a multi-institution partnership to develop a cancer outcomes research infrastructure in Southwest Georgia (SWGA), a primarily rural 33-county area with over 700,000 residents. The partnership includes eight institutions: the Emory University in Atlanta, the Centers for Disease Control and Prevention (CDC), the Georgia Comprehensive Center Registry (the Registry), the Southwest Georgia Cancer Coalition (the Coalition), and the four community cancer centers located within the SWGA region. The practical application of the partnership model, its organizational structure, and lessons learned are presented using two specific examples: a study evaluating treatment decisions and quality of life among prostate cancer patients, and a study of treatment discontinuation among prostate, breast, lung, and colorectal cancer patients. Our partnership model allowed us to (1) use the Coalition as a link between Atlanta-based researchers and local community; (2) collaborate with the area cancer centers on day-to-day study activities; (3) involve the Registry personnel and resources to identify eligible cancer cases and to perform data collection; and (4) raise community awareness and sense of study ownership through media announcements organized by the Coalition. All of the above activities were performed in consultation with the funding institution (CDC) and its project directors who oversee several other studies addressing similar research questions throughout the country. Our partnership model may provide a useful framework for cancer outcomes research projects in rural communities.

Correlates of depressive symptoms among women seeking cancer genetic counseling and risk assessment at a high-risk cancer clinic.

The aims of this study were to (1) assess the level of depression among women seeking cancer genetic counseling and risk assessment and to (2) identify and describe the demographic, health history, and health behavior correlates of clinically significant depression. Participants were 280 women presenting for an intake appointment at a university cancer risk clinic. During intake, participants completed questionnaires assessing demographics, health history, health practices, and depression. Twenty-eight percent of the sample met criteria for at least mild depression. Descriptive statistics indicated that depressed women were more likely to be African American, to have more children, less likely to receive a mammogram, and consumed fewer alcoholic drinks per week than nondepressed women. Given the known associations between depression, health behaviors such as cancer screening, and potential responses to the genetic testing process, assessment of mood disturbance remains an important consideration for genetic counselors.

CDC-funded intervention research aimed at promoting colorectal cancer screening in communities.

BACKGROUND: Although strong scientific evidence has shown that screening for colorectal cancer saves lives, most U.S. adults who are at the recommended age are not being screened. Prior studies suggest that barriers to routine screening vary by race, ethnicity, socioeconomic status, urban/rural residence, health insurance status, and factors related to health care providers and the health care environment. Relatively few studies, however, have identified and tested intervention approaches to promote routine colorectal cancer screening among diverse populations. METHODS: The Division of Cancer Prevention and Control at CDC has funded ongoing projects to develop and test interventions to promote routine colorectal cancer screening among medically underserved populations in Appalachia, the Lower Rio Grande Valley in Texas, the High Plains region of Colorado, and other U.S. communities. RESULTS: This article provides an overview of colorectal cancer screening intervention studies currently funded by CDC that focus on a wide range of populations, including medically underserved persons who live in predominately rural areas, Hispanic and non-Hispanic persons, urban African Americans, persons with low health literacy, and persons enrolled in managed care organizations. CONCLUSIONS: These CDC-funded intervention research projects are likely to contribute importantly to evidence about what works to promote colorectal cancer screening in diverse U.S. communities. .

Why do men choose one treatment over another?: a review of patient decision making for localized prostate cancer.

Treatment choices for localized prostate cancer appear to vary widely, although it is unclear whether this variation is a result of patient values or other factors. The authors conducted a systematic review of the literature, identifying 70 articles that focused on prostate cancer decision making. Studies suggest that men consider several issues when making treatment decisions. The authors found conflicting evidence regarding the importance that men place on cancer eradication, with considerable variation in how patients interpret evidence regarding treatment efficacy. The number of physicians that men see and the importance of the physician recommendation were found to vary considerably. Although men stated that side effects are important, few patients reported that side effect factors ultimately influenced their treatment choice. To the authors' knowledge, there is little research regarding how patients' personal values shape and influence their decision, or the role of race/ethnicity or socioeconomic status in preferences for treatment. The authors conclude that variations in treatment decisions may be more indicative of differences in the information patients receive rather than truly reflective of underlying patient preferences. Considerable progress is needed in helping patients fully understand how to balance the complex issues surrounding prostate cancer treatment decision making.

A group approach to the depressed adolescent girl in foster care.

Depression reactive to severe early loss and current environmental pressure is a salient common characteristic of many adolescent girls in foster care. This paper describes work with developmentally-oriented mutual aid groups focused on depression and coping, which have been successful in promoting ego strengths and growth in this population.