Challenges and solutions during analysis in a longitudinal narrative case study.

AIM: To describe the challenges faced by those performing complex qualitative analysis during a narrative study and to offer solutions. BACKGROUND: Qualitative research requires rigorous analysis. However, novice researchers often struggle to identify appropriately robust analytical procedures that will move them from their transcripts to their final findings. The lack of clear and detailed accounts in the literature that consider narrative analysis and how to address some of the common challenges researchers face add to this problem. DATA SOURCES: A longitudinal narrative case study exploring the personal and familial changes reported by uninjured family members during the first year of another family member's traumatic brain injury. Review methods This is a methodological paper. DISCUSSION: The challenges of analysis included: conceptualising analysis; demonstrating the relationship between the different analytical layers and the final research findings; interpreting the data in a way that reflected the priorities of a narrative approach; and managing large quantities of data. The solutions explored were: the mapping of analytic intentions; aligning analysis and interpretation with the conceptual framework; and the use of matrices to store and manage quotes, codes and reflections. CONCLUSION: Working with qualitative data can be daunting for novice researchers. Ensuring rigorous, transparent, and auditable data analysis procedures can further constrain the interpretive aspect of analysis. Implications for research/practice The solutions offered in this paper should help novice researchers to manage and work with their data, assisting them to develop the confidence to be more intuitive and creative in their research

Are Preseason Functional and Biomechanical Measures Associated with Lower Quadrant Injury Risk in Division III Athletes?

A recent trend in sports medicine research is to determine risk of injury during sport based on preseason functional performance test (FPT) measures. Equivocal findings associated with prior studies may leave PTs with uncertainty as to which FPT, or combination of FPTs, can best identify athletes who have a greater risk for injury. Previous studies have utilized low-tech FPT measures: standing long jump (SLJ), single-leg hop (SLH), lower extremity functional test (LEFT), and the Y-balance test (YBT) (1,3,4). These low-tech options may not be able to identify potential deficits that could be collected with high-tech measures (e.g., DVJ measures collected in a motion capture lab) (2). The purpose of this study was to determine if “high-tech” and/or “low-tech” preseason functional performance test measures were associated with non-contact time loss lower quadrant (LQ = low back and/or lower extremity) injuries

Managing clinical uncertainty in older people towards the end of life: a systematic review of person-centred tools.

BACKGROUND: Older people with multi-morbidities commonly experience an uncertain illness trajectory. Clinical uncertainty is challenging to manage, with risk of poor outcomes. Person-centred care is essential to align care and treatment with patient priorities and wishes. Use of evidence-based tools may support person-centred management of clinical uncertainty. We aimed to develop a logic model of person-centred evidence-based tools to manage clinical uncertainty in older people. METHODS: A systematic mixed-methods review with a results-based convergent synthesis design: a process-based iterative logic model was used, starting with a conceptual framework of clinical uncertainty in older people towards the end of life. This underpinned the methods. Medline, PsycINFO, CINAHL and ASSIA were searched from 2000 to December 2019, using a combination of terms: "uncertainty" AND "palliative care" AND "assessment" OR "care planning". Studies were included if they developed or evaluated a person-centred tool to manage clinical uncertainty in people aged ≥65 years approaching the end of life and quality appraised using QualSyst. Quantitative and qualitative data were narratively synthesised and thematically analysed respectively and integrated into the logic model. RESULTS: Of the 17,095 articles identified, 44 were included, involving 63 tools. There was strong evidence that tools used in clinical care could improve identification of patient priorities and needs (n = 14 studies); that tools support partnership working between patients and practitioners (n = 8) and that tools support integrated care within and across teams and with patients and families (n = 14), improving patient outcomes such as quality of death and dying and satisfaction with care. Communication of clinical uncertainty to patients and families had the least evidence and is challenging to do well. CONCLUSION: The identified logic model moves current knowledge from conceptualising clinical uncertainty to applying evidence-based tools to optimise person-centred management and improve patient outcomes. Key causal pathways are identification of individual priorities and needs, individual care and treatment and integrated care. Communication of clinical uncertainty to patients is challenging and requires training and skill and the use of tools to support practice

Identification and characterisation of enteroaggregative Escherichia coli subtypes associated with human disease

Enteroaggregative E. coli (EAEC) are a major cause of diarrhoea worldwide. Due to their heterogeneity and carriage in healthy individuals, identification of diagnostic virulence markers for pathogenic strains has been difficult. In this study, we have determined phenotypic and genotypic differences between EAEC strains of sequence types (STs) epidemiologically associated with asymptomatic carriage (ST31) and diarrhoeal disease (ST40). ST40 strains demonstrated significantly enhanced intestinal adherence, biofilm formation, and pro-inflammatory interleukin-8 secretion compared with ST31 isolates. This was independent of whether strains were derived from diarrhoea patients or healthy controls. Whole genome sequencing revealed differences in putative virulence genes encoding aggregative adherence fimbriae, E. coli common pilus, flagellin and EAEC heat-stable enterotoxin 1. Our results indicate that ST40 strains have a higher intrinsic potential of human pathogenesis due to a specific combination of virulence-related factors which promote host cell colonization and inflammation. These findings may contribute to the development of genotypic and/or phenotypic markers for EAEC strains of high virulence

Higgs friends and counterfeits at hadron colliders

We consider the possibility of "Higgs counterfeits" - scalars that can be produced with cross sections comparable to the SM Higgs, and which decay with identical relative observable branching ratios, but which are nonetheless not responsible for electroweak symmetry breaking. We also consider a related scenario involving "Higgs friends," fields similarly produced through gg fusion processes, which would be discovered through diboson channels WW, ZZ, gamma gamma, or even gamma Z, potentially with larger cross sections times branching ratios than for the Higgs. The discovery of either a Higgs friend or a Higgs counterfeit, rather than directly pointing towards the origin of the weak scale, would indicate the presence of new colored fields necessary for the sizable production cross section (and possibly new colorless but electroweakly charged states as well, in the case of the diboson decays of a Higgs friend). These particles could easily be confused for an ordinary Higgs, perhaps with an additional generation to explain the different cross section, and we emphasize the importance of vector boson fusion as a channel to distinguish a Higgs counterfeit from a true Higgs. Such fields would naturally be expected in scenarios with "effective Z's," where heavy states charged under the SM produce effective charges for SM fields under a new gauge force. We discuss the prospects for discovery of Higgs counterfeits, Higgs friends, and associated charged fields at the LHC.Comment: 27 pages, 5 figures. References added and typos fixe

Discovery of a recent, natural whale fall on the continental slope off Anvers Island, western Antarctic Peninsula

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Whale falls provide a substantial, nutrient-rich resource for species in areas of the ocean that may otherwise be largely devoid of food. We report the discovery of a natural whale fall at 1430 m depth in the cold waters of the continental slope off the western Antarctic Peninsula. This is the highest-latitude whale fall reported to date. The section of the carcass we observed—the tail fluke—was more complete than any previously reported natural whale fall from the deep sea and in the early stages of decomposition. We estimate the entire cetacean to measure 5–8 m in length. The flesh remained almost intact on the carcass but the skin was missing from the entire section except for the end of the fluke, clearly exposing blubber and soft tissue. The absence of skin indicates rapid and Homogeneous loss. The dominant macrofauna present were crustaceans, including most prominently the lithodid crab Paralomis birsteini, and zoarcid fish typical of the ‘mobile-scavenger’ successional stage. The density of mobile macrofauna was greatest on the carcass and declined to background levels within 100 m, indicating that they were attracted to the whale fall. This whale fall offers an important opportunity to examine the decomposition of a carcass under deep-sea conditions at polar latitudes.We are grateful to the captain and crew of the RV Nathaniel B. Palmer, and to the US Antarctic Support Contractor, Lockheed Martin, for their assistance at sea. We thank J.T. Eastman and two anonymous reviewers for helpful comments on the manuscript. Funding was provided by grants from the U.S. National Science Foundation: ANT-1141877 to R.B.A. and ANT-1141896 to J.B.M. This is contribution 122 from the Institute for Research on Global Climate Change at the Florida Institute of Technology

Pumice attrition in an air-jet

We present the results from a series of jet-attrition experiments performed using a standard ASTM device (ASTM D5757-00) on naturally occurring ash-sized (b 2 mm) pumice, a product of explosive volcanic eruption compris- ing highly porous silicate glass. We investigate the effect of both feed grain size and attrition duration on the pro- duction of fines. We utilize a wet methodology for fines collection to ensure recovery of the total grain size distribution for each experimental run. The experiments convert a restricted size range of pumice particles to a bimodal population of parent and daughter particles. The bimodal distribution develops even after short (~ 15 min) attrition times. With increased attrition time, the volume of daughter particles increases and the mode migrates to finer grain sizes. Jet attrition efficiency depends heavily on the particle size of the feed; our data show little attrition for a feed of 500 μm vs. highly efficient attrition for a 250 μm feed. Our rates of attrition for pumice are extremely high compared to rates recovered from experiments on limestone pellets. Fines pro- duction data are well modeled by: mfines m0 bed ¼ 0:291 1−e−0:312t where m0bed is the initial mass of particles in the bed, t is in hours, and the two adjustable coefficients dictate the long time limiting behaviour (0.291) and the rate at which the limit is reached (−0.312). This functional form provides more realistic limits in time while preserving a zero intercept and defining a plateau for long residence time

Gluon fusion contribution to W+W- + jet production

We describe the computation of the $gg \to W^+W^-g$ process that contributes to the production of two $W$-bosons and a jet at the CERN Large Hadron Collider (LHC). While formally of next-to-next-to-leading order (NNLO) in QCD, this process can be evaluated separately from the bulk of NNLO QCD corrections because it is finite and gauge-invariant. It is also enhanced by the large gluon flux and by selection cuts employed in the Higgs boson searches in the decay channel $H \to W^+W^-$, as was first pointed out by Binoth {\it et al.} in the context of $gg \to W^+W^-$ production. For cuts employed by the ATLAS collaboration, we find that the gluon fusion contribution to $pp \to W^+W^-j$ enhances the background by about ten percent and can lead to moderate distortions of kinematic distributions which are instrumental for the ongoing Higgs boson searches at the LHC. We also release a public code to compute the NLO QCD corrections to this process, in the form of an add-on to the package {\tt MCFM}.Comment: 13 pages, 4 figures, 3 table