Beyond Exploratory: A Tailored Framework for Assessing Rigor in Qualitative Health Services Research

Objective: To propose a framework for assessing the rigor of qualitative research that identifies and distinguishes between the diverse objectives of qualitative studies currently used in patient-centered outcomes and health services research (PCOR and HSR). Study Design: Narrative review of published literature discussing qualitative guidelines and standards in peer-reviewed journals and national funding organizations that support PCOR and HSR. Principal Findings: We identify and distinguish three objectives of current qualitative studies in PCOR and HSR: exploratory, descriptive, and comparative. For each objective, we propose methodological standards that can be used to assess and improve rigor across all study phases—from design to reporting. Similar to quantitative studies, we argue that standards for qualitative rigor differ, appropriately, for studies with different objectives and should be evaluated as such. Conclusions: Distinguishing between different objectives of qualitative HSR improves the ability to appreciate variation in qualitative studies as well as appropriately evaluate the rigor and success of studies in meeting their own objectives. Researchers, funders, and journal editors should consider how adopting the criteria for assessing qualitative rigor outlined here may advance the rigor and potential impact of qualitative research in patient-centered outcomes and health services research

Piecing together the data of the U.S. marine aquaculture puzzle

Aquaculture recently became the main source of global seafood production and many countries, including the United States, see potential in marine aquaculture to sustainably fill growing demand. The U.S. supports the majority of its seafood consumption through imports, and therefore identifying bottlenecks to domestic aquaculture growth is a priority at the federal and state level. Yet, one critical aspect that appears not yet addressed is the quality and accessibility of marine aquaculture data. In this study we conducted the first multi-state synthesis and comparison of the most comprehensive suite of species, volume, and value information on U.S. marine aquaculture over time, across the 23 marine coastal states. Using publicly available data sources from the U.S. Department of Agriculture (USDA), state-level solicited data that we aggregated, and data from the National Oceanic and Atmospheric Administration (NOAA), we found strong evidence that marine aquaculture has played an increasingly important role in marine coastal states, but also uncovered numerous data gaps and discrepancies between and within these sources. In particular, we found a dearth of volumetric data and millions in missing value (USD$). We found U.S. marine aquaculture is likely much more diverse, abundant and valuable than is currently reported, but the main sources of error in any given state remain unclear. We recommend U.S. state governments adopt a standardized, digital and annual data collection program, such as the NOAA Fisheries Information Networks. Better strategic aquaculture planning, management, and research depend on accurate data, and existing digital data infrastructures provide strong opportunities for improvement

Pregnancy-related factors and the risk of breast carcinoma in situ and invasive breast cancer among postmenopausal women in the California Teachers Study cohort

Abstract Introduction Although pregnancy-related factors such as nulliparity and late age at first full-term pregnancy are well-established risk factors for invasive breast cancer, the roles of these factors in the natural history of breast cancer development remain unclear. Methods Among 52,464 postmenopausal women participating in the California Teachers Study (CTS), 624 were diagnosed with breast carcinoma in situ (CIS) and 2,828 with invasive breast cancer between 1995 and 2007. Multivariable Cox proportional hazards regression methods were used to estimate relative risks associated with parity, age at first full-term pregnancy, breastfeeding, nausea or vomiting during pregnancy, and preeclampsia. Results Compared with never-pregnant women, an increasing number of full-term pregnancies was associated with greater risk reduction for both breast CIS and invasive breast cancer (both P trend < 0.01). Women having four or more full-term pregnancies had a 31% lower breast CIS risk (RR = 0.69, 95% CI = 0.51 to 0.93) and 18% lower invasive breast cancer risk (RR = 0.82, 95% CI = 0.72 to 0.94). Parous women whose first full-term pregnancy occurred at age 35 years or later had a 118% greater risk for breast CIS (RR = 2.18, 95% CI = 1.36 to 3.49) and 27% greater risk for invasive breast cancer (RR = 1.27, 95% CI = 0.99 to 1.65) than those whose first full-term pregnancy occurred before age 21 years. Furthermore, parity was negatively associated with the risk of estrogen receptor-positive (ER+) or ER+/progesterone receptor-positive (PR+) while age at first full-term pregnancy was positively associated with the risk of ER+ or ER+/PR+ invasive breast cancer. Neither of these factors was statistically significantly associated with the risk of ER-negative (ER-) or ER-/PR- invasive breast cancer, tests for heterogeneity between subtypes did not reach statistical significance. No clear associations were detected for other pregnancy-related factors. Conclusions These results provide some epidemiologic evidence that parity and age at first full-term pregnancy are involved in the development of breast cancer among postmenopausal women. The role of these factors in risk of in situ versus invasive, and hormone receptor-positive versus -negative breast cancer merits further exploration

Bringing It All Together: Multi-species Integrated Population Modelling of a Breeding Community

Integrated population models (IPMs) combine data on different aspects of demography with time-series of population abundance. IPMs are becoming increasingly popular in the study of wildlife populations, but their application has largely been restricted to the analysis of single species. However, species exist within communities: sympatric species are exposed to the same abiotic environment, which may generate synchrony in the fluctuations of their demographic parameters over time. Given that in many environments conditions are changing rapidly, assessing whether species show similar demographic and population responses is fundamental to quantifying interspecific differences in environmental sensitivity and highlighting ecological interactions at risk of disruption. In this paper, we combine statistical approaches to study populations, integrating data along two different dimensions: across species (using a recently proposed framework to quantify multi-species synchrony in demography) and within each species (using IPMs with demographic and abundance data).We analyse data from three seabird species breeding at a nationally important long-term monitoring site. We combine demographic datasets with island-wide population counts to construct the first multi-species Integrated Population Model to consider synchrony. Our extension of the IPM concept allows the simultaneous estimation of demographic parameters, adult abundance and multi-species synchrony in survival and productivity, within a robust statistical framework. The approach is readily applicable to other taxa and habitats

Comparison of two methods to estimate within-lake regenerated nutrients and determine their role in harmful algal blooms

Harmful algal blooms (HABs) in surface waters world-wide decreases their aesthetic, recreational value, and use as potable source waters. This is important in the face of the expanding human population that relies on access to clean water. To remediate HABs requires whole-lake nutrient budgets including internal loading which can contribute significantly to HABs. I used a dual approach to quantify the internal phosphorus (P) load at Willow Creek Reservoir (WCR), OR. I calculated the volume-weighted concentration of P from field-collected samples during summer anoxia and from laboratory incubations of sediment cores collected from various sites in WCR; both commonly used approaches, but rarely applied together. The load calculated from field collected samples was 1.7 fold higher than that calculated from sediment core incubations indicating that the latter would severely underestimate internal loading rates in WCR. I also found a large inter-annual difference between 2014 and 2015 that was likely related to annual precipitation and reservoir drawdown. The comparison of internal loading along with external P sources is recommended as a balanced approach to lake management when applying remediation efforts of in-lake controls as well as within the watershed.Thesis (M.S., Natural Resources) -- University of Idaho, 201

Identifying Significant Predictors of COVID-19 Mortality Rate in the United States

Identifying useful predictors of COVID-19 mortality rate is of critical importance to fight the ongoing pandemic. Based on the Lasso regression and linear discriminant analysis (LDA), hospitalization rate and incident rate seem to be more significant as predictors of COVID-19 mortality rate than latitude, longitude, and testing rate. We further discuss possible causes and implications of the results above by analyzing associations between testing rate, incident rate, and mortality rate

Intelligent RF-Based Gesture Input Devices Implemented Using e-Textiles

We present an radio-frequency (RF)-based approach to gesture detection and recognition, using e-textile versions of common transmission lines used in microwave circuits. This approach allows for easy fabrication of input swatches that can detect a continuum of finger positions and similarly basic gestures, using a single measurement line. We demonstrate that the swatches can perform gesture detection when under thin layers of cloth or when weatherproofed, providing a high level of versatility not present with other types of approaches. Additionally, using small convolutional neural networks, low-level gestures can be identified with a high level of accuracy using a small, inexpensive microcontroller, allowing for an intelligent fabric that reports only gestures of interest, rather than a simple sensor requiring constant surveillance from an external computing device. The resulting e-textile smart composite has applications in controlling wearable devices by providing a simple, eyes-free mechanism to input simple gestures

Ail-gyflwyniad yr afanc Ewropeaidd Castor fiber i Gymru. Astudiaeth dichonoldeb ecolegol

This report discusses the biological feasibility of the reintroduction of the Eurasian beaver Castor fiber to Wales. Beavers are one of the most extensively reintroduced species of the Euro- pean fauna, and a great deal of information is available on the methods, progress, and effects of reintroductions. In most of Europe beavers live mainly in human-dominated ‘cultural’ landscapes, and are man- aged as an element of that landscape. This assessment considers feasibility primarily in this light, that is, of the reintroduction of a formerly present element to the Welsh cultural land- scape. However, while touching on matters of desirability and management where appropriate in such a context, it is not primarily concerned with those topics but, rather, is intended to pro- vide part of the basis on which further consideration of those issues can proceed. A survey of the extensive beaver reintroduction ecology literature shows that beaver popula- tions spread rapidly through watersheds but only slowly (and with appropriate management containably), between them. This implies that reintroductions, and management, should be considered at a whole watershed scale. Accordingly, following training and experience in bea- ver ecology on the ground, fieldworkers closely familiar with Welsh rivers conducted an ap- praisal of the country and identified six river systems for more detailed analysis: the Glaslyn, Dee, Rheidol, Teifi, Eastern Cleddau, and Western Cleddau. Investigation of these river systems indicates that all, with the possible exception of the Glas- lyn, could support viable populations of beaver of varying size. Potential populations on each river, their distribution, and ecological factors such as the likely degree of dam-building activity, which is closely related to stream flow characteristics, are discussed. Beaver reintroduction to Wales is biologically feasible and would be technically unproblematic to achieve. In landscapes dominated by human activities, European experience indicates that the human element is by far the most influential in determining the practical feasibility of a pro- gramme. The biology of beaver reintroduction is very well known; the course of population de- velopment on a river system and its ecological effects can be predicted with reasonable confi- dence. It is the (human) social aspects of reintroductions that typically require the most atten- tion, care, and forethought. Beaver Castor fiber, Wales, reintroduction, feasibility, Bever Castor fiber gjeninnføring, Wales, gjennomførlighetMae’r adroddiad hwn yn trafod ymarferoldeb biolegol ailgyflwyno’r afanc Ewrasiaidd, Castor fiber, yng Nghymru. Yr afanc yw’r rhywogaeth sydd wedi’i ailgyflwyno fwyaf bron o blith anifeiliaid Ewrop ac mae llawer iawn o wybodaeth ar gael am ddulliau, cynnydd ac effeithiau’r ailgyflwyno. Yn bennaf, mae afancod Ewrop yn byw mewn tirluniau ‘diwylliannol’ a reolir gan ddyn yn bennaf. Mae’r asesiad hwn yn ystyried yr ymarferoldeb yng ngoleuni hyn, yn bennaf, hynny yw, ailgyflwyno elfen o dirlun diwylliannol Cymru a arferai fod yn bresennol yma o’r blaen. Fodd bynnag, tra’n rhoi sylw i faterion fel dymunoldeb a rheolaeth lle bo hynny’n berthnasol i’r drafodaeth ar ymarferoldeb mewn cyd-destun o’r fath, nid yw’n ymwneud yn bennaf â’r pynciau hynny ond, yn hytrach, y diben yw darparu rhan o’r sail ar gyfer bwrw ymlaen ag ystyriaeth bellach o’r materion hynny. Mae arolwg ar y llenyddiaeth eang sydd ar gael ar ecoleg ailgyflwyno’r afanc yn dangos bod poblogaeth yr afanc yn ymledu’n gyflym iawn drwy wahanfeydd dŵr ond dim ond yn araf iawn (a chyda rheolaeth briodol a chynhwysol) rhyngddynt. Mae hyn yn awgrymu y dylid ystyried ailgyflwyno, a’r dull o reoli hynny, ar raddfa gwahanfa ddŵr gyflawn. Yn unol â hynny, wedi hyfforddiant a phrofiad o ecoleg yr afanc ar y tir, cynhaliodd gweithwyr maes oedd yn gyfarwydd iawn ag afonydd Cymru werthusiad o’r wlad gan nodi chwe system afon ar gyfer dadansoddiad manylach: y Glaslyn, y Ddyfrdwy, Rheidol, Teifi, Dwyrain y Cleddau a Gorllewin y Cleddau. Mae ymchwiliad i’r systemau afon hyn yn dynodi y gallai pob un, ac eithrio’r Glaslyn o bosibl, gefnogi poblogaethau hyfyw o’r afanc o faint amrywiol. Trafodir y boblogaeth bosibl ar gyfer pob afon, eu dosbarthiad a ffactorau ecolegol fel graddfa debygol eu gweithgarwch codi argaeau, sydd â chysylltiad agos â nodweddion llif nentydd. Mae ailgyflwyno’r afanc yng Nghymru’n ymarferol yn fiolegol ac, yn dechnegol, ni fyddai’n broblemus i’w gyflawni. Mewn tirluniau a reolir gan weithgarwch dyn, mae profiad Ewropeaidd yn dynodi mai’r elfen ddynol yw’r un fwyaf dylanwadol o bell ffordd o ran penderfynu ar ymarferoldeb y rhaglen. Mae gwybodaeth dda ar gael am fioleg ailgyflwyno’r afanc; gellir rhagdybio datblygiad poblogaeth ar system afon a’i effeithiau ecolegol yn rhesymol hyderus. Yr agweddau cymdeithasol (dynol) ar ailgyflwyno sydd angen y sylw, y gofal a’r cynllunio mwyaf.Halley, D.J.; Jones, A.C.L; Chesworth, S.; Hall, C.; Gow, D.; Jones-Parry, R.; & Walsh, J. 2009. Gjeninnføringen av den Eurasiatisk bever Castor fiber til Wales: en økologisk gjennomførliget undersøkelse. - NINA Rapport 457. 66 ss. Denne rapporten diskuterer den biologiske gjennomførlighet av gjeninnføringen av den Eurasiatiske bever Castor fiber til Wales. Arten er en av de mest vidt gjeninnført arter i den Europeiske faunaen, og mye opplysning er tilgjengelig om metodikk, framgang, og effektene av gjeninnføringer. I det fleste av Europa lever beveren i menneskedominerte kulturlandskaper, og er forvaltet som et element av dette landskapet. Denne vurderingen behandler gjennomførlighet primært i denne lys, det vil si, som gjeninnføringen av en tidligere tilstedsværende element til det walisiske kulturlandskapet. Likevel, mens den berører saker som ønskelighet og forvaltning som hensiktsmessig i konteksten, den dreier seg ikke primært på disse emner men, heller, er tilsiktet som en del av basisen som brukes i videre overveielse av disse emner. En gjennomgang av den omfattende litteratur på bever gjeninnføringsøkologi viser at beverbestand sperr seg raskt gjennom et vassdrag, men bare sakte (og med tilpasset forvaltning beholdelig) mellom vassdrag. Dette innebærer at gjeninnføringer skal vuderes på et hele vassdrags målestokk. Følgelig, etter opplæring og erfaring i beverøkologi på bakken, feltarbeidere med nær bekjentskap på elvene i Wales gjennomført en vurdering av landet og identifisert seks vassdrag for mer detaljert undersøkelser: Glaslyn, Dee, Rheidol, Teifi, Eastern Cleddau, og Western Cleddau. Undersøkelse av disse vassdrag indikerer at all, med mulig unntak av Glaslynvassdraget, kan støtte levedyktige bestand av bever av ulike størrelse. Estimerte bestandstørrelser på hver vassdrag, sannsynlig utbredelsen på vassdraget, og økologiske faktorer som den sannsynlig nivå av oppdemningsaktiviteter, som er nær knyttet til strømegenskaper, er diskuterte. Gjeninnføringen av beveren til Wales er biologisk gjennomførbart og blir teknisk sett uproblematisk å oppnå. I landskapene dominerte av menneskeaktiviteter, erfaringen fra Europa viser at den menneskelige elementet er langt det mest innflytelsesrik i bestemmelse av den praktiske gjennomførlighet av et program. Biologien av bevergjeninnføringer er meget godt forstod og kurset av bestandsutvikling på et vassdrag, og dens økologiske effekter, kan forutsies med rimelig sikkerhet. Det er den (menneskelige) sosiale aspekter av gjeninnføringer som typisk trenger det meste oppmerksomhet, forsiktighet, og omtanke.© Norsk institutt for naturforskning. Publikasjonen kan siteres fritt med kildeangivelse

Patient- and Provider-Reported Experiences of a Mobile Novel Digital Therapeutic in People With Opioid Use Disorder (reSET-O): Feasibility and Acceptability Study

BackgroundMedications for the treatment of opioid use disorder, such as buprenorphine, are effective and essential for addressing the opioid epidemic. However, high dropout rates from medication remain a challenge. Behavioral treatment with contingency management and cognitive behavioral counseling has shown promise for improving the outcomes of buprenorphine treatment but is complicated to deliver. The delivery of behavioral treatment through technology-based platforms has the potential to make it more feasible for widespread dissemination. ObjectivereSET-O is a prescription digital therapeutic and a commercial adaptation of the Therapeutic Education System, an internet-based program with a Community Reinforcement Approach to cognitive behavioral therapy. It delivers cognitive behavioral therapy modules and contingency management rewards upon completion of modules and negative urine drug screens. This pilot study aims to assess the feasibility and acceptability of reSET-O in a community-based opioid treatment program with a Hub and Spoke model of care as part of a larger strategy to maintain individuals in treatment. Objective and qualitative results, as well as acceptability and likeability of reSET-O, were obtained from 15 individuals. MethodsEnglish-speaking individuals aged ≥18 years with a diagnosis of current opioid use disorder were recruited after being on buprenorphine for at least 1 week of treatment. Two 12-week prescriptions for reSET-O were written for the 24-week study. Patient reports of drug use and likeability scales of reSET-O were conducted at weeks 4, 8, 12, and 24 of the study. Qualitative interviews were also conducted. A total of 4 providers were recruited and provided feedback on the acceptability and feasibility of reSET-O. ResultsOf the 15 participants who participated in this pilot study, 7 (47%) completed 24 weeks, and 8 (53%) were unable to complete because of dropout after enrollment, attrition in treatment, or incarceration. An average of US $96 in contingency management rewards were earned by participants for the completion of modules for the duration of the pilot study. Participants’ subjective feedback revealed that reSET-O was easy to use, enjoyable, and helped provide a safe space to admit recurring substance use. ConclusionsreSET-O was well accepted based on patient and provider feedback in this pilot study; however, adherence and retention in treatment remain areas for improvement. Randomized control trials are needed to assess whether retention of community-based buprenorphine treatment is enhanced through the use of technology-based behavioral interventions such as reSET-O

Intelligent RF-Based Gesture Input Devices Implemented Using e-Textiles

We present an radio-frequency (RF)-based approach to gesture detection and recognition, using e-textile versions of common transmission lines used in microwave circuits. This approach allows for easy fabrication of input swatches that can detect a continuum of finger positions and similarly basic gestures, using a single measurement line. We demonstrate that the swatches can perform gesture detection when under thin layers of cloth or when weatherproofed, providing a high level of versatility not present with other types of approaches. Additionally, using small convolutional neural networks, low-level gestures can be identified with a high level of accuracy using a small, inexpensive microcontroller, allowing for an intelligent fabric that reports only gestures of interest, rather than a simple sensor requiring constant surveillance from an external computing device. The resulting e-textile smart composite has applications in controlling wearable devices by providing a simple, eyes-free mechanism to input simple gestures