Dating and Digging Stratified Archaeology in Circumpolar North America : A View from Nunalleq, Southwestern Alaska

The results presented in this paper were funded by a NERC Radiocarbon Facility grant (NRCF 1917.0415), while the wider project is funded by the Arts and Humanities Research Council (AH/K006029/1). The authors wish to thank all the members of the excavation crew from the 2014 field season for their hard work in the challenging weather conditions of southwest Alaska – without their attention to detail this study would not have been possible. Additional thanks are also due to Qanirtuuq Incorporated for logistical support and warm hospitality in Quinhagak. We also wish to thank Kevin Edwards and Kate Britton, who read an earlier draft of this paper, and three anonymous reviewers for highly constructive criticism that helped us to improve the final manuscript.Peer reviewedPublisher PD

Application of the Intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]

Background: The intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) has been developed to facilitate detailed assessments of intervention complexity in systematic reviews. Worked examples of the tool's application are needed to promote its use and refinement. The aim of this case study was to apply the iCAT_SR to a subset of 20 studies included in a Cochrane review of interventions aimed at improving appropriate polypharmacy in older people.  Methods: Interventions were assessed independently by two authors using the six core iCAT_SR dimensions: (1) 'Target organisational levels/categories'; (2) 'Target behaviour/actions'; (3) 'Active intervention components'; (4) 'Degree of tailoring'; (5) 'Level of skill required by intervention deliverers'; (6) 'Level of skill required by intervention recipients'. Attempts were made to apply four optional dimensions: 'Interaction between intervention components'; 'Context/setting'; 'Recipient/provider factors'; 'Nature of causal pathway'. Inter-rater reliability was assessed using Cohen's Kappa coefficient. Disagreements were resolved by consensus discussion. The findings are presented narratively.  Results: Assessments involving the core iCAT_SR dimensions showed limited consistency in intervention complexity across included studies, even when categorised according to clinical setting. Interventions were delivered across various organisational levels and categories (i.e. healthcare professionals and patients) and typically comprised multiple components. Intermediate skill levels were required by those delivering and receiving the interventions across all studies. A lack of detail in study reports precluded application of the iCAT_SR's optional dimensions. The inter-rater reliability was substantial (Cohen's Kappa = 0.75)  Conclusions: This study describes the application of the iCAT_SR to studies included in a Cochrane systematic review. Future intervention studies need to ensure more detailed reporting of interventions, context and the causal pathways underlying intervention effects to allow a more holistic understanding of intervention complexity and facilitate replication in other settings. The experience gained has helped to refine the original guidance document relating to the application of iCAT_SR.</p

Additional file 1: of Implementation considerations when expanding health worker roles to include safe abortion care: a five-country case study synthesis

Search strategy. (DOCX 14 kb

Desired additional services on day of survey, by clinic.

<p>*Anova F Statistic (p value)</p><p>Desired additional services on day of survey, by clinic.</p

Providers and services accessed on day of survey and since testing HIV positive, by clinic.

<p>Providers and services accessed on day of survey and since testing HIV positive, by clinic.</p

Contextual influences on structure, process and outcomes of integrated RH-HIV care.

<p>Contextual influences on structure, process and outcomes of integrated RH-HIV care.</p

Current guidance for reporting complex interventions and where further research is required.

<p>Current guidance for reporting complex interventions and where further research is required.</p

Identifying the key components of a complex intervention for a systematic review.

<p>Identifying the key components of a complex intervention for a systematic review.</p

The CERQual approach—Definitions of levels of confidence in a review finding.

<p>The CERQual approach—Definitions of levels of confidence in a review finding.</p

Example of a CERQual Summary of Qualitative Findings table^*^#.

<p>*Findings were taken from [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001895#pmed.1001895.ref009" target="_blank">9</a>] and adapted to fit the context of this article.</p><p>^# The synthesis findings presented here are drawn from the wider thematic synthesis undertaken for this review. The themes identified were summarised into evidence statements, as illustrated in this table. The methods are described in more detail in [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001895#pmed.1001895.ref009" target="_blank">9</a>], and the CERQual assessments for each component are shown in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001895#pmed.1001895.t002" target="_blank">Table 2</a>.</p><p>Example of a CERQual Summary of Qualitative Findings table^{<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001895#t004fn001" target="_blank">*</a>}<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001895#t004fn002" target="_blank">^#</a>.</p