Wildlife conservation and the management of human–wildlife conflicts require cost‐effective methods of monitoring wild animal behavior. Still and video camera surveillance can generate enormous ...quantities of data, which is laborious and expensive to screen for the species of interest. In the present study, we describe a state‐of‐the‐art, deep learning approach for automatically identifying and isolating species‐specific activity from still images and video data.
We used a dataset consisting of 8,368 images of wild and domestic animals in farm buildings, and we developed an approach firstly to distinguish badgers from other species (binary classification) and secondly to distinguish each of six animal species (multiclassification). We focused on binary classification of badgers first because such a tool would be relevant to efforts to manage Mycobacterium bovis (the cause of bovine tuberculosis) transmission between badgers and cattle.
We used two deep learning frameworks for automatic image recognition. They achieved high accuracies, in the order of 98.05% for binary classification and 90.32% for multiclassification. Based on the deep learning framework, a detection process was also developed for identifying animals of interest in video footage, which to our knowledge is the first application for this purpose.
The algorithms developed here have wide applications in wildlife monitoring where large quantities of visual data require screening for certain species.
A state of the art, deep learning automatic recognition approach for identifying and isolating species‐specific activity from still images and video data.
Objectives
Evidence is needed for designing interventions to address health literacy–related issues among adults with prediabetes to reduce their risk of developing type 2 diabetes. This study ...assessed health literacy and behaviors among US adults with prediabetes and the mediating role of health literacy on health behaviors.
Methods
We used data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) (N = 54 344 adults). The BRFSS health literacy module included 3 questions on levels of difficulty in obtaining information, understanding health care providers, and comprehending written information. We defined low health literacy as a response of “somewhat difficult” or “very difficult” to at least 1 of these 3 questions. Respondents self-reported their prediabetes status. We included 3 health behavior indicators available in the BRFSS survey—current smoking, physical inactivity, and inadequate sleep, all measured as binary outcomes (yes/no). We used a path analysis to examine pathways among prediabetes, health literacy, and health behaviors.
Results
About 1 in 5 (19.0%) adults with prediabetes had low health literacy. The rates of physical inactivity (31.0% vs 24.6%, P < .001) and inadequate sleep (38.8% vs 33.5%, P < .001) among adults with prediabetes were significantly higher than among adults without prediabetes. The path analysis showed a significant direct effect of prediabetes and health literacy on health behaviors. The indirect effect of prediabetes through health literacy on health behaviors was also significant.
Conclusion
BRFSS data from 2016 showed that rates of low health literacy and unhealthy behaviors were higher among adults with prediabetes than among adults without prediabetes. Interventions are needed to assist adults with prediabetes in comprehending, communicating about, and managing health issues to reduce the risk of type 2 diabetes.
Our study aimed to examine the prevalence of chronic pain, its severity, its causes, and coping mechanisms that are used by North Carolina adults in rural, suburban, and urban areas.
We analyzed data ...from the Behavioral Risk Factor Surveillance System's first chronic pain module in 2018, representing 3,598 respondents. Self-reported chronic pain was defined as the affirmative response to the question, "Do you suffer from any type of chronic pain, that is, pain that occurs constantly or flares up often?" We computed prevalence of chronic pain and use of coping mechanisms by rural, suburban, or urban residential status. We used multiple logistic regression to assess the association between chronic pain and residential location, adjusting for demographic characteristics, employment, and health insurance.
In 2018, an estimated 27.5% (95% confidence interval CI, 25.6%-29.3%) of North Carolina adults experienced chronic pain. Prevalence of chronic pain in rural areas (30.9%) and suburban areas (30.8%) was significantly higher, compared with urban areas (19.6%). Compared with urban residents with chronic pain, those with chronic pain in suburban areas (adjusted odds ratio AOR, 0.44; 95% CI, 0.26-0.76) and in rural areas (AOR, 0.39; 95% CI, 0.24-0.65) were less likely to use nonmedication therapies (eg, acupuncture, physical therapy, yoga) and were less likely to use 3 or more types of chronic pain treatment (suburban AOR, 0.47; 95% CI, 0.25-0.88; rural AOR, 0.53; 95% CI, 0.29-0.95).
Our results indicate that persons living in rural and suburban areas may be more likely to have chronic pain and less likely to use nonmedication treatments than those in urban areas.
Bovine tuberculosis (bTB) is an epidemiologically, politically, and socially complex disease. Across multiple international contexts, policy makers have struggled to balance the competing demands of ...wildlife and agricultural interests in their efforts to create workable and effective disease management strategies. This paper draws comparative lessons between the cases of Michigan in the USA and the UK to exemplify some of the challenges of developing an effective strategy for the long-term control of endemic disease, particularly reflecting on efforts to "responsibilise" cattle producers and engage them in proactive activities to mitigate transmission risks on their own farms. Using qualitative data derived from 22 stakeholder interviews, it is argued that the management of bTB in Michigan has important lessons for the UK on the role of human dimensions in influencing the direction of disease control. The management of endemic bTB relies on the actions of individuals to minimise risk and, in contrast to the predominantly voluntary approach pursued in the UK, Michigan has shifted the emphasis towards obtaining producer support for wildlife risk mitigation and biosecurity via a mix of regulatory, fiscal, and social interventions. Whilst the scale of the bTB challenge differs between these two contexts, analysis of the different ideological bases for selecting management approaches offers interesting insights on the role of negotiated outcomes in attempts to adaptively manage a disease that is characterised by complexity and uncertainty.
Clinical and real-world effectiveness data for the COVID-19 vaccines have shown that they are the best defense in preventing severe illness and death throughout the pandemic. However, in the US, some ...groups remain more hesitant than others about receiving COVID-19 vaccines. One important group is long-term care workers (LTCWs), especially because they risk infecting the vulnerable and clinically complex populations they serve. There is a lack of research about how best to increase vaccine confidence, especially in frontline LTCWs and healthcare staff. Our aims are to: (1) compare the impact of two interventions delivered online to enhanced usual practice on LTCW COVID-19 vaccine confidence and other pre-specified secondary outcomes, (2) determine if LTCWs' characteristics and other factors mediate and moderate the interventions' effect on study outcomes, and (3) explore the implementation characteristics, contexts, and processes needed to sustain a wider use of the interventions.
We will conduct a three-arm randomized controlled effectiveness-implementation hybrid (type 2) trial, with randomization at the participant level. Arm 1 is a dialogue-based webinar intervention facilitated by a LTCW and a medical expert and guided by an evidence-based COVID-19 vaccine decision tool. Arm 2 is a curated social media web application intervention featuring interactive, dynamic content about COVID-19 and relevant vaccines. Arm 3 is enhanced usual practice, which directs participants to online public health information about COVID-19 vaccines. Participants will be recruited via online posts and advertisements, email invitations, and in-person visits to care settings. Trial data will be collected at four time points using online surveys. The primary outcome is COVID-19 vaccine confidence. Secondary outcomes include vaccine uptake, vaccine and booster intent for those unvaccinated, likelihood of recommending vaccination (both initial series and booster), feeling informed about the vaccines, identification of vaccine information and misinformation, and trust in COVID-19 vaccine information provided by different people and organizations. Exploration of intervention implementation will involve interviews with study participants and other stakeholders, an in-depth process evaluation, and testing during a subsequent sustainability phase.
Study findings will contribute new knowledge about how to increase COVID-19 vaccine confidence and effective informational modalities for LTCWs.
NCT05168800 at ClinicalTrials.gov, registered December 23, 2021.
To examine the experiences, needs, and perceptions of health professionals(HPs) treating women diagnosed with cancer during pregnancy(gestational cancer, GC).
Interviews were undertaken with ...Australian HPs who had treated women diagnosed with GC over the previous five years. HPs were recruited via social media, and professional and community networks. Questions focussed upon HPs’ confidence caring for these women, whether current guidelines/training met their needs, psychological impacts of care provision, and service gaps. Interview data were analysed thematically.
Twenty-seven HPs were interviewed; most were oncology HPs(22/27) with experience caring for women with gestational breast cancer and 13 had a breast-specific clinical focus (e.g. breast surgeon). Many were currently treating women with GC(48%) or had in the last 6–12 months(29.6%). Four themes were identified: A clinically complex case, Managing multi-disciplinary care, Centralised resources for health professionals, and Liaison, information and shared experiences for women. HPs found this population personally challenging to treat. They reported initial uncertainty regarding treatment due to infrequent exposure to GC, limited resources/information, and the need to collaborate with services with which they did not usually engage. Solutions offered include centralised resources, clinical liaison/care coordinators, and connecting women with GC with peer support.
HPs perceived women with GC as a vulnerable, complex population and experienced challenges providing comprehensive care; particularly when treatment was delivered at geographically separated hospitals. Systemic changes are needed to optimise comprehensive care for these women. Their insights can guide the development of more integrated cancer and obstetric care, and better HP support.
•Women with cancer diagnosed in pregnancy require complex, coordinated, multidisciplinary care.•Clinicians consider these women vulnerable with needs that are hard to meet using standard care.•Systemic changes like co-locating services and integrating supportive care are needed.•Access to centralised, coordinated, up-to-date evidence-based guidelines is required.•Formalised ways to connect women with cancer in pregnancy with peer support would help.
Agriculture around the world needs to become more environmentally sustainable to limit further environmental degradation and impacts of climate change.
Many governments try to achieve this through ...enrolling farmers in agri‐environment schemes (AES) that encourage them to undertake conservation activities.
Studies show that AES can suffer from low uptake, meaning their environmental objectives remain unattained. To succeed for people and nature, policy‐makers are increasingly adopting multi‐actor approaches in the ‘co‐design’ of AES to make them more attractive and inclusive of a full range of stakeholders, including ‘harder to reach’ farmers.
To address why some land managers (principally farmers) may be harder to reach in the context of co‐designing England's new Environmental Land Management (ELM) approach, we undertook a quick scoping review of the literature, conducted 23 first‐round and 24 s‐round interviews with key informants, and held a workshop with 11 practitioners.
We outline why farming stakeholders may be harder to reach and how policy‐makers can adjust the engagement process to make co‐design more inclusive.
Based on the results, we make recommendations that could help policy‐makers to design better, more inclusive AES that would attract greater uptake and increase their chances of success.
Read the free Plain Language Summary for this article on the Journal blog.
Read the free Plain Language Summary for this article on the Journal blog.
Women with breast cancer experience a significantly higher prevalence of sleep disturbance and insomnia than the general population. The experience of persistent sleep disturbance places these women ...at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment for sleep in this population is not part of routine care and is often managed inadequately. This randomised controlled trial will examine the combined effects of cognitive behavioural therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue and mental health.
Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne, Australia, will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio-enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 min each morning for the 6-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the 6 weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT, and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS). Data will also be collected on potential treatment moderators and mechanisms and adherence to treatment. There will be 3-month follow-up measurements of insomnia symptoms, fatigue, sleep-related impairment, sleep disturbance, depression and anxiety.
This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbance in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy translation.
Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618001255279. Retrospectively registered on 25 July 2018.
A pilot project was conducted to evaluate the working conditions and work-related body pain among Latino immigrant tree trimmers (n = 57) in the commercial pine forest service industry. Participants ...were interviewed about personal and work characteristics, job-related occupational hazards, and body pain. A structured questionnaire and a body pain diagram were used as measures for evaluating associations between personal and work characteristics and body pain. The most common health complaints were physical exhaustion (80.7 percent) and headache (33.9 percent). The reported percent of work-related body pain was 54.4 percent. Statistically significant associations were identified between experiencing body pain in knees, working more than two years, and working more than six hours per day (p < .05) as a tree trimmer. Thorough clinical evaluations are needed to confirm these findings. Future research including a larger sample size and more in-depth evaluations are needed to better evaluate worker tasks, musculoskeletal risk factors, and safety climate issues among this highly vulnerable occupational group.
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