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The Delphi method is a pragmatic research method created in the 1950s by researchers at the RAND Corporation for use in policy making, organizational decision making, and to inform direct practices. While the Delphi method has been regularly utilized in mixed methods studies, far fewer studies have been completed using the Delphi method for qualitative research. Despite the utility of the Delphi method in social science research, little guidance is provided for using the Delphi in the context of theory building, in primarily qualitative studies, and in the context of community-engaged research (CER). This article will emphasize new and modest innovations in the Delphi method for improving the overall rigor of the method in theory building and CER.

Across decades of co-circulation in humans, influenza A subtypes H1N1 and H3N2 have caused seasonal epidemics characterized by different age distributions of cases and mortality. H3N2 causes the majority of severe, clinically attended cases in high-risk elderly cohorts, and the majority of overall deaths, whereas H1N1 causes fewer deaths overall, and cases shifted towards young and middle-aged adults. These contrasting age profiles may result from differences in childhood imprinting to H1N1 and H3N2 or from differences in evolutionary rate between subtypes. Here we analyze a large epidemiological surveillance dataset to test whether childhood immune imprinting shapes seasonal influenza epidemiology, and if so, whether it acts primarily via homosubtypic immune memory or via broader, heterosubtypic memory. We also test the impact of evolutionary differences between influenza subtypes on age distributions of cases. Likelihood-based model comparison shows that narrow, within-subtype imprinting shapes seasonal influenza risk alongside age-specific risk factors. The data do not support a strong effect of evolutionary rate, or of broadly protective imprinting that acts across subtypes. Our findings emphasize that childhood exposures can imprint a lifelong immunological bias toward particular influenza subtypes, and that these cohort-specific biases shape epidemic age distributions. As a consequence, newer and less \"senior\" antibody responses acquired later in life do not provide the same strength of protection as responses imprinted in childhood. Finally, we project that the relatively low mortality burden of H1N1 may increase in the coming decades, as cohorts that lack H1N1-specific imprinting eventually reach old age.

Multiple factors contribute to community practice’s ongoing challenge of developing effective, evidence-informed, and socially just practice interventions. Currently, rationally driven systematic reviews dominate intervention design and development in various interprofessional applied health and human service fields, including community practice. As a result, community interventions often undergo significant development outside complex community contexts in which social problems manifest. Drawing from a case example of one author’s participation in a community engaged intervention development study based on mobilizing across differences, this piece advances an inclusive approach to community-based participatory intervention development driven by critical grounded theory. Undergirded by critical research perspectives, the article offers an early-stage intervention development methodology derived from the field in collaboration with community practitioners and resident leaders. Built upon existing interdisciplinary scholarship, it blends prominent intervention development frameworks, participatory research approaches, and critical grounded theory methods. Authors aim to aid scholars, practitioners, and community leaders in developing socially just, inclusive, and contextually relevant intervention approaches that originate from within communities directly impacted by social problems.

Coccidioides is the fungal causative agent of Valley fever, a primarily pulmonary disease caused by inhalation of fungal arthroconidia, or spores. Although Coccidioides has been an established pathogen for 120 years and is responsible for hundreds of thousands of infections per year, little is known about when and where infectious Coccidioides arthroconidia are present within the ambient air in endemic regions. Long-term air sampling programs provide a means to investigate these characteristics across space and time. Here we present data from > 18 months of collections from 11 air sampling sites across the Phoenix, Arizona, metropolitan area. Overall, prevalence was highly variable across space and time with no obvious spatial or temporal correlations. Several high prevalence periods were identified at select sites, with no obvious spatial or temporal associations. Comparing these data with weather and environmental factor data, wind gusts and temperature were positively associated with Coccidioides detection, while soil moisture was negatively associated with Coccidioides detection. These results provide critical insights into the frequency and distribution of airborne arthroconidia and the associated risk of inhalation and potential disease that is present across space and time in a highly endemic locale.

The authors examine how the profession's adaptation to Flexner's criteria influences the emergence of the neomedical model as the majoritarian paradigm within social work even in the face of a pluralism manifest by the existence of other competing paradigms. One endorses empowerment in social work, and the other embraces societal transformation in radical terms. Given this pluralism, we consider how fragmentation exists within the profession, such that two scenarios are useful in considering how social work will evolve as a profession: (a) seeking unity with a majoritarian paradigm in ascendancy as it attempts to co-opt the other two paradigms; or (b) fragmenting into multiple entities each with its own stance on society, theory of social issues, and models of practice.

The perceptions of 12 middle school girls regarding the health promoting and inhibiting aspects of their community were explored using the innovative methodology known as Photovoice that was situated in a youth-participatory-action research (YPAR) methodology. The photographs and resulting focus group discussions revealed overarching themes of Community Health and Safety, Food, Relationships, Socioeconomic Status (SES), Moral Development, and Physical Activity. The themes offer a way to organize the multiple realities of adolescent girls and how they interpret their personal health and the health of their communities, while the outcomes associated with participating in the project provide evidence of gains in self-esteem, collective efficacy, and leadership and advocacy skills.

Abstract             This study provides qualitative results from a unique mentorship and teaching support program designed, implemented, and evaluated in a school of social work at a major Midwestern research I university over a three year span. Primary qualitative data was collected through regular check-in meetings and end of the semester focus groups. Additional data was collected through orientation notes and detailed process notes from individual communications and consults with new instructors. Lessons learned point to both the importance of providing support and mentorship to new instructors as well as challenges in building and sustaining a positive culture for teaching and mentorship at a research I institution. 

Enteroviruses frequently result in respiratory and gastrointestinal illness; however, multiple subtypes, including poliovirus, can cause severe neurologic disease. Recent biennial increases (i.e., 2014, 2016, and 2018) in cases of non-polio acute flaccid paralysis have led to speculations that other enteroviruses, specifically enterovirus D68 (EV-D68), are emerging to fill the niche that was left from poliovirus eradication. A cluster of 11 suspect cases of pediatric acute flaccid myelitis (AFM) was identified in 2016 in Phoenix, AZ. Multiple genomic analyses identified the presence of EV-D68 in the majority of clinical AFM cases. Beyond limited detection of herpesvirus, no other likely etiologies were found in the cluster. These findings strengthen the likelihood that EV-D68 is a cause of AFM and show that the rapid molecular assays developed for this study are useful for investigations of AFM and EV-D68. Enteroviruses are a common cause of respiratory and gastrointestinal illness, and multiple subtypes, including poliovirus, can cause neurologic disease. In recent years, enterovirus D68 (EV-D68) has been associated with serious neurologic illnesses, including acute flaccid myelitis (AFM), frequently preceded by respiratory disease. A cluster of 11 suspect cases of pediatric AFM was identified in September 2016 in Phoenix, AZ. To determine if these cases were associated with EV-D68, we performed multiple genomic analyses of nasopharyngeal (NP) swabs and cerebrospinal fluid (CSF) material from the patients, including real-time PCR and amplicon sequencing targeting the EV-D68 VP1 gene and unbiased microbiome and metagenomic sequencing. Four of the 11 patients were classified as confirmed cases of AFM, and an additional case was classified as probable AFM. Real-time PCR and amplicon sequencing detected EV-D68 virus RNA in the three AFM patients from which NP swabs were collected, as well as in a fourth patient diagnosed with acute disseminated encephalomyelitis, a disease that commonly follows bacterial or viral infections, including enterovirus. No other obvious etiological causes for AFM were identified by 16S or RNA and DNA metagenomic sequencing in these cases, strengthening the likelihood that EV-D68 is an etiological factor. Herpes simplex viral DNA was detected in the CSF of the fourth case of AFM and in one additional suspect case from the cluster. Multiple genomic techniques, such as those described here, can be used to diagnose patients with suspected EV-D68 respiratory illness, to aid in AFM diagnosis, and for future EV-D68 surveillance and epidemiology. IMPORTANCE Enteroviruses frequently result in respiratory and gastrointestinal illness; however, multiple subtypes, including poliovirus, can cause severe neurologic disease. Recent biennial increases (i.e., 2014, 2016, and 2018) in cases of non-polio acute flaccid paralysis have led to speculations that other enteroviruses, specifically enterovirus D68 (EV-D68), are emerging to fill the niche that was left from poliovirus eradication. A cluster of 11 suspect cases of pediatric acute flaccid myelitis (AFM) was identified in 2016 in Phoenix, AZ. Multiple genomic analyses identified the presence of EV-D68 in the majority of clinical AFM cases. Beyond limited detection of herpesvirus, no other likely etiologies were found in the cluster. These findings strengthen the likelihood that EV-D68 is a cause of AFM and show that the rapid molecular assays developed for this study are useful for investigations of AFM and EV-D68.

Whole-genome sequencing has advanced our understanding of the population structure of the pathogenic species complex Cryptococcus gattii, which has allowed for the phylogenomic specification of previously described major molecular type groupings and novel lineages. Recently, isolates collected in Mexico in the 1960s were determined to be genetically distant from other known molecular types and were classified as VGVI. We sequenced four clinical isolates and one veterinary isolate collected in the southwestern United States and Argentina from 2012 to 2021. Phylogenomic analysis groups these genomes with those of the Mexican VGVI isolates, expanding VGVI into a clade and establishing this molecular type as a clinically important population. These findings also potentially expand the known Cryptococcus ecological range with a previously unrecognized endemic area.