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The goal of this study is to determine barriers and facilitators to the implementation of medication adherence interventions to support cancer patients taking novel, targeted oral anticancer agents (OAAs). We conducted qualitative interviews using a semi-structured guide from the Consolidated Framework for Implementation Research (CFIR). We used purposive sampling to identify clinicians (physicians, pharmacists, nurse practitioners, nurses) and administrators (leadership from medicine, pharmacy, and nursing) who delivered care and/or oversee care delivery for patients with chronic leukemia prescribed an OAA. A total of 19 individuals participated in an interview (12 clinicians and 7 administrators), with 10 primarily employed by an academic cancer center; 5 employed by the community cancer center; and 4 employed by the integrated health-system specialty pharmacy. Barriers identified included low awareness of adherence interventions, difficulty in adherence measurement, complexity of designing and implementing a structured adherence intervention, and competing priorities. Facilitators identified included support of hospital administrators, value for pharmacists, and willingness to embrace change. Participants also made recommendations moving forward including standardizing workflow, designating champions, iterating implementation strategies, and improving communication between clinicians and with patients. Individual and system level factors were identified as determinants of implementation effectiveness of medication adherence interventions. A multidisciplinary advisory panel will be assembled to design comprehensive and actionable strategies to refine and implement a structured intervention to improve medication adherence in cancer patients.

For the first time, a small dual-phase (liquid/gas) xenon time projection chamber was equipped with a top array of silicon photomultipliers for light and charge readout. Here we describe the instrument in detail, as well as the data processing and the event position reconstruction algorithms. We obtain a spatial resolution of ∼ 1.5 mm in the horizontal plane. To characterise the detector performance, we show calibration data with internal 83 m Kr and 37 Ar sources, and we detail the production of the latter as well as its introduction into the system. We finally compare the observed light and charge yields down to electronic recoil energies of 2.82 keV to predictions based on NEST v2.0.

For the first time, a small dual-phase (liquid/gas) xenon time projection chamber was equipped with a top array of silicon photomultipliers for light and charge readout. Here we describe the instrument in detail, as well as the data processing and the event position reconstruction algorithms. We obtain a spatial resolution of [Formula omitted] in the horizontal plane. To characterise the detector performance, we show calibration data with internal [Formula omitted] and [Formula omitted] sources, and we detail the production of the latter as well as its introduction into the system. We finally compare the observed light and charge yields down to electronic recoil energies of [Formula omitted] to predictions based on NEST v2.0.

Plant species continue to be introduced in North America for various purposes. If the trend continues, it is probable that some will escape cultivation and become invasive in native ecosystems. We present a retrospective analysis of several structural, life history, and biogeographical attributes of woody plants introduced in North America to determine which traits characterize species that have and have not invaded. Predictive models derived from discriminant analysis correctly classified 86.2% of the species in cross-validation, whereas those derived from classification and regression trees classified 76% correctly. From these models we created a hierarchical predictive tree that allows the user to divide species into three categories: admit (low risk of invasiveness), deny admission (high risk of invasiveness), or delay admission for further analyses and/or monitor intensively (risk cannot adequately be assessed based on only the included attributes). We recommend that species that are highly invasive elsewhere not be allowed into the U.S. and that a more conservative introduction policy using a hierarchical predictive method be employed.

Abstract There must have been plenty of them about, growing up quietly and inoffensively, with nobody taking any particular notice of them…. And so the one in our garden continued its growth peacefully, as did thousands like it in neglected spots all over the world…. It was some little time later that the first one picked up its roots and walked. John Wyndham, The Day of the Triffids

Purpose Patient reported outcome measures (PROMs) are increasingly used in oncology care, but pharmacists providing direct patient care have been overlooked. We engaged pharmacists and adults receiving oral oncolytics (chemotherapy medication taken by mouth) to develop a SmartForm© in the electronic health record (EHR) for PROM monitoring. Pharmacists verbally ask the patient side effect questions during routine telehealth encounters and enter responses in real time. Methods Our development process was guided by the Knowledge to Action Framework. In phase 1 (Knowledge Inquiry), we prioritized side effects to assess in the EHR SmartForm© via interviews with patients and a Delphi panel with pharmacists. Adults receiving oral oncolytics for breast (n = 12), thoracic (n = 12), or hematological (n = 12) cancer were interviewed, with purposeful sampling for adults who were aged 65 + years or Black. Interviews were coded with content analysis. We conducted three Delphi rounds, with 11/19, 13/19, and 19/19 pharmacists, respectively. In phase 2 (Knowledge Synthesis), PROM items were selected and the EHR SmartForm© programmed. In phase 3 (Knowledge Tailoring), we conducted usability testing with pharmacists. Results Pharmacists and patients were consistent in prioritizing side effects of oral oncolytics and 10 were retained. Patients advocated asking whether they can do their usual activities, while pharmacists added medication adherence. Usability testing yielded suggestions to simplify the SmartForm©. Conclusion By presenting screenshots of our SmartForm©, our findings are useful to other healthcare systems looking for a PROM solution integrated in the EHR, with a reasonable pharmacist/clinician workload, and no requirement for patients to have internet access/comfort.

The Ecological Society of America has evaluated current U.S. national policies and practices on biological invasions in light of current scientific knowledge. Invasions by harmful nonnative species are increasing in number and area affected; the damages to ecosystems, economic activity, and human welfare are accumulating. Without improved strategies based on recent scientific advances and increased investments to counter invasions, harm from invasive species is likely to accelerate. Federal leadership, with the cooperation of state and local governments, is required to increase the effectiveness of prevention of invasions, detect and respond quickly to new potentially harmful invasions, control and slow the spread of existing invasions, and provide a national center to ensure that these efforts are coordinated and cost effective. Specifically, the Ecological Society of America recommends that the federal government take the following six actions: (1) Use new information and practices to better manage commercial and other pathways to reduce the transport and release of potentially harmful species; (2) Adopt more quantitative procedures for risk analysis and apply them to every species proposed for importation into the country; (3) Use new cost-effective diagnostic technologies to increase active surveillance and sharing of information about invasive species so that responses to new invasions can be more rapid and effective; (4) Create new legal authority and provide emergency funding to support rapid responses to emerging invasions; (5) Provide funding and incentives for cost-effective programs to slow the spread of existing invasive species in order to protect still uninvaded ecosystems, social and industrial infrastructure, and human welfare; and (6) Establish a National Center for Invasive Species Management (under the existing National Invasive Species Council) to coordinate and lead improvements in federal, state, and international policies on invasive species. Recent scientific and technical advances provide a sound basis for more cost-effective national responses to invasive species. Greater investments in improved technology and management practices would be more than repaid by reduced damages from current and future invasive species. The Ecological Society of America is committed to assist all levels of government and provide scientific advice to improve all aspects of invasive-species management.

The majority of agricultural and environmental weeds in Australia have originated from ornamental horticulture. Botanic gardens require a simple yet robust method for rapidly screening the relative weed risk of taxa in their collections. A ten question, multiple choice, additive weed risk assessment system was developed for application to taxa growing in gardens. The major city botanic gardens in Melbourne, Hobart and Perth used the system to score 100 taxa. Separately, a national survey and a literature review of the same 100 taxa were undertaken to obtain two independent datasets for assessing their level of weediness. Testing of the system showed that it has good discriminatory power and cut-off scores were chosen that have about 80% accuracy for both low weed risk and high weed risk species. There was poorer accuracy to distinguish medium weed risk species. The system has wider potential application for the nursery and garden industry as a tool to help reduce the number of high weed risk ornamental species in cultivation.