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Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. Discussion: A group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. Conclusions: HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research. [ABSTRACT FROM AUTHOR]

SNAPSHOT USA is a multicontributor, long‐term camera trap survey designed to survey mammals across the United States. Participants are recruited through community networks and directly through a website application (https://www.snapshot-usa.org/). The growing Snapshot dataset is useful, for example, for tracking wildlife population responses to land use, land cover, and climate changes across spatial and temporal scales. Here we present the SNAPSHOT USA 2021 dataset, the third national camera trap survey across the US. Data were collected across 109 camera trap arrays and included 1711 camera sites. The total effort equaled 71,519 camera trap nights and resulted in 172,507 sequences of animal observations. Sampling effort varied among camera trap arrays, with a minimum of 126 camera trap nights, a maximum of 3355 nights, a median 546 nights, and a mean 656 ± 431 nights. This third dataset comprises 51 camera trap arrays that were surveyed during 2019, 2020, and 2021, along with 71 camera trap arrays that were surveyed in 2020 and 2021. All raw data and accompanying metadata are stored on Wildlife Insights (https://www.wildlifeinsights.org/), and are publicly available upon acceptance of the data papers. SNAPSHOT USA aims to sample multiple ecoregions in the United States with adequate representation of each ecoregion according to its relative size. Currently, the relative density of camera trap arrays varies by an order of magnitude for the various ecoregions (0.22–5.9 arrays per 100,000 km2), emphasizing the need to increase sampling effort by further recruiting and retaining contributors. There are no copyright restrictions on these data. We request that authors cite this paper when using these data, or a subset of these data, for publication. Any use of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the US Government. [ABSTRACT FROM AUTHOR]

Paciorek and Wehner raise important questions around our use of the Mann‐Kendall nonparametric trend test on smoothed data for analyzing long‐term hydrometeorological trends in Zhang et al. (2021, https://doi.org/10.1029/2020gl092293). We thank them for initiating this important conversation and their gracious cooperation in exploring the issues addressed in their comment. In this reply we confirm the inflation of significant p‐values by our choice to smooth, illustrate the relatively minor impacts on the main conclusions of our paper, and add our voices to those of Paciorek and Wehner in highlighting the lack of methodology for hypothesis testing across multiple stations that have spatial structure (i.e., testing for regionally consistent trends). Plain Language Summary: Our colleagues Drs. Paciorek and Wehner have raised concerns about our paper (Zhang et al., 2021, https://doi.org/10.1029/2020gl092293), which showed widespread increases in the duration of drought events over the last five decades in the western United States. They point out that our decision to smooth the data using a moving average inflated the number of weather stations at which the trends toward longer droughts were deemed significant by a statistical test. We agree with them on this point, and we have recomputed all our results using unsmoothed data to determine the impacts. We find that for most stations and regions, trend magnitudes remained largely unchanged, with many stations nearby one another often suggesting similar trends. Finally, we agree with Paciorek and Wehner that there is a lack of statistical methods to test such coherent regional patterns, and we caution that over‐reliance on p‐values limits the power of regional data to identify important climate trends. Key Points: We agree that smoothing to 5‐year moving windows introduced serial correlation into time series of annual statistics of daily rainfall data, inflating the number of weather stations individually showing significant trends (p < 0.05) with the Mann‐Kendall testRecomputation with unsmoothed values produced substantially the same dry intervals trend magnitude and direction at most stations individually and had only minimal impacts on dry interval trends computed for National Ecological Observatory Network domains using the Regional Kendall testNo perfect statistical approach leverages the capacity of coherent regional patterns among spatially correlated weather stations, and an over‐reliance on p‐values as a binary (significant vs. insignificant) determinant of trends limits the power of regional data [ABSTRACT FROM AUTHOR]

Changes in precipitation patterns with climate change could have important impacts on human and natural systems. Zhang et al. (2021, https://doi.org/10.1029/2020gl092293) report trends in daily precipitation patterns over the last five decades in the western United States, focusing on meteorological drought. They report that dry intervals (calculated at the annual or seasonal level) have increased across much of the southwestern U.S., with statistical assessment suggesting the results are statistically robust. However, Zhang et al. (2021, https://doi.org/10.1029/2020gl092293) preprocess their annual (or seasonal) averages to compute 5‐year moving window averages before using established statistical techniques for trend analysis that assume independence about some fixed trend. Here we show that the moving window preprocessing violates that independence assumption and inflates the statistical significance of their trend estimates. This raises questions about the robustness of their results. We conclude by discussing the difficulty of adjusting for spatial structure when assessing time trends in a regional context. Plain Language Summary: A recent paper reports trends in drought in the western United States, in particular increases in drought in the southwestern United States, based on changes in the lengths of time intervals without precipitation. In this "comment" we note that the preprocessing approach used in the paper artificially increases the apparent statistical signal in the data and caution that the evidence for the trends reported is not as strong as presented in the paper. We conclude by discussing the difficulty of estimating trends in a statistically rigorous fashion across multiple weather stations. Key Points: Statistical uncertainty about trends in droughts in the southwestern US is larger than reported in a recent GRL letter [ABSTRACT FROM AUTHOR]

Atmospheric rivers (ARs) significantly impact the hydrological cycle and associated extremes in western continental regions. Recent studies suggest ARs also influence water resources and extremes in continental interiors. AR detection tools indicate that AR conditions are relatively frequent in areas east of the Rocky Mountains. The origin of these ARs, whether from synoptic‐scale waves or mesoscale processes, is unclear. This study uses meteorological composite maps and transects of AR conditions during the four seasons. The analysis reveals that ARs east of the Rockies are associated with long‐wave, baroclinic Rossby waves. This result demonstrates that eastern North American ARs are dynamically similar to their western coastal counterparts, though mechanisms for vertical moisture flux differ between the two. These findings provide a foundation for understanding future climate change and ARs in this region and offer new methods for evaluating climate model simulations. Plain Language Summary: Atmospheric rivers (ARs) are a weather pattern that brings high amounts of atmospheric water and winds in a relatively narrow region. ARs are typically considered a "west coast" phenomenon, largely because the majority of the scientific research on ARs has focused on ARs in western coastal regions: particularly the western United States (US). ARs occur in continental interiors, but there has been some debate about whether these ARs represent the same type of weather as those in western coastal regions. This paper uses two objective methods for identifying ARs and finds times when ARs are present in three locations in the eastern half of the US: Norman, OK, Bloomington, IN, and Washington, DC. Examination of weather conditions during these AR times shows remarkable similarity to conditions associated with west coast ARs. This gives strong evidence that ARs do occur in the eastern half of the US. This result is important because it suggests that ARs may be important for water resources and extreme weather in the eastern half of the US, just as they are in the western US. This result also suggests that ARs may be important for water resources and extremes in other continental interiors. Key Points: Atmospheric rivers (ARs) east of the Rockies are associated with baroclinic wavesWestern coastal ARs and eastern/midwest ARs are dynamically similarSynoptic‐scale uplift, combined with convective instability, provide efficient mechanisms for generating precipitation [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Gawrieh et al papers. To view these articles, visit https://doi.org/10.1111/apt.17849 and https://doi.org/10.1111/apt.17886 [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Gawrieh et al papers. To view these articles, visit https://doi.org/10.1111/apt.17849 and https://doi.org/10.1111/apt.17871 [ABSTRACT FROM AUTHOR]