The results in this study highlight the potential for effective improvement of immediate detection and profiling of BAs in real samples, which will make a tremendous impact in the analytical field or clinical diagnosis.Although bile acids (BAs) have been suggested as important biomarkers for endocrine diseases, the identification and quantification of different BAs are still challenges due to their enormous species and wide range concentrations. Herein, a copolymer probe based on β‐cyclodextrin (β‐CD) is fabricated through a simple in‐mold photopolymerization for the selective extraction of BAs. Through the unique stereochemical affinity between BAs and the cavity of β‐CD, the custom probe shows superior enriching capacities to series BAs. Moreover, the outstanding extraction ability is proved to be consistent in various interfering conditions, including pH changing and the addition of complex matrix. Further comparison shows that the stereostructure of the nucleus of BAs plays a vital role during the formation of the β‐CD/BA complex, indicating the potential for efficient extraction of other BAs, including their structural analogues or some unknown ones. The developed probe is used for solid phase microextraction, and the limits of detection are lower than 0.075 ng mL SPME has been considered a promising method to promote the sample preparation efficiency especially when treating highly complex samples, because it integrates separation, enrichment, and purification into one step.22.1Figure1H NMR spectroscopy , majority of the spectroscopy of the derivatives was consistent with β‐CD, however, the appearance of peaks at 5.97 ppm CH2–), 5.60 ppm CH2–), and 1.84 ppm CH2–) indicated the successful introduction of vinyl group. The derivatization took place on 6‐OH rather than 2‐OH, or 3‐OH, which led to a slight declination at 4.44 ppm , as well as slight chemical shift increase on 6‐H (details could be found in the Supporting Information), probably due to the 6‐OH exhibited lower steric hindrance and intramolecular hydrogen bonds were formed between 2‐OH and 3‐OH.The schematic diagram of fabrication procedure of the copolymer probe was presented in FigureIn order to get a better performance for BAs extraction, the composition of copolymer was optimized by adjusting the ratio of two monomers, β‐CD‐MA and PEG400AD. Ursodeoxycholic acid (UDCA), a typical dihydroxycholanic acid, was used as the model analyte for the evaluation. According to Figure−1 were associated with the stretching vibration of C=C bond and C=O bond respectively, while no additional bands above 1750 cm−1 (referring to the stretching vibration of C=O bond in the reactant anhydride) was observed, demonstrated that the monomer β‐CD‐MA was successfully synthesized. The disappearing of adsorption band around 1655 cm−1 and the slight blue shift at 1720 cm−1 indicated the polymerization was successful and the residual unreacted monomers were completely removed. We subsequently compared the thermogravimetric  analysis . As a novel method integrates separation, enrichment and purification into one step, SPME has been successfully employed for sample preparation in many bioanalysis studies.rs Figure4. CommMoreover, pure PEG probe was fabricated through the in‐mold polymerization strategy, without adding β‐CD‐MA in the polymerization system. Still, poor extraction capacity was observed for the PEG fiber, which was strong evidence demonstrated β‐CD made the major contribution for the superior extraction capacity of the probe to UDCA. A simple docking study was operated on UDCA and β‐CD by using Discover in Materials Studio ).2.3Direct extraction without pretreatments  to biosamples is preferred as it guarantees the detection reflecting actual levels of target analytes in samples. Herein, the resistance of the custom probe to matrix interferences was evaluated.D value as the pH declines  was used for extraction. The extraction amount on the probe in the mixing solution showed good consistent to the value obtained in pure UDCA solution .Protein fouling is another difficulty should be overcome for direct extraction in biofluids, because the fouling protein might block the binding sites and lead to performance reduction. In this study, PEG, a well‐known biocompatible material, was used as the crossing linker in polymerization to avoid protein fouling, which was subsequently proved to be successful in the following real sample detection, as no obvious peak was found when the 2.4The hydroxylation occurred at C3, C6, C7, and C12 sites as well as the conjugation of glycine or taurine at the C24‐carboxyl group Figure c are twoFigureThe extraction capacity of the probe showed declining tendency as the hydroxyl groups gradually increased on the tetracyclic nucleus, while four geometric isomers, UDCA, deoxycholic acid (DCA), hyodeoxycholic acid (HDCA), and chenodeoxycholic acid (CDCA), preformed similar affinity to the probe Figure d. On oneFrom the aforementioned results, we could draw a conclusion that the stereostructure of the nucleus, rather than the conjugation at C24‐carboxyl group plays the vital role during the formation of β‐CD/BA complex. Although dehydrogenation of hydroxyl groups also generates certain species of BAs, the keto groups on these products process similar effect to the hydroxyl groups, therefore will be extracted by the β‐CD through the same mechanism. Considering there are limit species of BAs contain more hydroxyl groups on the nucleus than CA and the superior performance revealed by the mentioned results Figure d,e, the 2.5−1, which is much lower than the reported works . Besides, the wide linear ranges, good reproducibilities (for intrafiber and interfiber) ensured the feasibility of the developed method  of the method for eight BAs were all below 0.075 ng mLm/z was over 1000, while peak around 2900 was observable when using the traditional methanol precipitation method . The recoveries of eight BAs are around 80.74–108.47%, which also indicated the reliability of the method.Real sample detection was operated on human urine sample by using the present method, and six of target BAs were successfully detected . Due to the outstanding matrix‐resistance of the custom probe, the extraction was directly operated in urine samples without further pretreatment. TOF‐MS analysis of the eluent showed that larger molecules were successfully removed, as no obvious peaks were found when the 3A novel PEG/β‐CD copolymer SPME probe was fabricated through a simple in‐mold photopolymerization method and utilized for extracting BAs in biofluids. Different from traditional separation methods based on polarity similarity, the developed probe showed extremely high extraction capacity to BAs because of the unique stereochemical selectivity between BAs and the cavity of β‐CD. Moreover, the high enrichment efficiency was proved to be free from the matrix interfering, including the pH changing, the competitive extraction by other endogenous molecules and the protein fouling, which is vital for direct extraction from the highly complex biofluid samples. Further comparison demonstrated that the stereostructure of the nucleus of BAs played the vital role during the formation of β‐CD/BA complex, indicating the potential for efficient extraction of unknown BAs or their structural analogues. It is believed to bring significant improvement to BAs identification by the developed method, which is of great importance in disease diagnosis, biomarker profiling, or metabolomics studies. As in vivo SPME has been well‐developed and widely applied in analyzing pharmaceuticals or endogenous substances,4The Synthesis of Beta‐Cyclodextrin Methacrylate (β‐CD‐MA): Vinyl group was derived on β‐CD by a simple esterification reaction . Β‐CD  was weighted and dissolved in dry dimethyl formamide  in a flask. Then methacrylic anhydride  was added and the mixture was stirred at 500 rpm for 12 h at 80 °C under reflux. After the reaction finished, residue was filtered and large amount of chloroform was poured into the filtrate. The precipitation was three times washed by acetone, then collected and dried in vacuum at 20 °C for 24 h. The product was stored at −20 °C to avoid oxidation until use.The Preparation of β‐CD/PEG Copolymer Probe: β‐CD‐MA (0.12 g) was dissolved in DMF (0.06 g) in a 0.5 mL centrifuge tube, then 1‐hydroxycyclohexyl phenyl ketone solution  was added and stirred roughly. A mixture of polyethylene glycol 400 diacrylate (PEG400DA) and polyethylene glycol 200 (PEG200) was prepared . Then the mixture (0.06 g) was added in the centrifuge tube and stirred evenly in dark. The preparation procedure  spectra were recorded on a Bruker EQUINOX 55 Fourier transform infrared spectrometer. Thermogravimetric analysis was conducted from 30 to 850 °C with the heating rate of 5 °C min−1 under N2 protection on thermogravimetric analyzer (TG 209 F3 Tarsus) from NETZSCH‐Gerätebau GmbH. The contact angle of water on the copolymer material was detected by an optical contact angle analysis system (OCA200) DataPhysics Instruments GmbH. SEM images were obtained from a SU8010 ultrahigh resolution field emission scanning SEM .Method Development and Evaluation: Extractions were conducted by immersing the probe in 8 mL prepared solutions for 30 min under vibration (600 rpm). After the extraction finished, the probes were washed by deionized water for 5 s and gently wiped, then immersed in 80 µL of methanol for desorption (60 min) on vibration (400 rpm). All the desorption solution was stored under −20 °C until instrumental analysis. An Agilent 1260 HPLC system  coupled to an Triple Quad 4500 triple‐quadrupole tandem mass spectrometer with an ESI source  was operated in the negative ion mode for analyzation. Detail instrumental states could be found in Tables S3 and S4 in the Supporting Information. In order to evaluate the linear ranges and LODs of the method, solutions with a wide range concentrations of BAs ) were used in extraction. Subsequently, the interfiber and intrafiber reproducibilities of the probe were also determined by sampling in 20 ng mL−1 BAs solution (n = 6). Sampling‐rate calibration methodRs referred to the sampling rate, n was the extraction amount of target BAs in the fiber, Cs referred to the BAs concentrations in sample matrices and t was the extraction time. After getting the sampling rates of eight BAs in PBS solution based on the standard lines , verification experiments were conducted by extracting BAs from solution (20 ng mL−1) for 10 and 50 min respectively. The similar extraction amounts obtained by the actual experiment and calculated according to Equation Real Sample Detection: The custom copolymer probes were directly immersed in 2 mL human urine mixing samples (n = 6) for extraction, and the subsequent extraction and desorption procedures were the same as those mentioned above.The authors declare no conflict of interest.SupplementaryClick here for additional data file.


Cranberry growers in New England are increasingly pressured by negative effects associated with global climate change, some of which are familiar to this group (such as precipitation fluctuations and pest pressures), others that are rather new (such as warmer winters that threaten needed chill hours for the plants to bloom). The first study of this population of its kind, we use a survey, supplemented with observations and interviews, to assess Massachusetts cranberry grower attitudes towards climate change, and whether certain conditions of production might be associated with their attitudes. Our findings suggest that certain personal and ecological conditions are associated with greater worry of climate change effects, and that communal conditions of the cranberry grower social network provide some ways to cope with a warming climate. While the cranberry growing community has created a strong social network that has allowed it to sustain production, a warming planet will likely require significant change in order to overcome general attitudes of climate skepticism so that cranberry production may continue in the future. Surface air temperature has increased in the Northeastern United States at a faster rate than the global trend of about 1°C since 1880 . AssociaThe cranberry industry is of great social, historical and ecological significance to Massachusetts, being intimately tied to the development of the state since the days of the Pilgrims, associated with one of its most historic regions, Cape Cod, and valued by the community as an integral component of the Massachusetts landscape. Our study investigates the attitudes that cranberry growers in Massachusetts hold towards global climate change and its effects on their own livelihoods. In order to understand cranberry grower attitudes towards climate change, it is necessary to understand the broader social and ecological context in which cranberry growing is embedded. In this way, cranberries stand out as a unique agro-ecological system, one that makes neat divisions between agriculture and the surrounding landscape impossible to create. It is useful, then, to draw from theories in environmental sociology, a discipline that has long engaged with society-nature relations in efforts to discover how various social groups interact with their surroundings in socially, politically, economically, and ecologically entangled ways ,4.2 and lengthening of the growing season has generally increased plant productivity, including for several important grain crops )personal, communal and ecological conditions of production to frame the positioning of cranberry growers–and the attitudes they hold towards climate change–in their local and regional contexts [Below, we use a social theoretical approach to help us comprehend grower attitudes in their broader context. Data were gathered with a survey distributed to cranberry growers in Massachusetts, supplemented  with observations of cranberry production at multiple research site visits as well as in-depth and informal interviews. Specifically, we draw from O’Connor’s theorization of the contexts ,36. Thishttps://www.ers.usda.gov/topics/rural-economy-population/), meaning growers are willing to work in the industry for lifestyle choice, itself a personal condition of production .We would emphasize in O’Connor’s personal conditions a need to focus on the age, gender, and education level of the cranberry growers, because these personal conditions  have an impact on how one approaches the labor process, and likely reveal how various actors view their condition vis-a-vis the broader social and economic landscape. Socialization impacts individuals differently, and we know from previous studies that age, gender, and education have an impact on attitudes towards society-ecology interactions such as those caused by climate change . TherefoCommunal conditions of production are the social and physical infrastructures required for economies to operate, but oftentimes are not a part of specific production platforms . Roads, ecological conditions, or socionatural conditions, in order to bring out the mutually constitutive, hybrid character of social and natural systems [O’Connor calls the third condition of production the “natural condition,” meaning those environmental conditions “external” to the economy but necessary for it to function. Soil quality, abundance of water, and all the processes that the natural world provides “outside” of the economy would be considered among these conditions. Natural conditions are considered “external” to the economy until they become recognized as having value and thus become factored into the production process . Recentl systems ,42–45. WWhat is of particular novelty in this paper is our interrogation of cranberry growers’ relationship with ecological conditions of production. How growers have interacted with specific weather patterns and other conditions that affect cranberry harvests over the long-term likely has an effect on how growers interpret climate change. O’Connor  providesVaccinium macrocarpon, is a temperate perennial wetland plant native to northeastern North America. Native cranberries can still be found in moist low lying areas that naturally flood. Commercial cranberry bogs were first established in Massachusetts in the 1800s in peat-filled, impermeable kettle holes formed from glacial deposits. Many of the original kettle bogs are still in production today [The American cranberry, on today . However∘F) and 7.2°C (45∘F) depending on the variety, which is more than other temperate fruit crops. This is an important distinction, because in New England the average monthly high temperature is rising across winter months and at a faster rate and with higher variability than in summer months . Online respondents read a consent form explaining the nature of the study prior to answering questions, and respondents to the mailed survey were given a hard copy to review prior to answering the questions. This research complies with ethical practices and was approved by the Boston College Institutional Review Board (Protocol number 12.139.01e) prior to disseminating the survey. Survey respondents were assured that their identities would be kept anonymous in any publications using these data. We received ninety-one responses out of roughly four hundred cranberry growers, approximately twenty-three percent of the grower population . The U-Mass Cranberry Station emailed the solicitation to its list of growers, and the CCCGA posted an advertisement to participate in their monthly newsletter, pulation . For a ppulation . TherefoOur survey responses are informed by observations while gathering ecological data over the past eight years at bog sites in the region, as well as formal and informal interviews with cranberry growers. Interview data are limited here, but will be central to future publications. One of the authors (Pisani Gareau) has been gathering ecological data, from 2015 –present, on bog-insect-weed interactions in a warming climate that are part of the authors’ larger interdisciplinary research project. This work has led to multiple conversations with dozens of cranberry growers that have helped us discern our survey results and draw conclusions from the findings. Two authors (Pisani Gareau and Gareau), along with research team members, have conducted twenty interviews between 2012 and 2018 with cranberry growers to learn more about the history of cranberry production, as well as grower attitudes towards environmental conditions, including climate change. These interviews helped us make sense of survey results as well, contributing to our understanding of personal and communal conditions of cranberry production in particular.Based on the extant literature, our observations in the field, and our general understanding of cranberry growers and their conditions, the following hypotheses emerged that we tested with statistical analysis of the survey data:Growers reporting that ecological conditions of cranberry production are worsening will place greater importance on global warming , and in Specific reported ecological conditions, such as water availability, increasing temperatures, pest pressures, etc. will have more of an effect on global warming attitudes because cranberry bogs are embedded in a diverse landscape and highly dependent on water resources, appropriate temperatures for bud and fruit development, and pest management. Thus we would expect that growers who report greater pest pressure, will see global warming as a greater threat. Similarly, growers who report low access to water resources, will be more likely to view global warming as a threat or to worry about it.Increased ownership of ecological conditions of production, especially water but also dry upland habitat, will have an inverse effect on attitudes towards the importance of global warming, because increased access to these ecological conditions of production buffer growers from the negative effects of global warming. The novelty of cranberry production might explain why this hypothesis has not previously been tested in other studies.Personal production conditions such as gender, education, and age will have an effect on attitudes about the importance of global warming, with women, higher education individuals, and younger individuals being more aware of climate change risks than men, less educated and older individuals ,40.global warming threat, measures the binary responses to the survey item “Do you think that global warming will pose a serious threat to you or your way of life in your lifetime?” . Cranberry growers have an intimate connection to their surrounding landscape, including its weather, and so we expect they can identify long-term changes that might escape other actors, especially among conservative populations. Thus, we expect that cranberry growers in general will view global warming as a threat in their lifetime. Since growers report being more skeptical of global warming in general, it is possible that some connections to the landscape have an impact on attitudes. The second dependent variable, also examined by Dunlap, McCright, and Yarosh [global warming worry, measures ordinal responses to the survey item “Please tell us how much you personally worry about global warming?” . Given the socio-ecological relationship between cranberry growers and ecological conditions of production , we anticipate that Massachusetts cranberry growers are more concerned about global warming than the average American.We model two dependent variables on attitudes toward global warming. The first variable, used as well by McCright, Dunlap, and Xiao  global wd Yarosh  and Chond Yarosh  in termsGeneral conditions is a dummy variable that measures responses to the survey item “Over the past 5 to 10 years, how are conditions in general for cranberry growers?” . In the questionnaire, we provided 3 response categories: getting worse, remaining the same, and getting better. In the analyses, we combined the categories of remaining the same and getting better because only 5.5% of respondents chose getting better. It is impossible to know precisely what types of conditions growers referred to when they answered this survey question. Nevertheless we argue that it is acceptable to assume that this question primarily reflects growers' perceptions of an assortment of environmental conditions, and to a lesser extent, their perceptions of other, non-environmental conditions of cranberry production. This is because, first, we positioned this survey question amongst questions on specific environmental pressures/conditions. Thus, growers may have thought primarily of environmental conditions when they answered this question. Second, we calculated the bivariate correlations between the dummy variable on general condition and a series of variables measuring growers' perceptions of the severity of environmental pressure (12 variables) and non-environmental pressures (8 variables). The results show that a group of 5 variables on environmental pressures and only 1 variable on non-environmental pressures (i.e. the concern over price of cranberry) are significantly (a = 0.10) albeit weakly correlated with the variable on general conditions. None of the other variables examined are significantly correlated with the variable on general conditions and the magnitude of the correlations are weak. Weather importance measures responses to the survey item “Have weather-related issues become more important (worse) over the past 5 to 10 years?” . Weather counts records the number of responses from each cranberry grower to the survey item “which of the following specific weather-related events severely impacted your cranberry production from 2010- present? Check all that apply.” Respondents chose from 6 answer categories: high precipitation in short amount of time, drought, summer heat wave , warmer winter, hail or sudden frost event, and other. Respondents who chose “other” were invited to elaborate on their responses in the questionnaire; and all these respondents wrote salt-water incursion as their elaboration.We have three groups of key independent variables. Group One measures general conditions related to cranberry growing and contains 3 variables. Group Two measures specific ecological conditions that are essential to cranberry production (these conditions are discussed in detail above). Respondents were asked to rate the importance of 9 specific aspects of ecological conditions observed in the last 5 to 10 years: 1) water scarcity for irrigation, 2) competition for water, 3) heavy precipitation, 4) extended high temperatures in the summer, 5) extended high temperatures in the fall, 6) insufficient chill hours in the winter, 7) insect pests, 8) weed pests, and 9) diseases. The responses are on a scale from 1 to 5 with 1 being not important and 5 being very important.Group Three measures cranberry growers’ access to important ecological conditions/natural resources. Upland habitat acreage and wetland habitat acreage are self-reported sizes of upland habitat  and wetland habitat  within each respondent’s farm. As discussed above, upland and wetland habitat ownership are important ecological conditions of production due to the access to water they provide, as well as habitat to pollinators and other beneficial insects. Water is a critical component to cranberry production throughout the year, and growers have varying levels of access to it. Acres of upland habitat, wetland habitat, and cranberry bog are measured in tens of acres and are top-coded to correct for outliers with extremely large values. We also include a variable that measures the relative size of natural habitat (of both types) as percentage of total farm size.personal conditions of the growers. All these personal conditions of production are found by prior studies in agriculture and the general American public to be predictors of climate change attitudes [We include educational attainment, age group, and gender of cranberry growers as independent variables of ttitudes ,20,32,55global warming threat, we estimate logistic regression models. For the ordinal outcome global warming worry, we estimate generalized ordered logit regression models. This modeling technique tests for each independent variable if the proportional odds assumption is violated. If it is violated for an independent variable, the estimator generates multiple coefficients, each coefficient corresponding to a cut point in the ordinal outcome. Otherwise, the estimator generates one coefficient for each independent variable. This modeling technique is less restrictive than the proportional odds models but more parsimonious than multinomial models [For the binary outcome l models .For each outcome, we estimate separate models that include one of the three groups of key independent variables, and a full model that includes selected independent variables from all three groups. Model 1 includes all independent variables on general ecological conditions as well as personal conditions of production. Model 2 includes all independent variables on specific ecological conditions. Model 3 includes a selected subset of 6 variables on specific ecological conditions that are more directly related to climate change as well as personal conditions of production. Model 4 includes all independent variables on ownership of ecological conditions/natural resources (such as upland habitat acreage). Model 5 is the full model. We exclude additional control variables in Model 2 to preserve degrees of freedom. We exclude total cranberry acreage in Models 4 and 5 to avoid extreme multi-collinearity. Due to a constraint on the degrees of freedom posed by the small sample size, we are unable to include in the full models all independent variables, so we select independent variables based on the need for hypothesis testing, as well as the statistical significance tests of variables in prior, separate models. The sample size varies slightly across models due to the missing data for certain independent variables.Communal conditions are discussed in the context of our findings. Understanding the role that cranberry production plays in the Massachusetts cranberry growing region helps us discern the attitudes that growers hold, and gives us insights into the ways that the grower community approaches both their operation, but also issues associated with climate change. As discussed above, the communal conditions of cranberry production form a social network of tight-knitted growers and community members interested in seeing this industry survive in the Massachusetts landscape. Through site visits and in-depth interviews, the researchers recognize that growers are oftentimes very familiar with the bogs of neighboring growers, sometimes sharing equipment, water, and knowledge of local pests and other nuisances. Growers participate together in workshops held by the University of Massachusetts Cranberry Station, or the Cape Cod Cranberry Growers Association. Additionally, many growers participate in the annual cranberry harvest festival, and other events. The majority of growers are members of either the grower cooperative, Ocean Spray, or are connected to the private business, Decas, adding another level of networking to this agricultural production platform. Finally, cranberry growers are a rather small group, numbering around four hundred in total in Massachusetts, and they are clustered geographically in Southeastern Massachusetts.global warming as a threat . Growers are only a little worried about global warming . Although, the majority of growers reported that conditions in general for cranberry production were getting worse (mean = 0.70 ±0.46 SD). Particularly noteworthy, growers report insect pests, weed pests, and disease as important environmental conditions . Growers on average manage 40.7 acres of cranberry bogs, with the minimum acreage of 1 acres and a maximum of 200. On average growers have access to 39.4 acres of wetland habitat and 102.6 acres of upland habitat. Thus on average for every acre of cranberry bog, growers manage 3.5 acres of natural habitat.We present the means and range of values for the dependent and independent variables in Our data suggest that cranberry growers are more skeptical of the threat of global warming than the average American citizen . As we eIn sum, the majority of cranberry growers do not see global warming as threatening to their way of life and are generally not too worried about it, and slightly less than half think the seriousness of global warming is exaggerated in the media. Looked at another way, we find that the cranberry population is almost split down the middle between a group that recognizes the threat of climate change and is a little to very concerned about it and a group that does not view global warming as a threat and is not worried about it. To understand what predicts those differences, we look next to ecological and personal conditions of production.weather importance and weather event counts are positively and consistently associated with global warming threat  for growers who think the general conditions for cranberry production are getting worse, holding other predictors constant. Similarly, each additional type of weather-related event a grower reports affecting cranberry production increases the odds of this grower worrying more about global warming by 47.5% (1.475–1), shown in tion see . The outglobal warming worry relate to temperature–the importance of high temperatures in summer and insufficient chill hours in winter, only partly supporting Hypothesis II. Based on Model 5, a one-unit increase  in the reported importance of the insufficient chill hours in winter increases the odds of a grower considering global warming as a serious threat by to 90.1% (1.901–1) and worrying more about global warming by 94.7% (1.947–1). In contrast, a one-unit increase in the reported importance of high temperatures in summer reduces the odds of a grower worrying more about global warming by 53.7% (1–0.463). Said another way, growers who report worsening insufficient chill hours in winter are more likely to see global warming as a threat and worry more about it, while the opposite is observed for growers who report worsening high temperatures in summer , such that a one percentage point increase in the relative size of natural habitats  reduces the odds of a grower considering global warming as a serious threat by 4.3%   are less likely to worry about global warming, supporting Hypothesis III. However, those who have access to larger amounts of wetland habitat are more likely to worry about global warming, which works against Hypothesis III. According to Model 5, a 10-acre increase in the size of wetland habitat that a grower can access increases the odds of this grower worrying more about global warming by 15.2% (1.152–1), as shown in The results provide mixed evidence for Hypothesis III––1–0.957) . The relglobal warming worry , and bogs have a system of ditches, levees, and gates to allow water to move through them and be released in times of flood. Additionally, communal conditions allow growers to share water resources, helping each other during drought times. In sum, while water is critical to the growth and harvest of cranberries, it is something that cranberry growers are accustomed to managing collectively under variable precipitation levels.global warming threat with good reason. Unlike drought or flooding, there is nothing cranberry growers can do for their plants to compensate for insufficient freezing temperatures. Although if cranberry plants break dormancy early in spring, growers manage the risk of frost damage by regularly irrigating the fields. Through in-depth interviews and observations, we understand from growers that this is arduous work as it entails periodically testing all the sprinkler heads throughout the night and dawn. As one grower said to us, “we’d prefer that the bogs stay covered in snow until the end of April” , because then the plants, with more than sufficient chill hours met, break dormancy and develop without the constant threat of a damaging frost. Unfortunately opportunities for long cold winters are slipping away as winter months are getting warmer and more variable. For example, on 21 Feb 2018 the high temperature in Boston was 22.2°C at 12 pm; 24 hours later the temperature was 3.8°C–a difference of more than 18°C. If growers are to maintain their production amid warming temperatures, they will need to rely on communal conditions, on a community network of support, increased input from extension, the development of new cranberry varieties with lower chill hour requirements and frost tolerance, and likely increased support from the state.Temperature changes, however, are another matter for cranberry growers. Insufficient chill hours during winter were positively associated with We also discover that personal conditions of production have an effect on global warming attitudes, where being female, and to a lesser extent, being more educated, are both positively associated with the degree to which a person recognizes global warming as a serious threat and worries about it. We know from our observations that many cranberry growers are women, women who are responsible for all aspects of their cranberry growing operation, while a larger percentage of women are involved in cranberry production as a family business, from managing the books and labor to participating in the harvest. Women cranberry growers might thus play an important role in climate change adaptation and raising awareness among what is a relatively small community of cranberry growers. As we know, communal conditions of production involve both infrastructural and cultural connections that allow for economic activities to flourish, and this tight-knit community could learn from the knowledge of this sub-group. Education to the extent of receiving a bachelor's degree was the threshold for being more concerned about global warming. People with less education as well as people with graduate education showed less concern for global warming. This pattern concurs with McCright and Dunlap’s findings which demonstrated that white, well-educated males were most skeptical about climate change ,55.Besides the importance of chill hours the most revealing finding for us is the importance of the ownership of certain ecological conditions of production over others. While both wetland and upland habitat were associated with global warming attitudes, an increase in wetland habitat increases odds of worry while an increase in upland habitat reduces those odds. We suspect that this has to do with the intimate relationship that cranberry growers have to their surrounding landscape; the style of cranberry growing might be the reason for this finding. This meshes with scholarship in political ecology that identifies varying environmental attitudes, perceptions of ‘nature,’ and interest in working to resolve community-level environmental problems among small-scale farmers –48. Cranhttp://agproducts.rutgers.edu/cranberries/varieties.html.). However, when global warming reduces the number of chill hours accumulated during the winter below the requirements for successful cranberry bud development, it is likely that cranberry growers will experience a novel growing environment and cranberry production in Massachusetts will take a big economic hit. Perhaps then concern over global warming will increase among all cranberry growers. Thus, personal, communal and ecological conditions of cranberry production have distinct effects on how cranberry growers approach both their cranberry growing operation and broader ecological changes impacting the world. What is worth further investigation in particular is the finding that women cranberry farmers, who tend to be more worried about global warming, might be important agents for community adaptation to a warming New England.Massachusetts cranberry bogs are particularly vulnerable to climate change impacts due to their high chill hours requirements, perennial habit (making them harder to re-establish in a new bog or rotate with other crops for pest control), and their high dependence on great quantities of water. However, we found that cranberry growers, with the exception of women, are generally less concerned about global warming than the average American, despite the fact that increasing temperatures and more variable precipitation are predicted for the region. We suggest two main reasons for this trend: one that growers may lean more politically conservative than the average American, as is typical of many American farmers ,30; and Our study, the first of its kind on cranberry production, suggests that ecological conditions also matter a great deal. Cranberry growers’ attitudes on climate change are shaped in part by the ecological landscape in which they are enmeshed. This finding is particularly important because cranberry growers on average manage more than three times as much upland and wetland habitat than acres of cranberry bog. The cranberry production landscape is a mosaic of peaty cranberry bogs, man-made cranberry bogs, forest, meadow, ponds, streams, rivers, and suburban habitat, and it turns out that the amount of upland and wetland habitat a grower has makes a difference in the grower’s concern over climate change. Growers will need to take advantage of its tight-knit communal conditions in order to attempt to sustain this production system in a warming New England.


In addition to health literacy, several other concepts, such as electronic health  literacy and mental health literacy, have been developed across disciplines. This study examines how these different concepts are used when studying health-related competencies in Web contexts.Health literacy research seems to lack a consensus on what aspects to include into This study systematically reviews health literacy concepts and definitions and their operationalization in studies focused on Web-based health information environments.A systematic literature search was conducted in April 2016 in 6 electronic databases with a limitation to articles in English published between January 2011 and April 2016. Altogether, 1289 unique records were identified and screened according to the predefined inclusion criteria: (1) original, peer-reviewed research articles written in English; (2) the topic of the article concerned literacy in the context of health; (3) informants of the study were lay people, not health professionals or students of the field; and (4) the focus of the study was placed on an Web-based information environment. In total, 180 full texts were screened, of which 68 were included in the review. The studies were analyzed with an emphasis on the used health literacy concepts and measures.On the basis of the included studies, several concepts are in use when studying health-related literacy in Web environments, eHealth literacy and health literacy being the most common ones. The reviewed studies represent a variety of disciplines, but mostly medical sciences. Typically, quantitative research methods are used. On the basis of the definitions for health literacy, 3 thematic categories were identified: general and skill-based, multidimensional, and domain-specific health literacy. Most studies adopted a domain-specific concept, followed by the ones that used a general and skill-based concept. Multidimensional concepts occurred least frequently. The general health literacy concepts were usually operationalized with reading comprehension measures, the domain-specific concepts with self-efficacy measures, and multidimensional concepts with several types of measures. However, inconsistencies in operationalization were identified.The results show that in studies conducted in Web-based information environments, several different health literacy concepts are in use, and there is no clear consensus on the definitions for these concepts. Future studies should place emphasis on the conceptual development of health literacy in Web contexts to gain better results on operationalization for measurement. Researchers are encouraged to provide clear operational definitions for the concepts they use to ensure transparency in reporting. The contemporary digital information environment challenges our understanding of what it means to be literate. The fast and free flow of information on the internet offers multiple ways to communicate, but it can also challenge with overload of information and loss of authority and identity . Exercisliteracy in the context of health and on how to operationalize it for measurement purposes [The concept of health literacy has been widely used to address literacy competencies required in health settings. A recent definition  describepurposes -8.On the basis of earlier reviews, health literacy is typically understood as individuals’ functional skills, such as reading comprehension and numeracy  that areThe aim of this study was to increase understanding of the health literacy concepts that are used as well as their definitions and operationalization in Web-based information environments. The purpose was to provide a synthesis of their use in a sample of studies published between the years 2011 and 2016.Contemporary discussion on health literacy reveals that there is no consensus on the definition of the concept ,10,13,14The internet and the new digital tools for seeking, communicating, and using information have become embedded in the social actions of people since the 1990s. Moreover, the growing interest in consumer health and digital solutions to tailor health information for electronic health  purposes has increased research and generated new conceptualizations for health literacy. The concept of eHealth literacy by Norman and Skinner  was one health literacy concepts to refer to all health-related literacy concepts.The definition of eHealth literacy by Norman and Skinner  has beenThe first health literacy assessment tools were designed to measure the functional health literacy of individuals in clinical settings . The basAltin et al  reviewedA systematic review on eHealth literacy measures  found thEarlier reviews have focused on: (1) the definitions and measures of the concepts of health literacy ,12,25,26Web-based information environments and in different disciplines. It differs from the earlier reviews as it reviews not only the definitions of different health literacy concepts but also the measures used to operationalize these concepts in empirical studies. By elaborating remarks made in previous literature about the conceptions of health literacy, the following objectives were set:This systematic review contributes to these earlier reviews by synthesizing health literacy research conducted in To categorize thematically the definitions of health literacy and related concepts used in empirical studies focused on Web-based information environments.To examine the operationalization of the concepts within these thematic categories.This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) . The revComputers in Human Behavior) was searched manually as it was not indexed in the searched databases but showed potential to finding relevant articles. Search from this journal was conducted by searching with the phrase “health” AND “literac*” OR “knowledge” from article titles and abstracts and within the same time frame as the database search. This search resulted in 4 relevant articles. In total, 1289 articles were identified through the literature search, as presented in In addition, 1 academic journal  screened independently by the first author to identify eligible articles for full-text screening. A 10% random sample was screened by the second author with an interrater agreement rate of 93%. The articles chosen for the full-text screening had to fulfill the following inclusion criteria: (1) original, peer-reviewed full-text article written in English; (2) the topic of the article concerned literacy in the context of health; (3) informants of the study were lay people, not health professionals or students of the field; and (4) the focus of study was health literacy in a Web-based information environment. In the second phase of the selection process, 180 full-text articles were screened, 112 of which were excluded.After the study selection process, 68 articles were included in the review. The following data were extracted from these articles:TitleAuthorsPublication titleYear of publicationResearch area or discipline (according to the first authors’ affiliation)Aim or objective of the studyMethod of data collectionMethod of data analysisHealth literacy concept usedDefinition of the conceptMeasurement tool and its description.A detailed description of the study selection process is presented in the PRISMA chart see . The chaIn total, 68 studies were included in the systematic review. The studies represent a variety of disciplines (based on the first author’s affiliation), including medicine (n=13), health education and promotion or health communication (n=8), nursing (n=6), health sciences or public health (n=5), health policy (n=2), nutrition science (n=2), pharmacy (n=2), gerontology (n=1), biomedical informatics (n=1), communication or advertising (n=9), psychology (n=8), information science and information studies (n=8), sociology or social work (n=2), and behavioral sciences (n=1).bad health literacy (n=1). The concepts of health information literacy and everyday health information literacy were presented in 1 study. Refer to the study by Huhta et al [A total of 8 different health literacy concepts  with 21 ta et al  for a deThe most common method for data collection was a questionnaire survey, which was the only data collection method in 58 studies. There were 2 studies where interviews or focus groups were the only methods used. In 8 studies, several data collection methods were used. The analysis methods were predominantly quantitative (n=62). Mixed methods were applied in 4 studies and qualitative methods in 2 studies.The included studies focused on different populations: patients or adults with risk factors for a disease (n=17), older adults or veterans (n=14), students (n=8), adults (n=8), and parents or caregivers (n=4). Other groups were participants with limited health literacy or computer literacy (n=2), middle-aged men (n=1), library users (n=1), members of an online support group (n=1), and the general public (n=12). The sample sizes ranged from 20 to 4368.definitions of the health literacy concepts identified in the included articles, the studies were grouped into 3 thematic categories: health literacy as (1) a general skill, (2) a multidimensional concept, and (3) as a domain-specific concept. The categorization is drawn from the data, and it follows remarks made on health literacy research in earlier literature [The content analysis focused on the health literacy concepts along with their definitions and measures. On the basis of the terature ,25. In TIf several concepts were cited, the main concept of the included study was derived from the article title, or if it was not mentioned, from the abstract. A detailed description of all identified concepts and their definitions is provided in The definitions that describe health literacy as personal skills to utilize health information to gain better health were categorized as general and skill-based constructs. A general health literacy concept was adopted as the main concept in 23 studies. These studies referred to the health literacy definitions by Nutbeam , AmericaThe definition of health literacy as a capacity that individuals have in certain degrees by Ratzan and Parker  was citeThe health literacy definition adopted by the WHO and outlined by Nutbeam , stressiThe concept of health information literacy by the Medical Library Association  presentsCommon for these definitions of health literacy and health information literacy is the focus on individuals’ abilities to obtain health information to make good health decisions. These definitions describe health literacy from 2 perspectives. First, health information is seen as general information obtained through information seeking. Second, health literacy is seen as a general skill set that an individual has to some degree and that it can be utilized universally in decision-making situations. Thus, health literacy is understood as a general, skill-based ability that can be applied to all kinds of situations that are related to health.In total, 11 studies in this category used 1 or several measurement tools with an aim to detect the functional reading skills and numeracy of the selected population see . The mosSelf-efficacy measures of health literacy were used in 5 studies ,70,83,96Other self-efficacy measures used were a reading comprehension screener called Single Item Literacy Screener  , the main concept was eHealth literacy ,109-126.Bodie and Dutta  present bad health literacy used in 1 study [bad health literacy originally introduced by Schulz and Nakamoto [Other domain-specific health literacy concepts identified in the studies were mental health literacy used in 3 studies -129, ora 1 study . The def 1 study , unlike  1 study  is based 1 study  and thusNakamoto  refers, Nakamoto , to “theNakamoto .Within the studies that adopted a domain-specific concept as the main health literacy concept (n=39), the operationalization is more often done with a self-efficacy measurement tool than other types of measures, as seen in Most of the studies that adopted eHealth literacy as the main concept used the eHealth Literacy Scale (eHEALS) by Norman and Skinner  as the mOther types of measures used in the included articles that adopted eHealth literacy as the main concept were performance tests ,126; combad health literacy [bad health literacy with a knowledge test focused on vaccine information.Mental health literacy was measured in 3 studies -129 and literacy  both in literacy ,129, theliteracy  used sevliteracy , oral heliteracy , a word literacy  measuredThe aim of this systematic review was to identify health literacy concepts and their definitions and operationalization in studies focused on Web-based information environments. The concept of eHealth literacy by Norman and Skinner  was usedThe general concept of health literacy was typically operationalized by using reading comprehension and numeracy measures. In turn, the domain-specific concepts were most often operationalized by using a self-efficacy measure. Several types of measures were used in studies that adopted multidimensional constructs of health literacy. Nevertheless, inconsistencies in the operationalization of the different concepts were identified.The lack of consensus in defining health literacy, as presented in several reviews ,11,30, iAs earlier reviews indicate, the currently used measures of health literacy have focused on assessing individuals’ reading comprehension and understanding of medical texts in clinical contexts ,135. In The concept of eHealth literacy by Norman and Skinner  was cleaMeasurement of eHealth literacy is more often focused on assessing the self-reported skills of individuals. Unlike in the systematic review by Karnoe and Kayser , dual-deThe trend toward mixing different measuring types, as indicated by Altin et al , was notTo our knowledge, this study is among the first cross-disciplinary reviews of health literacy concepts, definitions, and their operationalization in Web contexts. The systematic process of this review enabled thorough investigation of the health literacy–related academic research focused on the context of Web-based information environments. The main limitations of this review lie within the search strategy. Only studies written in English were included in the review, which excluded relevant studies in other languages. In addition, some studies may have been missed due to the restricted search terms and limited time frame.This systematic review identified health literacy concepts, definitions, and operationalization used in research focusing on Web-based information environments. On the basis of the results, several concepts are being used, eHealth literacy and health literacy being the most common ones. In addition, 3 thematic categories of the different definitions were identified: general and skill-based, multidimensional, and domain-specific. Typically, general and skill-based health literacy was measured with reading comprehension or numeracy tests and domain-specific health literacy with self-efficacy tests. Multidimensional concepts were used less often and operationalized by using several types of measures. Future studies conducted in Web contexts should place emphasis on the conceptual development of health literacy. Researchers are encouraged to provide clear operationalization for the concepts they use to ensure transparency in reporting.