Search

Background: Deep Brain Stimulation (DBS) has been widely applied and accepted in the treatment of neurological and psychiatric disorders. Despite numerous studies exploring the effects of DBS on the progression of neurodegenerative diseases and the treatment of advanced Parkinson's disease (PD), there is a limited number of articles summarizing this research. The purpose of this study is to investigate the current trends, hot topics, and potential in research surrounding DBS therapy for PD, as well as to anticipate the challenges of such research. Methods: We searched the Web of Science Core Collection database (WoSCC) for DBS research literature related to PD published from January 2014 to January 2024, utilized CiteSpace, VOS viewer, the bibliometric online analysis platform, Scimago Graphica, Microsoft Excel 2021, and R software version 4.2.3 for data analysis. And we conducted quantitative research on publications, citations, journals, authors, countries, institutions, keywords, and references, visualized the results in network graphs. Results: From 2014 to 2024, papers from 39 journals from 11 countries were among the top 100 cited. Most papers were published in Neurology, with the highest average citations per paper in Nature Neuroscience. The United States (US) contributed the most publications, followed by the United Kingdom (UK) and Germany. In terms of total publications, University College London (UCL) contributed the most papers. The primary classifications of articles were Clinical Neurology, Neurosciences, and Surgery. The top five keywords were subthalamic nucleus, DBS, PD, medical therapy, and basal ganglia. Cluster analysis indicates that DBS research focus on improving quality of life and applying computational models. Conclusion: Through bibliometric analysis, researchers could quickly and clearly understand the hotspots and boundaries of their research field, thus guiding their research direction and scope to improve research efficiency and the quality of outcomes. Although studies indicate that DBS is currently a crucial method for treating advanced PD, in the long run, creating a personalized, lowcost treatment regimen with precise targeting and long-term efficacy poses a challenge. [ABSTRACT FROM AUTHOR]

Why you should read this article: • UK care homes are an important example of a complex environment where research is essential but faces multiple challenges in terms of rigour and methodology • This paper offers a variety of important methodological strategies to identify and address challenges that could impact findings and the ability to carry out research • It highlights the importance of taking a critical stance with all elements of the research process and illustrates the need to identify and mitigate challenges when conducting research in complex environments. Background: The evidence base for hydration practice in care homes is underdeveloped. High-quality research is therefore needed to determine what practices support older people with dementia in drinking sufficient fluid. However, methodological developments are needed to be able to do this. Aim: To highlight the methodological issues researchers encountered during a feasibility cluster, randomised controlled trial of ThinkDrink, a hydration care guide for people with dementia living in UK care homes. Discussion: This is a challenging area because of the complexity of recruitment, participation and data collection in care homes. Researchers must pay extra attention to rigour and quality in the design of their studies. There may be multiple challenges, so various strategies may be required. Conclusion: It is important that researchers continue to reflect on rigorous approaches to develop evidence in a crucial area of care, despite these challenges. Implications for practice: Researchers working in complex environments face a variety of challenges to complete methodologically rigorous research. It is important for researchers to be critical of research processes and data, to mitigate and overcome these challenges. [ABSTRACT FROM AUTHOR]

Decarbonizing industrial sectors is a critical global challenge, involving the creation of new industrial spaces—'net zero industrial clusters'—co‐locating energy sectors and 'hard‐to‐abate' industries such as oil refining and steelmaking. This paper provides the first empirically grounded geographical investigation of these emerging spaces. It employs a place‐based research agenda to unpack how UK net zero industrial clusters (ICs) are imagined and emplaced in policy and industry discourses through place‐based naming, spatial configuring and mapping activities. By conducting document analysis, 33 in‐depth stakeholder interviews and five field trips to three UK case studies, we show how cluster imaginaries vary across cases and policy contexts in terms of constituents, focus and purpose. Ontological complexity is compounded by different rationales among stakeholders in configuring clusters and by contested cluster naming and boundary setting. This ambiguous, evolving spatiality raises important political and justice concerns over who and where is excluded in cluster building. These findings advance the geographies of low‐carbon transitions by showing: (1) ways that ICs' spatial embeddedness, which underlies cluster spatial configurations, helps increase industry actors' recognition of their economic, social and cultural ties with the places of their making, even if this risks path dependency; (2) how fluid cluster boundaries, reflected in cluster names and maps, emphasize the value of a network topology of scale to enable spatially inclusive, multi‐scalar climate mitigation. Finally, we argue that a place‐sensitive net zero policy mindset is vital for fulfilling ICs and the UK's decarbonization potential in a manner that is both fair and locally grounded. [ABSTRACT FROM AUTHOR]

Against the background of the rise in higher‐education participation rates, this paper examines the spatial redistribution of undergraduates across the United Kingdom resulting from moves to and from university. Drawing on the Graduate Outcomes Surveys of 2017/2018 and 2018/2019, address data coded to 53 subregions (SRs) are used to track those enrolled on degree courses by age 20 from domicile to university and workplace 15 months after graduation. The paper begins by examining how university‐ward migration serves to concentrate this group geographically and the way in which subsequent job‐related moves tend to reinforce this process. Each person is then classified on the basis of their migration trajectories between domicile and workplace, enabling a set of migration accounts to be produced for each SR. Applying cluster analysis to these accounts, a six‐way grouping of SRs is used to gauge change between their domicile and workplace populations in both overall numbers and qualitative characteristics, the latter being measured in terms of educational qualifications preuniversity and occupational status 15 months after graduation. These analyses demonstrate how the different types of SRs fare in these exchanges of students/graduates, with more subregions suffering the 'double whammy' of losing out in both quantitative and qualitative terms than gaining from this process, with challenging implications for central government's current 'levelling‐up' agenda. [ABSTRACT FROM AUTHOR]

Background: In many Westernised countries, children do not consume a sufficient amount of vegetables for optimal health and development. Child-feeding guidelines have been produced to address this, but often only promote offering vegetables at midday/evening meals and snack times. With guidance having limited success in increasing children's vegetable intake at a population level, novel approaches to address this must be developed. Offering vegetables to children at breakfast time in nursery/kindergarten settings has the potential to increase children's overall daily vegetable consumption as children typically attend nursery/kindergarten and many routinely eat breakfast there. However, the feasibility and acceptability of this intervention (Veggie Brek) to children and nursery staff has not been investigated. Methods: A feasibility and acceptability cluster randomised controlled trial (RCT) was undertaken in eight UK nurseries. All nurseries engaged in one-week baseline and follow-up phases before and after an intervention/control period. Staff in intervention nurseries offered three raw carrot batons and three cucumber sticks alongside children's main breakfast food each day for three weeks. Control nurseries offered children their usual breakfast. Feasibility was assessed by recruitment data and nursery staff's ability to follow the trial protocol. Acceptability was assessed by children's willingness to eat the vegetables at breakfast time. All primary outcomes were assessed against traffic-light progression criteria. Staff preference for collecting data via photographs versus using paper was also assessed. Further views about the intervention were obtained through semi-structured interviews with nursery staff. Results: The recruitment of parents/caregivers willing to provide consent for eligible children was acceptable at 67.8% (within the amber stop–go criterion) with 351 children taking part across eight nurseries. Both the feasibility and acceptability of the intervention to nursery staff and the willingness of children to consume the vegetables met the green stop–go criteria, with children eating some part of the vegetables in 62.4% (745/1194) of instances where vegetables were offered. Additionally, staff preferred reporting data using paper compared to taking photographs. Conclusions: Offering vegetables to children at breakfast time in nursery/kindergarten settings is feasible and acceptable to children and nursery staff. A full intervention evaluation should be explored via a definitive RCT. Trial registration: NCT05217550. [ABSTRACT FROM AUTHOR]

Genetic research's growing importance in understanding pulmonary arterial hypertension (PAH) and developing effective treatments prompted the RAPID‐PAH study. This study sought feedback from stakeholders who participated in two genomic studies to enhance genetic study delivery and clinical integration. Stakeholders from nine UK PH centres, representing various roles, ages, genders, and mutation statuses, took part in 53 semi‐structured interviews and focus groups. Transcripts were thematically coded using inductive analysis. Clustering analysis was conducted to identify patient groups that shared attitudes. In this paper, we focus on patients', carers', and relatives' perspectives. The key interview themes revealed insights into participants' attitudes toward genetic research and testing more generally, expertise and knowledge of the disease itself, motivations and barriers to participating in genetic research, awareness of and interest in consent procedures and the use of personal and genetic data, as well as the process of communicating individual genetic results. Factors influencing genetic research participation included altruistic motives, personal diagnostic experiences, and family‐related hopes. Clustering analysis produced distinct clusters based on the presence of barriers and motivators for research participation; however, hardly any patients shared identical sets of attitudes, emphasising the need for personalised approaches to recruitment. Most patients reported poor engagement with study‐related materials. Patients who received individual genetic results expressed satisfaction with the process, whereas those who did not were disappointed with the lack of feedback. Reflecting on patient perspectives, we offer recommendations to improve the genetic study delivery process. Enhancing genetic research integration into clinical practice requires tailored engagement, clear communication, and support from healthcare stakeholders. [ABSTRACT FROM AUTHOR]

The United Nations Development Programme Human Development Index (HDI) aggregates information on achievements in health, education and income. These achievements are given a weight of one-third each. These weights have been the subject of long-standing controversy, from the moment the HDI was released in 1990. Alternative weights reflecting stated citizen preferences are obtained in this paper using a discrete choice experiment involving a survey 2578 adult residents of the United Kingdom. Health is the most important achievement, with a mean weight of 0.428, followed by income and education, with mean weights of 0.292 and 0.280 respectively. Evidence in support of the view that HDI weights should vary among achievements and countries is provided, based on cluster and econometric analysis of the survey data. [ABSTRACT FROM AUTHOR]

Educational functions of digital games are often seen only in the light of the serious and purposeful activities that aim for learning outcomes, in contrast with noneducational games that are designed for entertainment. The focus of this paper is in studying players’ learning outcomes from playing non-educational games, and how these relate to wellbeing outcomes of playing, and gaming motivation. The data for this study was collected via a survey (N = 1,202) in the United Kingdom and the United States. The survey respondents answered the question regarding what players perceive they have learnt by playing digital games. A generic datadriven qualitative content analysis of the responses to this question yielded 11 categories representing different types of game-based learning outcomes. A consequent cluster analysis suggested three groups of informal game-based learning, which differed in their emphasis on (1) learning persistence, (2) learning practices and community, and (3) learning to perform. Our analyses indicated substantial connections between the learning outcomes and gameplay motives and gameplay activity preferences. Such connections point out how gameplay activity has an inherently close relationship with learning. Moreover, the results yielded significant association between learning outcomes, wellbeing measures, and eudaimonic motives to play digital games. These results indicate that playing games because gaming is aligned with players’ core values and need for self-realization are clear precedents for both wellbeing and learning outcomes. [ABSTRACT FROM AUTHOR]

Policymakers are generally most concerned about improving the lives of the worst-off members of society. Identifying these people can be challenging. We take various measures of subjective wellbeing (SWB) as indicators of the how well people are doing in life and employ Latent Class Analysis to identify those with greatest propensity to be among the worst-off in a nationally representative sample of over 215,000 people in the United Kingdom. Our results have important implications for how best to analyse data on SWB and who to target when looking to improve the lives of those with the lowest SWB (The authors owe a massive debt of gratitude to the Office for National Statistics for their support throughout this research. We are particularly grateful to Dawn Snape and Eleanor Rees for their valuable comments on earlier drafts of this paper, to Salah Mehad for the thorough review of methodology, and to Vahe Nafilyan for advice on clustering analysis. We also thank the anonymous reviewers for the very helpful comments. Thank you all very much.). [ABSTRACT FROM AUTHOR]

Due to the continuous growth of online interaction, social media is becoming increasingly useful in understanding trends in human behavior both locally and globally. On average there are approximately 6,000 tweets posted on Twitter every second, equating to approximately 500 million tweets per day. This wealth of information shared publicly can be hugely beneficial in gaining insights into reactions and implications caused by social, environmental, or financial events. The information has the potential to be particularly useful to retailers in terms of market research and sales forecasting when used along with some of the latest data analysis and Artificial Intelligence (AI) tools. The goal of this study is to utilize data from the Twitter platform, shared by the public, to extract what benefits and insights can be gained by analyzing the correlation between external KPIs, extracted from non-UK based geographical social media data, and sales recorded in a UK based luxury retailer at the corresponding time. [ABSTRACT FROM AUTHOR]

This study employs the bibliometric analysis approach to examine research on ethical decision‐making (EDM) of accountants from 1987 to 2022. The study specifically examines the developments in EDM research and evaluates the intellectual structure of the research field. Employing citation, co‐authorship, co‐occurrence and bibliographic coupling analyses, bibliometric data on 908 publications from the Scopus database was analysed. The results indicate that there has been a significant increase in the rate of publication on EDM of accountants following the spate of ethical breaches in the early 2000s. Further, we find that a large proportion of EDM in accounting research originates from developed countries like USA, Australia and UK. Our cluster analysis suggests that two main research streams have evolved over the period. Prior to 2012, researchers in this field mainly focused on individual level issues, particularly, on the determinants of the EDM process of individuals. Research, post 2012, however, has focused on firm‐level EDM issues including organisational ethics, culture, and corporate governance. The study further discusses the themes in detail andproposes a future research agenda. [ABSTRACT FROM AUTHOR]

The issue of gender in global cross-generational consciousness must be urgently addressed. Gender equality (Sustainable Development Goal 5 or SDG5) should be the responsibility of all countries around the world. As a result, this study intends to draw a map of knowledge on gender issues in consciousness across generations to investigate the state of research and future possibilities. This study aims to build a knowledge map that provides a comprehensive understanding of gender issues in awareness across generations. Vosviewer was used to perform bibliometric techniques on 370 English articles from Scopus on cross-generational awareness and gender equality themes. The study emphasizes the continued focus and upward trend of publications after cluster analysis and time series analysis and outlines the important authors, and research countries on the issue. The US has made significant contributions and influenced the UK and Australia. Gender, generation, gender equality, awareness, generational differences, gender issues, culture, education, gender inequality, feminism, health equity, diversity, social psychology, policy, and sustainable development are some of the groups of terms generated by the author's collaboration. As a result, the conclusions propose that research on gender issues could be expanded to include more authors, fields, subjects, and other diverse cooperative sectors. The implications of this knowledge mapping go beyond academia, holding practical and policy relevance, especially regarding gender equality and cross-generational awareness. This study is critical to inform future policies and practices aimed at fostering inclusivity and equality across generations. [ABSTRACT FROM AUTHOR]

Background: To address if the long-standing association between maternal infection, depression/anxiety in pregnancy, and offspring neurodevelopmental disorder (NDD) is causal, we conducted two negative-control studies. Methods: Four primary care cohorts of UK children (pregnancy, 1 and 2 years prior to pregnancy, and siblings) born between 1 January 1990 and 31 December 2017 were constructed. NDD included autism/autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, cerebral palsy, and epilepsy. Maternal exposures included depression/anxiety and/or infection. Maternal (age, smoking status, comorbidities, body mass index, NDD); child (gender, ethnicity, birth year); and area-level (region and level of deprivation) confounders were captured. The NDD incidence rate among (1) children exposed during or outside of pregnancy and (2) siblings discordant for exposure in pregnancy was compared using Cox-regression models, unadjusted and adjusted for confounders. Results: The analysis included 410 461 children of 297 426 mothers and 2 793 018 person-years of follow-up with 8900 NDD cases (incidence rate = 3.2/1000 person years). After adjustments, depression and anxiety consistently associated with NDD (pregnancy-adjusted HR = 1.58, 95% CI 1.46–1.72; 1-year adj. HR = 1.49, 95% CI 1.39–1.60; 2-year adj. HR = 1.62, 95% CI 1.50–1.74); and to a lesser extent, of infection (pregnancy adj. HR = 1.16, 95% CI 1.10–1.22; 1-year adj. HR = 1.20, 95% CI 1.14–1.27; 2-year adj. HR = 1.19, 95% CI 1.12–1.25). NDD risk did not differ among siblings discordant for pregnancy exposure to mental illness HR = 0.97, 95% CI 0.77–1.21 or infection HR = 0.99, 95% CI 0.90–1.08. Conclusions: Maternal risk appears to be unspecific to pregnancy: our study provided no evidence of a specific, and therefore causal, link between in-utero exposure to infection, common mental illness, and later development of NDD. [ABSTRACT FROM AUTHOR]

Clinical decision support systems (CDSSs) play a critical role in enhancing the efficiency of mental health care delivery and promoting patient engagement. Transdiagnostic approaches that utilize raw psychological and biological data enable personalized patient profiling and treatment. This study introduces a CDSS incorporating symptom profiling and drug recommendation for mental health care. Among the UK Biobank cohort, we analyzed 157,348 participants for symptom profiling and 14,358 participants with a drug prescription history for drug recommendation. Among the 1307 patients in the Samsung Medical Center cohort, 842 were eligible for analysis. Symptom profiling utilized demographic and questionnaire data, employing conventional clustering and community detection methods. Identified clusters were explored using diagnostic mapping, feature importance, and scoring. For drug recommendation, we employed cluster- and network-based approaches. The analysis identified nine clusters using k-means clustering and ten clusters with the Louvain method. Clusters were annotated for distinct features related to depression, anxiety, psychosis, drug addiction, and self-harm. For drug recommendation, drug prescription probabilities were retrieved for each cluster. A recommended list of drugs, including antidepressants, antipsychotics, mood stabilizers, and sedative–hypnotics, was provided to individual patients. This CDSS holds promise for efficient personalized mental health care and requires further validation and refinement with larger datasets, serving as a valuable tool for mental healthcare providers. [ABSTRACT FROM AUTHOR]

Background: There is a lack of studies comparing the status of dental specialties worldwide. Therefore, this study aimed to analyze the differences and similarities between the number and types of dental specialties in 31 countries, including every continent, in the world. Materials and methods: Available official documents and webpages from regulatory bodies, official colleges and councils, and dental institutions were collected from 31 countries and analyzed to obtain reliable data on dental specialties. Differences were analyzed using the Lorentz curve and Gini test. Additionally, a cluster analysis was performed to obtain groups of countries with similar patterns in the number and types of dental specialties. Results: A total of 32 different specialties were officially recognized among all the analyzed countries. Orthodontics and oral surgery (100% and 93.1%, respectively) were the two most frequently officially recognized dental specialties worldwide. The total global degree of inequality in the 31 analyzed countries was 42.4%. The Anglo-Saxon countries showed the greatest similarity, approximately 15-fold higher than the European countries. Cluster analysis differentiated six main groups of countries according to the number and types of dental specialties. European countries formed one of the two largest clusters, and the other cluster was of Anglo-Saxon, Asian, African, and several Eastern European countries with a high number of specialties. Conclusions: Officially recognized dental specialties in the different continents and countries show an asymmetric organization. The number, names, and skills of officially recognized dental specialties exhibited significant differences, showing inequalities in their organization. The Anglo-Saxon pattern of dental specialties showed greater equality than the European pattern. Orthodontics was the only constant element among the different patterns. [ABSTRACT FROM AUTHOR]

Aims Left ventricular systolic dysfunction (LSVD) is a heterogeneous condition with several factors influencing prognosis. Better phenotyping of asymptomatic individuals can inform preventative strategies. This study aims to explore the clinical phenotypes of LVSD in initially asymptomatic subjects and their association with clinical outcomes and cardiovascular abnormalities through multi-dimensional data clustering. Methods and results Clustering analysis was performed on 60 clinically available variables from 1563 UK Biobank participants without pre-existing heart failure (HF) and with left ventricular ejection fraction (LVEF) < 50% on cardiovascular magnetic resonance (CMR) assessment. Risks of developing HF, other cardiovascular events, death, and a composite of major adverse cardiovascular events (MACE) associated with clusters were investigated. Cardiovascular imaging characteristics, not included in the clustering analysis, were also evaluated. Three distinct clusters were identified, differing considerably in lifestyle habits, cardiovascular risk factors, electrocardiographic parameters, and cardiometabolic profiles. A stepwise increase in risk profile was observed from Cluster 1 to Cluster 3, independent of traditional risk factors and LVEF. Compared with Cluster 1, the lowest risk subset, the risk of MACE ranged from 1.42 [95% confidence interval (CI): 1.03–1.96; P < 0.05] for Cluster 2 to 1.72 (95% CI: 1.36–2.35; P < 0.001) for Cluster 3. Cluster 3, the highest risk profile, had features of adverse cardiovascular imaging with the greatest LV re-modelling, myocardial dysfunction, and decrease in arterial compliance. Conclusions Clustering of clinical variables identified three distinct risk profiles and clinical trajectories of LVSD amongst initially asymptomatic subjects. Improved characterization may facilitate tailored interventions based on the LVSD sub-type and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Transport megaprojects often struggle to offer social value (SV) that meets local communities' needs. This problem is embedded in how local communities' views are captured and incorporated into SV plans through local community engagement (LCE). By problematising the literature, this article aims to identify LCE issues and their impacts on SV plans at the front-end of transport megaprojects. Design/methodology/approach: The theoretical lens of the study is the practice theory developed by Schatzki (2016, 2005). The authors conceptualised LCE as a practice and conducted 32 semi-structured interviews with UK practitioners. The authors collected data in three steps from three types of practitioners involved in LCE practice and SV planning: project managers, LCE experts and SV experts. Findings: The authors identified 18 LCE issues with thematic analysis and clustered them into five themes. These issues impact LCE with five mechanisms. Findings show that a weak link between LCE and SV plans due to the issues reduces LCE to a tick-box exercise and presents a distorted view of local communities. This reduces SV plans to the bare minimum for project approval instead of offering relevant SV to local communities. Addressing the issues goes beyond changing the approach of project teams to engagement (from instrumental to normative) and requires changing the practices. Originality/value: For the first time, the study uses practice theory to conceptualise LCE as a practice, following the notion of project as practice. The study problematises the literature to address the under-represented link between LCE and SV plans. [ABSTRACT FROM AUTHOR]

The text engages with the ongoing discussion about the role played by religion in social life, with attention paid to transnational dynamics of religiosity in migrants' individual experiences, expectations and modes of involvement. We concentrate on the research problem: how does the Roman Catholic Church, through the networks of the faithful, facilitate, challenge, and intersect with the adaptation or integration of migrants in their new settings? The study draws on a survey conducted with a sample (n = 620) Polish Catholics in Great Britain in 2019. With the cluster analysis, we distinguished five categories of participants in parish life. The results of the study concern the declared expectations of the respondents in the confessional and non-confessional (charity, leisure, tourist, or cultural) activities. It shows two paths of respondents' religious experience: the old parochialism and the new one. The first attitude, represents a general religious-community context, while the second one emphasizes socio-cultural background and cooperative style of work based on associations and goals-achievement. Our findings concern the socio-cultural specificity of migrants resulting from belonging to migrant parishes outside Poland and how this specificity can be juxtaposed with information concerning mainstream Catholic parishes in Great Britain. [ABSTRACT FROM AUTHOR]

Simple Summary: (Multi-)Morbidity shares common biological mechanisms or risk factors with breast cancer. However, the risk of breast cancer among women with (multi-)morbidity remains unclear. In this study, using data of 239,436 female participants aged 40–69 of the UK Biobank cohort, we identified five chronic disease patterns: no-predominant morbidity, psychiatric morbidities, respiratory/immunological morbidities, cardiovascular/metabolic morbidities, and unspecific morbidities. After a median follow-up of 7 years, 5326 women developed breast cancer. We found no association between breast cancer risk and either the number of chronic diseases or chronic disease patterns, apart from an increased risk among women aged younger than 50 with a psychiatric pattern. Women with any multi-morbidity were more likely to die or to be diagnosed with other cancers. Our findings suggest that multi-morbidity may not be a key factor to help identify patients at an increased risk of breast cancer. (Multi-)Morbidity shares common biological mechanisms or risk factors with breast cancer. This study aimed to investigate the association between the number of morbidities and patterns of morbidity and the risk of female breast cancer. Among 239,436 women (40–69 years) enrolled in the UK Biobank cohort who had no cancer history at baseline, we identified 35 self-reported chronic diseases at baseline. We assigned individuals into morbidity patterns using agglomerative hierarchical clustering analysis. We fitted Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer risk. In total, 58.4% of women had at least one morbidity, and the prevalence of multi-morbidity was 25.8%. During a median 7-year follow-up, there was no association between breast cancer risk (5326 cases) and either the number of morbidities or the identified clinically relevant morbidity patterns: no-predominant morbidity (reference), psychiatric morbidities (HR = 1.04, 95%CI 0.94–1.16), respiratory/immunological morbidities (HR = 0.98, 95%CI 0.90–1.07), cardiovascular/metabolic morbidities (HR = 0.93, 95%CI 0.81–1.06), and unspecific morbidities (HR = 0.98, 95%CI 0.89–1.07), overall. Among women younger than 50 years of age only, however, there was a significant association with psychiatric morbidity patterns compared to the no-predominant morbidity pattern (HR = 1.25, 95%CI 1.02–1.52). The other associations did not vary when stratifying by age at baseline and adherence to mammography recommendations. In conclusion, multi-morbidity was not a key factor to help identify patients at an increased risk of breast cancer. [ABSTRACT FROM AUTHOR]

Justice evaluations are proposed to provide a link between the objective level of inequality and the consequences at the individual and societal level. Available instruments, however, focus on the subjective perception of inequality and income distributions. In light of findings that subjective perceptions of inequality and income levels can be biased and subject to method effects, we present the newly developed Justice Evaluation of the Income Distribution (JEID) Scale, which captures justice evaluations of the actual earnings distribution. JEID comprises five items that provide respondents with earnings information for five groups at different segments along the distribution of earnings in a given country. We provide a German-language and an English-language version of the scale. The German-language version was developed and validated based on three comprehensive heterogeneous quota samples from Germany; the translated English-language version was validated in one comprehensive heterogeneous quota sample from the UK. Using latent profile analysis and k-means clustering, we identified three typical response patterns, which we labeled "inequality averse," "bottom-inequality averse," and "status quo justification." JEID was found to be related to normative orientations in the sense that egalitarian views were associated with stronger injustice evaluations at the bottom and top ends of the earnings distribution. With a completion time of between 1.50 and 2.75 min, the JEID scale can be applied in any self-report survey in the social sciences to investigate the distribution, precursors, and consequences of individuals' subjective evaluations of objective differences in earnings. [ABSTRACT FROM AUTHOR]

Increasing numbers of women with HIV are experiencing menopause. We use data from a large, representative sample of women with HIV to describe the prevalence and clustering of menopausal symptoms amongst pre-, peri- and post-menopausal women using hierarchical agglomerative cluster analysis. Of the 709 women included, 21.6%, 44.9% and 33.6% were pre-, peri- and post-menopausal, respectively. Joint pain (66.4%) was the most commonly reported symptom, followed by hot flashes (63.0%), exhaustion (61.6%) and sleep problems (61.4%). All symptoms were reported more commonly by peri- and post-menopausal women compared to pre-menopausal women. Psychological symptoms and sleep problems clustered together at all menopausal stages. Somatic and urogenital symptom clusters emerged more distinctly at peri- and post-menopause. We recommend regular and proactive assessment of menopausal symptoms in midlife women with HIV, with an awareness of how particular patterns of symptoms may evolve over the menopausal transition. [ABSTRACT FROM AUTHOR]

Background Education is broader than academic teaching. It includes teaching students social--emotional skills both directly and indirectly through a positive school climate. Objective To evaluate if a universal school-based mindfulness training (SBMT) enhances teacher mental health and school climate. Methods The My Resilience in Adolescence parallel group, cluster randomised controlled trial (registration: ISRCTN86619085; funding: Wellcome Trust (WT104908/ Z/14/Z, WT107496/Z/15/Z)) recruited 85 schools (679 teachers) delivering social and emotional teaching across the UK. Schools (clusters) were randomised 1:1 to either continue this provision (teaching as usual (TAU)) or include universal SBMT. Data on teacher mental health and school climate were collected at prerandomisation, postpersonal mindfulness and SBMT teacher training, after delivering SBMT to students, and at 1-year follow-up. Finding Schools were recruited in academic years 2016/2017 and 2017/2018. Primary analysis (SBMT: 43 schools/362 teachers; TAU: 41 schools/310 teachers) showed that after delivering SBMT to students, SBMT versus TAU enhanced teachers' mental health (burnout) and school climate. Adjusted standardised mean differences (SBMT minus TAU) were: exhaustion (-0.22; 95% CI -0.38 to -0.05); personal accomplishment (-0.21; -0.41, -0.02); school leadership (0.24; 0.04, 0.44); and respectful climate (0.26; 0.06, 0.47). Effects on burnout were not significant at 1-year follow-up. Effects on school climate were maintained only for respectful climate. No SBMT-related serious adverse events were reported. Conclusions SBMT supports short-term changes in teacher burnout and school climate. Further work is required to explore how best to sustain improvements. Clinical implications SBMT has limited effects on teachers' mental and school climate. Innovative approaches to support and preserve teachers' mental health and school climate are needed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and resulting government-enforced lockdown affected the travel behavior and lives of people worldwide. In this research, hierarchical cluster analysis (HCA) is used to quantify the impact on daily flow profiles of cyclists due to the public's response to different levels of restrictions during a 6-month period of the COVID-19 pandemic in 2020. An inductive loop network in Tyne and Wear, the UK provided cycle flow data from 25 sites. A paired sample t-test was carried out between the "Pre-COVID-19" baseline year and 2020 to determine how cycling volumes changed at each site. The HCA was then performed on the diurnal hourly flow profiles to observe how they changed within the same time period. Finally, the relationship between diurnal flow profile and volume was assessed. Overall cycling volume in the study area increased by 38% during the lockdown. The highest increases were found at coastal sites, with more modest increases in suburban areas and reduced volumes at city center locations. The HCA of the diurnal flow profiles revealed that locations associated with noncommuting-shaped flows witnessed the largest increases while commuting profiles saw a decrease. As lockdown restrictions eased, flow profiles began to revert back to the prepandemic norm but never fully returned to prepandemic levels. The adoption of working from home postpandemic will change commuting behavior. The conclusions drawn from this study suggest consideration of noncommuting trips should be made when planning the design and location of future cycling schemes, and the HCA of flow profiles can assist in this decision-making process as a method to quantify changes in daily flow profiles of cycling. [ABSTRACT FROM AUTHOR]

Background: In cluster randomised controlled trials (cRCTs), groups of individuals (rather than individuals) are randomised to minimise the risk of contamination and/or efficiently use limited resources or solve logistic and administrative problems. A major concern in the primary analysis of cRCT is the use of appropriate statistical methods to account for correlation among outcomes from a particular group/cluster. This review aimed to investigate the statistical methods used in practice for analysing the primary outcomes in publicly funded cluster randomised controlled trials, adherence to the CONSORT (Consolidated Standards of Reporting Trials) reporting guidelines for cRCTs and the recruitment abilities of the cluster trials design.Methods: We manually searched the United Kingdom's National Institute for Health Research (NIHR) online Journals Library, from 1 January 1997 to 15 July 2021 chronologically for reports of cRCTs. Information on the statistical methods used in the primary analyses was extracted. One reviewer conducted the search and extraction while the two other independent reviewers supervised and validated 25% of the total trials reviewed.Results: A total of 1942 reports, published online in the NIHR Journals Library were screened for eligibility, 118 reports of cRCTs met the initial inclusion criteria, of these 79 reports containing the results of 86 trials with 100 primary outcomes analysed were finally included. Two primary outcomes were analysed at the cluster-level using a generalized linear model. At the individual-level, the generalized linear mixed model was the most used statistical method (80%, 80/100), followed by regression with robust standard errors (7%) then generalized estimating equations (6%). Ninety-five percent (95/100) of the primary outcomes in the trials were analysed with appropriate statistical methods that accounted for clustering while 5% were not. The mean observed intracluster correlation coefficient (ICC) was 0.06 (SD, 0.12; range, - 0.02 to 0.63), and the median value was 0.02 (IQR, 0.001-0.060), although 42% of the observed ICCs for the analysed primary outcomes were not reported.Conclusions: In practice, most of the publicly funded cluster trials adjusted for clustering using appropriate statistical method(s), with most of the primary analyses done at the individual level using generalized linear mixed models. However, the inadequate analysis and poor reporting of cluster trials published in the UK is still happening in recent times, despite the availability of the CONSORT reporting guidelines for cluster trials published over a decade ago. [ABSTRACT FROM AUTHOR]

While public research organisations (PROs) are increasingly expected to transfer knowledge to businesses and other stakeholders, their engagement in knowledge transfer (KT) activities is still under-researched. Better understanding of PROs' KT engagement, including how it is shaped by PROs' organisational characteristics, could lead to better tailored policies in support to PROs' effort to transfer knowledge. We develop a conceptual framework linking PROs' specialisation in different fields of knowledge to their profiles of KT engagement and validate it empirically using a six-year panel data set of 33 PROs in the UK. We use multidimensional scaling and cluster analysis techniques to identify three distinct KT profiles, which are stable over time, and strongly associated with the PROs' knowledge field specialisation. We argue that these profiles may depend on the different market readiness and user specificity of knowledge outputs arising from different fields of knowledge and derive implications for theory, policy, and practice. [ABSTRACT FROM AUTHOR]