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Objective: Although medication abortion has become more common in high-income countries, the procedure has not yet met early expectations for widening access to abortion. High-quality evidence can serve as a catalyst for changes in policy and practice. To direct research priorities, it is important to understand where quality evidence is concentrated and where gaps remain. High-income countries have developed a body of evidence that may have implications for the future of medication abortion. This literature review assesses the characteristics and quality of published studies on medication abortion conducted in the last 10 years in high-income countries and indicates future areas for research to advance policy and practice, and broaden access. Study design: A structured search for literature resulted in 207 included studies. A framework based upon the World Health Organization definition of sub-tasks for medication abortion was developed to categorize research by recognized stages of the medication abortion process. Using an iterative and inductive approach, additional sub-themes were created under each of these categories. Established quality assessment frameworks were drawn upon to gauge the internal and external validity of the included research. Results: Studies in the US and the UK have dominated research on MA in high-income countries. The political and social contexts of these countries will have shaped of this body of research. The past decade of research has focused largely on clinical aspects of medication abortion. Conclusion: Researchers should consider refocusing energies toward testing service delivery approaches demonstrating promise and prioritizing research that has broader generalizability and relevance outside of narrow clinical contexts. Plain English summary: Although medication abortion is more commonly available worldwide, it is not being used as often as people thought it would be, particularly in high income countries. In order to encourage changes in policy and practice that would allow greater use, we need good quality evidence. If we can understand where we do not have enough research and where we have good amounts of research, we can determine where to invest energies in further studies. Many high-income countries have produced research on medication abortion that could influence policy and practice in similarly resourced contexts. I conducted a literature review to be able to understand the type and quality of research on medication abortion conducted in high-income countries in the past 10 years. I conducted the review in an organized way to make sure that the papers reviewed discussed studies that I thought would be important for answering this question. The literature review found 207 papers. Each of these papers were reviewed and organized them by theme. I also used existing methods to determinine the quality of each study. Most of the research came from the US and the UK. Furthermore, most of the research conducted in the past 10 years was focused on clinical studies of medication abortion. In future studies, researchers should focus more on new ways of providing medication abortion to women that offers greater access. Also, the studies should be designed so that the results have meaning for a broader group of people or situations beyond where the study was done. [ABSTRACT FROM AUTHOR]

Objective: Describe and compare levels of happiness, psychological well-being, perceived stress, and health behaviors of university students. Participants: Thai university students were selected (N = 478) during November 2016 using random cluster sampling. Methods: A health and well-being questionnaire was constructed, translated from English to Thai, back-translated, and pilot tested. Descriptive and chi-square statistics were calculated for study variables. Results: Thai male students had lower happiness and psychological well-being than Thai female students. Overall, Thai students had lower happiness and higher perceived stress than US/UK samples. Thai male students reported greater alcohol and tobacco use than Thai female students. Overall, Thai students reported inadequate diet (57%), poor sleep quantity/quality (67%) and depressive symptoms (40%). Conclusions: These preliminary results identify specific areas of concern in the health and well-being of Thai university students. Further analyses are needed to shed light on the factors contributing to these increased health risks. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak has taken many governments by surprise. While the crisis unfolds, it is instructive to explore how different governments reacted to the onslaught of an unknown disease. This research, using very recently collected and open-source data, meets this objective. The research reveals that, regarding 7 most commonly adopted preventive measures, governments have varied notably concerning their actions in relation to infection rate, disease rate, and timing of measures. The research also illustrates variations between governments for 6 countries: Australia, New Zealand, Spain, the United Kingdom, Italy, and the United States. As revealed in the summary independent-samples t test and Hedges' g values, both Oceanian countries (Australia and New Zealand) reacted differently compared to the other countries, which may have played a role in their low death and infection rates to date. [ABSTRACT FROM AUTHOR]

Background: We examined the association of objective and subjective oral health markers with inflammatory, hemostatic, and cardiac biomarkers in older age.Methods: Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising British men aged 71-92 years (n = 2,147), and the Health, Aging and Body Composition (HABC) Study comprising American men and women aged 71-80 years (n = 3,075). Oral health markers included periodontal disease, tooth count, dry mouth. Inflammatory biomarkers included C-reactive protein (CRP), interleukin-6 (IL-6) in both studies, and tissue plasminogen activator (t-PA), von Willebrand Factor (vWF), fibrin D-dimer, high-sensitivity Troponin T (hsTnT), and N-terminal pro-brain natriuretic peptide (NTproBNP) only in the BRHS.Results: In both studies, tooth loss, was associated with the top tertile of CRP-odds ratios (ORs) (95% confidence interval [CI]) are 1.31 (1.02-1.68) in BRHS; and 1.40 (1.13-1.75) in the HABC Study, after adjusting for confounders. In the HABC Study, cumulative (≥3) oral health problems were associated with higher levels of CRP (OR [95% CI] =1.42 [1.01-1.99]). In the BRHS, complete and partial tooth loss was associated with hemostatic factors, in particular with the top tertile of fibrin D-dimer (OR [95% CI] = 1.64 [1.16-2.30] and 1.37 [1.05-1.77], respectively). Tooth loss and periodontal disease were associated with increased levels of hsTnT.Conclusions: Poor oral health in older age, particularly tooth loss, was consistently associated with some inflammatory, hemostatic, and cardiac biomarkers. Prospective studies and intervention trials could help understand better if poor oral health is causally linked to inflammatory, hemostatic, and cardiac biomarkers. [ABSTRACT FROM AUTHOR]

Background To stop the spread of the new coronavirus disease in 2019 (COVID-19), many countries had completely locked down. This lockdown restricted the everyday life of the affected residents and changed their mobility pattern, but its effects on sleep pattern were largely unknown. Methods Here, utilizing one of the largest crowdsourced database (Sleep as Android), we analyzed the sleep pattern of 25 217 users with 1 352 513 sleep records between 1 January and 29 April 2020 in the US and 16 European countries (Germany, UK, Spain, France, Italy, The Netherlands, Belgium, Hungary, Denmark, Finland, Norway, Czech, Sweden, Austria, Poland and Switzerland) with more than 100 records in all days of 2020. Results During the COVID-19 pandemic, the sleeping pattern before and after the country-level lockdown largely differed. The subjects increased their sleep duration by an average of 11.3 to 18.6 min on weekday nights, except Denmark (4.9 min) and Finland (7.1 min). In addition, subjects form all 16 European countries delayed their sleep onset from 10.7 min (Sweden) to 29.6 min (Austria). Conclusion During the COVID-19 pandemic, residents in the US and 16 European countries delayed their bedtime and slept longer than usual. [ABSTRACT FROM AUTHOR]

Aims: To understand patient preferences for once‐daily oral versus once‐weekly injectable type 2 diabetes mellitus (T2DM) medication administration profiles, and reasons for their preferences. Materials and methods: The REVISE study, a cross‐sectional online survey of 600 participants with T2DM (United Kingdom, n = 300; United States, n = 300), elicited general preferences for once‐daily oral versus once‐weekly injectable diabetes medications, and reasons for the preference. Participants then viewed two videos describing the administration procedures for injectable dulaglutide and oral semaglutide, based on the product instructions for use. Thereafter, participants indicated their preference for a once‐weekly injectable or a once‐daily oral medication based on the video descriptions. Participants who switched preferences were asked to identify the reasons influencing their decision. Results: The participants were predominantly male (n = 349; 58.2%), with a mean (SD) age of 64 (11.3) years. Nearly all (n = 557; 92.8%) were taking an oral T2DM medication, and 158 (26.3%) were using an injectable. Initially, 76.5% (n = 459; 95% confidence interval [CI] 73.1–79.9) preferred a once‐daily oral and 23.5% a once‐weekly injectable (n = 141; 95% CI 20.1–26.9; P < 0.0001). After viewing the videos describing the product‐specific administration, the proportions of participants preferring each option were not statistically different (oral semaglutide administration description (n = 315; 52.5%; 95% CI 48.5–56.5; dulaglutide administration description (n = 285; 47.5%; 95% CI 43.5–51.5; NS, P = 0.2207). The most common reason for switching preferences was the timing and steps of administration. Conclusion: Several treatment‐related characteristics, including route, frequency and complexity of the treatment, play a role in patients' preferences for T2DM treatments and should be considered during treatment selection. [ABSTRACT FROM AUTHOR]

The majority of research participants in the social sciences are recruited from populations that are Western , educated , industrialized , rich , and democratic. This has the potential to threaten the external validity and limit the generalizability of research findings. It also highlights the need to provide a historical accounting of participant characteristics and reporting practices across coherent disciplines of research. This paper reports the participant characteristics from studies published in 12 leading journals in the sport and exercise psychology literature. In total, 15,650 peer-reviewed articles were published across these outlets from 1930 to 2021, involving 4,487,437 human participants. A descriptive overview of participant characteristics and reporting practices suggests that empirical understanding of human experiences and outcomes in sport and exercise settings is built from an incomplete and unrepresentative sample of participants. Findings illuminate potential knowledge gaps that may have resulted from the lack of diverse samples and offer potential paths forward for contemporary sport and exercise psychology scholars who wish to address these gaps. • 15,650 articles with 4,487,437 human participants have been published across 12 sport and exercise psychology journals from 1930 to 2021. • 75.6% of participants from these studies have been drawn from the United States, Canada, the United Kingdom, and Australia. • Across this literature, many important participant characteristics have gone uncollected and/or unreported. [ABSTRACT FROM AUTHOR]

The article offers information on ageing anaesthetist is the lessons from the North American experience. Topics include the anaesthetists is growing because of an ageing and sicker general population who need more surgical procedures, and the loss of working memory leading to diminished ability to make multiple decisions in a rapid fashion.

In both the United Kingdom and United States of America legislation has been proposed or enacted which claims to provide patients with a 'right' of access to experimental drugs and treatments where there is no other hope. In this paper we will explore this narrative and consider the steps taken in the United States to shift to a more rights driven legal framework. The paper will critically assess the United States model and the similarly framed 'Saatchi' model in the United Kingdom; demonstrating that, despite the rights-based narrative, these laws do not represent a significant change in access to treatment for patients. Rather, the reality is that this 'right to try' paradigm represents a patient advocate narrative that is deeply flawed. It fails to implement any meaningful change, exposes vulnerable patients to risk of harm and, potentially, delays safe development of potentially life-saving treatment regimes. [ABSTRACT FROM AUTHOR]

With a recent surge of research on narcissism, narcissism questionnaires are increasingly being translated and applied in various countries. The measurement invariance of an instrument across countries is a precondition for being able to compare scores across countries. We investigated the cross-cultural measurement invariance of three narcissism questionnaires (Brief Pathological Narcissism Inventory [B-PNI], Narcissistic Personality Inventory [NPI], and Narcissistic Admiration and Rivalry Questionnaire [NARQ]) and mean-level differences across samples from the United States (N = 2,464), the United Kingdom (N = 307), and Germany (N = 925). Overall, the B-PNI and NARQ functioned equivalently for the U.S. and U.K. participants. More violations of measurement invariance were found between Germany and the combined U.S. and U.K. samples, and for the NPI. In the B-PNI and NARQ, Americans scored higher than individuals from the United Kingdom regarding agentic aspects (self-sacrificing self-enhancement, admiration), while Germans scored lower than both Americans and U.K. individuals regarding antagonistic (entitlement rage, rivalry) and neurotic (hiding the self, contingent self-esteem) aspects. More inconsistent results were found for NPI facets. When noninvariance was present, observed means yielded biased results. Thus, the degree of measurement invariance across translated instrument versions should be considered in cross-cultural comparisons, even with culturally similar countries. [ABSTRACT FROM AUTHOR]

Aim: To analyse the current status and publication trends of funded studies in nursing‐related research from 2008 to 2018, available in the Web of Science. Design: A longitudinal bibliometric analysis of publications of funded studies in nursing‐related research, obtained from the Web of Science, was conducted. Methods: On 10 May 2019, we accessed 77,772 funded studies (2008–2018) from the Web of Science. Bibliometric methods and indicators were used to classify the publications and summarize the overall number, countries/regions, institutions, journals, and other parameters of the publications. Results: The global output of nursing‐related funded research publications increased significantly over time. The three leading countries with the highest number of funded publications were the United States, Australia, and the United Kingdom, with the United States accounting for 15 of the top 20 institutions associated with funded publications, which mostly included institutions of higher education. The most common disciplines of these publications were oncology, psychiatry, and paediatrics. The top three journals that published the largest number of nursing‐related funded publications were the Journal of Clinical Nursing, the Journal of Advanced Nursing, and the International Journal of Nursing Studies. Keywords with the highest frequency of occurrence included "nurses," "qualitative research," "older people," "quality of life," "depression," "cancer," and "children." Conclusions: Nursing‐related research has been drawing increasing attention over the years. Analysing the output of funded publications and monitoring the new dynamics of the international development of academic research in the field of nursing are crucial for determining future directions of nursing‐related research development. Impact: The results of this study will provide a reference for scholars to evaluate the current utilization efficiency of global nursing‐related research funding and demonstrate the development and trends in nursing‐related research. [ABSTRACT FROM AUTHOR]

Aim: This study aims to present a general bibliometric overview of the development status of global nursing research from 2000 to 2019. Design: A longitudinal bibliometric analysis of nursing research was conducted. Methods: Nursing research publications (N = 88,665) were obtained from Web of Science. Bibliometric method was used to map the output and citation impact trends of countries/regions, institutions, disciplines, and journals and analyse the research collaboration among countries/regions and institutions. Results: The global paper output in nursing research increased steadily over the past two decades and it varied in different countries/regions with the USA being far ahead of the others. The paper output and cross‐border collaboration are mainly distributed in several developed countries like the USA, the UK, Australia, and Canada. The University of Pennsylvania, Harvard University, University of Toronto, and University of North Carolina at Chapel Hill have high academic influence in the field of nursing. Increasing attention from academic fields has been paid to research on nursing. Journal of Advanced Nursing is the most prolific and most cited journal in nursing field. Conclusion: Nursing research has developed steadily over the last two decades. Both the scientific output and research collaboration are disproportionally distributed between high‐income countries/regions and low‐ and middle‐income countries/regions. Most research and collaboration have taken place in a few developed countries across North America, Europe, and Oceania. Impact: The study highlighted the need for policy makers and funding agencies, especially those from low‐ and middle‐income countries/regions, to allocate research funding that supports the nursing higher education and international cooperation so as to promote the development of high‐quality nursing research in those countries/regions. At the same time, researchers from non‐English‐speaking countries/regions should attach more importance to publishing papers in English, strengthening the academic exchanges with international nursing colleagues and better integrating into the international academic community. [ABSTRACT FROM AUTHOR]

This article contrasts the experiences of the United States and United Kingdom during and after the Great Recession to understand the role of financial shocks in the magnitude of the crises and length of the recoveries. It starts from the common consensus that the Great Recession first and foremost was a financial crisis. It shows that relative to the United States, the Great Recession in the United Kingdom was more closely associated with a decline in productivity. Motivated by the similar behavior of financial variables at a business cycle frequency, it contrasts the behavior of the U.S. and U.K. economies through the lens of a simple real business cycle model augmented with financial shocks. A credit channel that operates on firm hiring decisions captures the magnitude of the output decline in both the United States and United Kingdom but exaggerates the response of the hours margin for the United Kingdom. The conclusion is that the financial channel supported in the U.S. data seems less appropriate for understanding the U.K. experience. [ABSTRACT FROM AUTHOR]

Many countries use demand-side housing subsidies to support low-income households. Unlike public or social housing programs, demand-side subsidies require recipients to enter the private market to use their benefits. The focus of this study is the experiences of assisted households in the private housing market and the outcomes they achieve. Given the link between policy design and program outcomes and because all housing subsidy programs are not created equal, one might expect the experiences and outcomes of recipients to also vary. To examine this relationship, using data from national housing surveys, this study analyzes cross-national variation in housing support programs and compares the housing and neighbourhood outcomes of subsidized households in the US, the UK, and the Netherlands. The findings of this study highlight that market context and policy design are associated with housing outcomes. In particular, the strong tenant supports and favourable design of housing assistance in the Netherlands is associated with favourable outcomes for subsidized households. In the US and the UK, subsidized households, in general, underperform their unsubsidized peers. This article underscores the importance of institutional context and program design when public assistance programs require recipients to enter the private market to use a benefit. [ABSTRACT FROM AUTHOR]

Objectives: There is important variation in beliefs about immigration within the publics of immigrant‐receiving societies but empirical social research has largely overlooked it. The "imagined immigration" concept aims to bring these beliefs back in as an important component of public attitudes toward immigrants. It also offers a new perspective on the political conflict around immigration that persists despite the consensus on desired qualities of potential immigrants among citizens in industrial democracies. Methods: I review the imagined immigration concept and present new empirical evidence in its favor using original survey studies in the United States and Britain. Results: I describe respondents' beliefs about immigrants, demonstrate their association with partisanship, and confirm that these beliefs are significantly related to perceptions of immigration as harmful—even when controlled for partisanship, ideology, and ethnocentrism. Conclusion: I corroborate the foundations of the imagined immigration concept and discuss its promise and limitations. [ABSTRACT FROM AUTHOR]

Traditional citation analysis has been greatly criticized because the process of citation accumulation requires considerable time after publication. So, the term "altmetrics" was proposed in 2010 to measure the scientific and social impact of a paper. According to the deficiencies of traditional citation analysis, we performed a comprehensive search for medical ethics publications using the altmetrics approach from the beginning until 2019. In this descriptive-analytical study, we retrieved the articles discussing any topics relating to medical ethics that published in the Scopus database from the beginning till 2019 using related medical ethics keywords. A total number of 455 articles with altmetrics scores and citations, included in this study. Altmetrics data were extracted via an altmetrics bookmarklet. Dimensions, Mendeley, and Twitter, had prominent sources of attention on social media platforms. The most number of tweets, and Mendeley's attentions, in the medical ethics fields, originated from the United States (US) and the United Kingdom (UK). Moreover, master students have the largest share in the citation of articles in Mendeley. Journal of Medical Ethics and History of Medicine has the most proportion of altmetrics score among Iranian papers in medical ethics. The correlation between the altmetrics score and citation index was significant (p <0.05). The medical ethics researchers have to pay more attention to social activities (such as creating and updating their profiles on social media) on the web for wide dissemination and proper evaluation of their scientific publications. [ABSTRACT FROM AUTHOR]

In the COVID-19 pandemic, patients who are older and residents of long-term care facilities (LTCF) are at greatest risk of worse clinical outcomes. We reviewed discharge criteria for hospitalised COVID-19 patients from 10 countries with the highest incidence of COVID-19 cases as of 26 July 2020. Five countries (Brazil, Mexico, Peru, Chile and Iran) had no discharge criteria; the remaining five (USA, India, Russia, South Africa and the UK) had discharge guidelines with large inter-country variability. India and Russia recommend discharge for a clinically recovered patient with two negative reverse transcription polymerase chain reaction (RT-PCR) tests 24 h apart; the USA offers either a symptom based strategy—clinical recovery and 10 days after symptom onset, or the same test-based strategy. The UK suggests that patients can be discharged when patients have clinically recovered; South Africa recommends discharge 14 days after symptom onset if clinically stable. We recommend a unified, simpler discharge criteria, based on current studies which suggest that most SARS-CoV-2 loses its infectivity by 10 days post-symptom onset. In asymptomatic cases, this can be taken as 10 days after the first positive PCR result. Additional days of isolation beyond this should be left to the discretion of individual clinician. This represents a practical compromise between unnecessarily prolonged admissions and returning highly infectious patients back to their care facilities, and is of particular importance in older patients discharged to LTCFs, residents of which may be at greatest risk of transmission and worse clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: End-of-life doulas are emerging as a potentially important new form of community-based caregiving in the global North, yet we know little about this form of care. The aim of our study was to solicit the perspective of key stakeholders and early innovators in community-based end-of-life care about the development and practices of end-of-life doulas. Methods: We conducted 22 semi-structured interviews with participants in four countries where end-of-life doulas are most active: Australia, Canada, the United States, and the United Kingdom. Findings: This article focuses on participants' description of the end-of-life doula role and attendant practices, and our findings provide the first detailed taxonomy of the end-of-life doula role and specific services on the basis of the perspective of subject experts in four countries. We situate our findings within literature on the professionalization of caregiving, with particular attention to nomenclature, role flexibility and boundary blurring, and explicit versus tacit knowledge. We also discuss the importance of jurisdictional considerations as the end-of-life doula movement develops. Discussion: We speculate that the end-of-life doula role is potentially experiencing common developmental antecedents similar to other now-professionalized forms of caregiving. Our findings contribute substantial new information to the small body of empirical research about the end-of-life doula role and practices, provide critical firsthand insight as the movement develops, and are the first research to explore end-of-life doulas from a comparative international perspective. [ABSTRACT FROM AUTHOR]

A just transition to renewable energy requires accounting for the effects of offshore wind projects (OWPs) on the fishing industry. Research on the interaction of OWPs with coastal communities and fisheries in the United Kingdom and the United States offers insights into minimizing conflict and enhancing constructive engagement between fishers and wind energy developers. Recent innovations include earlier and more meaningful inclusion of fisheries representatives in planning and decisionmaking, involving fisheries liaisons in the process, and conducting more cumulative studies and taking collaborative approaches to considering the effects of OWP on fishing. [ABSTRACT FROM AUTHOR]

Background Hearing loss can have an effect on the physical, psychosocial, and cognitive wellbeing of an individual. Despite the research on attitudes and stigma associated with hearing loss, people with hearing loss (PHL) continue to delay seeking help. Thus, it is vital to look at alternative theories which have been successfully used in disability research to better understand how PHL perceive hearing loss. Purpose The aim of the current exploratory study was to examine the social representation (SR) of "hearing loss" in PHL in India, Republic of Korea (ROK), United Kingdom (UK), and the United States (US). Research Design The study used a cross-sectional survey design. Study Sample In this study, 424 participants were recruited using a consecutive sampling method in four countries (India, Republic of Korea, United Kingdom, and United States). Data Collection and Analysis Data collection was conducted using a questionnaire. Data were analyzed using content analysis, similarities analysis, prototypical analysis, and chi-square analysis. Results The free associations of the PHL were grouped into 37 categories. The most commonly reported categories were communication difficulties, negative mental state, aging, assessment and management, causes of hearing loss, hearing ability or disability, hearing instruments, and symptoms of hearing loss. Similarities analysis and prototypical analysis highlighted two main negative categories (negative mental state and communication difficulties) which form the central elements of SR of hearing loss. PHL associated hearing loss mainly as a negative phenomenon, but with some positive and neutral aspects. Respondents from ROK reported a greater number of neutral associations compared with other countries. There were cross-cultural similarities and differences in terms of PHL's SR of hearing loss, but there were more similarities than differences. Conclusion The study provides an insight into how PHL collectively view their "hearing loss" and helps to develop our understanding of the influence of culture on the SR of "hearing loss." The results will aid the development of culturally appropriate public education campaigns, marketing material, and appropriate rehabilitation for PHL. [ABSTRACT FROM AUTHOR]

Background: Excess sugar consumption has been linked to numerous negative health outcomes, such as obesity and type II diabetes. Reducing sugar-sweetened beverage (SSB) consumption may reduce sugar intake and thus improve health. The aim of the study was to test the impact of the potentially different rewarding nature of water or diet drinks as replacements for SSB, using a habit and implementation intention–based intervention. Method: An online randomised, two-arm parallel design was used. One hundred and fifty-eight participants (mainly from the UK and USA) who regularly consumed SSBs (Mage = 31.5, 51% female) were advised to create implementation intentions to substitute their SSB with either water or a diet drink. Measures of SSB consumption, habit strength and hedonic liking were taken at baseline and at 2 months. Water or diet drink consumption was only measured at 2 months. Results: There was a large and significant reduction in SSB consumption and self-reported SSB habits for both the water and diet drink groups, but no difference between groups. There were no differences in hedonic liking for the alternative drink, alternative drink consumption and alternative drink habit between the two groups. Reduction in SSB hedonic liking was associated with reduced SSB consumption and habit. Conclusion: This study demonstrates that an implementation intention–based intervention achieved substantial reductions in SSB consumption and habits. It also indicates that hedonic liking for SSBs and alternative drinks are associated with changes in consumption behaviour. Substituting SSBs with water or diet drinks was equally as effective in reducing SSB consumption. [ABSTRACT FROM AUTHOR]

Background: End-of-life doulas are emerging as a potentially important new form of community-based caregiving in the global North, yet we know little about this form of care. The aim of our study was to solicit the perspective of key stakeholders and early innovators in community-based end-of-life care about the development and practices of end-of-life doulas. Methods: We conducted 22 semi-structured interviews with participants in four countries where end-of-life doulas are most active: Australia, Canada, the United States, and the United Kingdom. Findings: This article focuses on participants' description of the end-of-life doula role and attendant practices, and our findings provide the first detailed taxonomy of the end-of-life doula role and specific services on the basis of the perspective of subject experts in four countries. We situate our findings within literature on the professionalization of caregiving, with particular attention to nomenclature, role flexibility and boundary blurring, and explicit versus tacit knowledge. We also discuss the importance of jurisdictional considerations as the end-of-life doula movement develops. Discussion: We speculate that the end-of-life doula role is potentially experiencing common developmental antecedents similar to other now-professionalized forms of caregiving. Our findings contribute substantial new information to the small body of empirical research about the end-of-life doula role and practices, provide critical firsthand insight as the movement develops, and are the first research to explore end-of-life doulas from a comparative international perspective. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections are a significant reason for readmission to hospital post-discharge to the community. In this paper, the authors describe some of the key findings from a programme of work conducted in a home care agency (community care organisation) in the US. A survey was conducted to explore home care nurses' knowledge, attitudes and beliefs around infection control (n=415); 400 nurse-patient visits were observed, and 50 nurses were interviewed about their infection control practices. Nurses reported high compliance with infection control practices. However, the overall average adherence rate to observed hand hygiene practices was 45.6%. Interview data provided valuable insights into specific challenges faced by nurses in a home care setting. This study provides insights that can be used to enhance infection control practice in community care in the UK. [ABSTRACT FROM AUTHOR]

Background: The United States (US) spends more on health care than any other high‐resource country. Despite this, their maternal and newborn outcomes are worse than all other countries with similar levels of economic development. Our purpose was to describe maternal and newborn outcomes and organization of care in four high‐resource countries (Australia, Canada, the Netherlands, and United Kingdom) with consistently better outcomes and lower health care costs, and to identify opportunities for emulation and improvement in the United States. Method: We examined resources that described health care organization and financing, provider types, birth settings, national, clinical guidelines, health care policies, surveillance data, and information for consumers. We conducted interviews with country stakeholders representing the disciplines of obstetrics, midwifery, pediatrics, neonatology, epidemiology, sociology, political science, public health, and health services. The results of the analysis were compared and contrasted with the US maternity system. Results: The four countries had lower rates of maternal mortality, low birthweight, and newborn and infant death than the United States. Five commonalities were identified as follows: (1) affordable/ accessible health care, (2) a maternity workforce that emphasized midwifery care and interprofessional collaboration, (3) respectful care and maternal autonomy, (4) evidence‐based guidelines on place of birth, and (5) national data collections systems. Conclusions: The findings reveal marked differences in the other countries compared to the United States. It is critical to consider the evidence for improved maternal and newborn outcomes with different models of care and to examine US cultural and structural failures that are leading to unacceptable and substandard maternal and infant outcomes. [ABSTRACT FROM AUTHOR]

Formerly heterosexually partnered gay fathers raised with religion are an under-researched group of LGBTQ parents. This group have potentially complex coming out journeys, which can result in them seeking counselling. This research qualitatively explores the counselling experiences of 12 such men and offers suggestions for working therapeutically with them. The key finding of the qualitative analysis of the participants' interviews was that they wanted therapists to not assume a "best" outcome for them as either gay or "straight". Instead, they wanted therapists to respect and assist them to explore their own individual sense-making around their identities and to reject fixed notions from both ex-gay and gay affirmative therapy of what it means to be a "well-adjusted" gay father. [ABSTRACT FROM AUTHOR]

On March 11, 2020 the World Health Organization classified COVID‐19, caused by Sars‐CoV‐2, as a pandemic. Although not much was known about the new virus, the first outbreaks in China and Italy showed that potentially a large number of people worldwide could fall critically ill in a short period of time. A shortage of ventilators and intensive care resources was expected in many countries, leading to concerns about restrictions of medical care and preventable deaths. In order to be prepared for this challenging situation, national triage guidance has been developed or adapted from former influenza pandemic guidelines in an increasing number of countries over the past few months. In this article, we provide a comparative analysis of triage recommendations from selected national and international professional societies, including Australia/New Zealand, Belgium, Canada, Germany, Great Britain, Italy, Pakistan, South Africa, Switzerland, the United States, and the International Society of Critical Care Medicine. We describe areas of consensus, including the importance of prognosis, patient will, transparency of the decision‐making process, and psychosocial support for staff, as well as the role of justice and benefit maximization as core principles. We then probe areas of disagreement, such as the role of survival versus outcome, long‐term versus short‐term prognosis, the use of age and comorbidities as triage criteria, priority groups and potential tiebreakers such as 'lottery' or 'first come, first served'. Having explored a number of tensions in current guidance, we conclude with a suggestion for framework conditions that are clear, consistent and implementable. This analysis is intended to advance the ongoing debate regarding the fair allocation of limited resources and may be relevant for future policy‐making. [ABSTRACT FROM AUTHOR]

Over the past decade, some of the world's most stable parliamentary democracies have witnessed a revival in right‐wing populist political parties, movements and leaders. Although there is a growing body of theoretical and empirical literature documenting the rise of populism, there has been very little exploration of the implications for health policy of this important political development. In this article, we draw from three illustrative international cases, originating from the USA, the UK and Italy, to explore the ways in which right‐wing populism influences health policy: the election of President Trump in the United States (and subsequent healthcare reforms), the United Kingdom's vote to withdraw from the European Union (Brexit), and how this has played out in the context of the UK National Health Service, and the rise of a politically aligned anti‐vaccination movement in Italy. Drawing on the work of the influential socio‐political theorist Ernesto Laclau, we interpret populism as a performative political act, predicated on drawing logics of equivalence (and difference) between different actors. We use this theoretical framing to explore the ways in which the recent upsurge in right‐wing populism creates a specific set of barriers and challenges for access to healthcare and the health of populations. [ABSTRACT FROM AUTHOR]

Background: Harmevents such as pneumothoraces and pneumonia continue to be associated with feeding tube insertion. Most bedside verification methods are not accurate to discriminate pulmonary from gastrointestinal system. Evidence-based clinical practice guidelines do not support auscultation of feeding tubes in adults, yet auscultation is the most common method used. Objectives: Our survey assessed national feeding tube verification practices used by critical care nurses, including progress in auscultation method deimplementation, and stylet reinsertion and cleansing practices. Methods: A national survey of 408 critical care nurses was performed. Results: The majority performed auscultation (311 of 408 [76%]) to verify feeding tube placement. In the final multivariable model, nursing education, facility type, observation of colleagues performing auscultation, and awareness of an institutional policy were associated with auscultation of feeding tubes. Thirty-five percent used enteral access devices to verify initial feeding tube placement. Stylet cleansing methods were variable; 38% of reinserted stylets were not cleansed. Discussion: Minimal progress has been made in deimplementation of auscultation in the past 7 years despite passive knowledge dissemination in research articles, clinical practice guidelines, and procedure manuals. Although pH measure is used as a first-line feeding tube verification method in the United Kingdom, it is rarely used in the United States. Clinical practice guidelines should be updated to incorporate new research on enteral access systems. Conclusions: Tradition-based practices such as auscultation and certain stylet cleansing methods should be deimplemented. A focused interdisciplinary, multifaceted program is needed to deimplement auscultation practice for adult feeding tubes. [ABSTRACT FROM AUTHOR]

Online self-presentation refers to the ways in which individuals share aspects of the self to portray a particular image. Being online presents opportunities for individuals to experiment with different versions of the self as part of identity development but also to manage how others perceive them. Research has shown that personality can influence online self-presentation behaviors, but these studies have mainly focused on internal characteristics, and more research is needed exploring the relational facets of personality. This study aims to investigate the extent to which an individual's self-concept clarity, self-monitoring tendency, self-esteem, and social anxiety predict different presentations of the online self. A cross-sectional online survey was conducted with 405 adult participants from Australia, the United Kingdom, and the United States. Results show that individuals with higher self-concept clarity and self-monitoring are more likely to present a single consistent online and offline self. Younger adults and those with greater social anxiety are more likely to present idealized self-images online, and participants with higher social anxiety and lower self-esteem are more likely to prefer online, rather than offline, communication. Findings are broadly consistent with the literature, and suggest the need for more systematic investigation into a variety of personality variables that take into account the relational nature of identity formation and impression management. This research emphasizes the multifaceted nature of online self-presentation behaviors, and the ways in which they are differentially influenced by personality variables. [ABSTRACT FROM AUTHOR]

The article compares how the governments in Germany, the U.S. and Great Britain use scientific expertise to understand the novel coronavirus SARS-COV-2 and how to limit its damage. Topics discussed are importance of cooperation between public agencies and private sector organizations for diagnostic testing and a well-trained workforce that administer tests, formulation of policy for responding to the virus, and differences in government strategies for public compliance and communication.

Synthetic biology represents a recent and explicit attempt to make biology easier to engineer, and through this to open up the design space of genetic engineering to a wider range of practitioners (including, but not limited to, engineers). Proponents of this approach emphasize the standardization of practices as key to successful biological engineering; yet, meaningful transatlantic differences are emerging with respect to the constitution of key concerns and the governance of synthetic biology in the United States (US) and the United Kingdom (UK). In this article, I tease out how national approaches to governing synthetic biology are being framed against different salient past experiences with recombinant DNA technology. In the US, the governance of synthetic biology is consistently articulated in relation to the early days of recombinant DNA technology and the self-governance mechanisms pioneered in response to Asilomar. In the UK, more recent experiences with genetically modified crops provide the overarching imaginary against which governance initiatives are being proposed. I suggest that these differing sociotechnical imaginaries have implications for how new "groups of concern" are being defined in relation to synthetic biology and how measures to contain perceived risks are being pursued in the US and Britain. [ABSTRACT FROM AUTHOR]

The article discusses studies which examined the impact of lifestyle and the role of diet on cognitive decline. It includes a study which found that dietary flavanols can restore hippocampal-dependent memory in older adults and another which highlighted the lasting effects of caloric intake and diet composition on the brain as well as the impact that emotions have on cognition.

Global mobility, technological developments, and evolved organizational design have expanded the scope of workplace teams beyond traditional arrangements, giving rise to global virtual teams. As universities across the world encouragemobility, there are unprecedented opportunities to create discipline-specific international networks, increase cross-cultural understanding, and create rich interactions in research. Team structure, trust formation, and communication processes are known to positively influence global virtual team performance. They are discussed to illustrate the value of a structured model of work in an international research-focused collaboration of nursing academics from the United States, the United Kingdom, and Australia. [ABSTRACT FROM AUTHOR]

The heterogeneity of COVID-19 experience and response for each individual is irrefutable; nevertheless, similarities can be observed between countries with respect to people's psychological responses. The main aim of this Commentary is to provide a cultural perspective of the sources of trauma, at the individual and social level, in three different countries: Italy, US and UK. The evidence from previous outbreaks, such as SARS, H1N1 flu, Ebola, and the ongoing Italian, the US, and the UK experience of COVID-19 shows that COVID-19 has introduced not only an individual trauma but also a collective trauma, that researchers should attend to now and in future global emergencies. Future clinical interventions should aim to reconnect dissociated parts both in the individual and in society. This commentary discusses four potential sources of trauma: high-stakes decision fatigue in healthcare professionals, traumatic grief, and bereavement in people who have lost loved ones, loss of roles and identity, and social divisions related to economic shutdown. [ABSTRACT FROM AUTHOR]

Objective: This research explored health sciences librarians' perceptions of intergenerational communication in the workplace. Methods: The authors developed and sent a survey to health sciences librarians through email discussion lists from August 2018 to September 2018. A chi-square test was performed to determine whether one's length of employment as a librarian was associated with belief that age and/or generation impacts communication in the workplace. Results: A total of 150 respondents from 5 countries completed the survey. There was no significant association between length of employment as a librarian and respondents' belief that age and/or generation impacts communication in the workplace. However, regardless of length of employment, most respondents indicated that generational differences do have an impact on communication in the workplace. Also, most respondents expressed interest in institutional initiatives to foster intergenerational communication. Conclusion: The authors found that health sciences librarians believe that differences among generations impact communication in the workplace. Librarians, managers, and library organizations should consider providing training and other opportunities for health sciences librarians to improve their intergenerational communication skills. [ABSTRACT FROM AUTHOR]

The clinical utility of the 70-gene signature (MammaPrint®) to guide chemotherapy use in T1-3N0-1M0 breast cancer was demonstrated in the Microarray in Node-Negative and 1 to 3 Positive Lymph Node Disease May Avoid Chemotherapy (MINDACT) study. One thousand four ninety seven of 3356 (46.2%) enrolled patients with high clinical risk (in accordance with the modified Adjuvant! Online clinical-pathological assessment) had a low-risk 70-gene signature. Using patient-level data from the MINDACT trial, the cost-effectiveness of using the 70-gene signature to guide adjuvant chemotherapy selection for clinical high risk, estrogen receptor positive (ER+), human epidermal growth factor 2 negative (HER2-) patients was analysed. A hybrid decision tree-Markov model simulated treatment strategies in accordance with the 70-gene signature with clinical assessment versus clinical assessment alone, over a 10-year time horizon. Primary outcomes were quality-adjusted life years (QALYs), country-specific costs and incremental cost-effectiveness ratios (ICERs) for six countries: Belgium, France, Germany, Netherlands, UK and the US. Treatment strategies guided by the 70-gene signature result in more QALYs compared with clinical assessment alone. Costs of the 70-gene signature strategy were lower in five of six countries. This led to dominance of the 70-gene signature in Belgium, France, Germany, Netherlands and the US and to a cost-effective situation in the UK (ICER £22,910/QALY). Annual national cost savings were €4.2M (Belgium), €24.7M (France), €45.1M (Germany), €12.7M (Netherlands) and $244M (US). UK budget increase was £8.4M. Using the 70-gene signature to safely guide chemotherapy de-escalation in clinical high risk patients with ER+/HER2- tumours is cost-effective compared with using clinical assessment alone. Long-term follow-up and outcomes from the MINDACT trial are necessary to address uncertainties in model inputs. • The 70-gene signature is cost-effective compared with clinical assessment alone • Minimal survival differences are balanced against quality of life gains • Results are consistent amongst the five studied countries [ABSTRACT FROM AUTHOR]

The article focuses on the European attitudes towards nuclear deterrence. Topics include Europeans remain unwilling to renew their thinking on nuclear deterrence, despite growing strategic instability; the UK and France should convert the idea of a European deterrent from mere notion into credible offer, by thickening their bilateral nuclear cooperation; and Europe can no longer count on the United States has been a core element of French security.

Research shows that, for most people, homelessness is not a chronic state that one enters and never leaves. Instead, homelessness tends to be dynamic, with individuals cycling in and out of multiple periods of homelessness throughout their lives. Despite this recognition, and a wealth of research on the causes of homelessness, generally, there is a lack of scholarship on the pathways to multiple episodes of homelessness. In particular, the relationship between violent victimization and women's likelihood of being homeless multiple times is largely unexplored. Drawing on data collected from 269 structured interviews conducted with women using the services of homeless shelters and/or transitional housing in three U.S. and two U.K. cities, we use multivariate logistic regression to assess whether violent victimization increases women's likelihood of experiencing multiple episodes of homelessness. Our results show that adult victims of stranger-perpetrated physical assault are significantly more likely to be homeless on multiple occasions. In addition, those who experience multiple forms of victimization (e.g., physical and sexual abuse) in childhood, adulthood, and/or across the life course are significantly more likely to experience multiple episodes of homelessness. Given recent efforts to eradicate homelessness, our results suggest specific vulnerable groups that may benefit from targeted social and policy interventions. [ABSTRACT FROM AUTHOR]

Although international students have been a notable research topic in higher education for more than 100 years, to date only one qualitative literature review has been published on the topic. In order to help researchers better understand the intellectual landscape of global research related to international students, we conducted a quantitative scientometric review of 3685 relevant journal articles published between 1900 and 2018 and indexed in the Web of Science Core Collection. The findings show that the number of articles published in the field has increased rapidly, especially since 2006, and this expansion has been led primarily by Australia, the U.K., and the USA, as these three countries not only produced most of the high-yielding research institutions and productive authors, but also published a majority of the prolific journals. Among the numerous topics discussed in these selected articles, cross-cultural adjustment, mental health problems, second-language acquisition, intercultural development, and student migration were most frequently studied, while social integration, graduate employability, and student satisfaction have emerged as new trends. These results complement the existing qualitative literature review from a quantitative perspective and provide valuable insights into and implications for global research related to international students. [ABSTRACT FROM AUTHOR]

The scientific study of animal cognition has roots in both experimental psychology and evolutionary biology, with researchers often working in related disciplines such as neuroscience, computing science, or ecology. The interdisciplinary nature of the endeavor is both a strength and a challenge for the field. We begin this review with a brief history of comparative cognition and cognitive ecology, focusing on cognitive processes as a mechanistic link between ethology and behaviorism. We then present a "snapshot" of modern-day undergraduate courses in Canada, the United States of America, and the United Kingdom that focus on animal cognition, highlighting the various course names and host departments. We emphasize the value of keeping (or adding) this subject material within curricula, either as independent courses or as enhanced material in other courses. We also present pedagogical approaches to teaching animal cognition that include techniques in large lecture-based courses and in smaller courses that emphasize hands-on experiential learning. [ABSTRACT FROM AUTHOR]

In the last decade, research in transplant medicine has focused on developing interventions in the management of the deceased organ donor to improve the quality and quantity of transplantable organs. Despite the promise of interventional donor research, there remain debates about the ethics of this research, specifically regarding gaining research consent. Here, we examine the concerns and ambiguities around consent for interventional donor research, which incorporate questions about who should consent for interventional donor research and what people are being asked to consent for. We highlight the US and UK policy responses to these concerns and argue that, whereas guidance in this area has done much to clarify these ambiguities, there is little consideration of the nature, practicalities and context around consent in this area, particularly regarding organ donors and their families. We review wider studies of consent in critical care research and social science studies of consent in medical research, to gain a broader view of consent in this area as a relational and contextual process. We contend a lack of consideration has been given to: what it might mean to consent to interventional donor research; how families, patients and health professionals might experience providing and seeking this consent; who is best placed to have these discussions; and the socio-institutional contexts affecting these processes. Further, empirical research is required to establish an ethical and sensitive model for consent in interventional donor research, ensuring the principles enshrined in research ethics are met and public trust in organ donation is maintained. [ABSTRACT FROM AUTHOR]

Introduction: National Cancer Organisations (NCO) provide web‐based diet and nutrition information for patients with all types and stages of cancer. We examined diet and nutrition information provided by nine NCO in English‐speaking countries. Methods: Diet and nutrition information was examined under four headings: disease phases, treatment modalities, nutrition impact symptoms and cancer primary sites. We also examined the degree of concordance between NCO websites and appraised the readability of materials. Results: Nine NCO websites from six English‐speaking countries were included: Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States. All provided general healthy eating advice. Information at diagnosis and pre‐treatment was inadequate, but well‐addressed for survivorship. Specific treatment modalities such as biological and hormone therapy were largely ignored. Symptom management was well‐addressed, with some exceptions. Cancer site‐specific advice was readily available. All recommended consultation with a dietitian/healthcare professional for personalised guidance. Only one met the universal health literacy standard. Conclusions: NCO websites provided important general diet and nutrition information for cancer patients. The information was reliable and safe, but more in‐depth, evidence‐based and health‐literate information is required. There is an urgent need for an international consensus for consistent cancer diet and nutrition advice. [ABSTRACT FROM AUTHOR]

In many countries, health technology assessment (HTA) organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries' methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in (1) the methodologies HTA organizations use to conduct their evaluations and (2) considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. [ABSTRACT FROM AUTHOR]

OBJECTIVE To compare the prevalence of negative mental health outcomes among lesbian, gay, bisexual, transgender, queer, questioning, and asexual (LGBTQ+) veterinary professionals and students with the prevalence reported in a previous study of veterinarians; compare LGBTQ+ veterinary professionals and students in regard to access to LGBTQ+ policies and resources, workplace or school climate, and identity disclosure; and examine whether these variables were associated with mental health (eg, psychological distress) or work- and school-related (eg, emotional labor) outcomes. SAMPLE 440 LGBTQ+ veterinary professionals and students in the United States and United Kingdom. PROCEDURES Between July and December 2016, a web-based questionnaire was distributed through email messages to members of LGBTQ+ veterinary groups and announcements at general veterinary and LGBTQ+-focused conferences and in newsletters. RESULTS Nonheterosexual cis men, nonheterosexual cis women, and transgender and nonbinary individuals all had higher lifetime prevalences of suicidal ideation and attempted suicide, compared with previously reported prevalences for male and female veterinarians in general. Professionals reported more welcoming climates than did students (eg, lower frequency of exposure to homophobic language and more supportive environments) and greater identity disclosure; however, students reported greater access to institutional resources and policies. Climate variables had a more robust relationship with negative outcomes than did access to LGBTQ+ policies or identity disclosure variables. CONCLUSIONS AND CLINICAL RELEVANCE Comparatively high rates of suicidal ideation and suicide attempts among LGBTQ+ professionals and students and the relationship between climate variables and negative mental health outcomes suggested enhanced efforts are needed to improve the climates in veterinary workplaces and colleges. [ABSTRACT FROM AUTHOR]

The American Democratic leadership in the White House and Congress in 2009-10 and the British Conservative/Liberal-Democrat Coalition government in 2010-12 each pursued a strategy of rapidly assembled multiple adjustments to the prevailing policy framework for health care rather than attempting a "big-bang" strategy of sweeping institutional change. Despite their relative modesty, each set of reforms encountered a highly conflictual and tortuous process of legislative passage. Subsequently, the reforms failed to gain broad public acceptance and were variously hobbled (in the United States) and transformed (in the United Kingdom) in the course of implementation. These two cases thus offer some common lessons about the potential and the pitfalls of such complex "mosaic" reforms. [ABSTRACT FROM AUTHOR]

Objectives: To describe and summarize evidence on economic evaluations (EEs) of primary caries prevention in preschool children aged 2 to 5 years and to evaluate the reporting quality of full EE studies using a quality assessment tool.Methods: A systematic literature search was conducted in several databases. Full and partial EEs were included. The reporting quality of full EE studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.Results: A total of 808 studies were identified, and 39 were included in the review. Most papers were published between 2000 and 2017 and originated in the United States and the United Kingdom. The most common type of intervention investigated was a complex multicomponent intervention, followed by water fluoridation. Cost analysis and cost-effectiveness analysis were the most frequently used types of EE. One study employed cost-utility analysis. The proportion of full EEs increased over time. The parameters not reported well included study perspective, baseline year, sensitivity analysis, and discount rate. The CHEERS items that were most often unmet were characterizing uncertainty, study perspective, study parameters, and estimating resources and costs.Conclusions: Within the past 2 decades, there has been an increase in the number of EEs of caries prevention interventions in preschool children. There was inconsistency in how EEs were conducted and reported. Lack of preference-based health-related quality-of-life measure utilization in the field was identified. The use of appropriate study methodologies and greater attention to recommended EE design are required to further improve quality. [ABSTRACT FROM AUTHOR]

Objectives Smoking is a major risk factor for the development of both cardiovascular disease (CVD) and RA and may cause attenuated responses to anti-rheumatic treatments. Our aim was to compare disease activity, CVD risk factors and CVD event rates across smoking status in RA patients. Methods Disease characteristics, CVD risk factors and relevant medications were recorded in RA patients without prior CVD from 10 countries (Norway, UK, Netherlands, USA, Sweden, Greece, South Africa, Spain, Canada and Mexico). Information on CVD events was collected. Adjusted analysis of variance, logistic regression and Cox models were applied to compare RA disease activity (DAS28), CVD risk factors and event rates across categories of smoking status. Results Of the 3311 RA patients (1012 former, 887 current and 1412 never smokers), 235 experienced CVD events during a median follow-up of 3.5 years (interquartile range 2.5–6.1). At enrolment, current smokers were more likely to have moderate or high disease activity compared with former and never smokers (P  < 0.001 for both). There was a gradient of worsening CVD risk factor profiles (lipoproteins and blood pressure) from never to former to current smokers. Furthermore, former and never smokers had significantly lower CVD event rates compared with current smokers [hazard ratio 0.70 (95% CI 0.51, 0.95), P  = 0.02 and 0.48 (0.34, 0.69), P  < 0.001, respectively]. The CVD event rates for former and never smokers were comparable. Conclusion Smoking cessation in patients with RA was associated with lower disease activity and improved lipid profiles and was a predictor of reduced rates of CVD events. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: International patterns of antibiotic use and laboratory testing in bronchiolitis in emergency departments are unknown. Our objective is to evaluate variation in the use of antibiotics and nonindicated tests in infants with bronchiolitis in 38 emergency departments in Pediatric Emergency Research Networks in Canada, the United States, Australia and New Zealand, the United Kingdom and Ireland, and Spain and Portugal. We hypothesized there would be significant variation, adjusted for patient characteristics. METHODS: We analyzed a retrospective cohort study of previously healthy infants aged 2 to 12 months with bronchiolitis. Variables examined included network, poor feeding, dehydration, nasal flaring, chest retractions, apnea, saturation, respiratory rate, fever, and suspected bacterial infection. Outcomes included systemic antibiotic administration and urine, blood, or viral testing or chest radiography (CXR). RESULTS: In total, 180 of 2359 (7.6%) infants received antibiotics, ranging from 3.5% in the United Kingdom and Ireland to 11.1% in the United States. CXR (adjusted odds ratio [aOR] 2.3; 95% confidence interval 1.6-3.2), apnea (aOR 2.2; 1.1-3.5), and fever (aOR 2.4; 1.7-3.4) were associated with antibiotic use, which did not vary across networks (P = .15). In total, 768 of 2359 infants (32.6%) had ≥1 nonindicated test, ranging from 12.7% in the United Kingdom and Ireland to 50% in Spain and Portugal. Compared to the United Kingdom and Ireland, the aOR (confidence interval) results for testing were Canada 5.75 (2.24-14.76), United States 4.14 (1.70-10.10), Australia and New Zealand 2.25 (0.86-5.74), and Spain and Portugal 3.96 (0.96-16.36). Testing varied across networks (P < .0001) and was associated with suspected bacterial infections (aOR 2.12; 1.30-2.39) and most respiratory distress parameters. Viral testing (591 of 768 [77%]) and CXR (507 of 768 [66%]) were obtained most frequently. CONCLUSIONS: The rate of antibiotic use in bronchiolitis was low across networks and was associated with CXR, fever, and apnea. Nonindicated testing was common outside of the United Kingdom and Ireland and varied across networks irrespective of patient characteristics. [ABSTRACT FROM AUTHOR]

Research collaboration is promoted by governments and research funders, but if the relative prevalence and merits of collaboration vary internationally then different national and disciplinary strategies may be needed to promote it. This study compares the team size and field normalized citation impact of research across all 27 Scopus broad fields in the 10 countries with the most journal articles indexed in Scopus 2008–2012. The results show that team size varies substantially by discipline and country, with Japan (4.2) having two‐thirds more authors per article than the United Kingdom (2.5). Solo authorship is rare in China (4%) but common in the United Kingdom (27%). While increasing team size associates with higher citation impact in almost all countries and fields, this association is much weaker in China than elsewhere. There are also field differences in the association between citation impact and collaboration. For example, larger team sizes in the Business, Management & Accounting category do not seem to associate with greater research impact, and for China and India, solo authorship associates with higher citation impact in this field. Overall, there are substantial international and field differences in the extent to which researchers collaborate and the extent to which collaboration associates with higher citation impact. [ABSTRACT FROM AUTHOR]

Efforts to combat continuing gender inequalities in academia need to be informed by evidence about where differences occur. Citations are relevant as potential evidence in appointment and promotion decisions, but it is unclear whether there have been historical gender differences in average citation impact that might explain the current shortfall of senior female academics. This study investigates the evolution of gender differences in citation impact 1996–2018 for six million articles from seven large English‐speaking nations: Australia, Canada, Ireland, Jamaica, New Zealand, UK, and the USA. The results show that a small female citation advantage has been the norm over time for all these countries except the USA, where there has been no practical difference. The female citation advantage is largest, and statistically significant in most years, for Australia and the UK. This suggests that any academic bias against citing female‐authored research cannot explain current employment inequalities. Nevertheless, comparisons using recent citation data, or avoiding it altogether, during appointments or promotion may disadvantage females in some countries by underestimating the likely greater impact of their work, especially in the long term. [ABSTRACT FROM AUTHOR]