Outcomes with ibrutinib in patients with chronic lymphocytic leukaemia: Results from the German multicentre REALITY study.

OBJECTIVES: To assess treatment adherence, effectiveness and safety outcomes of patients with chronic lymphocytic leukaemia (CLL) receiving ibrutinib in a real-world setting. METHODS: Patients enrolled in REALITY were ≥18 years with a confirmed diagnosis of CLL and were receiving ibrutinib as a first-line (1L), 2L or ≥3L therapy. Treatment retention, adherence, progression-free survival (PFS), overall survival (OS) and time to next therapy were assessed at 1 and 2 years overall, by typology and by cytogenetic subgroups. PFS and OS were analysed using Kaplan-Meier methods. RESULTS: Exactly 302 patients were enrolled across 57 sites in Germany, from January 2017 to July 2021. One-year retention rates were 69.9% overall (primary endpoint), 77.9% for 1L patients, and 77.6%/78.8% for high-risk patients with del17p/TP53. At 2 years, PFS/OS rates were 77.8%/90.7% overall (1L, 82.7%/90.4%), and were consistent across cytogenetic subgroups. PFS rates were higher for 1L versus ≥3L patients. Patients with the low-acceptance/low-control typology at baseline were less likely to retain treatment at 1 year versus the high-acceptance/high-control typology. No new safety signals were observed. CONCLUSIONS: The REALITY study provides further evidence of the effectiveness and safety of ibrutinib in patients with CLL in a real-world setting, particularly in earlier treatment lines.

Harm reduction strategies for cannabis-related problems: a literature review and typology.

Measures that seek to minimise the health and social consequences of substance use are an integral part of national drug strategies in many European countries. Against the backdrop of a high prevalence of cannabis use in the economically advanced countries, and increasing demand for treatment for cannabis-related problems, a range of harm reduction measures have been implemented by peers, statutory bodies and third-sector organisations. Based on a systematic review of the literature, the author describes these different forms of intervention, identifies innovative strategies and presents a simple typology that can be used when exploring existing measures or seeking to develop new policies. This typology covers different kinds of legal, socio-organisational and health-related interventions. All study designs were eligible for inclusion, with the exception of case reports, non-systematic reviews, editorials and news stories. Studies had to be published between 2011 and 2022, in English, and they had to refer to Europe, the Americas, Australia or New Zealand. A two-concept search was implemented using Embase.com and a number of other databases, combined with citation searches and manual website searching to improve coverage of research reports and advocacy documents. A total of 35 documents were deemed eligible, many of which rely on qualitative research methods.

Developing a typology of interventions to support doctors' mental health and wellbeing.

BACKGROUND: The problem of mental ill-health in doctors is complex, accentuated by the COVID-19 pandemic, and impacts on healthcare provision and broader organisational performance. There are many interventions to address the problem but currently no systematic way to categorise them, which makes it hard to describe and compare interventions. As a result, implementation tends to be unfocussed and fall short of the standards developed for implementing complex healthcare interventions. This study aims to develop: 1) a conceptual typology of workplace mental health and wellbeing interventions and 2) a mapping tool to apply the typology within research and practice. METHODS: Typology development was based on iterative cycles of analysis of published and in-practice interventions, incorporation of relevant theories and frameworks, and team and stakeholder group discussions. RESULTS: The newly developed typology and mapping tool enable interventions to be conceptualised and/or mapped into different categories, for example whether they are designed to be largely preventative (by either improving the workplace or increasing personal resources) or to resolve problems after they have arisen. Interventions may be mapped across more than one category to reflect the nuance and complexity in many mental health and wellbeing interventions. Mapping of interventions indicated that most publications have not clarified their underlying assumptions about what causes outcomes or the theoretical basis for the intervention. CONCLUSION: The conceptual typology and mapping tool aims to raise the quality of future research and promote clear thinking about the nature and purpose of interventions, In doing so it aims to support future research and practice in planning interventions to improve the mental health and wellbeing of doctors.

The forms and meanings of grammatical markers support efficient communication.

Functionalist accounts of language suggest that forms are paired with meanings in ways that support efficient communication. Previous work on grammatical marking suggests that word forms have lengths that enable efficient production, and work on the semantic typology of the lexicon suggests that word meanings represent efficient partitions of semantic space. Here we establish a theoretical link between these two lines of work and present an information-theoretic analysis that captures how communicative pressures influence both form and meaning. We apply our approach to the grammatical features of number, tense, and evidentiality and show that the approach explains both which systems of feature values are attested across languages and the relative lengths of the forms for those feature values. Our approach shows that general information-theoretic principles can capture variation in both form and meaning across languages.

Journey for a cure: Illness narratives of obstetric fistula survivors in North Central Nigeria.

Obstetric fistula is a life transforming event resulting in embodied biographical disruption. Survivors suffer myriad long-term physical and emotional consequences. This paper is an account of a narrative inquiry, conducted with 15 fistula survivors in North-central, Nigeria, who described how their identities had been transformed by their condition. A narrative therapeutic approach, using Frank's 'chaos, restitution and quest' typology, was used to map their recovery narratives. 'Chaos', described by Frank as the opposite of restitution, dominated, with women losing hope of recovery. Women's shift towards 'restitution' began with treatment, but inadequate health-care access often delayed this process. In their quest narratives, women's life and identify changes enabled them to derive meaning from their experience of obstetric fistula within the context of their own lives. The findings highlight socio-structural factors raising the risk of obstetric fistula, which in turn causes biographical disruption and hampers sufferers' treatment and recovery. Rehabilitation should include income-generating skills to bring succour to survivors, particularly those whose incontinence persists after repairs.

A Typology of Social Media Use by Human Service Nonprofits: Mixed Methods Study.

BACKGROUND: Nonprofit organizations are increasingly using social media to improve their communication strategies with the broader population. However, within the domain of human service nonprofits, there is hesitancy to fully use social media tools, and there is limited scope among organizational personnel in applying their potential beyond self-promotion and service advertisement. There is a pressing need for greater conceptual clarity to support education and training on the varied reasons for using social media to increase organizational outcomes. OBJECTIVE: This study leverages the potential of Twitter (subsequently rebranded as X [X Corp]) to examine the online communication content within a sample (n=133) of nonprofit sexual assault (SA) centers in Canada. To achieve this, we developed a typology using a qualitative and supervised machine learning model for the automatic classification of tweets posted by these centers. METHODS: Using a mixed methods approach that combines machine learning and qualitative analysis, we manually coded 10,809 tweets from 133 SA centers in Canada, spanning the period from March 2009 to March 2023. These manually labeled tweets were used as the training data set for the supervised machine learning process, which allowed us to classify 286,551 organizational tweets. The classification model based on supervised machine learning yielded satisfactory results, prompting the use of unsupervised machine learning to classify the topics within each thematic category and identify latent topics. The qualitative thematic analysis, in combination with topic modeling, provided a contextual understanding of each theme. Sentiment analysis was conducted to reveal the emotions conveyed in the tweets. We conducted validation of the model with 2 independent data sets. RESULTS: Manual annotation of 10,809 tweets identified seven thematic categories: (1) community engagement, (2) organization administration, (3) public awareness, (4) political advocacy, (5) support for others, (6) partnerships, and (7) appreciation. Organization administration was the most frequent segment, and political advocacy and partnerships were the smallest segments. The supervised machine learning model achieved an accuracy of 63.4% in classifying tweets. The sentiment analysis revealed a prevalence of neutral sentiment across all categories. The emotion analysis indicated that fear was predominant, whereas joy was associated with the partnership and appreciation tweets. Topic modeling identified distinct themes within each category, providing valuable insights into the prevalent discussions surrounding SA and related issues. CONCLUSIONS: This research contributes an original theoretical model that sheds light on how human service nonprofits use social media to achieve their online organizational communication objectives across 7 thematic categories. The study advances our comprehension of social media use by nonprofits, presenting a comprehensive typology that captures the diverse communication objectives and contents of these organizations, which provide content to expand training and education for nonprofit leaders to connect and engage with the public, policy experts, other organizations, and potential service users.

Identifying victim types in sexual homicide: A latent class analysis using interactional victimology theories.

Sexual homicide (SH) research has focused on those who commit these crimes and the crimes themselves. This leaves the victim, an equally crucial piece to the puzzle, left as a sort of afterthought, despite the valuable insight that victimology provides to the crime. For the current study, victim information related to their routine activities and lifestyles was taken from an international database containing 662 solved cases of SH. Nine victim variables were used in a latent class analysis to find hidden subgroups within the victim population. Three classes were identified-low-risk, homebody, and overt risk victims-which suggests that SH victimization varies depending on the victim lifestyles and routine activities. These groups were externally validated by examining their association with different phases of the crime commission process. Some sexual homicide offenders may be more drawn to a victim because they present as vulnerable and opportunistic, while others might be methodically targeted. The theoretical relevance of this typology, along with investigative and prevention strategies, is discussed.

Superhomicide offenders: Nosology, empirical features, and linkages to sexual and multiple murder typologies.

The nosology for criminals who murder multiple victims is at once well-established and controversial, perhaps because theorists have largely segregated such offenders from the broader criminal population. The current study introduces the superhomicide offender, an individual convicted of at least five murders, to locate multiple homicide offenders within the criminological and epidemiological science pertaining to the most pathological offenders, and statistically place them with other conceptualizations of severe offenders at the 95th percentile of the offending distribution. Relative to other capital murderers, superhomicide offenders have lengthier criminal history, greater conviction history, and coextensive psychopathology characterized by psychopathy, sexual sadism, homicidal ideation, cluster A and B personality disorders, and major depressive disorder. Superhomicide offenders are profoundly psychopathic with 20 of the 39 offenders reaching the clinical threshold of 30 or more on the PCL-R, and 19 of the 39 are sexually sadistic. Regarding extant typologies of sexual and multiple homicide offenders, 15 are serial murderers, 17 are sexual homicide offenders, 17 are mass murderers, and 17 are spree murderers. Twenty-four of the 39 superhomicide offenders (61.5%) met criteria for multiple typologies, suggesting the new prototype can help unify the study of those who perpetrate multicide and embed them within criminological and epidemiological models that specify pathological antisocial outcomes.

Boundary of ecosystem services: Differentiating between ecosystem services and geosystem services is needed.

Geosystem services (GSs) and ecosystem services (ESs) are interconnected, both representing nature's contributions to people. Whether GSs are a subset of ESs depends on the definition of ESs. The answer would be "not necessarily" (i.e., some GSs are, while other GSs are not), if ESs are the benefits humans derive from ecological functions, processes, or characteristics. The boundary proposed by Chen et al. (2023) to differentiate ESs from other ecosystem-related benefits adopted this definition, and suggested that ESs are renewable and affected by biotic elements to occur. Gray et al. (2024) criticized this boundary for separating out bits of nature and ignoring the contributions of GSs and abiotic elements to ESs and human wellbeing. In fact, highlighting that ESs are affected by biotic elements to occur does not deny that ESs' occurrence is also affected by abiotic elements. However, ESs' dependence on abiotic elements cannot be a criterion to differentiate ESs from other benefits because abiotic elements are integral to geosystems, ecosystems, and many other natural and artificial systems, as well as to these systems' services. Conversely, while geosystems might persist without biotic elements, ecosystems cannot. Chen et al. (2023) only excluded those (not the whole) abiotic benefits, such as wind energy, that may occur independently of biotic elements, while allowing for integrating certain GSs into ESs. For example, geological structures can offer flood protection and water storage as GSs, which can also be classified as ESs when their qualities or quantities are affected by biotic elements. Differentiation between GSs and ESs should not be misinterpreted as splitting their interconnections or undervaluing or dividing nature. Instead, such differentiation and classification of nature's benefits serve to facilitate communication, management, education, research, and policy-making associated with nature's benefits, while also highlighting the richness and diversity of nature's benefits.

The Influence of Race on Detected and Undetected Sexual Offense Histories: A Comparison of White and Black Men Committed as Sexually Violent Persons.

Understanding the difference between the proportion of sexual offenses that are officially detected versus the total number of sexual crimes that occur has been of interest to decision makers for some time. Previous studies have not considered possible racial differences. More aggressive responses by police and the criminal justice system as well as cultural differences in victim type/reporting rates may result in differences between detection rates of Black versus White men. In the current study (N = 190), we examined the difference between Black (n = 51) and White (n = 139) men committed to a forensic hospital as a Sexually Violent Person on factors that could impact the detected rate. Overall, we found that White men had significantly more total victims, undetected victims, undetected and detected child victims, total male victims, undetected male victims, undetected acquaintance victims, and total (detected and undetected) acquaintance victims than Black men. Black men had significantly more detected adult victims, but this difference did not remain when accounting for undetected victims. We explore reasons for these differences as well as provide recommendations for practice.

Decoding healthcare teamwork: a typology of hospital teams.

The effectiveness of healthcare depends on successful teamwork. Current understanding of teamwork in healthcare is limited due to the complexity of the context, variety of team structures, and unique demands of healthcare work. This qualitative study aimed to identify different types of healthcare teams based on their structure, membership, and function. The study used an ethnographic approach to observe five teams in an English hospital. Data were analyzed using a combined inductive-deductive approach based on the Temporal Observational Analysis of Teamwork framework. A typology was developed, consisting of five team types: structural, hybrid, satellite, responsive, and coordinating. Teams were challenged to varying degrees with staffing, membership instability, equipment shortages, and other elements of the healthcare environment. Teams varied in their ability to respond to these challenges depending on their characteristics, such as their teamworking style, location, and membership. The typology developed in this study can help healthcare organizations to better understand and design effective teams for different healthcare contexts. It can also guide future research on healthcare teams and provide a framework for comparing teams across settings. To improve teamwork, healthcare organizations should consider the unique needs of different team types and design effective training programs accordingly.

Understanding change - developing a typology of therapy outcomes from the experience of adolescents with depression.

Outcome measures mostly focusing on symptom reduction to measure change cannot indicate whether any personally meaningful change has occurred. There is a need to broaden the current understanding of outcomes for adolescent depression and identify whether holistic, interlinked patterns of change may be more clinically meaningful.To create a typology of therapy outcomes based on the experiences of adolescents with depression.Interview data from 83 participants from a clinical trial of the psychological treatment of adolescent depression was analysed using ideal type analysis.Six ideal types were constructed, reflecting different evaluations of the holistic impact of therapy: "I've worked on my relationships", "With the insight from therapy, and feeling validated, I can cope with life challenges better", "My mood still goes up and down", "If I want things to change, I need to help myself", "Therapy might help, but it hasn't been enough", and "I don't feel therapy has helped me".Assessing change using outcome measures may not reflect the interconnected experience for adolescents or the contextual meaning of symptom change. The typology developed offers a way of considering the impact of therapy, taking into account how symptom change is experienced within a broader perspective.

Linguacultural and Cognitive Peculiarities of Linguistic Universals.

The discussion about linguistic universals, initiated over 50 years ago by J. Greenberg, remains a topic of significant interest today. While there's an ongoing debate on the universality of linguistic forms - with some supporting the notion and others dismissing it as baseless-the idea of a unifying linguistic essence stands firm. The article aims to explore the linguacultural values of language, particularly how they enable the reconstruction of ideas and stereotypes within specific segments of a language system. The research found that universal language characteristics serve as a rich source of information for those studying linguacultural aspects. These traits offer nationally determined interpretations of words, drawing from associations rooted in either tangible or cultural codes. When delving into cultural codes present within every culture, the study discerned the presence of basic and universal codes. The existence of these codes provides insights into the formation of stereotypes, which encapsulate the experiences and knowledge intrinsic to the bearers of a culture. Linguistic universals, underpinned by universal grammar and semantic foundations, occupy a central position in linguacultural examinations, especially when reconstructing cultural ideas and stereotypes. Basic and universal cultural codes inherent in each culture facilitate the creation of linguistic worldviews.

Informal Caregiver Social Network Types and Mental Health: The Mediating Role of Psychological Resilience.

Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends.

Informal caregiver social network typologies were explored using data from Singapore.Diverse, friend, family, and restricted social network types were identified.Diverse social network type was negatively associated with depressive symptoms.Psychological resilience fully mediated the association.

Using Two-Step Cluster Analysis and Latent Class Analysis to Construct a Typology of Internet Users Among Community-Dwelling Older People.

This study utilizes data, spanning 2016-2021, from the Belgian Ageing Studies and presents a typology of older internet users based on nine internet activities. Two-step Cluster Analysis and Latent Class Analysis revealed three groups: (1) "Basic users" primarily engage in information search and mailing, (2) "Allrounders" participate in nearly all internet activities and (3) "Selective users" are intermediary, predominantly using the internet for information search, mailing, e-banking and communication with (grand)children. These clusters varied in sociodemographic characteristics, with "Allrounders" being younger, more educated, wealthier and predominantly male, compared to "Selective users" and "Basic users," respectively.

Can muscle typology explain the inter-individual variability in resistance training adaptations?

Considerable inter-individual heterogeneity exists in the muscular adaptations to resistance training. It has been proposed that fast-twitch fibres are more sensitive to hypertrophic stimuli and thus that variation in muscle fibre type composition is a contributing factor to the magnitude of training response. This study investigated if the inter-individual variability in resistance training adaptations is determined by muscle typology and if the most appropriate weekly training frequency depends on muscle typology. In strength-training novices, 11 slow (ST) and 10 fast typology (FT) individuals were selected by measuring muscle carnosine with proton magnetic resonance spectroscopy. Participants trained both upper arm and leg muscles to failure at 60% of one-repetition maximum (1RM) for 10 weeks, whereby one arm and leg trained 3×/week and the contralateral arm and leg 2×/week. Muscle volume (MRI-based 3D segmentation), maximal dynamic strength (1RM) and fibre type-specific cross-sectional area (vastus lateralis biopsies) were evaluated. The training response for total muscle volume (+3 to +14%), fibre size (-19 to +22%) and strength (+17 to +47%) showed considerable inter-individual variability, but these could not be attributed to differences in muscle typology. However, ST individuals performed a significantly higher training volume to gain these similar adaptations than FT individuals. The limb that trained 3×/week had generally more pronounced hypertrophy than the limb that trained 2×/week, and there was no interaction with muscle typology. In conclusion, muscle typology cannot explain the high variability in resistance training adaptations when training is performed to failure at 60% of 1RM. KEY POINTS: This study investigated the influence of muscle typology (muscle fibre type composition) on the variability in resistance training adaptations and on its role in the individualization of resistance training frequency. We demonstrate that an individual's muscle typology cannot explain the inter-individual variability in resistance training-induced increases in muscle volume, maximal dynamic strength and fibre cross-sectional area when repetitions are performed to failure. Importantly, slow typology individuals performed a significantly higher training volume to obtain similar adaptations compared to fast typology individuals. Muscle typology does not determine the most appropriate resistance training frequency. However, regardless of muscle typology, an additional weekly training (3×/week vs. 2×/week) increases muscle hypertrophy but not maximal dynamic strength. These findings expand on our understanding of the underlying mechanisms for the large inter-individual variability in resistance training adaptations.

Abundance trends for river macroinvertebrates vary across taxa, trophic group and river typology.

There is mounting evidence that terrestrial arthropods are declining rapidly in many areas of the world. It is unclear whether freshwater invertebrates, which are key providers of ecosystem services, are also declining. We addressed this question by analysing a long-term dataset of macroinvertebrate abundance collected from 2002 to 2019 across 5009 sampling sites in English rivers. Patterns varied markedly across taxonomic groups. Within trophic groups we detected increases in the abundance of carnivores by 19% and herbivores by 14.8%, while we estimated decomposers have declined by 21.7% in abundance since 2002. We also found heterogeneity in trends across rivers belonging to different typologies based on geological dominance and catchment altitude, with organic lowland rivers having generally higher rates of increase in abundance across taxa and trophic groups, with siliceous lowland rivers having the most declines. Our results reveal a complex picture of change in freshwater macroinvertebrate abundance between taxonomic groups, trophic levels and river typologies. Our analysis helps with identifying priority regions for action on potential environmental stressors where we discover macroinvertebrate abundance declines.

External validity of the reduced Morningness-Eveningness Questionnaire for Children and Adolescents: an actigraphic study.

The aim of this study was to examine the external validity of the reduced Morningness-Eveningness Questionnaires for Children and Adolescents, using circadian motor activity, assessed through actigraphy, as an external criterion. Overall, 458 participants (269 females), with a mean (standard deviation) age of 15.75 (1.16) years, took part in this study. Each adolescent was requested to wear the actigraph Micro Motionlogger Watch actigraph (Ambulatory Monitoring, Inc., Ardlsey, NY, USA) around the non-dominant wrist for 1 week. At the end of the actigraphic recording, participants completed the reduced Morningness-Eveningness Questionnaires for Children and Adolescents. We extracted the motor activity counts, minute-by-minute over the 24 h, to depict the 24-h motor activity pattern, and we adopted the statistical framework of functional linear modelling to examine its changes according to chronotype. According to the reduced Morningness-Eveningness Questionnaires for Children and Adolescents cut-off scores, 13.97% of participants (n = 64) belonged to the evening-types category, 9.39% (n = 43) to morning-types, while the remaining (76.64%, n = 351) to the intermediate-types category. Evening types moved significantly more than the intermediate and morning types from around 10:00 p.m. to 2:00 a.m., while the opposite pattern of results was observed around 4:00 a.m. The results highlighted a significant difference in the 24-h motor activity pattern between chronotypes, in line with the expectations based on their well-known behaviour. Therefore, this study shows that the external validity of the reduced Morningness-Eveningness Questionnaire for Children and Adolescents, established by considering motor activity (recorded through actigraphy) as an external criterion, is satisfactory.

Time and change: a typology for presenting research findings in qualitative longitudinal research.

BACKGROUND: Qualitative longitudinal research (QLR) is an emerging methodology used in health research. The method literature states that the change in a phenomenon through time should be the focus of any QLR study, but in empirical studies, the analysis of changes through time is often poorly described, and the emphasis on time/change in the findings varies greatly. This inconsistency might depend on limitations in the existing method literature in terms of describing how QLR studies can present findings. The aim of this study was to develop and describe a typology of alternative approaches for integrating time and/or change in QLR findings. METHODS: In this method study, we used an adapted scoping review design. Articles were identified using EBSCOhost. In total, methods and results sections from 299 QLR articles in the field of health research were analyzed with inspiration from content analysis. RESULTS: We constructed a typology of three types and seven subtypes. The types were based on the underlying structural principles of how time/change was presented: Type A) Findings have a low utilization of longitudinal data, Type B) Findings are structured according to chronological time, and Type C) Findings focus on changes through time. These types differed in 1) the way the main focus was on time, change or neither; 2) the level of interpretation in the findings; and 3) how theoretical understandings of time/change were articulated in the articles. Each type encompassed two or three subtypes that represented distinct approaches to the aim and results presentation of QLR findings. CONCLUSIONS: This method study is the first to describe a coherent and comprehensive typology of alternative approaches for integrating time/change into QLR findings in health research. By providing examples of various subtypes that can be used for results presentations, it can help researchers make informed decisions suitable to their research intent.

Assessing Engagement of Adolescents and Young Adults (AYA) in HIV Research: A Multi-method Analysis of a Crowdsourcing Open Call and Typology of AYA Engagement in Sub-Saharan Africa.

Engagement of adolescents and young adults (AYA) in HIV research is increasing in many settings. We organized a crowdsourcing open call to solicit examples of how AYA have been engaged in HIV research in Africa and to develop an engagement typology. We formed a steering committee, promoted the open call, organized judging and recognized finalists. We used a multi-methods approach to identify emerging themes and measure engagement. We received 95 entries from individuals in 15 countries; 74 met the eligibility criteria. More than three-quarters of entries were from AYA (55/74, 74%). Four themes characterized AYA engagement: (1) AYA were co-creators in the HIV research process. (2) AYA were involved in community-level capacity building. (3) AYA were co-leaders in minor risk research. (4) AYA used digital methods to enhance engagement. Our open call identified diverse methods of AYA engagement, which can enhance strategies used to reach AYA in African HIV studies.