A History of Cluster Analysis Using the Classification Society's Bibliography Over Four Decades

The Classification Literature Automated Search Service, an annual bibliography based on citation of one or more of a set of around 80 book or journal publications, ran from 1972 to 2012. We analyze here the years 1994 to 2011. The Classification Society's Service, as it was termed, has been produced by the Classification Society. In earlier decades it was distributed as a diskette or CD with the Journal of Classification. Among our findings are the following: an enormous increase in scholarly production post approximately 2000; a very major increase in quantity, coupled with work in different disciplines, from approximately 2004; and a major shift also from cluster analysis in earlier times having mathematics and psychology as disciplines of the journals published in, and affiliations of authors, contrasted with, in more recent times, a "centre of gravity" in management and engineering.Comment: 23 pages, 9 figure

Time to improve informed consent for dialysis: an international perspective

The literature reveals that current nephrology practice in obtaining informed consent for dialysis falls short of ethical and legal requirements. Meeting these requirements represents a significant challenge, especially because the benefits and risks of dialysis have shifted significantly with the growing number of older, comorbid patients. The importance of informed consent for dialysis is heightened by several concerns, including: (1) the proportion of predialysis patients and patients on dialysis who lack capacity in decision making and (2) whether older, comorbid, and frail patients understand their poor prognosis and the full implications to their independence and functional status of being on dialysis. This article outlines the ethical and legal requirements for a valid informed consent to dialysis: (1) the patient was competent, (2) the consent was made voluntarily, and (3) the patient was given sufficient information in an understandable manner to make the decision. It then considers the application of these requirements to practice across different countries. In the process of informed consent, the law requires a discussion by the physician of the material risks associated with dialysis and alternative options. We argue that, legally and ethically, this discussion should include both the anticipated trajectory of the illness and the effect on the life of the patient with particular regard to the outcomes most important to the individual. In addition, a discussion should occur about the option of a conservative, nondialysis pathway. These requirements ensure that the ethical principle of respect for patient autonomy is honored in the context of dialysis. Nephrologists need to be open to, comfortable with, and skillful in communicating this information. From these clear, open, ethically, and legally valid consent discussions, a significant dividend will hopefully flow for patients, families, and nephrologists alike

Unlocking Thesis Data through persistent identifiers: what next?

7-minute presentation made at RepoFringe 2016 as part of the 24x7 "Making a Difference with Data" session. Contributors: Stephen Grace (London South Bank University), John Murtagh (London School of Hygiene and Tropical Medicine), Sara Gould and Rachael Kotarski (both of the British Library) and Michael Whitton (University of Southampton)

Implementing person-centred outcome measures in palliative care: An exploratory qualitative study using Normalisation Process Theory to understand processes and context

© The Author(s) 2020. Background: Despite evidence demonstrating the utility of using Person-Centred Outcome Measures within palliative care settings, implementing them into routine practice is challenging. Most research has described barriers to, without explaining the causal mechanisms underpinning, implementation. Implementation theories explain how, why, and in which contexts specific relationships between barriers/enablers might improve implementation effectiveness but have rarely been used in palliative care outcomes research. Aim: To use Normalisation Process Theory to understand and explain the causal mechanisms that underpin successful implementation of Person-Centred Outcome Measures within palliative care. Design: Exploratory qualitative study. Data collected through semi-structured interviews and analysed using a Framework approach. Setting/participants: 63 healthcare professionals, across 11 specialist palliative care services, were purposefully sampled by role, experience, seniority, and settings (inpatient, outpatient/day therapy, home-based/community). Results: Seven main themes were developed, representing the causal mechanisms and relationships underpinning successful implementation of outcome measures into routine practice. Themes were: Subjectivity of measures; Frequency and version of Integrated Palliative care Outcome Scale; Training, education, and peer support; Building and sustaining community engagement; Electronic system readiness; The art of communication; Reinforcing use through demonstrating value. Conclusions: Relationships influencing implementation resided at individual and organisational levels. Addressing these factors is key to driving the implementation of outcome measures into routine practice so that those using palliative care services can benefit from the systematic identification, management, and measurement of their symptoms and concerns. We provide key questions that are essential for those implementing and using outcome measures to consider in order to facilitate the integration of outcome measures into routine palliative care practice

The ACS Fornax Cluster Survey VII. Half-Light Radii of Globular Clusters in Early-Type Galaxies

We measure the half-light radii of globular clusters (GCs) in 43 galaxies from the ACS Fornax Cluster Survey (ACSFCS). We use these data to extend previous work in which the environmental dependencies of the half-light radii of GCs in early type galaxies in the ACS Virgo Cluster Survey (ACSVCS) were studied, and a corrected mean half-light radius (corrected for the observed environmental trends) was suggested as a reliable distance indicator. This work both increases the sample size for the study of the environmental dependencies, and adds leverage to the study of the corrected half-light radius as a possible distance indicator (since Fornax lies at a larger distance than the Virgo cluster). We study the environmental dependencies of the size of GCs using both a Principal Component Analysis as well as 2D scaling relations. We largely confirm the environmental dependencies shown in Jordan et al. (2005), but find evidence that there is a residual correlation in the mean half-light radius of GC systems with galaxy magnitude, and subtle differences in the other correlations - so there may not be a universal correction for the half-light radii of lower luminosity galaxy GC systems. The main factor determining the size of a GC in an early type galaxy is the GC color. Red GCs have = 2.8+/-0.3 pc, while blue GCs have = 3.4+/-0.3 pc. We show that for bright early-type galaxies (M_B < -19 mag), the uncorrected mean half-light radius of the GC system is by itself an excellent distance indicator (with error ~11%), having the potential to reach cosmologically interesting distances in the era of high angular resolution adaptive optics on large optical telescopes.Comment: ApJ in press, 19 pages, 16 figures

Nurse-led advance care planning with older people who have end-stage kidney disease: feasibility of a deferred entry randomised controlled trial incorporating an economic evaluation and mixed methods process evaluation (ACReDiT)

© 2020, The Author(s). Background: Advance Care Planning is recommended for people with end-stage kidney disease but evidence is limited. Robust clinical trials are needed to investigate the impact of advance care planning in this population. There is little available data on cost-effectiveness to guide decision makers in allocating resources for advance care planning. Therefore we sought to determine the feasibility of a randomised controlled trial and to test methods for assessing cost-effectiveness. Methods: A deferred entry, randomised controlled feasibility trial, incorporating economic and process evaluations, with people with end-stage kidney disease, aged 65 years or older, receiving haemodialysis, in two renal haemodialysis units in Northern Ireland, UK. A nurse facilitator helped the patient make an advance care plan identifying: a surrogate decision-maker; what the participant would like to happen in the future; any advance decision to refuse treatment; preferred place of care at end-of-life. Results: Recruitment lasted 189 days; intervention and data collection 443 days. Of the 67 patients invited to participate 30 (45%) declined and 36 were randomised to immediate or deferred advance care plan groups. Twenty-two (61%) made an advance care plan and completed data collection at 12 weeks; 17 (47.2%) were able to identify a surrogate willing to be named in the advance care plan document. The intervention was well-received and encouraged end-of-life conversations, but did not succeed in helping patients to fully clarify their values or consider specific treatment choices. There was no significant difference in health system costs between the immediate and deferred groups. Conclusions: A trial of advance care planning with participants receiving haemodialysis is feasible and acceptable to patients, but challenging. A full trial would require a pool of potential participants five times larger than the number required to complete data collection at 3 months. Widening eligibility criteria to include younger (under 65 years of age) and less frail patients, together with special efforts to engage and retain surrogates may improve recruitment and retention. Traditional advance care planning outcomes may need to be supplemented with those that are defined by patients, helping them to participate with clinicians in making medical decisions. Trial registration: Registered December 16, 2015. ClinicalTrials.gov Identifier: NCT02631200