Social cohesion, mental wellbeing and health-related quality of life among a cohort of social housing residents in Cornwall: a cross sectional study

Background: Research and policy have identified social cohesion as a potentially modifiable determinant of health and wellbeing that could contribute to more sustainable development. However, the function of social cohesion appears to vary between communities. The aim of this study was to analyse the levels of, and associations, between social cohesion, mental wellbeing, and physical and mental health-related quality of life among a cohort of social housing residents from low socioeconomic status communities in Cornwall, UK. Social housing is below market-rate rental accommodation made available to those in certain health or economic circumstances. These circumstances may impact on the form and function of social cohesion. Methods: During recruitment, participants in the Smartline project completed the Short Warwick-Edinburgh Mental Wellbeing Scale, SF-12v2 and an eight item social cohesion scale. Cross sectional regression analyses of these data adjusted for gender, age, national identity, area socioeconomic status, rurality, education, employment, and household size were undertaken to address the study aim. Results: Complete data were available from 305 (92.7%) participants in the Smartline project. Univariable analyses identified a significant association between social cohesion, mental wellbeing and mental health-related quality of life. Within fully adjusted multivariable models, social cohesion only remained significantly associated with mental wellbeing. Sensitivity analyses additionally adjusting for ethnicity and duration of residence, where there was greater missing data, did not alter the findings. Conclusions: Among a relatively homogeneous cohort, the reported level of social cohesion was only found to be significantly associated with higher mental wellbeing, not physical or mental health-related quality of life. The efforts made by social housing providers to offer social opportunities to all their residents regardless of individual physical or mental health state may support the development of a certain degree of social cohesion. Sense of control or safety in communities may be more critical to health than social cohesion. Additional observational research is needed before attempts are made to alter social cohesion to improve health.This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.The Smartline project is receiving up to £4,188,318 of funding from the England European Regional Development Fund as part of the European Structural and Investment Funds Growth Programme 2014–2020. The Ministry of Housing, Communities and Local Government (and in London the intermediate body Greater London Authority) is the Managing Authority for European Regional Development Fund. Established by the European Union, the European Regional Development Fund helps local areas stimulate their economic development by investing in projects which will support innovation, businesses, create jobs and local community regenerations. For more information visit https://www.gov.uk/european-growth-funding. Additional funding is from the South West Academic Health Science Network. KW is supported by the National Institute for Health Research Applied Research Collaboration South West Peninsula. KMa was funded by a National Institute for Health Research (NIHR) Knowledge Mobilisation Research Fellowship and ESRC Smartline Project for this research. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. The funders did not contribute to the design of the study or collection, analysis, and interpretation of data or in writing the manuscript in any way.published version, accepted versio

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

About being in the middle: Conceptions, models and theories of centrality in urban studies.

The (dis)advantages accrued by centrality, by being in the middle, is a pivotal causal mechanism explaining the existence of cities and inter-city relations. This chapter introduces classical theories of centrality and elaborates some of the theoretical controversies surrounding them. Four theories are discussed: The von Thünen-Alonso land use theory, Christaller's variety of central place theory, developmental and critical renderings of centre- periphery theory, and urban networks theory. Although antecedents are often much older, these foundational theories developed strongly in the 1950 and 1960s as abstract models in relative space characteristic to that era. Such theories travel easily, but only provide crude pictures of the underlying geographic detail. Although abstract models have long been out of fashion in geography, this chapter argues that they can still make important contributions to contemporary urban thinking. As the different centrality theories have often got tangled up and hybridised over time, their differences need to be disentangled first

About being in the middle: Conceptions, models and theories of centrality in urban studies.

The (dis)advantages accrued by centrality, by being in the middle, is a pivotal causal mechanism explaining the existence of cities and inter-city relations. This chapter introduces classical theories of centrality and elaborates some of the theoretical controversies surrounding them. Four theories are discussed: The von Thünen-Alonso land use theory, Christaller's variety of central place theory, developmental and critical renderings of centre- periphery theory, and urban networks theory. Although antecedents are often much older, these foundational theories developed strongly in the 1950 and 1960s as abstract models in relative space characteristic to that era. Such theories travel easily, but only provide crude pictures of the underlying geographic detail. Although abstract models have long been out of fashion in geography, this chapter argues that they can still make important contributions to contemporary urban thinking. As the different centrality theories have often got tangled up and hybridised over time, their differences need to be disentangled first

About being in the middle: Conceptions, models and theories of centrality in urban studies.

The (dis)advantages accrued by centrality, by being in the middle, is a pivotal causal mechanism explaining the existence of cities and inter-city relations. This chapter introduces classical theories of centrality and elaborates some of the theoretical controversies surrounding them. Four theories are discussed: The von Thünen-Alonso land use theory, Christaller's variety of central place theory, developmental and critical renderings of centre- periphery theory, and urban networks theory. Although antecedents are often much older, these foundational theories developed strongly in the 1950 and 1960s as abstract models in relative space characteristic to that era. Such theories travel easily, but only provide crude pictures of the underlying geographic detail. Although abstract models have long been out of fashion in geography, this chapter argues that they can still make important contributions to contemporary urban thinking. As the different centrality theories have often got tangled up and hybridised over time, their differences need to be disentangled first