Background:This study aims to critically review, quantify, and assess research outcomes on brain-based learning with an evidence-based study on Scopus indexed literature, with a focus to understand the evolution structure and growth, detect trends, subject development, and most importantly, identify the gaps in the published body of literature that relates brain-based learning to design and visual arts education. Methods: Various scientometric tools were used to map, visualize, and analyze 186 research publications, indexed in Scopus in a twenty-year timespan ‘2001-2021’. Annual publication trends, relevant sources, prolific authors, authorship patterns, productive organizations and countries, funding agencies, keyword co-occurrence analysis, and thematic evolution mapping on brain-based learning publications were examined in this study. Results: Despite the significance to apply brain-based learning strategies in design and visual arts education to boost students’ knowledge and creative skills, the findings show a decline in quantities and growth patterns in brain-based learning research directed towards design disciplines in the past twenty years. Among the identified (186) documents published in (128) sources, with (1013) citations, the study detected only (57) research (30%) that were related to ‘design education,’ including those focusing on ‘instructional design, ‘and ‘syllabus design’ whereas only (3) articles were in ‘design and visual arts’ disciplines. Conclusion: These rather small numbers reflect the big gap in the current body of literature that associates brain-based learning with creativity-based disciplines, specifically in design and visual arts education. This infers the necessity to direct the attention of academics, researchers, and educationalists in the fields of design and arts towards brain-based learning applications, research and pedagogy. Brain-based learning (BBL) is perceived as a core theory; it represents a learning paradigm that takes a holistic approach, looking at teaching and learning developmentally, socio-culturally, and in other broader ways . It invoSeveral researchers examined the brain and its functions as ‘the primary learning organ.’ As a result, BBL emerged as one of the most effective learning methods, providing learners with excellent opportunities. According to the BBL theory, the brain’s plasticity  is maintained throughout life.A massive shift has been achieved in neuroscience during the last three decades; the discovery of neuroplasticity, ‘the brain’s ability to selectively modify itself in response to specific repeated actions and experiences,’ proved that the brain retains its flexibility throughout life . The wayThe last two decades witnessed several successful examples of practicing BBL at all levels of education in numerous subject areas. Academics from prominent universities worldwide have incorporated this knowledge in their classrooms and research, based explicitly on conclusions from neuroscience research .Disciplines that are based on creativity and visual creation, such as design and visual arts, may be served most by BBL methods and strategies.Learning design and art require exceptional capabilities and skills; students must manipulate knowledge, information, and experiences they gain, relate, connect and convert them into creative, aesthetical, and functional ideas and meaningful outcomes to solve a design problem. This manipulation is the core of creativity, and it takes varying lengths of time. It also requires concentration and effort, leaving the student emotionally involved and stressed.BBL can help design and visual art students understand how their brains work, think, and perceive; it can also facilitate the development of creative skills with reduced frustration . TherefoThe New, drawing on the Right Side of the Brain” (2002) is a brilliant approach to recent developments in brain-based research that relate to developing drawing skills. In addition, Gardner’s book “Art Education and Human Development” (1991) is another pioneering work that links art education with several brain capabilities.Very few studies were found that incorporated BBL principles into learning in the field of ‘Arts’ in general but not particularly in design and visual arts. For example, Betty Edwards from California State University and Howard Gardner from Harvard University are among the very few authors who incorporated BBL into the design and visual arts. Edwards’s book “A more recent pioneering study focusing on ‘Design’ applied BBL in studio-based design courses for three years, aiming to support, develop, and improve teaching strategies and learning processes . The stuDespite the relevance of BBL to design and arts education as creativity-inspired disciplines, there is a scarcity of published research that has made the proper connection between them. The necessity for more specialized studies and application of BBL in design and visual arts motivated the authors to perform a bibliometric analysis to identify the gaps, trends, subject development, and growth in the published body of literature on BBL in design, visual arts, and creativity-based subjects. Identifying such gaps will help direct more focused and applicable future research. Also, it has been found that no other scientometric studies conducted for BBL or on BBL in design, visual arts, and creativity-based subjects.1.To map and visualize Scopus-indexed BBL literature published in the past twenty years, using bibliometric methods and scientometric analysis tools to evaluate yearly research growth and trends, citation structure, topics of the most productive publication sources, prolific authors and their disciplines, authorship patterns, contributing organizations and countries, and collaborating funding bodies.2.To critically analyze patterns of progression and evolution of research in BBL according to their keywords, topics, themes, and titles in the studied time span.3.To detect the actual gaps and decline in BBL research in disciplines related to creativity, design, and visual arts based on the aforementioned analysis.Aiming to identify the gaps in the current body of literature that relates brain-based learning to creative subjects such as design and visual arts. This research, carries out the following objectives:Scopus,Web of Science,PubMed). The method used in this research presents the scientific landscape of annual growth trends, productive authors, actively participating countries, organizations, and collaborative contributors to the global scientific literature, with stress on investigating the evolution of themes and area topics studied in BBL research. Data was collected on 13th June 2021 at Imam Abdulrahman bin Faisal University in Dammam, Saudi Arabia, from theScopus database. The topics ‘design’ and ‘creativity’ were used in the initial search and then refined by the term ‘brain-based learning,’ this allowed the retrieval of records used in this study, the following search strategy was applied:The bibliometric method  was employed to assess the research performances of brain-based learning in terms of creativity-based subjects such as design and visual arts. Although this methodology of determining published research literature has been around for a long time, however, it became more prevalent with the introduction of large-scale bibliographic databases  OR TITLE-ABS-KEY (“Creativity”) AND (“brain-based learning”)For the topics ‘design’ and ‘creativity,’ 5,980,330 records were retrieved; when refined by ‘brain-based learning,’ only 186 documents were retrieved. Among the publications downloaded, 183 were in English, whereas other languages, such as Chinese, African, and French, had only one publication each. Since the number of publications was small, the authors individually reviewed each document to confirm that they were all linked to BBL and there was no duplication.Microsoft Excel, scientometric and bibliometric tools, such asBibexcel . The year 2019 recorded the highest in research outcomes , followed by 2020  2018 . The year 2021 recorded 11 publications with zero citations until 13Journal of physics: conference series (Q4) was acknowledged as the most relevant source for published BBL research with 22 publications and 17 citations, followed by theEuropean Journal of Social Sciences (Q4) and thenLecture Notes in Computer Science (Q3) with three publications each and 11, and 2 citations, respectively.International Journal of Advanced Computer Science and Applications (Q3),Journal on Mathematics Education (Q2),ACM International Conference Proceeding Series, andProcedia - Social and Behavioural Sciences with three publications each having 5, 26, 3, and 15 citations, respectively.Energy Education Science and Technology Part B: Social and Educational Studies,Journal of Cardiothoracic and Vascular Anesthesia andProceedings - IEEE Symposium on Computers and Communications came tenth in the top ten list with two publications each. Half of the leading sources belonged to the UK, followed by the USA (2), Germany, Indonesia, and Turkey each had only 1 source. It is observed from this result that none of the sources identified in the top ten for BBL research relate to design or visual arts specialties, so the authors had a closer look at all of the 186 publications, this revealed that most sources were within the fields of physics, computer science, education, behavioural sciences, etc., while there were only 3 sources that were directly related to design and visual arts studies and/or education, and they were not detected in the top ten results. This shows that there is a very slim opportunity for researchers to publish in platforms dedicated to this field which explains the extended literature gap in this area.The top ten sources of BBL research are listed inThe top ten most prolific authors of BBL research are listed inWhen looking at the specialties of authors with high citations, they happened to be specialized in the fields of engineering and technology education, neuroeducation, neuropsychological concepts, computer science, and medicine; these publications appear to have more acceptable and useable results. On the other hand, the low impact of authors specialized in design and visual arts education raises the question on why researchers, academics, and educationalists in design disciplines are not directed towards liking BBL to design education despite the significance of this topic and its high relevance to enhancing design students’ knowledge acquisition and creativity.The authorship pattern is visualized inThe top ten most beneficial organizations of BBL research are displayed inIndonesia was acknowledged as the most productive country in BBL research inVOSviewer software.The keywords set by authors in their published work are considered to be more precise and better express the research’s scope than those set by the publisher. The co-occurrences of authors’ keywords are assessed in this paper to identify BBL research trends; therefore, a minimum of two co-occurrences are considered; this is similar to the type of analysis done byThe authors’ keywords that appeared the most in the studied BBL research were; Brain-Based Learning, Education, Instructional Design, Learning, Creativity, Brain, Neuroscience, Achievement, Brain-Based Learning, and Collaborative Learning. Keywords are grouped in the following clusters:Cluster 1 consists of seven author keywords: Active Learning, Collaborative Learning, Critical Thinking, Flipped Classroom, Mathematics Education, Problem-Based Learning, and Students. The cluster’s most common (n = 4) author keywords are Collaborative Learning and Flipped Classrooms. This cluster represents themes of “Innovative Teaching and Learning Methods in Education”.Cluster 2 consists of seven author keywords: Brain, Constructivism, Design, EEG, Motivation, Neuroscience, and Visual Arts. The keywords Brain and Neuroscience were found to be the most occurring (five times each) author keywords in this group. The primary theme of this cluster is the “Intersection of Brain Science, Education, and Art”.Cluster 3 includes the five author keywords: Anxiety, Behaviors, Learning, Scaffolding, and Simulation. Learning (n=7) was found as a highly occurring author keyword in this group. Understanding and Supporting Learning in the Context of Anxiety and Behavior is the main theme of this cluster.Cluster 4 includes five author keywords: Achievement, Brain-Based Learning, Creative Thinking, Creativity, and Retention. Creativity (n=6) was noted as the highest occurring author keyword in this cluster. The main theme of this cluster is “Enhancing Achievement and Learning Through Brain-Based Strategies and Creativity”.Cluster 5 comprises four author keywords: Chemistry Education, Constructivist Learning Environment, Multimedia Learning Environment, and Scientific Thinking. All of the author’s keywords appeared at least twice in this cluster. “Promoting Effective and Engaging Science Education through Constructivist and Multimedia Learning Environments” is the main theme of this cluster.Cluster 6 consists of four author keywords: Co-Creation, Online Learning, Student Engagement, and Virtual Reality. Online learning appeared the most in this cluster (n=3). The theme of this cluster is “Enhancing Student Engagement and Collaboration in Online Learning through Co-Creation and Virtual Reality”.Cluster 7 includes four author keywords: Artificial Neural Networks, Face-To-Face Tutoring, Learning-Environment, and Mental Stimulation. All the chosen keywords appear at least twice. The cluster theme is “Exploring the Impact of Artificial Neural Networks and Learning Environments on Face-to-Face Tutoring and Mental Stimulation”.Cluster 8 includes the following keywords: education, game design, multiple intelligence, and serious games. Education (n=10) was pointed out as the most occurred author keyword in cluster 8. “Leveraging Game Design and Multiple Intelligence Theory in Education through Serious Games” is the main theme of this cluster.Cluster 9 consists of four author keywords: Brain-Based Learning, Elementary School, Serious Game, and Slow-Reading. The phrase Brain-based Learning (n = 14) highly appeared keyword in the cluster. The cluster deals with “Enhancing Elementary School Education through Brain-Based Learning, Serious Games, and Slow-Reading”.Cluster 10 includes the keywords: Instructional Design, Pedagogy, and Problem-Solving. Instructional design (n=8) was cluster’s highest-appearing keyword. “Effective Instructional Design and Pedagogy for Problem-Solving” is the theme of this cluster.The previous mapping shows that the authors’ keywords used to search for BBL research may not include the subject area related to brain-based learning, but rather they mostly include pedagogical aspects, teaching strategies, and instructional design. Searching for keywords such as Design and Visual arts may not yield many results; however, the keyword Neuroscience was found in the same cluster as Design and Visual Arts. The occurrences were very low, but there is a direct association between these fields researchers must relate to. Creativity and Creative thinking are keywords that find somewhat relevant literature related to design disciplines.For all keywords’ analysis, a minimum of four occurrences of all keywords were considered in this research; therefore, out of 1018 keywords, only 59 meet the thresholds. The total strength of the co-occurrence links with the other keywords was calculated for each of the 59 keywords, and the greatest total link strength was also calculated. Hence 59 keywords, 4 clusters, 527 links, and 1082 total link strength were observed. All 4 clusters were then differentiated into four different colours, as seen inCluster 1 comprises 20 keywords: article, controlled study, curriculum, female, human, human experiment, humans, learning, male, motivation, nursing student, online learning, priority journal, problem-based learning, scientist, simulation, skill, student, united states, and virtual reality. Among the 20 keywords, the most occurred keywords were human and article with 15 and 14 frequencies, respectively. “Exploring Learning and Skill Development in Online and Simulation-based Environments for Nursing Students in the United States” is the theme of this cluster.Cluster 2 consists of 14 keywords: achievement, brain, brain-based learning, brain-based learning, creative thinking, creativity, design, educational environment, learning achievement, learning process, learning systems, neuroscience, research, and scaffolds. Among the 14 keywords, the highest occurred keywords were brain-based learning and learning systems occurring 14 times each. The theme of this cluster is “Exploring the Relationship Between Brain-Based Learning, Creativity, and Achievement in Educational Environments”.Cluster 3 included 13 keywords: control groups, critical thinking, critical thinking skills, education computing, junior high schools, learning models, physics, problem-solving, quasi-experiments, research and development, research methods, students, and surveys. The most occurred keywords in this group were students and education computing with 42 and 14 respectively. “Investigating the Impact of Educational Computing and Research Methods on Critical Thinking and Problem-Solving Skills in Junior High School Students” is the main theme of this cluster.Cluster 4 represented 12 keywords: active learning, collaborative learning, computer-aided instruction, curricula, e-learning, education, engineering education, flipped classroom, instructional design, learning environments, and teaching. Education and teaching were the most occurring keywords in this cluster, with 24 and 23 occurrences, respectively. “Exploring Effective Instructional Design and Learning Environments for Active and Collaborative Learning in Engineering Education” is the theme of this cluster.It is observed inA comparison between the highly accruing ‘all-keywords’ and ‘authors’ keywords’ are listed inThe thematic evolution analysis by topic was considered to investigate the stability, progression, and/or regression in BBL research topics. For this type of analysis, a topic-model unigram was developed from 250 words with a minimum cluster frequency (5), and a time slice (4) with cutting years for each slice: 2006, 2011, 2016, and 2020 respectively, seeThe unigram shows the most frequent topics, where it can be seen that the period 2001-2006 includes BBL research related merely to two topics which are ‘creativity’ and ‘learning’, these topics remain in the focus of BBL research until 2007. The development in the subject area can be noticed starting from 2007 up to 2012, where combinations of topics are noticed relating the initial titles ‘creativity’ and ‘learning’ to ‘students’ and ‘education’. While there are a number of emerging topics such as ‘solving-problems’, ‘constructivist’, ‘brain’ and ‘approach’ with consistent development. By 2012, research relating those topics to ‘approach’, ‘learning’, ‘teaching’, ‘education’ and ‘engineering’ were published.The topic ‘framework’ emerged during the period 2012-2016, which mostly contributed to the development of research related to the topic ‘design’ in 2017-2020. However, this does not relate directly to ‘design and creativity’ or ‘design and art’, but rather to educational frameworks, engineering and curricula design, as shown inMore interestingly, this unigram shows that several topics such as ‘thinking’, ‘designing’, ‘model’, ‘effect’ and ‘skills’ are not showing any relationship with the topic ‘design’, contrary to what may be assumed. The visualization also reveals that in 2017-2020, a few new topics have emerged, such as ‘thinking’, and ‘skills’, which are strongly related to ‘mathematics’ and ‘education’. It is also worth mentioning that the topic ‘visual arts’ is missing from the unigram, meaning its frequency was not detected. The thematic evolution analysis substantiates that there is decline in the development of BBL research relating to the topics of design, visual arts, creativity and design education.Using a games console in the primary classroom: Effects of ‘Brain Training’ programme on computation and self-esteem” by Miller, D.J. and Robertson, D. P. was the most cited publication with 81 citations, followed by “The practical and principled problems with educational neuroscience” by Bowers, J.S. with 70 citations (2016), “Participatory Action Research: creating an effective prevention curriculum for adolescents in the Southwestern US” byLinking Architecture and Education: Sustainable Design for Learning Environments” (2009) byA review of empirical evidence on scaffolding for science education” byVariables Affecting Learning in a Simulation Experience: A Mixed Methods Study” byThe practical and principled problems with educational neuroscience” .Data are available under the terms of the I am satisfied with the responses of the authors. No further suggestions from my side for revision.Are the rationale for, and objectives of, the Systematic Review clearly stated?PartlyIs the statistical analysis and its interpretation appropriate?YesAre sufficient details of the methods and analysis provided to allow replication by others?PartlyAre the conclusions drawn adequately supported by the results presented in the review?PartlyReviewer Expertise:Bibliometrics, Scientometrics, systematic review, library automationI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. The authors’ efforts have greatly improved the quality and clarity of the manuscript. The changes implemented have effectively addressed the reviewer's comments and strengthened the overall argument of the paper. The modifications made have enhanced the coherence of the arguments and provided a more comprehensive analysis of the topic. Thus making it worthy for indexing.Are the rationale for, and objectives of, the Systematic Review clearly stated?YesIs the statistical analysis and its interpretation appropriate?YesAre sufficient details of the methods and analysis provided to allow replication by others?YesAre the conclusions drawn adequately supported by the results presented in the review?PartlyReviewer Expertise:Bibliometric, Scientometric, quantitative analysis.I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. The topic chosen for the study is interesting, the purpose of the study is also clear, however, 1) Authors should have looked for previous scientometric studies for BBL for insight of the topic.  2) All the indices have covered but the language-wise research production is missing.  3) Authors should have correlate their results with other bibliometric and scientometric studies to justify the findings.  4) In keyword analyses  the selection of keywords for the analysis needs to write more clearly.Are the rationale for, and objectives of, the Systematic Review clearly stated?YesIs the statistical analysis and its interpretation appropriate?YesAre sufficient details of the methods and analysis provided to allow replication by others?YesAre the conclusions drawn adequately supported by the results presented in the review?PartlyReviewer Expertise:Bibliometric , Scientometric, quantitative analysis.I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. 1: Authors should have looked for previous scientometric studies for BBL for insight of the topic.  Reply: This study stands out as an original contribution, as no previous bibliometric study on this particular topic has been conducted to date. Extensive exploration of the existing literature has revealed no comparable research. Therefore, it is evident that this study is unquestionably novel and innovative. 2: All the indices have covered but the language-wise research production is missing.  Reply: Thank you for suggesting language wise production, we have provided details of language wise research in methodology part. 3: Authors should have correlate their results with other bibliometric and scientometric studies to justify the findings.  Reply:  Done as suggested in results section. 4: In keyword analyses  the selection of keywords for the analysis needs to write more clearly. Reply: Done as suggested. This paper presents a bibliometric study conducted on 186 documents. The researchers did not explain the motivation behind this study. How would the study be helpful for the relevant audience, and what is the study’s significance? The methodology has some flaws. I could not retrieve the same number of records by using the query mentioned in the methodology section. I have retrieved only 51 documents by using the query in different ways in the Scopus database. The researcher did not provide details about the irrelevant and duplicate documents. The researchers should compare the previous research with their findings.Are the rationale for, and objectives of, the Systematic Review clearly stated?PartlyIs the statistical analysis and its interpretation appropriate?YesAre sufficient details of the methods and analysis provided to allow replication by others?PartlyAre the conclusions drawn adequately supported by the results presented in the review?PartlyReviewer Expertise:Bibliometrics, Scientometrics, systematic review, library automationI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. The researchers did not explain the motivation behind this study.It is mentioned at the end of the introduction and conclusion. How would the study be helpful for the relevant audience, and what is the study’s significance?It is mentioned in the introduction and conclusion. The methodology has some flaws. I could not retrieve the same number of records by using the query mentioned in the methodology section. I have retrieved only 51 documents by using the query in different ways in the Scopus database.The error shows if the query copy and paste into the search as some unnecessary brackets appear, instead type the query in advance search which now showing 238 results as on 21/11/2022. The researcher did not provide details about the irrelevant and duplicate documents.It is mentioned below the search query. The researchers should compare the previous research with their findings.Unfortunately, there are no previous scientometric studies found on this topic, hence, it motivated researchers to conduct one. Brain-based learning seems a good topic to be explored using bibliometric analysis. However, I have major concerns about the method of this study that will reflect the whole paper as below: The following search: TITLE-ABS-KEY (“Design”) OR TITLE-ABS-KEY (“Creativity”) AND (“brain-based learning”) will only reveal all documents that have keywords design and creativity in TITLE-ABS-KEY and “brain-based learning” anywhere in the text. So, the results only show all documents that met these criteria and NOT the articles related to the topic of “brain-based learning”. The screening process seems to have not been conducted. Although Figure 1 shows the screening process, it is actually a filtering process and NOT a screening process. The authors should look one by one at the title of the document to make sure all the documents being analysed are really about “brain-based learning”. Based on the dataset, it seems many documents are NOT about the topic of the study "Brain-based learning in design and visual arts education". In other words, the documents being analysed are totally NOT about "Brain-based learning in design and visual arts education". The authors have to make sure that all the documents being analysed are really about the topic or at least related to the topic of the study. The screening and cleaning process should be conducted for each of the documents before the data is downloaded from the Scopus database. Any irrelevant documents should be removed in order to make sure that all documents are really about the topic of the study and not about something else. Due to this, I can say that all the analyses conducted are considered invalid. The authors should re-design the search query to only gathered the documents related to "brain-based learning".Are the rationale for, and objectives of, the Systematic Review clearly stated?PartlyIs the statistical analysis and its interpretation appropriate?Not applicableAre sufficient details of the methods and analysis provided to allow replication by others?NoAre the conclusions drawn adequately supported by the results presented in the review?NoReviewer Expertise:Bibliometric analysis.I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. The authors appreciate the reviewer for reviewing the study and valuable suggestions.  The authors have no issues re-designing the search query to gather the data; however, they disagree that all the analyses conducted are considered invalid since the authors ensured a closer look at each document and ensured that all the documents are related to BBL. The research observed that there is a decline in the development of BBL research which is related to the topics of design, visual arts, creativity, and design education, despite the fact that BBL methods are strongly beneficial to those fields and provide significant advantages to students learning awareness and performance especially for enhancing creative design skills (as identified in the literature review).The topics ‘design’ and ‘creativity’ were used in the initial search and then refined by the term ‘brain-based learning,’ this allowed the retrieval of records used in this study; the following search strategy was applied: (TITLE-ABS-KEY (“Design”) OR TITLE-ABS-KEY (“Creativity”) AND (“brain-based learning”) The research then conducts thematic analysis and identifies the topics of each research and finds that very few research apply BBL in design education specifically, and finally recommends educators and researchers to direct their attention to BBL pedagogical activities and funded action research to benefit from neurosciences research on how the brain learns. This will increase researcher in the field of design and visual arts education that utilizes BBL methods to enhance students' learning and to keep pace with the global challenges in education.   The research aimed to identify the gaps in the current literature that relates brain-based learning to creative subjects such as design and visual arts, in order to identify the nature of such research and its topics, a refined search strategy is conducted and shown on page 4: The following parts of the research describe this:  The abstract (p.1): Despite the significance to apply brain-based learning strategies in design and visual arts education to boost students’ knowledge and creative skills, the findings show a decline in quantities and growth patterns in brain-based learning research directed towards design disciplines in the past twenty years. These rather small numbers reflect the big gap in the current body of literature that associates brain-based learning with creativity-based disciplines, specifically in design and visual arts education. This infers the necessity to direct the attention of academics, researchers, and educationalists in the fields of design and arts towards brain-based learning applications, research, and pedagogy. Brain-based learning for creative disciplines (p.3) BBL can help design and visual art students understand how their brains work, think, and perceive; it can also facilitate the development of creative skills with reduced frustration . Therefore, BBL provides a biologically based framework for teaching and learning in the context of design and visual arts that explains to students the concepts behind learning; essentially learning how to learn. This meta-concept encompasses a diverse range of strategies that reduce the amount of stress in the classrooms and achieve educational goals easier and faster. Yet, educationalists, especially in the field of design and visual arts, have not fully utilized results from neuroscience studies into BBL methodologies. …… Despite the relevance of BBL to design and arts education as creativity-inspired disciplines, there is a scarcity of published research that has made the proper connection between them. A very few studies were found that incorporated BBL principles into learning in the field of ‘Arts’ in general but not particularly in design and visual arts. P.4 The necessity for more specialized studies and application of BBL in design and visual arts motived the authors to perform a bibliometric analysis to identify the gaps, trends, subject development, and growth in the published body of literature on BBL in design, visual arts, and creativity-based subjects. Identifying such gaps will help direct more focused and applicable future research.Research aim and objectives (p.4) Aiming to identify the gaps in the current literature that relates brain-based learning to creative subjects such as design and visual arts. MethodsData selection and method (p.4) The topics ‘design’ and ‘creativity’ were used in the initial search and then refined by the term ‘brain-based learning,’ this allowed the retrieval of records used in this study, the following search strategy was applied: (TITLE-ABS-KEY (“Design”) OR TITLE-ABS-KEY (“Creativity”) AND (“brain-based learning”)Productive sources (p.9) while there were only 3 sources that were directly related to design and visual arts studies and/or education, and they were not detected in the top ten results. This shows that there is a very slim opportunity for researchers to publish on platforms dedicated to this field which explains the extended literature gap in this area. Productive authors (p. 9) On the other hand, the low impact of authors specialized in design and visual arts education raises the question of why researchers, academics, and educationalists in design disciplines are not directed towards liking BBL to design education despite the significance of this topic and its high relevance to enhancing design students’ knowledge acquisition and creativity.Analysis of author keywords  P.12: Searching for keywords such as Design and Visual arts may not yield many results; however, the keyword Neuroscience was found in the same cluster as Design and Visual Arts. The occurrences were very low, but there is a direct association between these fields researchers must relate to. Creativity and Creative thinking are keywords that find somewhat relevant literature related to design disciplines.Thematic evaluation by topic P.13: More interestingly, this unigram shows that several topics such as ‘thinking’, ‘designing’, ‘model’, ‘effect’ and ‘skills’ are not showing any relationship with the topic ‘design’, contrary to what may be assumed. The visualization also reveals that in 2017-2020, a few new topics have emerged such as ‘thinking’, and ‘skills’ which are strongly related to ‘mathematics’ and ‘education’. It is also worth mentioning that the topic ‘visual arts’ is missing from the unigram, meaning its frequency was not detected. The thematic evolution analysis substantiates that there is a decline in the development of BBL research relating to the topics of design, visual arts, creativity, and design education.Conclusion P.18: This research identified the relevance of brain-based learning in the field of design and arts education as it carefully considers how the brain learns, especially in creativity-based subjects. However, the initial literature review indicated the absence of publications relating BBL pedagogical methodologies to design and visual arts education despite the associated relevance regarding these vital topics. …. A comparison of authors’ keywords with all keywords indicated that the subject approach of author keywords is direct, more precise, and relatable to the topic. However, the keywords that appeared the most in the studied publications mainly focused on learning and education in general, instructional design and collaborative learning, neuroscience, and creativity. No keywords related to ‘design’ and ‘arts’ as a topic were found. This indicates that there is a large gap in the current body of literature that relates BBL to creativity-based disciplines such as design and visual arts despite the apparent relevance between them. In addition, the thematic evolution analysis carried out in this research substantiates that there is clear regression in the development of BBL research relating to the topics of design, visual arts, creativity, and design education. … Academics, researchers, and educationalists in design and visual arts institutes are advised to direct their attention to BBL pedagogical activities and funded action research to benefit from neurosciences research on how the brain learns. This will increase students’ conscious learning, expand their imagination, improve creativity and support multiple intelligences that develop their learning experience. This will also contribute to increasing the number of studies aiming at improving BBL methods to keep pace with the global challenges in education that we are currently facing.


Public health is funded with government funds gathered from tax revenues, whether national, provincial or municipal. The health system therefore suffers during economic crisis periods, whether due to disinvestment, loss of purchasing power among health care personnel or the decrease in the number of professionals. This worsens the situation, as it is necessary to cover the needs of an increasingly elderly population and with a longer life expectancy at birth. The present study intends to show a model which explains the determination of the “Public Health Personnel Expenditure” in Spain for a determined period. A multiple linear regression model was applied to the period including the years 1980–2021. Macroeconomic and demographic variables were analyzed to explain the dependent variable. Variation in health personnel expenditure: “We included those variables which presented a high or very high correlation above r > 0.6. The variables which explain the behavior of Variation in health personnel expenditure”. It was a determining factor in the present study to consider that the variables with the greatest repercussions on health policy were mainly macroeconomic variables rather than demographic variables, with the only significant demographic variable that had a specific weight lower than macroeconomic variables being “Birth Rate”. In this sense, the contribution made to the scientific literature is to establish an explanatory model so that public policy managers and states in particular can consider it in their public spending policies, bearing in mind that health expenditures in a Beveridge-style health system, as Spain has, are paid with funds drawn from tax revenues. The World Health Organization defines the health system as “Such as all activities whose main priorities include promoting, restoring or maintaining health” (WHO) .According to Fernández et al. , the pubReferring to specificity, we must highlight the multidisciplinary and multicultural character of the public health sector . RegardiIf we consider the Spanish state, the health care system it currently has and which is the objective of the present study is articulated in response to the General Health Law of 14 April 1986, and the principal characteristics of “universality” and “gratuity” in its services, since all citizens in Spain have guaranteed health care .The Spanish health care system lies within the framework of the Beveridge health care model ,12, and According to data from the National Health System of Spain , public In this vein, life expectancy in Spain is among the highest within the European Union at 83.4 years, compared to the EU median of 80.9 years. The social inequalities surrounding life expectancy are less pronounced than in other countries .Per capita health care spending during the 2010s in Spain was about 15% below the EU average at 8.9% of GDP, compared to the EU median of 9.8% . Apart fThe current global crisis has reinforced the importance of having a powerful public health system in order to face new epidemics in general, and new pandemics arising from globalization in particular, although Spain in the last ten years has seen public health care resources dwindle .According to Adhanom , COVID-1Beginning to read about current events in Spanish health care is depressing, according to Miranda , with coAccording to the Spanish Health System Report, by Bernal-Delgado et al. , there wIn this sense, Muthuri et al. , referreIn this vein, Blázquez-Fernández et al.  analyzedSpanish public health care, as Miranda  went on Thus, the present study is centered on public health personnel, defining which variables determine the behavior of “Public Health Expenditures” linked to public entities, in order to develop an explanatory model allowing for calculations of these costs for a determined period, and allowing its managers and actors to foresee variations in their purchasing power.The most representative section of health costs is personnel expenditures , and in In this sense, according to the World Health Organization , COVID-1Governments have reacted to this crisis in more or less diligent ways, establishing new health policies  and decrAll the aforementioned factors led to reduced GDP as most companies’ business activities ceased completely, because of the total lockdowns put in place by Spanish government decree and the GDP drop due to partial paralysis of different economic activities .In this sense, at the beginning of the crisis during March 2020, the consultancy firm Statista  went aheIn this sense, we can already affirm that the COVID-19 crisis has led the Spanish economy to register an 11% GDP drop in 2020, although the fourth trimester of the year saw positive numbers, with quarterly growth of 0.4% , and manThe aim of the study was to develop an explanatory model to calculate “Public Health Personnel Expenditure” in Spain for a given period.In this study, to approach this explanatory model we considered the timeframe of 1980–2021.The number of observations refers to the study timeframe of 41 years. For the consideration of different variables, we have employed the studies conducted by Marchildon et al. (2011) , SantricWe studied the determining factors for health personnel spending in Spain, considering that this system is highly decentralized. Data originated from the National Statistics Institute .For the multiple linear regression model, we chose the macroeconomic variables and demographic variables.This study aimed to analyze the behavior of health personnel spending, in order to be useful to health managers and to state authorities when making decisions.A variable analysis was conducted using empirical evidence from the data extracted from INE, as subsequently mentioned.To establish a mathematical model which explained the behavior of “Health Personnel Expenses” linked to public entities, we considered the period from 1980 to 2021 with the objective of identifying explanatory macroeconomic and demographic variables.We analyzed the time series (1980–2021), during which a consistent pattern was detected where “Public Health Personnel Expenses” adjusted to GDP variations from year to year. The GDP growth generated during 2019 should thus be applied to “Public Health Personnel Expenditures” in 2020, thereby generating increased purchasing power for said personnel and/or personnel increase.However, COVID-19 caused the cessation of business activity imposed by the Spanish government, an unforeseen increase in health care expenditures and a rise in extraordinary expenditures due to the implementation of economic aid measures for businesses, individuals and other entities. This meant that the “Public Health Care Personnel” area was negatively impacted due to the direct relation it has with GDP variations, as the latter number saw an initial variation calculation ranging from −2.83% to 0.83%.Using data from the National Statistics Institute (INE)  on the eThe evolution of “Public Health Care Expenditures” and “Expenditure on Health Personnel”, using monetary euros, does not subtract from the inflation effect. In spite of the variations which “Public Expenditures” saw during the 1980–2021 period, “Public Health Care Expenditures” remained virtually stable .Once the evolution of “Public Expenditures” has been analyzed, along with its relation to “Public Health Care Costs” and deflated GDP, based on INE data , we can Variations in both magnitudes followed similar trends, i.e., when there was an increase in “Health Care Expenditures”, there was a rise in “Public Health Care Personnel Expenditures” .Taking the figures from the International Monetary Fund (IMF) , which eThis showed that, in any of the four cases, the perspective of retributive variation for health care workers was negative, since they could face a purchasing power loss ranging between 0.90% and 1.78%. The estimation was made by using time data extracted from the INE, concerning GDP evolution, public spending and public health expenditures. An important part of the latter point was health personnel spending.Considering that, with this research focus, the results obtained were not precise, but ranged within a wide bracket, the authors considered reorienting their focus towards a multiple linear regression model.For the second study, the process and data analysis were completed via the IBM SPSS version 27.0 statistical packet for Windows, with macroeconomic variables including annual variation in public expenditures; annual health spending variation; annual GDP variation; and demographic variables including birth rate, death rate, median population age, population over 65 and annual population variation.We initially performed a descriptive analysis of the study target variables , includiIn this case, we used the Shapiro–Wilk test, since the number of data points obtained was below 50.Since the significance level was under 0.05, implying a lack of normality, the following variables were excluded from analyses: “Death Rate”, “Life Expectancy at Birth”, “Annual Population Variation” and “Percentage of Public Spending over GDP”.The dependent variable was “Annual Variation in Health Personnel Expenditure” and the independent variables were “Birth Rate”, “Median Population Age”, “Population over 65 years old”, “Annual Public Spending Variation”, “Annual Health Expenditures Variation“ and “Annual GDP Variation”. We intended to know whether these dependent variables predicted the behavior of the variable “Health Personnel Expenditure Variation”.A hierarchical regression model was used to identify more information about the dependent variables being used .The Durbin–Watson test score indicated an independence of errors (2.478) since the value was between 1 and 3.For the multiple regression model tested, we can explain 80.4% of the variance in the dependent variable. However, models 4 through 6 explained the same percentage. This means that the variables included in models 5 and 6 did not contribute to explaining the model, i.e., the variables “Median Population Age” and “Population Over 65” can be withdrawn and not used.This study seeks to answer the following question: What are the determinants of public health personnel spending in Spain?In the simple regression analysis conducted with the six models, we saw that the determination coefficient was 0.804, which shows that the variance proportion explaining “Health Personnel Expenditures” was very high.Below is the ANOVA and the table of coefficients .p-value < 0.001)  .For the regression model coefficients, the t scores indicated that the variables considered significantly contributed to the predictive model. Simultaneously, the Inflated Variance Factor (FIV) indicated compliance with the non-multicollinearity assumption .The regression equation was as follows:With the equation resulting from the model, we can see that the variation in health personnel spending had explicative variables, and only one demographic variable, namely Birth Rate.To be able to answer the research question in the present study—what are the determinants for public health personnel expenditures in Spain?—we have borne in mind that personnel health outlays are one of the most important parts of all public health spending, with health personnel accounting for around 57% of all health costs ,59.Even after realizing that GDP determines the wealth of a country and that total public spending is related with GDP, it is currently hard to coherently estimate income due to the lack of available data, leading to deficient decision-making by health managers . In thisIn the present study, the first analysis performed was considered to lack relevance, since its results were not highly concrete and lay within a bracket which was too wide to carry out reliable explanatory calculations on the variability of “Public Health Personnel Expenditures”, and therefore required econometrics to achieve the objective set forth in the present study.In the second analysis, we used a regression model where the dependent variable was “Public Health Personnel Expenditure”, and the explanatory variables used were both macroeconomic and demographic.We can thus affirm that the demographic variables have been significant for determining variation in “Public Health Personnel Expenditure“.There are prior studies, such as the case of Muthuri et al. , where aIn line with the previous points, although there are prior studies relating health care spending with GDP, there are no available studies relating it with public health care spending under the Beveridge health model .This study is not without limitations, since available data are limited, and it is not homogenized in various occasions. We also did not consider tax collection variables, budget deficits, public employment or the role of unions due to data homogenization problems, and the analysis covers a time span of 41 years, which is the period 1980–2021, since earlier dates for some variables had no data available.For future research lines, we suggest considering more countries inside and outside the European Union, since there are various health care models available, such as the Bismarck, Beveridge, liberal and socialist types. As a function of the reigning model, the results could be different. To this end, there is an important effort being made to homogenize data.One relevant data point to bear in mind would be considering the sustainable development objectives (SDO), which in a broader timeframe present an estimated deficit of 18 million health workers by the year 2030 .Due to progress achieved in increasing life expectancy and reducing mortality rates, it is ultimately essential for health policy makers to increase investment in health, since otherwise all the achievements up to now could revert, giving rise to the high costs associated with illness.Increased life expectancy is associated with more diseases, and thus with increased health spending, which must be considered by health policy managers. Spain is one of the countries with the highest life expectancy at birth; in 2021, this stood at 83.06 years.With the results obtained, it should be mentioned that health personnel spending variation depends largely on macroeconomic variables rather than demographic variables, since the only demographic variable we have considered is the birth rate. Out of all the variables considered in the model, it is also the one with the least effect on the dependent variable.We know that personnel spending is one of the main outlays for the public health system. Therefore, given the results presented herein, to carry out a good policy for the resources aimed at public health personnel expenditures, we can expect that national economic activity is favorable in terms of GDP and wealth creation, since we have shown that most determining factors for health personnel expenditure variation are macroeconomic variables. This is especially significant, since the present study indicates that demographic variables are not considered for establishing health policies.Economic activity in different countries and the decisions taken regarding public spending policies both ultimately have significant effects on health personnel expenditures, which, as the life expectancy rises and the population ages, mean that more and more of the population have multiple pathologies and will have greater health service needs.States will have to be conscious of the importance of being able to cover their populations’ needs, especially since their characteristics will vary over time, and GDP and public expenditures will be a determining factor for all states.The future lines of this work will include considering the impact of COVID-19, especially considering the various pathologies which can arise due to the pandemic and the medium- and long-term effects it will have on the population. This can lead to re-founding of health policies in the future, both in matters referring to public spending and the cost represented by health care personnel. It will also be interesting to carry out this study between different autonomous communities (AC), bearing in mind that significant differences exist in their public health systems.Due to the importance of various different studies where health personnel are responsible for about 57% of all health costs, future studies could consider how inflation will affect health costs, and specifically personnel costs. Health policy managers currently lack consistent data about income estimations, leading to major data shortfalls within global policies. In this sense, the efforts of the World Health Organization to gather data from all member states using International Labor Organization data WHO-CHOICE have also been used to make salary cost estimates.In the face of this situation, the present study contributes to health policy managers being able to consider possible future actions to take if they intend to maintain quality public health, and not trigger a significant migration out of the health care workforce.


In this paper, we explore the benefits of new forms of in-school grouping for children moving from primary to secondary school during the COVID-19 pandemic in England. Our three-phase study with over 400 students and teachers found that protective measures to limit COVID-19 though year group ‘bubbles’ generated an environment more aligned to children’s previous primary school experience. This natural experiment smoothed the process of transition by providing a better correspondence with students’ developmental needs, especially for those on the cusp of adolescence. We recommend that physical, administrative and pedagogical school structures are reimagined for this age group to this end. The negative impact of the COVID-19 pandemic on student learning and wellbeing globally across different age phases has been well reported OECD . In EnglIn England, the majority of students attend primary school from age 4 to 11, whereupon they transition to secondary school until at least age 16Initial findings from the first two phases of the research study on which this paper draws have highlighted the particularly negative impact which a lack of conclusion to the end of primary school in Year 6 (age 11) and missing standardised attainment tests (SATs) had on transitioning students relationships/demarcation with technological devices; andin relation to various ‘texts’ Bronfenbrenner, in later work , 724, suTherefore, we might consider how the social concept of ‘secondary school transition’ is defined in relation to not only (1) a perception of the natural rhythms of puberty and adolescence, but also (2) the formal requirements, affordances and constraints of feeding and receiving schools and (3) the formalisation of this in e.g. calendars, with (4) discussion principally constrained to Year 6 and 7 and not earlier or later in general.Naturally, there are issues with assuming any of these aspects as being fixed and there is a danger in particular of conflating transition with adolescence, given a potential six-year span of puberty onset within any cohort. In addition, the 2020–2021 transitioning Year 6 cohort, the focus of the present study, faced unique changes to almost all social apparatus associated with schooling and beyond, as well as a complete disruption to regular demarcations of time during lockdowns. During the 18 months of our study, this cohort faced multiple, smaller transitions in and out of lockdowns as well, an example of learning time being further ‘decentralised’ . However, it quickly became clear that the impact of COVID on this cohort would continue into Year 7 and two more phases were planned for the first and third terms of Year 7 in 2020–2021.Given pandemic restrictions, recruitment moved online through departmental colleagues’ social media accounts, parental WhatsApp groups, email circulars from organisations such as the Chartered College of Teaching and, once schools reopened, Initial Teacher Education (ITE) partners. Institutional ethical approval was expedited but close scrutiny was paid to any potential time burden and triggering of negative emotions. The option of surveys or interviews was always given and working completely remotely meant both students and teachers were often at ease and interviews usually lasted longer than anticipated. All interviewers of students had enhanced DBS checks and parents were actively involved in arranging interviews. Personal data was only requested as an option to facilitate further contact.Surveys were developed by considering questions from existing published studies but also to reflect the new pandemic context, with both closed and open-ended options, in line with the exploratory aims of the study, and designed using UCL Hosted REDcap software. Piloting led to slight refinements in each phase, although a consistent core of questions remained. Semi-structured interviews were video or audio recorded using UCL-hosted Microsoft Teams, with one UCL-hosted Zoom and one telephone interview due to participants’ requests. Pseudonymised transcripts were usually created within 48 h by checking auto transcripts.Analysis after the first phase proceeded, based on Braun and Clarke’s The usual transition preparation and end of primary school experience ground to a halt for the 2020 graduating Year 6 cohort on 17 March 2020, when schools were closed to all but a minority of keyworkers’ children, or the most vulnerable. During the following year, most of this focus cohort spent less than four months in school and at least six months learning remotely. Therefore, it is unsurprising that our teacher participants reported significant disruption to learning for many students, particularly during the lockdown in year 6 .Figure During the lockdown in year 6, students and teachers highlighted that, not only was most learning asynchronous, much was also offline. Only 19% (54/283) of students reported having live online lessons and a number of students reported that their written work was almost never submitted for feedback.Sending me textbooks/material for learning …  … allowed me to look at all the information and take my time with reading through it ‘ and ‘in the day, I had to help with the housework so I could do my school work later in the day when I am less busy’.The cancellation of SATs further disorientated, and even disappointed, many students in our study as they often felt that their hard work had gone unrecognised. However, a significant minority enjoyed exploring their own interests in greater depth and 60% (55/91) of teachers recognised that lockdown had provided students with opportunities to develop greater autonomy, while 25% recognised that students could follow more of their learning interests. Students with additional needs or caring responsibilities also appreciated the flexibility of timing provided in both lockdowns. As two students noted in the survey: ‘in lockdown, I did hardly any work …  … I just played computer games through all the lessons … … I feel like I only could start learning and being motivated again when I went back to school.’ It was also challenging to effectively monitor students’ progress, despite unprecedented efforts by school staff, such as Sophie: ‘we were relentless … . We didn't give up on any of them and as soon as a parent said, you know, we're struggling with something, we offered them something else straight away’.The second national lockdown in 2021 (Year 7) resulted in far more synchronous online learning  and teacthis week they've had the first official tests and I notice quite a few of them, even very able children who work really hard …  … they struggled sustaining the concentration’. She, like many, also noted the multiple ‘random gaps’ for many, particularly in Maths. Oracy skills were also a concern.When the Year 7 students returned to school in March 2021, teachers in our study reported that writing and test-taking ‘stamina’ had decreased, as Holly, a Year 7 teacher, noted: ‘Year 6 kind of it all changed, so I kind of changed my expectations … … I guess I kind of knew that it wasn't gonna be completely normal, so I was like, well, we probably won't be able to do everything the exact same as it worked out, so I kinda just went in open minded like, well, it's gonna be different.More importantly, to our surprise, the students and their teachers also revealed some unexpected benefits of being in their bubbles.To restrict the spread of COVID, students had been almost all organised in bubbles since the first lockdown eased, with 84% (110/131) of them in Year 7 in year group bubbles, 14% in form/class bubbles and 2% in bubbles of an intermediate size. These bubbles were usually restricted to one building or classroom for most of their lessons, according to student and teacher respondents. They also reported how the restricted use of buildings resulted in a narrower curriculum due to fewer practical opportunities or specialist equipment in many subjects. Social distancing rules also meant extracurricular opportunities were extremely limited, group work was rare and informal assessment and feedback were constrained by a need for social distancing. However, students were often stoic about the changes, as Carmen, a Year 7 student, reflects about her approach:You can’t do a lot of things like go in the science lab or art room but for me because all your lessons are in one building it feels nicer.Even by the end of Year 7, 32% (42/131) were still pleased to be mainly based in one classroom. However, the majority were keen to ‘explore’ other classrooms and buildings by this point. As Gina, a Year 7 student, reflected when asked whether bubbles should continue,If the bubbles are kept in place, then the Year Sevens, some of them who were sort of worried about the older years, could feel more comfortable. However, the ones that want to like be more, you know, ambitious and more explore-y can't really do that as much.But overall, many did appreciate the smoother transition bubbles afforded, at least for a short time. As a student reflected in the survey at the end of Year 7:Coronavirus makes it seem like primary because we would stay in the same classroom for every lesson so it has eased the transition and it will be easier hopefully soon to move around and discover the school. On the first day, I wouldn't want to encounter a year 11 but now, it would be much easier and I have adapted to secondary life.In spending most of Year 7 with the same class of around 25–30 students in the same room, for many students, starting secondary school ended up being more similar to Year 6 than expected. There appeared to be several ways in which the restrictions actually sheltered students from aspects which they said they had been concerned about. By being limited to one or two buildings, many were happy not to get as lost as they expected. As one student noted in the survey during their first weeks in Year 7:We can't do anything really except just talk ‘cause there's like no grass, so we can't play football …  … there's not a lot of room, like if you're trying to run around, you’re just probably just gonna run into something.Although some clearly felt frustrated by this, many students, particularly girls , seemed content to chat in small groups rather than engage in physical activity. This might be expected as many girls enter adolescence sooner than boys and are perhaps therefore more comfortable with less active play. Overall, this does suggest that bubbling did not facilitate an extension of primary-style play in the main, perhaps particularly due to a lack of space and equipment. However, with play restricted to Year 7 peers, there is some evidence that bubbling facilitated more imaginative play for some. As one teacher reported: ‘I still had Year Sevens playing almost make believe … dungeons and dragons … You don't normally get that in secondary’. Many students also appreciated the staggered lunch arrangements to reduce year group mixing, which many teachers reported would stay post-pandemic.Outdoor space was also limited, with most students reporting reduced time, space and play equipment than expected at break and lunchtime, particularly compared with their pre-lockdown, primary experience. Ball sports were sometimes permitted but usually impossible. As Jack, a Year 7 student, noted:it is better to stay in one class with all of my classmates rather than be separated by ability’. Tammy, a high achieving Year 7 student, also appreciated a whole class, mixed attainment approach to ‘catching up’ when noting on returning after lockdown: ‘I had been doing the work, but I still hadn't really got the opportunity to ask that many questions, but then we went over it back again at the end. I thought it was just like a relief’. Reviews of research on ability setting have shown that, although there is evidence of a small positive benefit in outcomes for higher attainers, there is zero or negative impact on outcomes for lower attainers  yet to reach adolescence, we would argue, makes the primary to secondary transition at age 11 inherently problematic, due to lower likelihood of ‘fit’ between school and student for many this young. However, what our data indicates is that, by bubbling these transitioning students in 2020 and 2021, a natural experiment occurred which inadvertently stretched the primary phase in many ways. This meant that the systems of social discipline which May and Thrift  had increased concerns about their students’ mental health because of the impact of COVID and reported particular issues with social isolation amongst Year Seven students, as Linsey, a head of Year 7, captures here:my friends in other classes, we kind of grew apart … ’ but also later: ‘ … I think our form’s probably closer than it would have been in other years because we kind of almost, not been fully isolated from everyone else, but we kind of met each other and like we’ve grown quite close.’It is worth noting that Becky and Holly were teachers who spent several hours daily with the same class, in schools with Year 7-specific models – so increased time with their forms was already a planned feature of their schools. Of course, as we noted above, bubbling restricted and limited some friendships, with 35% (46/131) of students surveyed saying they missed seeing friends outside their bubble. Therefore, ultimately, 62% of those surveyed didn’t want COVID bubbles to remain. However, 26% were clear that they did want some aspects to continue, with 30% overall saying they enjoyed the extra time bubbles had provided with their classmates. Carmen, a Year 7 student, in interview, highlights this tension in noting both that: ‘Bubbling also meant more time with one or two dedicated adults for many, like in primary school, in order to limit circulation of staff. We suggest that this approach may be partly responsible for the fact that many students expressed surprise at how kind and approachable their teachers, particularly form tutors, were, compared with their expectations of multiple, strict secondary school teachers.I couldn't interact with other year groups, making it more awkward whenever I saw them’. Several teachers also noted that the Year 7s had fewer role models and therefore appeared more confident, yet less ‘mature’, than previous cohorts. The flipside of this was, however, that quite a lot of students noted closer bonds with their peers, as noted above.Multiple students told us they felt less worried about bullying, as they were unlikely to encounter older students, particularly in crowded corridors, which removed what is a common concern of many transitioning students  has struggled to retain a foothold for a variety of reasons, including accountability issues created by a mismatch between the points of transition and government standardised ages of testing  Crook , 123. WeWe do, however, recommend that the benefits of bubbles for the majority of students may be significant, particularly for those who struggle with the multiple social, practical, emotional and cognitive demands of starting a secondary school environment designed for older adolescents. Their needs are likely to be better met by ensuring that the timespace in which transition occurs is made more developmentally appropriate and flexible in small ways. Recommendations already adopted by some schools in our study, or who have been in correspondence with us subsequently, include discrete Year 7 facilities, such as one floor of a building with their own toilets, pastoral support offices and a specific library or sitting area. Specified times, equipment and/or spaces for play with Year 7 peers might also facilitate developmentally appropriate play. Year 7 specific teachers, often primary trained, who teach mixed attainment classes in one classroom for up to several hours a day, also allow peer and teacher relationships to be closer to those of primary school with the concomitant advantages of mixed attainment teaching better supporting lower attaining students’ attainment outcomes.The discourse for a number of years now in primary schools, particularly regarding Year 6 academic achievement, has been on ensuring pupils are ‘secondary school ready’ BBC  but whatUnlike during the pandemic, Year 7 students should be free to circulate in other areas of the school, or choose to use their own dedicated facilities. Furthermore, a range of extracurricular activities should be made available for all, benefiting particularly those who are ready to engage with older students. We also recommend a staggered induction for the entire Year 7 cohort to whole school activities, as many schools already provide, through cross-year group house activities and buddy systems, where Year 7 students are given a buddy in an older year group. This would, we argue, go some way towards a more equitable transition for greater numbers of students.


The current paradigm of science is to accumulate as much research data as possible, with less thought given to navigation or synthesis of the resulting mass, which hampers locating and using the research. The aim here was to describe the number of randomized controlled trials (RCTs) and systematic reviews (SRs) focusing on exercise, and their journal sources, that have been indexed in PubMed over time. Descriptive study conducted at Bond University, Australia. To find RCTs, a search was conducted in PubMed Clinical Queries, using the category “Therapy” and the Medical Subject Headings (MeSH) term “Exercise”. To find SRs, a search was conducted in PubMed Clinical Queries, using the category “Therapy”, the MeSH term “Exercise” and various methodological filters. Up until 2011, 9,354 RCTs about exercise were published in 1,250 journals and 1,262 SRs in 513 journals. Journals in the area of Sports Science published the greatest number of RCTs and journals categorized as belonging to “Other health professions” area (for example nursing or psychology) published the greatest number of SRs. The Cochrane Database of Systematic Reviews was the principal source for SRs, with 9.8% of the total, while the Journal of Strength and Conditioning Research and Medicine & Science in Sports & Exercise published 4.4% and 5.0% of the RCTs, respectively. The rapid growth and resulting scatter of RCTs and SRs on exercise presents challenges for locating and using this research. Solutions for this issue need to be considered. The current paradigm of science is to accumulate as much research data as possible,,To answer questions about the effectiveness of interventions, the study designs that provide the highest levels of evidence are randomized controlled trials (RCTs), as primary research, and systematic reviews (SRs) for research synthesis.,,,,,,,Exercise, for both sports and medical conditions, has been the focus of many RCTs and SRs.This was a descriptive study conducted at Bond University, Australia, during the months of January and February 2013.An initial pilot search, conducted independently by AJG and PG, tested the specificity and sensitivity of using the term “Exercise” with the Therapy/narrow filter in PubMed Clinical Queries. This returned 75,367 results; we checked the 100 results from PubMed, in both the Trials and the Systematic Reviews columns, to assess whether the studies returned in the search matched the topic. Only approximately 40% were RCTs or SRs that had evaluated exercise. It is worth noting that searching for the Medical Subject Heading (MeSH) term “Exercise” also allows synonyms such as: “(Exercises); ; ; ; ; ; ; (Isometric Exercises); (Isometric Exercise); ; (Aerobic Exercises); ; (Aerobic Exercise)”.A modified search, with consensus among the authors, was conducted only by AJG in PubMed to find all RCTs involving exercise, and consisted of the MeSH term “Exercise [MeSH]” in PubMed Clinical Queries, selecting the category “Therapy” and the scope “Narrow”, and limited to “Humans”. To find SRs, the following strategy was used: (systematic [tiab] AND review [tiab]) OR meta-analysis [pt] OR CDSR [so] AND Exercise [MeSH], in PubMed Clinical Queries, with the category “Therapy” and the scope “Narrow” selected.The search was carried out by AJG in PubMed on January 22, 2013. We included RCTs and SRs that had been published from the beginning of indexed records until the end of 2011. We excluded those published in 2012, since indexation of these articles was incomplete at the time of searching.The RCTs and SRs were stratified by year and by journal. We considered the broad category of journal type that they were published in, using the following five categories: Sport Sciences; Rehabilitation; Medicine ; Medical Specialty; and other areas (for example nutrition or nursing). The classification of journals followed the categories used by ISI Web of Knowledge.All references were exported from PubMed to Endnote X6, and then an output style was developed and exported to Excel 2010. All records were individually classified by AJG in a computer spreadsheet. Data were analyzed descriptively.We found that 9,354 RCTs about exercise had been published in 1,250 journals up to the end of 2011, and 1,262 SRs in 513 journals. ,,,,,Exercise is a well-known intervention, which historically has been studied using an observational approach.“a subset of physical activity that is planned, structured and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness” and the definition of physical activity is “any bodily movement produced by skeletal muscles that results in energy expenditure”.Since exercise is relevant to many disciplines and it is a growing concept for health promotion and rehabilitation, it is important to reflect about its types  and where their MeSH trees are best included. One piece of advice in this regard would be to recall the definition of exercise and physical activity. The classical definition of exercise is that it is ,,In our study, we found that over 1100 journals are publishing RCTs and over 440 journals are publishing SRs about exercise. These data shows that it is almost impossible to keep up to date in the traditional “push” manner; using “just-in-case” information, where information is “pushed” to the user.This study has some limitations. Only one database (PubMed) was used for our search, although this is the largest database containing biomedical and health publications. It is possible that some of the studies that were included were not relevant to exercise, since we did not read the full text of each article. Conversely, it is also possible that some RCTs and SRs relevant to exercise were missed by our search.Although RCTs and SRs provide the best study designs for evaluating intervention effectiveness, users of exercise data need skills in a) locating exercise research and b) appraising it for its quality, either by having skills in critical appraisal or by using some of the existing solutions that exist for providing filtered, pre-appraised research (e.g. PEDro database or McMaster PLUS). We conducted a quick search on August 25, 2013, using “Exercise” in McMaster PLUS and in PEDro, and found 2,097 and 8,116 pre-appraised studies, respectively.,,,,Exercise is relevant to so many disciplines and such broad knowledge areas that methods for providing easier access to high quality exercise research are needed. We also believe that is time to discuss not only besides methodology but also the description of exercise programs, in order to improve their practical application.There has been rapid growth in the number of RCTs and SRs relevant to exercise over the last 15-20 years. Exercise RCTs and SRs have been published in journals in the Sports Science area more than in any other area . We found that one particular journal (Cochrane Database of Systematic Reviews) is the principal source for exercise SRs; and two journals  published the highest number of exercise RCTs. This growth and scatter of exercise RCTs and SRs presents challenges for locating and using this research, and solutions for this issue need to be considered.