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Accessing digital harm reduction services —exploring the impact of the “Here4UScotland” application
Get PDFBackground
The unique challenges faced by vulnerable drug users highlight the urgent need for accessible, immediate digital interventions which people can access anywhere and at any time. This study explores the impact of the Here4UScotland virtual supervised consumption app, examining relationships between service users and providers, their separate relationships with harm reduction digital solutions and the app’s effects on personal and collaborative service engagement.
Methods
The “Here4UScotland” app was piloted in Aberdeen, Scotland between May 2022 to Aug 2023, which incorporates its gestational inception to front-end live engagement. This qualitative study employed two focus groups (n = 8)). These were conducted independent of semi-structured interviews (n = 21) which individually investigated the various experiences of service users, supporters, and stakeholders. In total 26 people provided data which was thematically analysed using NVivo 12 to look for associated and relevant codes and themes using the Technology, People, Organisational, and Macro-environmental (TPOM) framework.
Results
Main technology themes were video calling, location and privacy and usability/connection. Under ‘people’ positive relationships, finding identify and enhanced digital safety were described. Organisational themes covered ways to cultivating trust, supporter’s responsibility, and associated training for services and supporters. Key concerns emerged regarding the absence of crucial visual cues for staff and the potential for police involvement.
Conclusions
Digital interventions like Here4UScotland offer significant benefits in enhancing harm reduction engagement and access, fostering new connections and community among vulnerable populations. Digital access beyond virtual consumption was considered. For successful integration of this technology, it appears crucial to balance technological advantages with ensuring privacy, providing adequate training for staff, and integrating these solutions with existing services, rather than replacing essential human interaction
An exploration of carbon emissions linked to research study delivery (MARIE project)
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Large-scale scientific research studies are critical for advancing knowledge and innovation, but they require substantial human and financial resources. Given their scale, such studies also generate a notable environmental footprint. Aligning research practices with Sustainable Development Goals (SDGs) 3 (health and wellbeing), 12 (responsible consumption and production), and 13 (climate action) necessitates assessing and mitigating these impacts. This study investigates the carbon emissions associated with different participant recruitment strategies such as digital, hybrid, and in-person across a selected group of countries from the MARIE project.
Methods
Recruitment-related data were collected from Brazil, the United Kingdom, Nigeria, Ghana, Singapore, Sri Lanka, Malaysia, and India, covering a total of 3,875 participants. Emissions were estimated from paper use, printer electricity, participant and staff transportation, and IT device usage. Calculations applied internationally recognised emission factors alongside country-specific carbon intensity metrics. Statistical comparisons between recruitment modalities were conducted using analysis of variance (ANOVA) and the non-parametric Kruskal–Wallis test to account for small group sizes and non-normal data distributions.
Results
Digital recruitment demonstrated the lowest carbon emissions, ranging from 0.23 to 437 kg CO2e, largely attributable to the limited electricity consumption of IT devices. Hybrid recruitment generated moderate emissions (mean ≈ 126 kg CO2e) due to combined digital engagement with some travel and material use. In-person recruitment produced markedly higher emissions, ranging between 4,260 and 27,070 kg CO2e, with transportation accounting for more than 90% of the total footprint. While statistical analyses did not reveal significant differences across modalities (p > 0.05), likely due to small sample sizes, effect sizes suggested meaningful environmental variation.
Findings
Digital and hybrid recruitment strategies substantially reduce the carbon footprint compared to traditional in-person approaches, offering sustainable alternatives for large-scale research. These approaches can help research institutions meet global sustainability targets while maintaining efficiency. Nevertheless, considerations of equity, accessibility, and cultural appropriateness remain critical, particularly in low-resource settings, to ensure inclusivity and generalisability of study findings
Identifying subgroups of frequent emergency department users: a latent class analysis with linked healthcare utilisation, cost and mortality outcomes in the UK
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Frequent users (FUs) of emergency departments (EDs) attend repeatedly, placing a disproportionate burden on healthcare systems. Although known to be heterogeneous, there is limited international evidence characterising FU subpopulations or examining how healthcare costs and outcomes differ across groups. Advancing this understanding is important for developing tailored interventions to meet diverse care needs.
Methods
FUs were defined as individuals with ≥5 ED attendances/year. We used two large UK datasets: Hospital Episode Statistics (HES, 2016–2019) and the Centre for Urgent and Emergency Care database (CUREd, 2017–2020). Together, these included over 148 000 FUs from 5 million ED users. Latent class analysis (LCA) was used to identify FU subgroups based on attendance patterns, healthcare use and diagnostic characteristics.
Results
We identified three consistent subgroups (HES and CUREd): (1) low-severity FUs (n=23 034, 43.2%; n=7081, 32.7%); (2) high-intensity FUs with mental health and neurological needs (n=6288, 11.8%; n=3456, 15.9%); (3) older FUs with chronic illness and high inpatient use (n=24 028, 45.0%; n=11 139, 51.4%). Subgroups differed substantially in healthcare utilisation, costs and mortality. A fourth class varied across datasets: in HES, it showed moderate morbidity and complex needs; in CUREd, high morbidity and high-intensity ED use.
Discussion
This is the first FU study to apply LCA across large-scale, multiyear ED datasets, identifying a potentially universal subgroup structure. Current services focus on a narrow subset of high-intensity users. Additional tailored strategies are needed to address the full spectrum of FU needs
Small punch testing and scanning electron microscopy analysis of damage evolution in dual-phase steel
Get PDFDual-phase (DP) steels are widely used in the automotive industry due to their excellent balance of strength and ductility. Enhancing their formability and crash performance requires a deeper understanding of microstructural deformation and damage mechanisms. This study presents an in-depth micromechanical investigation of damage initiation and propagation in DP1000 steel using a novel small-punch (SP) test setup combined with three-dimensional digital image correlation (3D DIC) and scanning electron microscopy (SEM). The test was strategically interrupted at multiple stages to capture the evolution of cracking. Initial cracks appeared at a punch displacement of approximately 1.12 mm, while the final stages revealed microstructural crack propagation resulting from deformation localized near the ferrite (F) – martensite (M) interface, leading to cracking of adjacent M islands or void growth within the F. 3D DIC measurements revealed maximum principal surface strains up to 23% before cracking. SEM analysis confirmed that the dominant through-thickness crack initiated at the punch sample interface and propagated toward the upper surface, aligning with surface strain localizations. M cracking was limited to the early stages, while subsequent damage growth was F-dominated. This integrated experimental approach offers new insights into the phase-specific damage behaviour and supports the development of predictive models for the formability and failure of advanced high-strength steels
Mixed methods process evaluation of behavioral support and nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India, and Pakistan
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Interventions for quitting smokeless tobacco are lacking in South Asia. In a pilot trial, we explored the feasibility of delivering and evaluating a culturally adapted behavioral intervention and/or nicotine replacement therapy in Bangladesh, India, and Pakistan. This article presents the process evaluation.
Methods
Mixed methods consisted of interviews with 46 participants and five cessation advisors, a questionnaire completed by 236 trial participants, fidelity assessment of intervention delivery for 38 participants and intervention logs. Data were triangulated across three process evaluation functions (implementation, mechanisms of impact, context) and self-reported abstinence outcomes.
Results
After everyone attending the pre-quit behavioral session, attendance dropped to 86.3% (quit session) and 65.9% (>1 post-quit sessions). Abstainers attended more sessions. Advisors were confident in delivering the intervention, favoring face-to-face over remote, yet fidelity scores showed room for improvement. Attendance and fidelity scores were consistently best in Bangladesh. There was high acceptability and perceived usefulness of the behavioral intervention with an important role for the advisor especially among abstainers. Two-thirds perceived nicotine replacement therapy as useful, higher among abstainers. Taste and side effects were barriers; adherence was highest in India. Perceived drivers to cessation were new knowledge leading to positive attitudes, beliefs in capability to quit, and family support. Perceived barriers were nicotine addiction, social pressure, and easy access to smokeless tobacco.
Conclusions
This process evaluation affirms the feasibility and acceptability of implementing the Behavioral Intervention to support Smokeless Tobacco Cessation in Adults and nicotine replacement therapy interventions while identifying important areas for improvement prior to a full effectiveness trial.
Implications
This study provides detailed insights on the feasibility and acceptability of a culturally adapted behavioral intervention and of nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India, and Pakistan. They identify important implications for the design and delivery of future effectiveness trials of smokeless tobacco cessation interventions that are lacking in this region
Measuring the accessibility of veterinary care for companion animals in England and Wales
Get PDFRecent surveys have suggested that over half of UK households own a pet. One important aspect to this ownership is ensuring that access to appropriate veterinary care is available for their pets. To measure the ease of accessibility to such care, three aspects are important, the local demand for veterinary care, the supply of care, and the ease of travel to obtain the care. For the first element, in this study estimates were made of the household pet population for all neighbourhoods in England and Wales (36,672 neighbourhoods each containing approximately 700 households). Information regarding the location and number of veterinarians working in local practices was then used, with vehicle journey times, to provide a measure of accessibility to veterinary care. It was found that the more affluent and rural locations have better accessibility to veterinary care than deprived and urban locations. The detailed geography of the estimates provided by this study enabled the location of potential ‘veterinary deserts’ to be identified. With this knowledge additional provision can be prioritised to such locations with a view to improving the welfare of companion animals. Not only will this improve the accessibility of veterinary care but, through competition, this also has the potential to reduce care costs. Thus, the likelihood of pets receiving the care they need will improve. Whilst this study focuses upon England and Wales, the methodology presented would be equally valid in other settings where appropriate data exist
Gamifying Academic Integrity: An Inclusive, Interactive Model for Teaching Ethical Academic Practice in Higher Education
Get PDFAcademic integrity remains a key challenge in higher education. At Teesside University, increasing cases of plagiarism, collusion, and contract cheating highlighted the need for more engaging and educationally grounded interventions. In response, the English Language Centre (ELC) designed and delivered a two-part initiative integrating gamification and inclusive pedagogy to reframe integrity as a participatory academic literacy rather than a compliance exercise. The programme combined a large interactive lecture introducing core integrity principles with a practical workshop developing paraphrasing, quoting, and summarising skills. Kahoot! was embedded throughout as a gamified learning tool that fostered participation, inclusivity, and real-time feedback. Across 26 Embedded Academic Literacies (EAL) sessions, the initiative engaged 620 students from all five Schools. Anonymous feedback showed that over 90% of participants found the sessions useful and reported increased understanding, frequently describing them as “informative,” “interactive,” “engaging,” and “fun.” Participants also demonstrated a 25% reduction in average similarity scores compared with previous cohorts, indicating measurable improvement in integrity-related practices. Staff observed that engagement and responsiveness declined when institutional access to Kahoot! was temporarily lost, reinforcing its pedagogical value. This short communication presents a case study of this innovation, drawing on routine anonymous feedback and staff reflections to illustrate how gamification can enhance academic integrity education in inclusive, diverse settings. The findings suggest that framing integrity as an interactive literacy, supported by game-based participation, can increase engagement, confidence, and ethical academic practice across disciplines
The design and evaluation of a postdoctoral mentoring programme to support the academic and professional development of NIHR Academy members
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This study provides insight into the design, implementation and evaluation of a structured developmental mentoring programme, created to support the academic and professional development of postdoctoral researchers from diverse disciplines and backgrounds. The research context is the National Institute for Health and Care Research (NIHR) Academy. The Academy attracts, trains and supports health and care researchers through personal or institutional career development awards, as well as training and academic career development within NIHR infrastructure, schools and capacity-building structures. The mentoring programme is open to all UK-based postdoctoral Academy members.
Design/methodology/approach
The approach first sets out the context, purpose and design of the mentoring programme. Second, we explore the extent to which the mentor- and mentee-defined relationship objectives were fulfilled and whether the programme met the underlying principles of the NIHR. Finally, we identified participants’ level of satisfaction with the programme. The study adopted a pragmatic multiple-method evaluation, with matched-pair mentee and mentor interviews that were thematically analysed.
Findings
The study found that all participants felt they met all or most of their mentoring objectives and overall programme objectives. The mentoring programme was highly valued by a diverse range of participating mentors and mentees from different health, care and research disciplines, reflective of the NIHR Academy.
Research limitations/implications
Limitations of this study include the short-term outcomes that participants were asked to reflect on at the end of the one-year programme; other studies may capture longer-term outcomes through longitudinal evaluation.
Originality/value
The study contributes to the body of knowledge regarding the benefits and organisational support that postdoctoral researchers (mentees) and their mentors receive through mentoring programme participation. This study underscores the importance and impact of a structured, formal organisational mentoring programme
Machine learning-based electrical impedance spectroscopy classification for oral cancer
No full textHead and neck cancers, particularly oral squamous cell carcinoma (OSCC), are major global health concern. An early detection can significantly improve the survival rate. Traditional diagnostic methods, such as biopsy, are invasive and analysis subjective, posing challenges for routine screening. This study explores the application of electrical impedance spectroscopy (EIS) combined with machine learning (ML) to classify oral cancer and healthy tissues non-invasively. By utilizing tissue-engineered oral mucosal model-based finite element modeling (FE) and simulations, we generate synthetic EIS data to train ML classifiers and apply the classifiers to real tissue data to classify the tissue status, Among the ML models tested, Random Forest (RF) showed the best performance, achieving an AVC of 0.95 and good sensitivity and specificity. This approach overcomes data scarcity issues by leveraging synthetic data and provides a promising pathway toward reliable, non-invasive diagnostic tools for oral cancer. Further research will focus on enhancing model accuracy by integrating clinical prior knowledge and refining tissue engineering techniques
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