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Healing while expecting: effects and experiences of trauma-focused interventions during pregnancy
No full textSection A
Mental health difficulties during pregnancy, such as anxiety, depression, and post-traumatic stress disorder (PTSD), are common but often underreported. PTSD in particular is of concern during pregnancy due to its negative impact on both maternal and child outcomes if left untreated. Although there is a strong evidence base for trauma-focused therapies, pregnant individuals are underrepresented in research due to perceived risks, leaving gaps in our understanding of treatment effectiveness during pregnancy. This review aims to better understand the treatment effects and drop-out rates of evidence-based trauma therapies delivered during pregnancy. A systematic review was conducted following PRISMA guidelines, searching Embase, PsycInfo, PsycArticles, and MIDIRS for synonyms of ‘pregnancy’ and trauma-focused therapies. Of 1296 papers screened, 12 studies were deemed suitable for inclusion. A narrative synthesis showed that trauma-focused therapies reduce key symptoms (e.g., PTSD, fear of childbirth, anxiety, and nausea and vomiting) without adverse effects. However, the majority of randomised controlled studies found no significant differences in treatment effects when compared to control groups. Drop-out rates were generally low (0% to 19%), except for one study (40%). Future research should compare different types of trauma-focused therapies and explore pregnant individuals’ lived experiences through high-quality qualitative studies.
Section B
Over a third of birthing people experience a traumatic birth, which can lead to post-traumatic stress disorder. Emerging evidence suggests that Eye Movement Desensitization and Reprocessing (EMDR) is an effective and time-efficient treatment for birth trauma. Nevertheless, the research base is scarce and lacks lived experience insights. This study investigated the experience of receiving EMDR for birth trauma during a subsequent pregnancy. Eight interviews were analysed using Interpretative Phenomenological Analysis, revealing four key themes: ‘There’s nothing like it’, ‘A ticking clock’, ‘I’m the architect’ and ‘Widening the lens’. The study highlights the clinical benefits, emphasising EMDR’s acceptability, effectiveness, and the importance of a strong therapeutic relationship. Further research is required to validate these findings as the small sample size and possible sampling
biases limit generalisability
Exploring religion and spirituality in psychosis: meaning-making and clinical psychologists' perspectives
No full textSection A
Background. Religious and spiritual (R/S) beliefs play a complex role in mental health recovery, yet their specific influence in the context of psychosis remains underexplored. This systematic review aimed to examine how individuals with psychosis use R/S to make sense of their experiences.
Methods. A systematic search of three databases (PsycINFO, CINAHL, and MEDLINE) identified 13 qualitative studies, which were appraised using the Critical Appraisal Skills Programme (CASP) checklist, and analysed using thematic synthesis.
Results. Three analytics themes were developed: 1) Constructing positive meaning through R/S, 2) Transforming struggle into spiritual understanding, and 3) Evolving explanations of unusual experiences.
Conclusion. This review highlights that mental health services must move beyond basic cultural awareness to actively support R/S meaning-making, creating flexible spaces where multiple explanatory frameworks (spiritual, cultural, and clinical) can safely coexist. Recognising and working with this complexity is crucial for supporting long-term recovery in psychosis.
Section B
Background. Religious and spiritual (R/S) beliefs can support meaning-making in psychosis but may also contribute to confusion or distress. Despite their importance to many service users (SUs), little is known about how clinical psychologists (CPs) engage with R/S content in practice. This study explored how CPs made sense of their own R/S beliefs and how these intersected with their work with SUs who also hold R/S beliefs in the context of psychosis.
Methods. Ten UK-based CPs with a range of R/S beliefs and practices participated in semi-structured interviews. Reflexive thematic analysis was used for data analysis.
Results. Four themes emerged: 1) personal R/S identity; 2) relational dynamics with SUs; 3) clinical complexity when working with R/S and psychosis; and 4) personal and professional development in building competence.
Conclusion. Findings highlight the need for clinical psychology training to move beyond policy recognition, embedding structured spaces for reflection on R/S
Dissociation and avoidance in psychosis: narratives through the trauma-lens
No full textSection A
Research on the relationship between trauma and psychosis continues to grow (Bloomfield et al., 2021), however, a clear understanding of processes involved from trauma-related stress to vulnerability for psychosis has yet to emerge. Processes associated with post-traumatic responses have been suggested to be involved in psychosis-related experiences, such as dissociation and avoidance. There is increasing evidence which depicts an association between dissociation and psychosis-related phenomena (Longden et al., 2020). Additionally, experiential avoidance has been found to relate to voice-related distress (Varese et al., 2016) and to forms of dissociation (Marx & Sloan, 2005). This review aimed to critically evaluate literature that depicts the roles of both dissociation and avoidance in the context of psychosis and to present a metasummary of the emerging themes across studies. Ten quantitative papers and three qualitative papers met the eligibility criteria, which collectively comprised of outcome evaluation data and interview-based research. Sandelowski & Barroso’s (2006) metasummary approach was taken to synthesise the findings, where six themes were found: dissociation and avoidance linking trauma and psychosis, working with dissociation and avoidance in psychosis, associations between dissociation and avoidance with psychosis, conceptualising dissociation and avoidance, using measures of dissociation, and the relationship between dissociation and avoidance in psychosis. Results suggested dissociation and avoidance could be grouped as emotion regulation strategies in the context of psychosis, and demonstrated ways in which these processes may distinctly occur. Combined investigation of both dissociation and avoidance as processes within psychosis requires further investigation considering the limited empirical research available. Implications for practice and further research are outlined.
Section B
Despite evidence, trauma-based explanations for psychosis are often overshadowed by biomedical ones (Harper et al., 2012) and individuals with psychosis remains underrepresented trauma-focused research and practice (Mueser et al., 2010; Hardy, 2017). However, strong links between trauma and psychosis have led to the development of effective trauma-focused therapies (TFT’s) for reducing associated distress (Brand et al., 2018). Furthermore, processes akin to post-traumatic stress, including emotion regulation strategies, are observed in individuals with psychosis (Hardy et al., 2024), such as experiential avoidance (Powers, 2016) and dissociation (Longden et al., 2020). Yet, research jointly exploring dissociation and avoidance as trauma-related processes in psychosis remains limited (Marx & Sloan, 2005; Longden et al., 2020). This study conducted a narrative analysis to investigate individual narratives of TFT for psychosis; whether and how they described experiences of dissociation and/or avoidance in their narratives, and if so, whether and how these were explored in TFT. Additional aims included analysing narrative structure and exploring the presence of biomedical or trauma-related frameworks e.g., comorbidity model. Narratives described the difficulty accepting psychiatric diagnoses and discussed biological versus trauma-informed explanations of psychosis. Dissociation and avoidance were described in the narratives as ways of managing trauma-related distress from early and later life experiences. The therapeutic relationship, eliminating self-blame and shame, and support to sit with emotions were identified as processes which supported overcoming distress. These findings highlight the need to assess for dissociation and avoidance in psychosis and inform trauma focussed clinical and research directions
Robotic surgery in healthcare: current challenges, technological advances, and global implementation prospects.
No full textRobotic surgery has transformed the field of surgery, offering enhanced precision, minimal invasiveness, and improved patient outcomes. This narrative review explores the multifaceted aspects of robotic surgery, examining the challenges, recent advances, and future prospects for its integration into healthcare. Our comprehensive analysis of 48 studies reveals significant geographic disparities in robotic surgery research and implementation, with 68.8% of studies originating from high-income countries. Despite its potential, the widespread adoption of robotic surgery faces significant obstacles, including high costs, training requirements, limited accessibility, and ethical considerations. Financial constraints make it difficult for resource-limited healthcare facilities to afford these systems, whilst the absence of standardised training restricts the pool of proficient robotic surgeons. Furthermore, ethical and medico-legal concerns about liability and patient consent complicate its adoption. Advances in artificial intelligence (AI) and machine learning (ML) are enhancing robotic systems with real-time decision support and personalised surgical approaches. In addition, telemedicine and remote robotic surgery show promise for expanding access to underserved areas. Looking forward, the development of affordable, portable robotic systems and integration of data-driven analytics are key to addressing current challenges and optimising patient care. This review provides a globally minded analysis of implementation barriers and identifies critical needs for more inclusive research and culturally appropriate solutions for diverse healthcare contexts. A multi-stakeholder approach involving policymakers, healthcare providers, and technology companies is crucial for overcoming these barriers and realising robotic surgery's full potential. As solutions to cost, training, and accessibility emerge, robotic surgery is expected to become a fundamental component of healthcare, offering substantial improvements in patient outcomes and operational efficiency. [Abstract copyright: © 2025. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
A mixed-methods evaluation study of an online education intervention for people with a new diagnosis of fibromyalgia at a South East England hospital trust
No full textPURPOSE
Patient education is recommended to manage fibromyalgia, a long-term predominantly widespread pain condition. It is not clear how effective online education is on providing patients with the skills and knowledge to self-manage. The study aimed to explore the experiences of newly diagnosed patients receiving an online education intervention, delivered at a South East England Hospital Trust, to evaluate how the intervention may contribute to their selfmanagement of the condition.
METHODS
Following a literature review a mixed methods study design was used to explore patients’ views of their journey to diagnosis and the experiences with the online education intervention. During the study period (February-December 2023), 100 patients newly diagnosed with fibromyalgia received the education intervention and completed a Patient Activation Measure (PAM). Four online focus groups were conducted and audio data transcribed and analysed with thematic analysis. PAMs were completed at baseline (T1), 24 completed at 2 months post-education (T2)
and 4 completed at 6 months (T3) and compared with patients receiving the education intervention as part of routine care.
RESULTS
Qualitative analysis of the focus groups using thematic analysis identified 4 main themes and 3 sub-themes linear with the patient journey to diagnosis: 1) Searching for a reason for their symptoms, 2) Need for compassion and understanding, 3) Contradictory and suspicious thoughts regarding the diagnosis 4) Conceptions of the treatment. Patients described the frustration of the prolonged diagnostic process. The rheumatology consultation and receiving a diagnosis was a
significant point in their journey and highlighted the challenge of illness and identity. Insight was gained into the education intervention offered, revealing it was viewed positively. Quantitative analysis of PAM scores indicated that the study participant data aligned with routine care. Most study participants (75%) scored L1 or L2 at baseline (T1) showing a low level of skills and confidence to self-manage at diagnosis. Following completion of the education intervention 50% scored L1 or L2, showing a possible trend towards increased skills and
confidence, but not statistically significant p<.226.
CONCLUSIONS
Insights gained into the patients’ views and feelings experienced of their journey to diagnosis, and views on online patient education indicate it was a valued intervention, and should be offered at the diagnosis stage. Self-management skills and confidence were low prior to the education intervention, with positive trends of improvement post-education in the study participants. The themes identified warrant greater exploration through further research to shape future long-term
self-management of fibromyalgia
Challenges for responsible AI design and workflow integration in healthcare: A case study of automatic feeding tube qualification in radiology
No full textNasogastric tubes (NGTs) are feeding tubes that are inserted through the nose into the stomach to deliver nutrition or medication. If not placed correctly, they can cause serious harm, even death to patients. Recent AI developments demonstrate the feasibility of robustly detecting NGT placement from Chest X-ray images to reduce risks of sub-optimally or critically placed NGTs being missed or delayed in their detection, but gaps remain in clinical practice integration. In this study, we present a human-centered approach to the problem and describe insights derived following contextual inquiry and in-depth interviews with 15 clinical stakeholders. The interviews helped understand challenges in existing workflows, and how best to align technical capabilities with user needs and expectations. We discovered the trade-offs and complexities that need consideration when choosing suitable workflow stages, target users, and design configurations for different AI proposals. We explored how to balance AI benefits and risks for healthcare staff and patients within broader organizational, technical, and medical-legal constraints. We also identified data issues related to edge cases and data biases that affect model training and evaluation; how data documentation practices influence data preparation and labelling; and how to measure relevant AI outcomes reliably in future evaluations. We discuss how our work informs design and development of AI applications that are clinically useful, ethical, and acceptable in real-world healthcare services
“In code I stand with you”: We still can’t breathe \u1f5a4
No full textThis is a social media artivist poster.
Photographic based AI and digital portrait with typography.
I am capturing a haunting moment of defiant stillness and collective memory. Cloaked in a hooded garment and framed in solemn lighting, both a visual autoethnography and a visual ethnography.
The tattoos represent me, and the fist represents an echo of Black Power iconography and global protest imagery. The gaze within my poster, unflinching and direct, holds the viewer accountable.
Over the female image, the words “WE STILL CAN’T BREATHE” strike in urgent red, invoking the lasting trauma and legacy of George Floyd’s murder and the ongoing police brutality disproportionately affecting Black communities worldwide.
My image is more than commemorative. It functions as a visual manifesto, calling attention not just to the violence inflicted on Black men but to the enduring emotional and political labour carried by Black women, who often shoulder the burden of mourning, organising, resisting, and remembering.
This is artivism, this is activism, this is the juxtaposition of digital platforms and tools.
Technology embodies historical systems of oppression; its gatekeepers remain the same dominant figures who have always controlled access and narrative."
Black British Art has always been embedded in the struggle of Black British Communities.
I am taking back my black female power and using these tools to resist and to challenge hegemonic power structures. Paying homage to 'The UK Black Art Movement' and continuing their legacy.
Historically in the UK, Black women have stood at the frontline of resistance, often without recognition, as we have mourned, mobilised, and challenged violence inflicted on Black communities, especially against Black men.
From the Mothers of the Mangrove and the New Cross Fire families, to the tireless campaigning of Doreen Lawrence for justice after the racist murder of her son Stephen Lawrence, Black British women have shouldered the emotional, legal, and activist burdens of police and government neglect.
This lineage of mourning-as-resistance and Black feminist care is themed within my social media post using art recalling both personal grief and collective struggle, echoing the work of women like Marcia Rigg, who continues to fight for justice after the death of her brother, Sean Rigg, in police custody.
Positioning our stories at the heart of both historical remembrance and visual activism.
The use of Typography is deliberate and includes over 100 hashtags, including Jamaican pidgin/creole language and African diaspora hashtags, as symbolic.
In the last 100 years, not much has changed for Black Britons:
1925 for Black Britons:
No legal protections against racial discrimination
Exclusion from skilled jobs, housing, and social mobility
Community organising beginning in the shadows of colonial rule
White British society upheld systemic racism as normalised policy and culture
Black people in Britain were marginalised in the 1920s and started forming the foundations of future resistance movements like the African Progress Union.
“Britain’s Black communities were already intellectually and politically engaged, laying the groundwork for later resistance movements.”
(Adi, 2019, p. 16)
Even in the 1920s, Black communities were disproportionately policed. Records show that Black seamen were often targeted for alleged immigration violations or petty crimes, despite their contributions to the British economy and Empire.
“Blackness was criminalised through the gaze of the police and press, contributing to a cycle of surveillance, deportation, and community trauma.”
(Solomos, 1993, p. 45)
My work aligns with Critical Race Theory, particularly its emphasis on counter-storytelling, systemic critique, and intersectionality. CRT argues that racism is not an abnormality but is embedded within legal and societal systems, including policing structures.
“We still can’t breathe” is a counter-narrative that reclaims space in a media landscape where Black pain is often sensationalised but not humanised or archived with dignity.
“The voice of people of colour is required for a deep understanding of the legal system... and of how the law is far from neutral or objective.”
(Delgado and Stefancic, 2017, p. 45)
My artwork is that voice: part testimonial, part resistance, and part archive. It makes visible the racialised violence that persists while centering the Black British woman’s role as a witness and power in the struggle for justice
Cardiac structure, function and mechanics in hypertensive disorders of pregnancy: A systematic review and meta-analysis
No full textBACKGROUND: Hypertensive disorders of pregnancy (HDP) are among the most common pregnancy complications and leading causes of maternal morbidity and mortality worldwide. This study aimed to perform the largest meta-analysis to date comparing conventional and advanced echocardiographic features in HDP against healthy pregnancy.
METHODS: PubMed (MEDLINE) and EMBASE were systematically searched for research articles published up to March 2024. Included studies reported at least 1 relevant echocardiographic parameter in pregnancies complicated by HDP and normotensive healthy pregnancies separately. A total of 53 studies met the inclusion criteria, comprising 7168 participants (3381 HDP and 3787 controls).
RESULTS: Myocardial mechanics, as measured by global longitudinal strain (weighted mean difference (WMD), −2.81% [95% CI, −3.70 to −1.91]; P<0.001) and left atrial reservoir strain (WMD, −9.36% [95% CI, −12.73 to −5.99]; P<0.001), were significantly impaired in HDP compared with healthy pregnancy. Furthermore, there were prominent cardiac structural differences, with significantly greater left ventricular mass index (WMD, 12.20 [95% CI, 9.77–14.64]; P<0.001), relative wall thickness (WMD, 0.055 [95% CI, 0.04–0.07]; P<0.001), left atrial size (WMD, 2.34 cm [95% CI, 1.62–3.06]; P<0.001),
and left atrial volume index (WMD, 2.38 mL/m2 [95% CI, 1.44–3.32]; P<0.001) in HDP compared with healthy pregnancy.
Finally, the ratio between early mitral inflow velocity and early mitral annular velocity average was significantly greater in HDP (WMD, 1.90 [95% CI, 1.42–2.38; P<0.001), indicative of an elevated left ventricular filling pressure.
CONCLUSIONS: This meta-analysis highlights clinically relevant differences in echocardiographic measures between HDP and healthy pregnancy. These results may enhance the utilization of echocardiography for the risk stratification and management of women with HDP. Advanced myocardial mechanics, including global longitudinal strain and left atrial reservoir strain, likely play a key role in detecting subclinical myocardial dysfunction and guidance for early intervention
Cannabis and cultural accommodation: exploring online drug normalisation through global visual representations and social media narratives with reference to Portugal and the Netherlands
No full textThis research investigates the cultural accommodation and normalisation of cannabis through global visual representations and online social media narratives, focusing on Portugal and the Netherlands as regulatory pioneers. These countries' distinct policy frameworks—Portugal’s harm-reduction approach centred on public health and the Netherlands’ coffeeshop model balancing accessibility with social control—reflect their pivotal roles in shaping contemporary cannabis perceptions. The study employs qualitative online ethnography and visual sociology to analyse digital content collected between 2021 and 2025, encompassing over 200 hours of data from platforms like TikTok, Instagram, and Reddit, alongside policy documents and cultural artefacts. A Grounded Theory framework guides the investigation, enabling a nuanced understanding of cannabis representations and their cultural implications (Glaser and Strauss (1967).The analysis highlights how aesthetic and commercial strategies transform cannabis from a criminalised substance into a ‘naturalised’ symbol of leisure, wellness, and social identity for everyday consumption (Blackman 2004). Medical cannabis emerges as a cornerstone of this normalisation process, with its integration into health narratives validating its therapeutic use (Adler et al., 2024). Social media platforms, particularly TikTok and Instagram, serve as critical spaces for cannabis normalisation, where it is portrayed through humour, wellness-oriented imagery, and consumerist aesthetics. Despite strict content regulations, users employ adaptive strategies to sustain visibility and reshape public attitudes. The significant contribution of this research lies in its examination of online normalisation, revealing how global narratives intersect with local practices in Portugal and the Netherlands. By integrating qualitative online ethnography, visual sociology, online media analysis, and policy studies, the findings underscore the role of digital platforms in redefining cannabis’ cultural, social, and economic significance, offering valuable insights for policymakers, academics, and public health
discours
Application of additive manufacturing on textiles
No full text3D printing is being increasingly explored in textile manufacturing, not only for producing yarns and fabrics but also to enhance their properties through direct printing on fabric. This technique offers the potential to create metamaterials that combine conventional textiles with functional, structural, or protective elements tailored for specific applications. This study aims to define and optimise the printing parameters of Poly-Lactic-Acid (PLA) and Thermoplastic-Polyurethane (TPU) filaments on Calico fabric. Key parameters such as filament temperature, layer height, and initial print speed were systematically varied to assess their influence on the adhesion properties of calico fabric. Initial testing has provided suitable ranges for these properties, but further testing is required to optimise the setting for each fabric-material combination.
Currently, there is no guidance for printing on fabric or a standard for testing adhesion; these results could be used to create a database that provides optimised 3D printing parameters for printing on fabrics. The findings from this study would provide information to textile manufacturers and designers interested in 3D printing on fabric to enhance its properties. Further work would involve printing metamaterials to tailor certain properties of the fabric, thereby improving and adapting its functionality