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Global multi-specialty clinician perspectives on the implementation of Alzheimer's disease blood biomarkers
No full textINTRODUCTION
Clinicians’ views on the clinical readiness of Alzheimer's disease (AD) blood biomarkers (BBMs) are not well understood.
METHODS
The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment Biofluid-Based Biomarkers Professional Interest Area conducted a survey to elicit clinician opinions on AD BBM implementation, including contexts of use, assay selection, reporting, and result interpretation.
RESULTS
Clinician respondents (n = 212) practiced in Europe (56%), North America (24%), the Caribbean and Central/South America (11%), and other continents (9%). Most respondents were medical doctors (80%) practicing in secondary or tertiary care (88%). For 56%, cerebrospinal fluid AD biomarkers or amyloid positron emission tomography were accessible, but 48% agreed and 52% disagreed with the implementation of AD BBMs in any clinical context. Respondents emphasized the need for data from diverse populations and educational resources to support test interpretation.
DISCUSSION
Surveyed clinicians generally agreed with published appropriate use recommendations but were divided on AD BBM readiness for clinical use.
Highlights
A survey of clinicians was conducted regarding clinical readiness of Alzheimer's disease (AD) blood biomarkers (BBMs).
Views were split on AD BBM clinical readiness: 48% agreed, 52% disagreed.
Most responders supported AD BBM use for treatment decisions.
Most responders opposed AD BBM testing in asymptomatic individuals.
Test performance data and educational materials to aid interpretation were of high importance
'Flexibility is the name of the game': Clinicians' views of optimal dose of psychological interventions for psychosis and paranoia
No full textIn the UK, NICE (2014) recommends a minimum of 16 sessions of Cognitive Behaviour Therapy for the treatment of psychosis. One of the barriers to implementation is that clinicians’ views of optimum doses may not fit with this guidance. This study investigates the views of clinicians on the optimal dose of interventions. Fifteen clinicians participated in four focus groups and completed a bespoke questionnaire investigating experiences of dose in different contexts. We used the framework method for data analysis, with Voils et al. (2012) conceptualisation of dose as the frame.
We identified three deductive themes on dose components; number, frequency, and length of therapy sessions. In community settings, participants recommended 1–5 sessions for shorter-term goals, 10–12 sessions for longer-term goals, and highlighted the importance of review after 20–26 sessions. While a range of 16–26 sessions was identified as optimal, a consensus formed around dose being variable to each individual. In inpatient settings, number of sessions was largely dependent on length of stay. In community settings participants found it helpful to initially have weekly sessions and then transition to fortnightly, while in inpatient settings participants met with patients 1–3 times a week. In community settings, participants reported often delivering 50–60 min sessions (although that could vary); while in inpatient settings sessions lasted from 5 min to 2 h. Dose recommendations for community settings applied to digital therapies.
We constructed four inductive themes on how clinicians adapt dose in clinical practice; (1) context matters, (2) individualised treatment approaches, (3) flexibility is key, and (4) balancing clinical idealism and service constraints. Complementing the NICE guidance, our findings endorsed the use of a variable index of sessions to address variability in clinical need. The incorporation of stakeholder views is essential to contextualise quantitative evidence-based recommendations
Puritan views of society and social obligations
No full textThis chapter examines the complex influences that shaped puritan ideas about society and social obligations between Elizabeth’s reign and the Restoration. Puritans adhered to the commonly held view that social relationships were based on a combination of Christian and Humanist principles, but they regarded their own religious faith as paramount. This placed immense importance on the conscience of the individual and also molded the puritans’ conviction that they were part of an exclusive community within English and later within North American society. Puritans imposed their views on society more widely during both the “Great Migration” to North America from the 1620s and during the Puritan Revolution in England in the 1640s. The Restoration marked a turning point, as royal control was reasserted in both regions, and by the end of the seventeenth century, many of the theories underpinning puritan social views were being replaced by new values based on the growth of commerce and concepts of polite etiquette, rather than religious beliefs
Male breast cancer: A single institutional clinicopathological profiling
No full textBackground/Aim: Male breast cancer (MBC) is an infrequent occurrence accounting for <1% of overall breast cancers. With limited data, MBC remains a therapeutic challenge, warranting the need for meticulous recording of all cases encountered.
Patients and Methods: A retrospective observational study in an Indian tertiary public hospital where 29 MBC cases registered between August 2020 and July 2023 were recorded and their epidemiological data, clinical profile, treatment history and survival data were analyzed.
Results: MBC was 3% of all breast cancer cases reported in three years, and the most common age group affected was between 41 and 60 years. Most cases presented at Stage IIIB, with the majority showing axillary nodal involvement. Invasive ductal carcinoma was the most frequent histology with luminal B and triple-negative variants having the highest incidence. Most patients underwent upfront surgery followed by adjuvant chemotherapy. At the end of one year, 50% of patients were found to survive with no disease progression.
Conclusion: Our results corroborate with previously recorded experience with MBC in terms of age distribution, stage of presentation, histology and treatment offered. However, our results demonstrated a higher proportion of triple-negative breast cancer (TNBC) cases, as compared to previous literature. The increment of TNBC cases among males, therefore, reassures the need for breast cancer (BRCA) gene testing among all males afflicted with breast cancer
Suicide and the internet
No full textIntroduction: Suicide is a complex key public health issue, with almost 1 million deaths by suicide each year. Recently, there has been much interest in the role of the Internet in suicide, with both potential benefits and risks proposed for the use of the Internet by those experiencing suicidal ideation
Aims: This review aimed to conduct an updated search of the literature for qualitative and mixed-methods research that addressed how people used the Internet for suicide-related purposes, and the responses to this from other Internet users
Method: A systematic literature search was carried out on four databases. Twenty papers were considered relevant and quality appraisal and a thematic synthesis was carried out on these
Key Findings: Key themes included finding a sense of community, help-seeking, researching suicide, suicide communication, provision of support, construction of a suicidal identity and suicide baiting
Implications: Clinical implications included the need for clinicians to ask about suicide-related Internet use. Research implications included the need for research focusing on social media, and for research into acceptability and efficacy of online intervention
‘Tiny humans’ outdoors: Understanding the factors that mediate opportunities for babies and toddlers
No full textThis paper contributes new knowledge and understanding to an area of international interest in research, policy and practice about the marginalisation of babies and toddlers through its novel outdoor focus. Drawing on a qualitative systematic literature review and adopting a ‘spatialities’ lens, it explores the factors that mediate the experiences of ‘tiny humans’ in outdoor spaces. It finds that since their access to, and interactions within, outdoor spaces are dependent upon adults both directly and indirectly, who these adults are (social characteristics) and how they are (cultural values and practices), are critical mediating factors. This positions the outdoors as a socially stratified space in which socio-economic status, class, ethnicity, and (dis)ability intersect in ways that can either include or marginalise even from before birth. At the same time, it is a cultural space in which values are expressed, transmitted and reproduced through care practices which may (or not) foster a sense of social and spatial inclusion. Finally, the outdoors emerges as a political space in which power relations play out. We argue that, given the rise in babies and toddlers attending ECEC settings globally, these may offer potential sites for developing counter-hegemonic practices that challenge social boundaries, the dominant cultural narrative of the Global North and the associated power relations that marginalise tiny humans and those that care for them. Alongside this, we call for further collaboration between disciplines to extend and disrupt the normative discourses about babies and the outdoors that are being reinforced through research in this area
Enhanced state of charge estimation through Cluster-Based Learning Model: Impact study on degradation and profitability of second-life electric vehicle batteries
No full textThe growing adoption of electric vehicles (EVs) presents an opportunity for repurposing end-of-life batteries for second life (SL) applications, such as energy storage systems. However, accurate estimation of the state of charge (SOC) remains critical for optimizing battery performance and extending operational life in these applications. This paper presents an in-depth investigation into the impact of advanced SOC estimation on the degradation and profitability of second-life EV batteries, utilising a Cluster-Based Learning Model (CBLM). An empirical degradation model is adapted to quantify how SOC estimation errors influence key battery health metrics, including capacity loss, State of Health (SOH), and energy retention. The study proposes the “energy advantage metric,” which quantifies the usable energy retained in SL batteries based on SOC estimation accuracy. Capacity loss analysis across various SL applications demonstrates that the CBLM model significantly reduces battery degradation compared to the Standard Long Short-Term Memory (S. LSTM) model, particularly under deep discharge cycles. These improvements in capacity retention are then translated into economic impact, revealing cost savings ranging from £339 in residential PV systems to over €200,000 in grid-scale energy arbitrage. t-Test confirmed significant differences in degradation performance between CBLM and S. LSTM models, with Cohen's d effect size showing a small but meaningful effect size for Loss of Lithium Inventory (LLI) (d = 0.24)
Anthro-Digital Narratives (ADN) framework & EthnoGo mobile app prototype V1
No full textI have created and developed a new composite theoretical and methodological research framework called Anthro-Digital Narratives (ADN), along with the mobile app software to implement it. Through the ADN framework, I will examine algorithmic bias and the visibility of Black British female art on Instagram, TikTok, and Twitter/X. This decolonial methodology integrates anthropology, digital humanities, ethical artificial intelligence (AI), and a mobile-first approach.
Using the EthnoGo app, which I also created and developed, a no-code mobile app, I will research platform-driven misrepresentations of Black British identity, co-create counter-strategies with artists, and advocate for equitable AI policies. Over 12 weeks, EthnoGo’s design will facilitate multimodal data collection (posts, engagement metrics, AI-generated content) and participatory workshops to analyse disparities in algorithmic reach and moderation. Ethical priorities include data sovereignty, ensuring artists retain ownership of cultural outputs, and auditing AI tools for racial and gender bias. Although limited by restricted access to proprietary algorithmic data, the study prioritises transparency through mobile-first methods, publicly available metrics, and community validation. The findings aim to inform policy reforms and demonstrate how mobile-first, inclusive methodologies like ADN and EthnoGo can challenge systemic inequities in digital cultural representation
An initial grounded theory of how young people with mental health problems experience and are affected by fictional representation
Get PDFYoung people with mental health problems (MHPs) are increasingly exposed to representations of MHPs within fiction, but little is known about this process. This study used grounded theory to develop a preliminary understanding of how 16- to 25-year-olds with MHPs experience and are affected by fictional media representation of MHPs. Fourteen individual interviews were conducted with nine young people. The developed theory suggests that fiction was experienced as a reflection on participants’ own reality, a process made up of two key stages, identification with fiction and transferring beyond fiction, whereby the representative portrayals led to both helpful and harmful impacts. Such effects seemed to depend on both personal context and the nature of the fiction. Findings are discussed in terms of relevant theory and outcomes for wellbeing, with study limitations and implications for practise and research considered
A virtual reality-enabled framework to promote the use of foresight innovation between universities and business
No full textThis thesis investigates how foresight innovation practices benefit from the use of immersive technologies with the aim to enhance collaboration and innovation-based activities between universities and business. Following an extensive systematic literature review, the three areas of theory, context and technology were identified as essential when researching this area.
The science fiction prototyping approach, Diegetic Innovation Templating (DIT) was identified as the foundational theory in support of this research. The context for where the theory was applied relied upon organisations that had a shared understanding for how collaboration should take place. This was established during the research as a new holistic approach that combined both Open Foresight and Open Innovation, named the Open Foresight Innovation Paradigm (OFIP). Virtual reality was identified as a suitable enabling technology due to its ability to lower technological barriers, encouraging collaboration and, by extension, innovation to take place within innovation workshops conducted using an immersive digital innovation lab.
Upon completion, the Theory, Context, and Technology (TCT) Taxonomy was established, which when combined with findings drawn from subject matter expert interviews, resulted in the specialised theoretical framework, named Digital Innovation Templating in Virtual Reality (DITVR).
DITVR was formed using a theoretical foundation that informed three components; the DITVR process, the 3D Innovation Template (3D-IT) and the Diegetic Gap in VR (DIGVR) feasibility assessment.
Collectively, these components were used through a series of innovation workshops to establish their validity using a between subjects experimental design. Observational data was collected during the innovation workshops and compared with participant questionnaire responses to understand the benefits that could be achieved through the use of DITVR.
The findings were that DITVR enhanced collaboration by enabling the sharing of ideas between participants using the DITVR process while also establishing the form that a valid 3D-IT should take when created in VR. The innovation outcomes were then assessed for feasibility using the DIGVR metric, establishing it’s value specifically in the context of University to Business (U2B) collaboration and the proposal to rename it as the Techno-Conceptual Gap (TCG) metric wherever used in the future.
Future research in this area should look at the quantitative dimension with the aim to develop DITVR to be generalised for application across a wider range of contexts while identifying other enabling technologies that could be used in place of VR