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Interpreter-mediated paediatric neuropsychological assessments:Clinician and interpreter experiences and consensus-based recommendations
Get PDFInterpreter-mediated assessments are increasingly common in paediatric neuropsychology, both globally and within the United Kingdom, due to the rising linguistic and cultural diversity of service users. However, limited research has examined how interpreters and clinicians navigate the complexities of delivering developmentally appropriate, culturally sensitive and psychometrically valid assessments. This qualitative study explored the experiences of 10 paediatric neuropsychologists and nine professional interpreters across NHS services in the United Kingdom. Semi-structured interviews examined the challenges, role expectations and collaborative practices within interpreter-mediated cognitive assessments. Data were analysed using reflexive thematic analysis, with key themes highlighting tensions between access and standardisation, differing interpretations of the interpreter's role and the unique demands of neuropsychological testing in children. Participants consistently emphasised the value of structured collaboration, such as pre-assessment briefings and post-assessment debriefs, though these practices were inconsistently applied. A two-round structured consensus-building exercise, informed by Delphi methodology but adapted for a smaller, profession-specific sample, was subsequently conducted with 13 participants to generate consensus-based recommendations. Nine statements reached an agreement of ≥80%, including the need for joint preparation, interpreter access to sample materials and tailored training for both interpreters and clinicians. These findings underscore the distinct cognitive, relational and linguistic challenges inherent to interpreter-mediated paediatric neuropsychological assessment and call for more explicit guidance and professional development. The study contributes to cross-cultural neuropsychology by providing practice-oriented recommendations to enhance the quality and equity of assessments. Future work should focus on implementation, particularly within resource-constrained or multilingual settings
Do alcohol industry-funded organisations act to correct misinformation? A qualitative study of pregnancy and infant health content following independent analysis
Get PDFBackground: Access to reliable, accurate, and up-to-date health information is a crucial component of global population health. Like other health-harming industries, the alcohol industry is known to provide misinformation to the public, including on alcohol, pregnancy, and infant health. It is unknown whether industry information changes following independent public health analysis. Methods: We extracted data using the homepage, menu, and search tool functions (where available) from seven industry-funded charity and nonprofit company websites (Aware, South Africa; Drinkaware, Ireland; Drinkaware, United Kingdom; Éduc’alcool, Canada; DrinkWise, Australia; Foundation for Advancing Alcohol Responsibility, United States; and International Alliance for Responsible Drinking) that have previously been found to misrepresent the evidence on alcohol, pregnancy, and infant health. We conducted a qualitative, thematic analysis using a published framework of ‘dark nudges and sludge’ misinformation techniques. Results: Omission of information, functionality problems, and the positioning and sequencing of information in ways that framed or obfuscated its meaning were the most common forms of misinformation identified. These types of misinformation were often mixed with (limited) relevant information and were most often found in combination. We found pregnancy and infant health information for the consumer on five of the seven websites studied (Drinkaware, Ireland; Drinkaware, United Kingdom; DrinkWise; Éduc’alcool; and Aware). Information on pregnancy and fetal alcohol spectrum disorder was found on these five sites, although they did not all provide information on miscarriage, breastfeeding, or fertility. We could not find any pregnancy and infant health information directed to the consumer on the remaining sites (Foundation for Advancing Alcohol Responsibility and International Alliance for Responsible Drinking). Six of the seven websites had a search tool function; these often produced irrelevant information. Conclusions: Following independent public health analysis of their informational outputs, misinformation about pregnancy and infant health remains present on alcohol industry-funded websites. Warnings to the public to avoid alcohol industry-funded information sources should form an essential part of the global effort to tackle health misinformation.</p
The workings of treasuries in Greek sanctuaries
No full textThesauroi are common in Greek sanctuaries, as we know from epigraphical, literary and physical evidence, although written sources, especially inscriptions, are often ambiguous as to whether they refer to money boxes or buildings since the same term can be used for either. Scholars have long studied the latter, particularly the architecture and sculpture of those at Olympia and in the Apollo sanctuary at Delphi. Far less attention has been given to the administration, placement, accessibility and the motivations for constructing these buildings. This paper gathers and discusses the evidence concerning these issues to better understand these common structures and their use and function within sanctuaries.*</p
Computer-assisted reading tools marks:First step of a promising protocol
No full textThis paper presents a multi-modal method for integrating rock-cut structures into current archaeological studies related to Ancient and Medieval periods, particularly focusing on a case study of the north-west wall of the Göreme 4b church in Cappadocia (Turkey). Historically marginalised within archaeological research, rock-cut architecture is now reassessed through a combination of building archaeology, traceology, photogrammetry, and computer-assisted analysis. The primary objective is to establish a replicable protocol for interpreting tool marks to define construction phases and occupation sequences, thereby contributing to relative dating and heritage conservation.The interdisciplinary project involved the creation of a high-resolution 3D model, a relational database, and a GIS-based vectorisation of stratigraphic units (SUs). The 3D models—generated from DSLR and smartphone photogrammetry—facilitated the production of orthophotographs and digital elevation models, essential for precise tool mark analysis. Using controlled vocabularies and standardised descriptors, the relational database supports both qualitative and quantitative analysis, enabling cross-referencing across architectural features and excavation contexts. GIS software was employed to integrate geospatial data, allowing for the vectorisation and chronological ordering of identified SUs.The results demonstrate the utility of this method in clarifying previously unseen features, such as a Christian cross near a tomb and stratigraphic relationships between excavation phases. Notably, the method confirmed that initial excavation proceeded from the top down, and identified multiple phases of tool use, including quarry picks and polkas. Although more time-consuming than traditional CAD-based methods, the systematic protocol enhanced interpretive precision.This approach offers significant advantages for understanding site chronology and spatial dynamics, and can be extended to larger areas and other structures. Future developments may incorporate artificial intelligence for automated tool mark recognition. The study underscores the potential of integrating digital technologies into archaeological research to refine structural analysis and conservation strategies
The bio-psycho-social determinants of health:Reflections on the CIAR Population Health Program (1987–2003)
No full textIn the mid-1980s, a remarkable polymath, Dr Fraser Mustard, founded the Canadian Institute for Advanced Research (now CIFAR – https://cifar.ca/), as a unique way to develop, across Canadian and selected international universities, over a dozen multi-disciplinary groups of researchers tackling major intellectual challenges of that era. Among these groups was the Population Health Program (PHP), led for its initial decade by the brilliant Canadian health economist Prof Bob Evans. Over the next decade-and-a-half, the PHP met nearly fifty times with top international scholars in all types of health research. Out of these interactions, the Program’s membership formulated a set of ideas about how the health of entire human populations and societies is determined, as well as enunciated clear policy and program implications of those ideas. This paper summarizes, from the point of view of the author (a Scholar, then Fellow in the PHP) the main themes that the PHP enunciated during its initial decade, culminating in the widely read volume “Why are Some People Healthy and Others Not”?. Finally, developments in the field of Population Health in the two decades since the “sunsetting” of the PHP are reviewed and commented upon.</p
How do ramping dynamics influence computations in the entorhinal cortex?
No full textThe entorhinal cortex is crucial for declarative memory and spatial cognition. Recent experiments reveal that many entorhinal neurons represent information through ramping activity in which their firing rate changes monotonically between behaviourally relevant boundaries. This Opinion considers the implications of entorhinal ramping dynamics for computations within the hippocampal formation. Localised firing of extensively investigated grid, border, and object cells is suited to categorisation and rapid learning, whereas ramping activity may reflect compressed codes for communication between areas, or entorhinal computations suited to generalisation. Thus, ramping dynamics may be a manifestation of fundamental but largely overlooked mechanisms contributing to memory and spatial cognition, suggesting a need to re-evaluate models of hippocampal–entorhinal function centred exclusively on sparse, localised codes.</p
An exploration of the factors influencing successful implementation, delivery and outcomes in an intensive care sedation study:process evaluation of the A2B RCT
No full textBACKGROUND: Choice of sedation of critically ill patients is a core element of intensive care practice. The alpha 2 agonists for sedation to produce better outcomes from critical illness (A2B) trial tested the effectiveness of two alpha agonist sedatives versus propofol in reducing time on mechanical ventilation in 38 intensive care units in the United Kingdom. To evaluate both how this complex trial was implemented and how this may have influenced trial outcomes, an understanding of the contextual and practice variation across multiple sites was required.AIM AND OBJECTIVES: The aim of this process evaluation of the A2B trial was to determine how the intervention was delivered, the extent to which it was delivered as intended and the impact this had on outcomes. Specifically, we aimed to: Establish the degree to which the A2B intervention was delivered as intended, specifically in relation to fidelity, dose and reach across patients. Understand factors that impacted on successful delivery of both the A2B intervention and trial, in relation to attitudes and perceptions of staff, including context and standard care.DESIGN AND METHODS: A mixed-methods, multiphase design was used following extensive pre-trial exploration of current practice. Quantitative data were drawn from the main trial database covering 38 sites to assess the intervention's fidelity, dose and reach in each site. Data were analysed descriptively and provided a low-moderate-high rating. Qualitative data were collected by interviews mid trial (phase 1) and end of trial (phase 2). Participants were recruited from a random sample of 30 intensive care units active at the time of sampling and included the principal investigator, research nurses and clinical staff. Semistructured interviews, informed by the trial's logic model, lasted 45-60 minutes. Data collection focused on whether the intervention could be delivered as intended, factors that impacted upon successful delivery and understanding intervention adherence. Analysis used a framework approach based on the logic model. Data collection and qualitative analyses were completed prior to knowing the primary results of the trial.RESULTS: Site intervention adherence ratings for fidelity, dose and reach were low (4), moderate (20) and high (14). Participants from 12 intensive care units in each of phase 1 (33 staff) and phase 2 (36 staff) provided qualitative data; participating intensive care units differed between phases. Factors identified in phase 1 focused on intervention delivery and trial conduct and incorporated both organisational and participant-related factors. In phase 2, participant-related factors included clinician preference, individual equipoise, clinician resistance and staff capability and capacity, while A2B trial-related factors included concerns relating to safety and side effects, overnight deep sedation practice, patient comfort and trial documentation. Many of these factors were impacted by the COVID-19 pandemic, particularly in regard to staffing numbers and experience.LIMITATIONS: Due to the impact of the COVID-19 pandemic, most data collection occurred remotely through video-conferencing rather than planned at site observation and interviews.CONCLUSION: Optimal sedation practice is influenced by multiple factors related to clinician perceptions, capacity and capability. Priorities in care focus on short-term safety and comfort. Limitations in staffing mean that longer-term consequences related to recovery and rehabilitation are second tier considerations.FUTURE WORK: Findings highlight the multiple contextual factors, including both organisational and participant-related characteristics, that should be considered when planning both clinical trials and changes to routine care. Multiple strategies for achieving behaviour change when implementing complex interventions are essential.FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 16/93/01.</p
Perspectives from South Africa on GenAI in higher education:A postdigital dialogue with the global context
No full textDrawn from an interdisciplinary gathering of 51 colleagues at the University of the Witwatersrand (Wits) in Johannesburg in March 2025, this collective article shares multiple perspectives from South Africa on our interactions with Generative AI (GenAI) across higher education (HE). Contributors have re-created our dialogue here, in the spirit of Ubuntu and via a postdigital lens, bringing together vital local knowledge and literature to demonstrate why context always matters deeply. Over decades now, HE policy language has inferred that we all experience digital technologies in the same way. With GenAI, this technocratic determinism is accompanied also, by a depressing dystopian fatalism. Rather than confine our diverse positionalities within either of these viewpoints, we favoured a relational approach of reciprocal listening and pedagogical responsiveness to explore the complex interplay between GenAI, learning design, assessment, and social justice. Amid the pressure to integrate GenAI, a deliberate pause is needed, to notice and respond to, the flaws it exposes in our traditional systems. It is therefore timely to also review the social contract that underpins equitable and ethical opportunities in HE. Under four themes, authors provide recommendations towards a new critical, relational GenAI governance, based on diverse lived experiences in this messy postdigital space. From this particular context in South Africa, we now warmly invite continued discussion across the wider global community
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