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The Impact of AI-Driven Chatbot Assistance on Protocol Development and Clinical Research Engagement: An Implementation Report
Get PDFBackground: The integration of artificial intelligence (AI) into healthcare research has the potential to enhance research capacity, streamline protocol development, and reduce barriers to engagement. Medway NHS Foundation Trust identified a plateau in homegrown research participation, particularly among clinicians with limited research experience. A generative AI-driven chatbot was introduced to assist researchers in protocol development by providing step-by-step guidance, prompting ethical and scientific considerations, and offering immediate feedback. Methods: The chatbot was developed using OpenAI’s GPT-3.5 architecture, customised with domain-specific training based on Trust guidelines, Health Research Authority (HRA) requirements, and Integrated Research Application System (IRAS) submission protocols. It was deployed to guide researchers through protocol planning, ensuring compliance with ethical and scientific standards. A mixed-methods evaluation was conducted using a qualitative-dominant sequential explanatory design. Seven early adopters completed a 10-item questionnaire (5-point Likert scales), followed by eight free-flowing interviews to achieve thematic saturation. Results: Since its launch, the chatbot has received an overall performance rating of 8.86/10 from the seven survey respondents. Users reported increased confidence in protocol development, reduced waiting times for expert review, and improved inclusivity in research participation across professional groups. However, limitations in usage due to free-tier platform constraints were identified as a key challenge. Conclusions: AI-driven chatbot tools show promise in supporting research engagement in busy clinical environments. Future improvements should focus on expanding access, optimising integration, and fostering collaboration among NHS institutions to enhance research efficiency and inclusivity
Enhancing Alzheimer's disease prediction using random forest: A novel framework combining backward feature elimination and ant colony optimization
Get PDFBackground
Alzheimer's disease (AD) represents a significant global health challenge due to its increasing prevalence and the limitations of current diagnostic approaches. Early detection is crucial as pathological changes occur 10-15 years before clinical symptoms manifest, yet current diagnostic methods typically identify the disease at moderate to advanced stages. Machine learning techniques offer promising solutions for early prediction, but face challenges related to feature selection and hyperparameter optimization.
Objective
To develop an enhanced predictive model for Alzheimer's disease by integrating advanced feature selection techniques with nature-inspired hyperparameter optimization for Random Forest classifiers while ensuring robust validation and statistical significance testing.
Methods
This study employed three feature selection techniques (Whale Optimization Algorithm, Artificial Bee Colony, and Backward Elimination Feature Selection) and two hyperparameter optimization algorithms (Artificial Ant Colony Optimization and Bald Eagle Search) to improve Random Forest model performance. A dataset comprising 2,149 instances with 34 features was preprocessed using MinMax normalization and Synthetic Minority Oversampling Technique (SMOTE) applied only to training data to prevent data leakage. Statistical significance testing using McNemar's test was conducted to compare model performances. Model performance was evaluated using accuracy, precision, recall, F1-score, and AUC with confidence intervals calculated using bootstrap sampling.
Results
The combination of Backward Elimination Feature Selection with Artificial Ant Colony Optimization achieved the highest performance (95% accuracy ± 1.2%, 95% precision ± 1.1%, 94% recall ± 1.3%, 95% F1-score ± 1.0%, 98% AUC ± 0.8%), outperforming other methodological combinations and conventional machine learning algorithms with statistically significant improvements (p < 0.001). This approach identified 26 significant features associated with Alzheimer's disease. Additionally, nature-inspired optimization algorithms demonstrated substantial computational efficiency advantages over empirical approaches (18 minutes versus 133 minutes).
Conclusion
The integration of advanced feature selection with nature-inspired hyperparameter optimization enhances Alzheimer's disease prediction accuracy while improving computational efficiency. However, external validation on independent datasets and prospective clinical studies are needed to establish real-world utility. This methodological framework offers promising applications for early diagnosis and intervention planning, with potential extensions to other complex medical prediction tasks
Conclusions and future directions: Language education and research as social justice activism
No full textThe “magic lipstick”: luxury values in an economic downturn
Get PDFWe aimed to investigate how consumers understood luxury during an economic downturn, values they gained from consuming luxury in a downturn and to refine the existing dimensions of luxury value framework.
This study was qualitative and interpretive in nature. We interviewed 16 female luxury consumers during an economic downturn in 2022-2024 in the UK and thematically analyzed the data.
The term ‘lipstick effect’, referring to increased consumption of affordable luxuries in downturns, is imprecise, as our respondents did not consume luxury lipsticks. We found that apart from escapism offered by luxury consumption, in a downturn participants were ensuring luxury’s durability and thus continued functional value, which they tied to their self-concepts as responsible consumers. Luxury was also consumed to improve well-being, which additionally generated negative emotions of guilt and shame. Some consumers were concealing luxury.
We contributed to better understanding of the construct of luxury values. We showed that in a downturn consumers turned to affordable and transformative luxury. We added durability and well-being as new luxury values, mapped to functional and symbolic value dimensions, respectively. We also added the principle of making links between different luxury values and added the links between durability (functional) and self-actualization (symbolic) and between social meaning (symbolic) and emotional value (experiential). Further, we advise marketers to prioritise ‘meaning’ and ‘doing’, over ‘owning’ luxury and to enhance visibility of durability signals of luxury, over its conspicuousness
Correction: Tribe and Paddison (2025). Tourism Economics: 20 Years After the Critical Turn. Tourism and Hospitality, 6(1), 37
Get PDFMissing Institutional Review Board Statement and Informed Consent Statemen
Contributing factors to aggressive incidents in correctional and forensic psychiatric care: a rapid evidence assessment
No full textPurpose
Aggression within secure settings poses considerable concern. This study aims to offer more recent considerations of factors, such as cultural and environmental, that contribute to the prediction of aggressive security incidents, focusing on a rapid evidence assessment (REA) of available literature since 2018.
Design/methodology/approach
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Moher et al., 2009) guidelines were used for this REA, taking guidance from a previous study (Ireland et al., 2019) for the development of search terms.
Findings
Twenty-three final studies were included in the REA. All studies were conducted in either a prison (n = 8), a psychiatric inpatient facility with involuntary or compulsory treatment (n = 7) or forensic secure services (n = 7), with one study looking at both a general inpatient psychiatric hospital and forensic services. The thematic analysis noted four main themes that were predictive of aggressive security incidents, these were inadequate living facilities and poor physical environment, institutional security levels predicting aggression, restricted movement and the lack of meaningful activities and ward atmosphere and staff factors impacting staff–client relationships and consequent aggression.
Practical implications
This REA adds value to understanding the current interplay between the living facilities, wider forensic environment and staff interaction in a forensic client’s aggressive behaviours.
Originality/value
This REA offers an updated reflection and understanding on the presentation of aggression in secure forensic environments
Supply-Chain Infrastructure as Architecture: A Case Study of Amazon in Darlington, UK
Get PDFUsing its ‘fulfilment centre’ in Darlington in the North East of England as a case study, this article first assesses Amazon’s existing arrangement in the UK economy, pointing to the spatial concentration of distribution centres that makes up its fulfilment network in this area. It frames Amazon’s decade-long growth as an expansionary fix to the problems of saturation and congestion that inundate the Golden Triangle of industrial logistics elsewhere in the country. It then illuminates the business of logistics by documenting the economic arrangements brokered by multiple actors that propelled the development into motion. It recognises Amazon as the ultimate beneficiaries of recent economic turmoil by investigating how platform power allowed them to ride out recession in becoming providers of last-mile delivery services. Finally, once the various scales of governance that need to be leveraged for the space-making to occur have been established, it finishes by returning to the town of Darlington to grapple with the construction of Amazon’s fulfilment centre there. Altogether, this article argues that through its logistical network Amazon is erecting a supply-chain infrastructure as architecture, which establishes the importance of mobile horizontality to the dominance of vertical enterprises like this logistics and e-commerce giant
Balancing nature-based tourism and sustainable well-being: exploring aesthetic quality, environmental benefits, and pro-environmental behaviour
Get PDFThis study investigates the trade-offs between biodiverse aesthetic quality, environmental benefits and nature-based tourism, emphasising their impacts on tourist well-being, pro-environmental behaviour and satisfaction. Questionnaire survey was conducted to obtain the responses of 406 visitors in nature-based destinations in Hong Kong. The biodiverse aesthetic quality has been identified as a significant stimulus in predicting perceived benefits and satisfaction. Although anthropocentric benefits perceived by visitors cannot directly predict pro-environmental behaviour, tourist satisfaction contributes to hedonic and eudaimonic well-being, and pro-environmental behaviour. These findings highlight the need for destination managers to design nature-based tourism experiences that optimise both visitor satisfaction and sustainability goals. This study provides a new perspective on the growing discourse on sustainable tourism management, offering policy contributions for balancing tourist well-being and environmental conservation
The Dire Need to Examine Relationships Between Prospection and Subtypes of Anxiety
Get PDFIn this commentary, we give an appraisal of future thinking and emotional disturbance in light of A. L. MacLeod’s (2025) target article. A. L. MacLeod (2025) provides a timely synthesis of how depression and anxiety can affect future thinking. We concur with many of his central tenets such as the importance of process and outcome goals, the content of future thoughts, and metacognitive beliefs. Nevertheless, in this commentary, we highlight several points that we believe are equally as important in the developing research on future thinking and mental health. Specifically, we identified and developed five points around a central argument: that the melding of cognitive theory, empirical studies, and clinical knowledge is required to bring about a greater understanding of future thinking and its relation to anxiety disorders. This work could bring about a new understanding of, and innovative therapies for, anxiety, in a similar way that memory research is pioneering novel treatments for depression
Exploring Ableism and Occupational Therapy: Perspectives of Occupational Therapy Educators Working within Higher Education
Get PDFAim: This study examined the viewpoints of occupational therapy educators in higher education regarding ableism and its impact on occupational therapy practice. It forms part of a wider study which also explored occupational therapy student perspectives, published separately.
Method: An online survey involved the administration of Likert-scales and open-ended survey questions, enabling a comprehensive examination of occupational therapy educators’ perspectives on ableism in occupational therapy.
Findings: The sample comprised 32 teaching staff actively engaged in occupational therapy degree-level education. Most participants (72%) perceived occupational therapy as inherently ableist. Content analysis showed variations in how respondents understood the term ‘ableism’, and this appeared to be a compounding factor in respondents’ views as to whether the profession is ableist. Most (89%) respondents agreed that the profession focuses on independence, affirming past critiques. Themes, including cultural sensitivity, challenges with engaging in disability studies, and power dynamics within occupational therapy education, emerged.
Conclusion/Impact: This study provides insight into educators’ opinions of occupational therapy practices and their promotion of ableism. Future qualitative research should aim to unravel additional understanding of ableism within occupational therapy, including its origins, so future systemic changes required to address the harm of ableism can begin to be addressed.
Keywords: Ableism, Occupational Therapy, Disability Studies, Educators, Surve