Interpersonal difficulties are a core challenge experienced by people who have borderline personality disorder (BPD). Relationships where one person has BPD are often rated lower in satisfaction than others due to their tumultuous and unstable nature. Interpersonal difficulties not only cause distress but may also catalyse crises for people with BPD. The ability to sustain emotionally positive attachments is fundamental for recovery in BPD. The aim of this study was to understand how couples, where one partner has BPD, experience their intimate relationships and make sense of their success. Through semi-structured interviews, we explored the role of attachment in the context of these romantic relationships and identified constructive behaviours that contribute to their longevity and satisfaction. In-depth interviews were conducted individually with six couples engaged in long-term (>1 year) relationships. Interpretative Phenomenological Analysis (IPA) was used, and two key themes were identified - a) navigating the impacts of the disorder and b) safe base and secure attachment. Our findings suggest that reorientation of interpersonal transactions, where the partner without BPD serves as a stable base, enables open communication. As a result, people with BPD feel secure, promoting emotion regulation, remission from symptoms, and an ability to sustain a long-term, satisfying relationship.
In response to the increasing numbers of older, frail and dying persons in Western prisons and associated healthcare costs, awareness of the need of high-quality peer care in correctional facilities is growing. This paper aims to describe perceptions and experiences of male and female peer caregivers in two US prisons regarding their roles. Data were collected via focus groups with peer caregivers (n = 15) incarcerated in two US state prisons and examined using thematic analysis. Three themes were identified: "motivation and benefits", "challenges and costs" and "learning" associated with caregiving. The findings point to differences between male and female caregivers' motivation to perform the roles. While male peer caregivers in the sample appeared to be motivated by issues related to identity, masculinity and religious beliefs, female peer caregivers cited the value of meaningful relationships. However, there were several similarities between male and female's daily experiences and learning needs, and both groups enjoyed intrinsic and extrinsic rewards associated with their roles. To the best of the authors' knowledge, this is the first paper to conjointly describe male and female peer caregiver views and experiences of caring for older persons or persons with life-limiting illness. Findings underscore the need for more research aimed at making explicit the varying benefits of peer caregiving behind bars, as well as policies ensuring increased training for peer caregivers and correctional staff.
A nurse's commitment to prioritizing compassionate, patient-centered care during traumatic medical events fosters an environment where patients feel seen, supported, and respected.
Autistic adults experience significant physical and mental health inequities yet remain underrepresented in clinical research, with few randomised controlled trials to guide care. Randomised controlled trials (RCTs) of selective serotonin reuptake inhibitors (SSRIs) are limited, underpowered, and rarely focused on anxiety. Anticipating recruitment challenges in a large RCT ("STRATA") evaluating sertraline for anxiety in autistic adults, we embedded qualitative research to support recruitment, retention, and monitoring trial acceptability. We organised our findings into the theoretical framework of acceptability (TFA) constructs to assess the acceptability of trial design and delivery for autistic adults. We conducted 64 interviews with autistic adults at different trial stages. Data were analysed thematically and mapped to the seven TFA constructs. Participants considered involvement in a blinded medication RCT acceptable across the TFA domains, which they weighed differently when reflecting on anticipated versus experienced aspects of participation. STRATA was a low-burden, ethically sound, and methodologically coherent study for most participants, who reported minimal trade-offs, potential benefits, and self-efficacy in managing anxiety and research participation. Acceptability of trial participation is dynamic and multidimensional, which can be enhanced by meaningful involvement of autistic people throughout the research cycle, accessible participant information design, and responsive ongoing engagement.Lay AbstractAutistic adults often experience poorer physical and mental health than the general population. Yet they are rarely included in clinical research. There have been very few high-quality studies (RCTs) testing medications for anxiety in this group. Most existing studies are small and focus on other outcomes. They don't provide clear guidance for care. To help address this gap, the STRATA trial tested whether the medication sertraline (an SSRI) can reduce anxiety in autistic adults. Recruiting participants for such trials can be challenging. We included a qualitative study to better understand what helps or hinders people from joining and staying in the trial. We aimed to explore what aspects of the STRATA trial made it easier or more appealing for autistic adults to take part. We used a framework called the theoretical framework of acceptability (TFA) to define acceptability in this context. We interviewed 64 autistic adults at different stages of the trial, including 2 who chose not to take part. Most participants found the trial acceptable when assessed against the seven aspects of the TFA (i.e., how someone feels about taking part, how much effort is needed, whether taking part fits with a person's values, how well someone understands the study, what someone may have to give up, whether the study is likely to help, and how confident someone feels about taking part). In summary, they felt positive about taking part. They thought the study was ethical and easy to understand and believed it could benefit them. Many also felt more confident in managing their anxiety and contributing to research. STRATA is one of the largest studies of its kind; 318 autistic adults took part across the United Kingdom and Australia. The trial had a very high retention rate. Ninety-two per cent of participants stayed until the main outcome point, and 87% completed the full 52 weeks. How acceptable clinical trials like STRATA are may change during their course, and researchers need to be responsive. To do this well, researchers should involve autistic people meaningfully throughout the research process and from an early stage. Researchers also need to respect individual communication needs and provide clear and accessible information. These approaches were central to STRATA and supported by other studies.
Much research suggests that people are remarkably poor at understanding how others judge them, particularly regarding the impact of their actions on others. People appear to succumb to a host of nominally distinct biases that take a similar form: They overestimate how harshly they will be judged for bad actions and underestimate how positively they will be judged for good actions. In this article, we demonstrate that these biases can arise from "response pressure" confounds that are baked into how metaperceptions are typically studied. Specifically, we show that socially appropriate responses differ between those asked to predict how another person will feel about their actions and those asked to report how they feel about another person's actions. Predicting that someone will feel extremely grateful for your good deed is less appropriate than reporting that you are extremely grateful for someone else's good deed, while predicting that someone will feel extremely upset for your minor transgression is more appropriate than reporting that you are extremely upset at someone else's minor transgression. So if some participants provide inauthentic but socially appropriate responses, apparent biases will emerge, even if they do not exist. Across 13 preregistered studies, we show that differences in response pressures between predicting "how others will judge me" versus reporting "how I would judge others" can generate apparent biases and produce fanciful ones, such as people overestimating how negatively a frog would judge them if they were an acorn that fell on its head. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Neuropsychologists possess knowledge that could benefit trainees as they navigate important career decisions within their unique training pathways. This wisdom is typically passed down in an individual mentorship model wherein supervisors and advisors relay advice directly. While this model has advantages, trainees can benefit from a broader range of perspectives. This study addressed this gap by consolidating advice for trainees through analysis of open-ended interview responses from a diverse group of brain-behavior experts. Participants were interviewees (N = 102) from the podcast Navigating Neuropsychology (Mage = 52, SD = 11, range = 32-87; 55% late-career, 28% mid-career, 15% early-career; 87% PhD and 8% MD). Participants were asked a standardized question: "What is one bit of advice that you wish someone told you when you were training, or someone did tell you, that really made a difference?" Responses were audio-recorded, transcribed, and analyzed. A preliminary codebook was developed through discussion among authors. Three coders independently analyzed transcripts and met periodically to arrive at consensus coding. Thematic analysis identified major themes and subthemes. Four major themes were identified: (a) mentorship and networking, (b) core knowledge and skill acquisition, (c) personal growth, and (d) decision making. Results offer actionable guidance for trainees, mentors, and training programs to improve training in neuropsychology. The four major themes underscore the multifaceted nature of training in neuropsychology and emphasize the importance of both technical competence and personal development throughout one's career. This work contributes to ongoing efforts to modernize neuropsychology training and prepare trainees for successful and personally fulfilling careers. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Carers of individuals with eating disorders (EDs) often experience high levels of psychological distress, which can lead to anxiety and depressive symptoms. While several interventions have been developed to support carers, the effectiveness on their mental health remains unclear. We performed a systematic review of randomized controlled trials (RCTs) assessing mental health interventions for carers of individuals with EDs, with anxiety and depressive symptoms defined as outcomes of interest. Searches were performed across major electronic databases up to 31 October 2025. Twelve RCTs met the inclusion criteria. Structured narrative synthesis indicated that statistically significant effects were infrequent, outcome-specific, and generally small in magnitude. Interventions based on the Cognitive-Interpersonal Maintenance Model (CIMM) were the most frequently evaluated. However, only one trial demonstrated significant improvements in depressive symptoms (p = 0.010), with no significant effect on the Depression Anxiety Stress Scale (DASS-21) total scores (p = 0.06) or on the anxiety subscale (p = 0.50). In addition, Cognitive Behavioural Therapy (CBT)-based interventions showed some promising effects on the Hospital Anxiety and Depression Scale (HADS) total score (p = 0.033), but these results were not consistently replicated across guided and unguided formats. Among the other approaches, a video-based skills-training intervention produced a measurable reduction in carer distress, but this effect was observed only when combined with professional support (p = 0.030). Overall, interventions incorporating professional or peer support appeared more promising than fully self-directed approaches, although direct comparisons between guided and unguided formats did not consistently show statistically significant differences. Quality assessment showed at least an average standard of quality for all the included trials. Interventions for carers of individuals with EDs are conceptually well-founded, yet current evidence provides only limited support for their effectiveness in reducing anxiety and depressive symptoms. Future research should prioritize interventions that combine more structured mental health strategies with guided self-help programmes and workshops, providing tailored support to address the various needs of carers. Caring for someone with an eating disorder can be emotionally overwhelming and may affect the carer’s own mental health. This review looked at whether support programmes for carers can help reduce feelings of anxiety, low mood, and emotional strain. We examined studies that tested different kinds of support for carers, including online programmes, workshops, guided self-help, and skills-based training. Overall, these interventions were often helpful in giving carers information, practical strategies, and a better understanding of how to support their loved one. However, the evidence that they improve carers’ own anxiety and depression was limited. Indeed, only a few studies showed significant benefits, and these were usually small, specific to one outcome, or observed only when additional professional support was provided. Programmes that included guidance from a professional or trained supporter seemed more helpful than those completed alone. This suggests that carers may benefit most from support that is not only informative, but also personal and interactive. More research is needed to develop programmes that directly support carers’ mental health, while also helping them care for someone with an eating disorder.
There is much excitement about the potential for dementia prevention by targeting modifiable risk factors, yet sociodemographic disparities in dementia-related knowledge, stigma, and risk factor awareness remain underexplored. This study examines these differences among minoritised ethnic communities in the UK. As part of a project by the NIHR Dementia and Neurodegeneration Policy Research Unit at Queen Mary (DeNPRU-QM), dementia knowledge, stigma, and risk factor awareness of 3500 participants were assessed in a secondary analysis of data from two national surveys conducted in 2023 by Alzheimer's Research UK. Linear regression models were used to examine associations between ethnicity and knowledge-related outcomes, while ordinal logistic regression was used for stigma, adjusting for age, sex, education, social grade, chronic conditions, and knowing someone with dementia. Compared to White participants, South Asian (Coef. = -0.45, 95% CI [-0.55, -0.34], p < 0.001) and Black participants (Coef. = -0.17, 95% CI [-0.27, -0.06], p < 0.005) had lower knowledge about dementia. Compared to White participants, Black participants had higher odds of reporting greater stigma (OR = 2.55, 95% CI [2.10, 3.09], p < 0.001), as did South Asian participants (OR = 1.62, 95% CI [1.34, 1.97], p < 0.001) and participants from Other ethnic groups (OR = 1.55, 95% CI [1.17, 2.07], p = 0.003). Black individuals also had lower knowledge of dementia risk factors compared to White participants (Coef. = -0.655, 95% CI [-1.110, -0.200], p = 0.005). Education level, chronic health conditions, gender, profession, and knowing someone with dementia were also associated with some outcomes, although associations varied by outcome. Ethnic disparities exist in dementia knowledge, stigma, and dementia risk factor awareness. Any future public information campaign around dementia risk reduction and timely diagnosis should ensure cultural competency and include strategies to reach minoritised ethnic communities. Policymakers should consider how prevention might be promoted in all health and social care encounters, since people with chronic conditions who may not be eligible for primary health checks had lower levels of knowledge about dementia.
The year 2023 witnessed the re-emergence of diphtheria in Nigeria. Kafanchan, Kaduna State, reported an unusual surge in cases and deaths. We investigated the outbreak to identify associated risk factors of the disease. We conducted an unmatched (1:2) case-control study. Case-patients were identified through the State linelist and traced to their residence. At the same time, controls were randomly selected from neighbors without symptoms or signs suggestive of diphtheria within the same community. Data was collected using an interviewer-administered structured questionnaire. Bivariate analysis was done to ascertain the odds ratio (OR), while multivariate logistic regression analysis was done to calculate the adjusted odds ratio (aOR). The confidence interval (CI) was set at 95%. A total of 91 case-patients and 182 controls were recruited. The median age of case-patients was 7 years (5-10 years). Forty (44%) of 91 case-patients were females. Sixty-four (70%) of 91 case-patients were from Kafanchan ward B, and the case fatality rate was 23%. Exposure to pentavalent vaccination was found to be associated with protection from diphtheria (aOR: 0.39, 95% CI: 0.20-0.77). Thirty-one (34.07%) of 91 case-patients had contact with someone with respiratory symptoms [OR = 37.2; 95% CI = 16.8-82.6; p <0.001]. Thirty-seven (40.66%) of 91 case-patients had contact with a confirmed case [OR = 25.1; 95% CI = 11.7-53.8; p < 0.001]. Twenty-three (25%) of 91 case-patients had never received the pentavalent vaccine, and the primary reason cited by caregivers was that they were unaware of any benefits of vaccination. The outbreak is attributable to suboptimal pentavalent vaccination coverage. Future outbreaks may be avoided or their impact reduced through improved risk communication and community engagement on the benefits of vaccination, strengthening routine immunization services, early warning surveillance, and prepositioning of diphtheria antitoxin (DAT) and antibiotics.
To evaluate whether a personal history of having an abortion, or knowing someone close who did, has an impact on how a physician practices. A web-based survey was sent to Ob/Gyn residents asking about personal abortion experience, demographics, religious background, political views, residency program metrics, and intent to provide abortion. Pearson Chi-square and Mann-Whitney U tests were performed to assess whether or not personal history of abortion (PHA) was significantly associated with personal characteristics or training patterns. Ob/Gyn residents with a personal history of abortion were older in age (p = 0.002), sought out additional training in family planning (p = 0.009), considered it extremely important that their program offers family planning training (p < 0.001), and were much more likely to intend to become an abortion provider themselves post-residency (p < 0.001). Personal experience is associated with training and practice patterns among Ob/Gyn residents, a finding that has implications for an Ob/Gyn workforce under pressure from increasing legislative restrictions to abortion care. Ob/Gyn residents should be supported in their training goals to combat moral injury associated with the inability to provide evidence-based care.
Remembering faces and their associated contexts is important for healthy social cognition. We used a social opinion paradigm to assess whether the valence and relevance (about the self or other) of expressed opinions influenced memory for faces and who the opinion was about. Participants (N = 144) read opinions varying in reference and valence (e.g. "She thinks your/his smile is beautiful/crooked") followed by neutral faces said to hold the opinion. Participants rated their feelings of valence and arousal, followed by a surprise old/new face recognition test. Face recognition was not influenced by the type of opinion. We also assessed accuracy of "reference attribution" for the social opinion. Participants reported whether the opinion was in reference to themselves or someone else. Reference attributions were more accurate for opinions directed toward others than oneself. Moreover, higher endorsement of symptoms of depression was linked to enhanced reference attribution accuracy for self-related contexts, while higher endorsement of anxiety symptoms was associated with lower attribution accuracy. Results suggest the influence of social context on memory depends on context valence and personal relevance, as well as participants' trait symptoms.
Based on attachment theory, individuals develop relational schemas that shape cognitive-emotional social relationship expectations (e.g., others are a source of safety). Social relationships (e.g., intimate relationships or close friendships) are a source of long-term happiness. However, expectations that they will save someone from life's challenges are a common fallacy (e.g., a shining prince/princess bringing lifelong happiness). This places illusionary expectations on others to not disappoint despite normal behavioral realities (e.g., relational misunderstandings and conflict). This project psychometrically developed the rescue fantasy beliefs (RFB) and expected relational disappointment (ERD) scales. Analysis of the scales demonstrated satisfactory reliability, discriminant validity, and convergent validity. Serial mediation analysis demonstrated that higher RFB is associated with higher shopping addiction. ERD and current relational satisfaction sequentially mediated this relationship. The results demonstrated a serial connection between RFB and lower ERD. This serial illusionary expectation gap in others is associated with lower current relational satisfaction and higher shopping addiction. Addictive shopping can function as a compensatory coping strategy to unmet social needs. Business marketing implications discuss how new offerings can encourage meaningful in-person social connections to better address underlying needs (for those with greater RFB).
Indigenous gay and bisexual men (GBM) in Guatemala face high rates of violence and HIV. This study seeks to understand the relationship between exposure to different forms of violence and PrEP use to inform PrEP programming in Guatemala. From June 2023- May 2024, two partner organizations administered a cross-sectional questionnaire to 395 Indigenous Guatemalan GBM. We examined the relationship between violence (physical, sexual, and police violence due to sexual orientation; forced migration and knowing someone missing, injured, or killed in the internal armed conflict; and intimate partner violence [IPV] victimization and perpetration) and PrEP use using logistic regression in R. In multivariable analysis, we found that participants who experienced police violence had 75% greater odds of PrEP use than those who did not experience police violence (aOR:1.73, 95% CI: 1.09, 2.75, p = 0.02). Participants who experienced forced migration during the internal conflict had twice the odds of being current PrEP users, (aOR: 2.02, 95% CI: 1.11, 3.70, p = 0.02). Participants who perpetrated IPV had 80% lower odds of using PrEP (aOR: 0.17, 95% CI: 0.03, 0.65, p = 0.02). Indigenous GBM experience a high burden of violence which may affect their use of PrEP. Future longitudinal research should explore how violence victimization affects perceived HIV risk and resilience, which may explain why Indigenous GBM who experienced violence may be more likely to use PrEP. Los hombres indígenas gais y bisexuales en Guatemala enfrentan altas tasas de violencia y VIH; este estudio investiga la relación entre la exposición a la violencia y el uso de la PrEP. Entre junio de 2023 y mayo de 2024, dos organizaciones de base comunitaria administraron un cuestionario transversal a 395 hombres indígenas gais y bisexuales en Guatemala. Examinamos la relación entre la violencia (violencia física, sexual y policial por motivos de orientación sexual; migración forzada y el hecho de conocer a alguien desaparecido, herido o asesinado durante el conflicto armado interno; y la victimización y perpetración de violencia por parte de la pareja íntima) y el uso de la PrEP, utilizando regresión logística en R. En el análisis multivariable, hallamos que los participantes que sufrieron violencia policial presentaban mayores probabilidades de utilizar la PrEP (aOR: 1.73; IC 95%: 1.09–2.75; p = 0.02). Los participantes que experimentaron migración forzada durante el conflicto interno mostraron mayores probabilidades de ser usuarios actuales de la PrEP (aOR: 2.02; IC 95%: 1.11–3.70; p = 0.02). Por el contrario, los participantes que perpetraron violencia de pareja íntima presentaron menores probabilidades de utilizar la PrEP (aOR: 0.17; IC 95%: 0.03–0.65; p = 0.02).
Genetic and environmental factors contribute to eating disorder risk, yet their interplay is poorly understood. We examined whether childhood maltreatment and polygenic scores for anorexia nervosa (PGS-AN) and binge-eating broad (PGS-BEB) are associated with eating disorders. We also examined the interactions between childhood maltreatment and PGSs in predicting eating disorders. This nested case-control study used data from up to 63,989 mothers in the MoBa (Norwegian Mother, Father and Child Cohort Study). Mothers reported on their own experiences of 4 childhood maltreatment types: long-term humiliation or degradation, threats to self or someone close, physical abuse, and sexual abuse. Diagnoses of AN, bulimia nervosa (BN), binge-eating disorder (BED), purging disorder (PD), and binge-eating spectrum disorders (BESP) were obtained using self-report data from 5 time points and population health registers. The prevalence of AN, BN, BED, PD, and BESP was 2.19%, 4.15%, 10.39%, 0.60%, and 12.96%, respectively. All childhood maltreatment types were strongly associated with elevated eating disorder likelihood (with odds ratios [ORs] ranging from 1.71 to 3.29) as were eating disorder PGSs (with ORs ranging from 1.05 to 1.31). There were no multiplicative interaction effects between childhood maltreatment and PGSs. Small additive interactions were observed between PGS-AN and PGS-BEB and degradation/humiliation for BN and BESP in exploratory analyses. Eating disorder PGSs and childhood maltreatment are associated with higher odds of eating disorders. Furthermore, we found tentative evidence of small additive interaction effects between polygenic liability and childhood maltreatment, suggesting that their combined influence further elevates the risk of some eating disorders. Genetic and environmental factors contribute to the development of eating disorders, but how these factors interact to predict eating disorder outcomes is not well understood. We examined associations between genetic risk for eating disorders, childhood maltreatment, and eating disorders in up to 63,989 mothers in the Norwegian Mother, Father and Child Cohort Study. Both genetic risk and childhood maltreatment exposure were associated with higher odds of several eating disorders. We also observed some small additive interaction effects, indicating that the combined impact of genetic risk and childhood maltreatment exposure may further increase the likelihood of some eating disorders.
Diabetes mellitus is an important public health challenge worldwide, particularly in low-resource settings where health literacy may be limited. This study assessed perceptions regarding the causes, symptoms, complications, and prevention of diabetes among adult market vendors in Butembo, Democratic Republic of Congo. A descriptive cross-sectional survey was conducted between March and April 2025 among adult market vendors recruited from seven major markets in Butembo, Democratic Republic of Congo. Data were collected using a pre-tested structured questionnaire administered face-to-face in French or Swahili using KoboCollect software and analyzed using descriptive statistics in IBM SPSS version 20. A total of 433 adults participated in the study. Among them, 334 (77.1%) reported having previously heard of diabetes and were included in the perception analyses. Commonly perceived signs of diabetes included weight loss (64.4%) and chronic fatigue (49.4%). High blood pressure (50.3%) and death (48.5%) were frequently perceived as complications. Healthy diet (49.1%) and regular exercise (37.4%) were commonly identified as preventive measures; however, some respondents also reported spiritual or cultural beliefs such as prayer (28.4%) and poisoning-related beliefs. Most respondents (73.7%) reported knowing someone with diabetes, while 52.1% stated that consulting a doctor would be the preferred response if diabetes was suspected. Participants demonstrated mixed perceptions regarding diabetes, combining biomedical explanations with cultural and spiritual beliefs. These findings highlight the importance of culturally adapted community health education interventions in Butembo.
Biological age describes how a person is aging on molecular, cellular, and physiological levels. At the present time, biological age is not something that can be fully quantified and aging itself is far too complicated to be captured by a single layer of information. As such, it is relegated to being an abstract and somewhat vague idea. In this sense, biological age is remarkably similar to health. Health, like biological age, is not well defined and too multifarious to be summarized with a single biomarker. Given their similarities, it is intriguing to consider whether or not biological age and health are synonyms. Indeed, these two ideas can be cleanly swapped with each other in a variety of scenarios. If someone appears uniquely vigorous and capable for their chronological age, that person can be described as either quite healthy or being biologically youthful. However, there are situations where biological age and health diverge from each other. It is possible, for instance, to have a short healthspan but a long lifespan. While biological age is otherwise comparable to health as an abstract idea, it is possible that biological age and health will be confidently quantifiable in the future. Indeed, such quantification may be unlocked by the integration of multimodal data and artificial intelligence. In such a scenario, biological age offers a clear advantage over health in that it operates on a more intuitive, familiar scale as opposed to an artificially created index.
Spite occurs when someone harms another individual at a personal cost to themselves. Spite is studied by evolutionary biologists and personality psychologists, but little behavioral spite research exists. A social discounting task was modified to determine whether repeated choices to spite a disliked person would decrease with social distance and/or increase as loss amount for the other disliked person increased. In Experiment 1, more than 50% of participants made at least one spiteful choice, resulting in less hypothetical rewards for themselves. Spite rates generally decreased hyperbolically as social distance increased but did not increase as loss amount for the other person increased. Experiment 2 enrolled older participants and showed that participants increased spiteful choices as the loss amount for the other person increased, although not for pairwise comparisons or in a hyperbolic manner. However, spiteful choices were significantly related to self-reported Spitefulness Scale and Machiavellianism scores, showing concurrent validity. Perceived social distance ratings for both liked and disliked individuals showed significant asymmetry, with disliked individuals perceived at larger social distances. Cumulatively, these results demonstrate that spite can be measured using a social discounting task and that generosity and spite may be governed by different processes. This opens new research pathways to quantify causal variables for spiteful behavior.
Using artificial intelligence (AI) to prescribe drugs has advanced slowly. Whether a "doctor-in-the-loop" design would increase acceptance of drug-prescribing AI is unknown, as are settings where physicians envision AI-driven drug prescription most likely to be implemented. We surveyed a stratified sample of 2708 physicians throughout China to interrogate their opinions on drug-prescribing AI. Most respondents (78%) are receptive to using drug-prescribing AI and anticipate doing so within 5 years. Respondents suggested initial settings for AI-driven drug prescribing include situations where there are standard guidelines (74%), where the decision is whether to continue a current prescription in someone (55%), and where prescribing decisions rely on high-complexity clinical data (44%). Many (66%) indicated a preference for conditional to fully autonomous drug-prescribing AI. Clustering analysis identified 2 psychological profile-types, "optimists" and "pragmatists", who have different standards for model efficacy, expediency, explainability, and governance/stewardship for drug-prescribing AI. A high level of using medical AI is the strongest predictor for being an optimist (OR = 2.98 [2.53, 3.51]; P < 0.0001). In conclusion, our data point to the wide acceptability of conditional autonomous drug-prescribing AI among Chinese physicians. Moreover, disparity in optimism about drug-prescribing AI is caused by disparity in prior exposure to medical AI.
Several novel tuberculosis vaccines (NTVs) are being evaluated in clinical trials. Understanding the perception of acceptability and confidence in NTVs will inform implementation strategies. We conducted a cross-sectional survey to assess acceptability in and confidence of NTVs among adult persons with HIV (PWH) at two clinics in KwaZulu-Natal province, South Africa. We evaluated associations between acceptability and sociodemographic factors. Among 225 PWH, 112 (50%) responded "Definitely yes, as soon as available", 86 (38%) "Definitely yes, but wait ≥6 months to receive it" and 27 (12%) "Unsure, leaning yes, any timeline" to an NTV. Acceptability was associated with perception of tuberculosis's (TB's) importance in the community, perceived risk of contracting TB, personal history of TB, not currently living with someone with TB, incompatibility of vaccines with religion, and unemployment. Most participants were confident in the vaccine's potential safety (110, 93%) and effectiveness (221, 98%). Participants preferred to receive information from government, community, and health entities, or internet, and vaccination at community settings over public health facilities. NTV acceptability was high amongst these PWH, and they preferred community-based delivery models. Our findings may inform strategies to increase implementation of NTVs among PWH in South Africa.
Introduction The perspectives of children who stutter (CWS) on their own talking experiences have received limited attention in the literature, particularly in non-Western contexts. This exploratory study examined the feasibility of using a drawing-and-talking approach to elicit Saudi CWS' perspectives on talking and of adapting an existing drawing protocol for Arabic and telepractice contexts. Methods Thirty CWS (26 boys, 4 girls) aged 6;0 to 10;11 years in Saudi Arabia completed the task, predominantly in online sessions. Children were invited to draw themselves talking to someone, to answer questions about their drawing, and to rate how they felt about talking. Analysis involved evaluating drawing maturity and meanings using Focal Point Analysis. Results Children demonstrated sufficient drawing maturity for participation in the task. Explicit visual markers of talking and listening appeared in 16/30 drawings (53.3%), and many children described themselves as talking during the post-drawing discussion despite sparse visual cues in the drawings themselves. Drawings frequently foregrounded relationships and connection (83.3%) and were more often positive (56.7%) than negative (26.7%) or coded as no talking (13.3%). One child explicitly referenced stuttering; most depicted ordinary, enjoyable conversations. Only minor linguistic and procedural adaptations appeared necessary for use in Arabic across online and in-person contexts. Conclusion This drawing-and-talking approach showed preliminary indications of feasibility in this sample, with high task completion and engagement suggesting the approach warrants further feasibility evaluation. It elicited child-centred information about talking partners, contexts, and experiences that may complement fluency-based assessment.