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Sleep disruption and its psychological treatment in young people at risk of psychosis: A peer methods qualitative evaluation.
OBJECTIVES: A recent randomized controlled feasibility trial showed that sleep problems in young people at risk of psychosis can be successfully treated with psychological therapy and that this may bring additional benefits such as reducing depression, anxiety and paranoia. Here we report participants' qualitative experience of sleep problems and therapy. DESIGN: A peer-methods qualitative study employing reflexive thematic analysis. METHODS: Semi-structured interviews, co-facilitated by peer researchers, were conducted with 16 young patients at risk of psychosis and having sleep problems who participated in the SleepWell Trial (ISRCTN85601537). Ten interviewees had received the 12-week sleep therapy. RESULTS: Four themes were generated: (1) the challenge to access mental health treatment ('bouncing between services'), (2) sleep problems and mental health difficulties are intertwined ('an obvious link'), (3) flexibility in therapy provision matters ('tailored to me as a person') and (4) improving sleep leads to wider benefits ('fixing the sleep helped everything else'). Participants described a frustrating journey to access mental health treatment, marked by rejection and invalidation, which resulted in hopelessness and often resignation. The interaction between sleep disruption and other mental health difficulties was seen as obvious. Treatment for sleep problems was highly valued. The clear focus, therapeutic style and flexible delivery of the treatment was seen to create patient ownership, active engagement and hope. Participants described transformative changes: better sleep, fewer voices and fears and improved mood and confidence. Improving sleep made a difference to everyday life. CONCLUSIONS: Treating sleep problems in people at risk of psychosis is highly valued and often brings rapid and widespread improvements across a range of domains.
Crossmodal semantics in memory: Scoping review and meta-analyses of multisensory effects in short-term and episodic memory systems.
The human brain represents objects and events in the environment by binding together their defining semantic attributes across the senses (e.g., vision, hearing, touch). Semantic relationships between these attributes in different senses, or crossmodal semantic relationships, are fundamental to carving out meaningful categories and to encode and store experiences in the form of memories for later retrieval. Unsurprisingly, the subject of crossmodal semantic interactions in human memory has been on the agenda of researchers interested in multisensory processes for several decades now and there appears to be a renewed wave of interest in the field currently. By and large, the central question has been whether or not memories for events with crossmodally congruent semantic attributes are better remembered. Nevertheless, this research area has been characterized by mixed methodological approaches, inconsistent outcomes, and alternative theoretical interpretations, with few attempts at synthesis. Here, we examine the past 30 years of research on the topic, covering short-term as well as episodic memory systems. First, we garner existing evidence in a systematic scoping review of studies, complemented by meta-analyses. Then, we provide a synthesis highlighting outstanding empirical questions and potential contradictions between competing theoretical interpretations. With some exceptions, there is abundant support for the hypothesis that crossmodally congruent events are better remembered than single-modality or crossmodal but incongruent events. Nevertheless, the mechanisms underlying this multisensory benefit and its theoretical interpretation are still the subject of substantial debates. We propose avenues to resolve these issues and advance current knowledge in this burgeoning research area. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
What motivate consumers’ purchase intention and the intention to continue watching in livestream shopping
Abstract A growing number of companies are adopting livestream shopping as a means of recommending their products to consumers. However, the question of whether the purchase intention for sustainable clothing amongst consumers can be increased by livestream shopping remains unclear. Therefore, the present study was designed to clarify the relationship between cognitive reactions (vividness, attractiveness, flow, and multisensory cues), emotion (arousal, pleasure), and behaviour (intention to continue watching, purchase intention) during livestream shopping for sustainable clothing. Factor analysis and structural equation model are adopted to analyse the data. The effect of social sharing, ‘stickiness’, and social presence are also explored in a research model. In this study, people’s cognitive reactions were found to have positive impacts on the emotion that consumers associate with sustainable clothing in the context of livestreaming shopping. Moreover, both arousal and pleasure mediated the relationship between cognitive reactions and behavioural intention, while stickiness mediated the relationship between cognitive reactions and purchase intention, and social presence positively impacts people’s intention to continue watching. Social sharing significantly affects purchase intention. These results therefore provide brands and companies with a number of actionable insights to adopt appropriate marketing strategies in the context of livestream shopping.
An fMRI study of initiation and inhibition of manual and spoken responses in people who stutter
Abstract Stuttering is characterised by difficulties initiating speech and frequent interruptions to the flow of speech. Neuroimaging studies of speech production in people who stutter consistently reveal greater activity of the right inferior frontal cortex, an area robustly implicated in stopping manual and spoken responses. This has been linked to an “overactive response suppression mechanism” in people who stutter. Here, we used fMRI to investigate neural differences related to response initiation and inhibition in people who stutter and matched controls (aged 19-45) during performance of the stop-signal task in both the manual and speech domains. We hypothesised there would be increased activity in an inhibitory network centred on right inferior frontal cortex. Out of scanner behavioural testing revealed that people who stutter were slower than controls to respond to ‘go’ stimuli in both the manual and the speech domains, but the groups did not differ in their stop-signal reaction times in either domain. During the fMRI task, both groups activated the expected networks for the manual and speech tasks. Contrary to our hypothesis, we did not observe differences in task-evoked activity between people who stutter and controls during either ‘go’ or ‘stop’ trials. Targeted region-of-interest analyses in the inferior frontal cortex, the supplementary motor area and the putamen bilaterally confirmed that there were no group differences in activity. These results focus on tasks involving button presses and production of single nonwords, and therefore do not preclude inhibitory involvement related specifically to stuttering events. Our findings indicate that people who stutter do not show behavioural or neural differences in response inhibition, when making simple manual responses and producing fluent speech, contrary to predictions from the global inhibition hypothesis.
Prehospital Extremity Fracture Management in Low and Middle‐Income Countries: A Scoping Review of Lay First Responders and Traditional Bonesetters
ABSTRACTPurposeLow‐ and middle‐income countries (LMICs) experience the highest rates of injury‐related deaths globally, exacerbated by a lack of robust emergency medical services (EMS). Though fractures contribute substantially to global injury, little is known about prehospital management of extremity fractures in LMICs.MethodsThis review included literature published between January 2000 and January 2024. Inclusion criteria pertained to prehospital settings, defined as care rendered prior to hospital presentation, including care provided by lay first responders (LFRs), professional EMS personnel, and traditional bonesetters (TBS). Multiple authors used the Newcastle‐Ottawa scale to assess texts meeting inclusion criteria, extracting relevant details for analysis.ResultsOf 1251 articles identified, 25 met inclusion criteria. Studies spanned 9 countries across 4 continents, with 14 articles studying care by TBS, 9 by LFRs, and 2 by other prehospital providers. LFR training courses report a combined weighted average pre‐/post‐course difference of 29.16 percentage points. A total of 67% of included studies report adverse outcomes associated with TBS‐managed fractures in the prehospital setting. TBS care is often sought prior to hospital presentation due to sociocultural beliefs, accessibility, and cheaper costs. Few training courses for TBS have been performed, though one course reports a 20.4% increase in fracture management knowledge.ConclusionIn certain resource‐limited settings, TBS provide most initial fracture management, which may adversely impact outcomes. Knowledge transfer has been demonstrated during prehospital fracture management courses for LFRs and TBS. Early evidence suggests TBS training and integration into healthcare systems may reduce complication rates, improving long‐term outcomes.
When to create embryos or organoids for research.
The development of brain organoids and use of human embryonic neural structures for research each raise distinct ethical considerations that require careful analysis. We propose that rather than attempting to resolve longstanding debates about embryonic moral status, a more productive approach is to examine how different positions on this fundamental question lead to distinct conclusions about appropriate research strategies. For those who ground moral status in species membership or developmental potential, even early-stage embryo research may be ethically impermissible, suggesting focus on carefully bounded organoid development. Conversely, for those who ground moral status in current capacities, embryonic neural tissue studied before the emergence of consciousness may offer significant advantages over organoids while raising fewer novel ethical concerns. Our analysis reveals inadequacies in current policies, particularly the 14-day rule, which appears difficult to justify under either ethical framework. We demonstrate how careful attention to the relationship between ethical premises and research implications can advance both scientific progress and ethical oversight, while suggesting specific policy reforms including capacity-based research guidelines and sophisticated monitoring protocols.
Research assistants' experiences recruiting patients with psychosis into clinical trials: a qualitative study.
OBJECTIVES: Treatments for patients diagnosed with psychosis need to be improved. Clinical trials are an important way of assessing the efficacy of new treatments. However, recruiting patients into trials is challenging. This study sought to better understand the reasons for this from the perspective of research assistants. DESIGN: A qualitative study underpinned by a critical realist ontology and contextualist epistemology. METHODS: Research assistants who had recruited patients with psychosis into trials, primarily of psychological interventions, were interviewed. Reflexive thematic analysis was used to identify themes. RESULTS: Overarching themes representing four types of factors influencing recruitment of patients with psychosis into clinical trials were generated: patient, clinical team, research team, and NHS infrastructure. Patients largely wished to take part in trials but needed time to build trust with research assistants. Clinical teams held the power in suggesting patients for trials; therefore, it was essential for research teams to build strong relationships with clinical staff. Research teams recruiting into trials benefited from lived experience expertise, support systems, and institutional knowledge. A key NHS infrastructure factor was that mental health staff had limited time to consider trials for their patients. CONCLUSIONS: Trial participation needs to be made more accessible to patients with psychosis, who often want to take part but lack opportunities. Methods of increasing accessibility could include identifying and addressing barriers to referral from clinical teams, employing multiple recruitment strategies, and flexible appointment formats. Qualitative research with clinical teams and patients will also help in developing the understanding of barriers to recruitment.
Exploring auditory morphodynamics: Audiovisual associations in sound-based music
This article explores audiovisual associations within the context of contemporary and experimental music practices, particularly focusing on sound-based music. While extensive studies exist on crossmodality in relation to traditional music genres (such as classical instrumental music), the perceptual potential of sound-based music remains an underexplored field of psychological research. In an online procedure, 152 participants were exposed to six musical excerpts from spectralism and electronic-glitch music and were asked to rate the extent to which each audio matched with six ad hoc generated black and white abstract images. Statistical analysis revealed that ratings were highly consistent across participants, indicating that they may rely on a shared set of implicit perceptual criteria rooted in Gestalt and morphodynamic features common to both auditory and visual stimuli. In particular, smoothness, continuity, numericity, symmetry, and spectrotemporal dimensions emerged as the primary factors influencing the association ratings. We discuss the implication of these findings both for crossmodal research and musicology, and suggest some directions for future research in audiovisual associations using sound-based music.
What will society think about AI consciousness? Lessons from the animal case.
How will society respond to the idea that artificial intelligence (AI) could be conscious? Drawing on lessons from perceptions of animal consciousness, we highlight psychological, social, and economic factors that shape perceptions of AI consciousness. These insights can inform emerging debates about AI moral status, ethical treatment, and future policy.
Malignancy Risk in Turner Syndrome+Y, Early Gonadectomy, and the Ethics of Parental Choices.
This case relates to an infant with Turner syndrome harboring the Y chromosome (TS+Y) and explores the boundaries of parental decision-making. Traditionally, gonads have been surgically removed in early childhood in this condition because of the risk of gonadoblastoma and potential malignant transformation. However, in the case discussed here, the infant's parents do not wish for surgery. In other differences of sex development resulting in intersex traits (increasingly termed congenital variations of sex characteristics [VSC]), some institutions report a shift in the last decade away from early surgical management, in favor of allowing children to be involved in decision-making when they are old enough to participate meaningfully. But should that approach change when there is a risk of malignancy? Two commentaries are presented. One outlines ethical considerations around early surgery in the case of VSC, highlighting implications for the child's bodily integrity and future sexual and reproductive autonomy. A second commentary analyzes the case in terms of pediatric ethics, medical uncertainty, and the zone of parental discretion. Both commentaries conclude that given a lack of adequate data to demonstrate net harms in delaying intervention, and some prospective benefit, it could be reasonable to defer surgery in accordance with the parental request.
Generative AI in healthcare education: How AI literacy gaps could compromise learning and patient safety.
AIM: To examine the challenges and opportunities presented by generative artificial intelligence in healthcare education and explore how it can be used ethically to enhance rather than compromise future healthcare workforce competence. BACKGROUND: Generative artificial intelligence is fundamentally changing healthcare education, yet many universities and healthcare educators have failed to keep pace with its rapid development. DESIGN: A discussion paper. METHODS: Discussion and analysis of the challenges and opportunities presented by students' increasing use of generative artificial intelligence in healthcare education, with particular focus on assessment approaches, critical thinking development and artificial intelligence literacy. RESULTS: Students' widespread use of generative artificial intelligence threatens assessment integrity and may inhibit critical thinking, problem-solving skills and knowledge acquisition. Without adequate artificial intelligence literacy there is a risk of eroding future healthcare workforce competence and compromising patient safety and professional integrity. CONCLUSION: While generative artificial intelligence presents significant challenges to healthcare education, it offers great promise if used carefully with awareness of its limitations. The development of artificial intelligence literacy is crucial for maintaining professional standards and ensuring patient safety and mitigating its potentially negative impact on the formation of critical thinking skills.
Adversarial testing of global neuronal workspace and integrated information theories of consciousness.
Different theories explain how subjective experience arises from brain activity1,2. These theories have independently accrued evidence, but have not been directly compared3. Here we present an open science adversarial collaboration directly juxtaposing integrated information theory (IIT)4,5 and global neuronal workspace theory (GNWT)6-10 via a theory-neutral consortium11-13. The theory proponents and the consortium developed and preregistered the experimental design, divergent predictions, expected outcomes and interpretation thereof12. Human participants (n = 256) viewed suprathreshold stimuli for variable durations while neural activity was measured with functional magnetic resonance imaging, magnetoencephalography and intracranial electroencephalography. We found information about conscious content in visual, ventrotemporal and inferior frontal cortex, with sustained responses in occipital and lateral temporal cortex reflecting stimulus duration, and content-specific synchronization between frontal and early visual areas. These results align with some predictions of IIT and GNWT, while substantially challenging key tenets of both theories. For IIT, a lack of sustained synchronization within the posterior cortex contradicts the claim that network connectivity specifies consciousness. GNWT is challenged by the general lack of ignition at stimulus offset and limited representation of certain conscious dimensions in the prefrontal cortex. These challenges extend to other theories of consciousness that share some of the predictions tested here14-17. Beyond challenging the theories, we present an alternative approach to advance cognitive neuroscience through principled, theory-driven, collaborative research and highlight the need for a quantitative framework for systematic theory testing and building.