Search Results (41)

Indigenous students remain significantly underrepresented in medical education, contributing to persistent health inequities in their communities. Systemic barriers, including cultural isolation, inadequate resources, and biased curricula, hinder their success. But what if generative artificial intelligence (GAI) could be the game-changer? This scoping review explores the potential of generative artificial intelligence (GAI) in making medical education more inclusive and supportive for Indigenous students through a comprehensive analysis of existing literature. From AI-powered engagement platforms to personalised learning systems and immersive simulations, GAI can be harnessed to bridge the gap. While GAI holds promise, challenges like biased datasets and limited access to technology must be addressed. To unlock GAI’s potential, we recommend faculty development, expansion of digital infrastructure, and Indigenous-led AI design. By carefully harnessing GAI, medical schools can take a crucial step towards creating a more diverse and equitable healthcare workforce, ultimately improving health outcomes for Indigenous communities. Full article

Many breast cancer patients follow a self-managed treatment pathway, which may lead to gaps in the data available to healthcare professionals, such as information about patients’ everyday symptoms at home. Mobile apps have the potential to bridge this information gap, leading to more effective treatments and interventions, as well as helping breast cancer patients monitor and manage their symptoms. In this paper, we elicit design requirements for breast cancer symptom-management mobile apps using a systematic review following the PRISMA framework. We then evaluate existing cancer symptom-management apps found on the Apple store according to the extent to which they meet these requirements. We find that, whilst some requirements are well supported (such as functionality to record multiple symptoms and provision of information), others are currently not being met, particularly interoperability, functionality related to responses from healthcare professionals, and personalisation. Much work is needed for cancer patients and healthcare professionals to experience the benefits of digital health innovation. The article demonstrates a formal requirements model, in which requirements are categorised as functional and non-functional, and presents a proposal for conceptual design for future mobile apps. Full article

Type 2 diabetes mellitus (T2DM) remains a significant global public health concern, largely driven by poor dietary habits, physical inactivity, and rising obesity rates. In recent years, personalised nutrition (PN) emerged as a promising approach to T2DM prevention and management. This narrative review synthesises current evidence on tailored dietary strategies, including the glycaemic index (GI), glycaemic load (GL), food insulin index (FII), and precision nutrition tools. It further explores their impact on glycaemic control, insulin sensitivity, and adherence to dietary interventions. A structured review of peer-reviewed and grey literature was conducted, taking into account behavioural, cultural, and systemic implementation factors. Although evidence supports the efficacy of PN in improving metabolic outcomes, implementation in low- and middle-income countries (LMICs) remains limited due to infrastructural, financial, and contextual challenges. This review emphasises the need for context-specific, scalable solutions integrated into primary healthcare systems. Full article

Background: Prostate cancer (PCa) remains a major health concern worldwide, although improved screening and treatments have reduced its incidence and mortality. MRI-targeted biopsies, especially using MRI–ultrasound fusion, enhance detection of clinically significant prostate cancer (CsPCa) and reduce unnecessary procedures. Transperineal biopsies offer the same diagnostic performance and reduce the risk of infection while limiting the need for antibiotic prophylaxis. However, they tend to be more painful under local anaesthesia and require greater operator experience. Methods: This study prospectively assessed the tolerability and effectiveness of transperineal targeted biopsies under local anaesthesia in a monocentric cohort of 51 patients. Results: Immediate pre-biopsy anxiety showed a clinically significant association with pain experienced during biopsies, and greater expected pain resulted in greater experienced pain. Overall patient tolerability was high. Local anaesthesia provided procedural flexibility, reduced resource utilisation, was cost-effective, and did not compromise precision. Conclusions: The results support local anaesthesia as a viable option, offering precision, patient satisfaction, and reduced healthcare resource utilisation. These results emphasise the importance of personalising the choice of anaesthesia modality for transperineal prostate biopsies, tailoring it to the patient’s anxiety. Larger studies are required to confirm these findings and validate the observed trends. Full article

As survival rates for teenagers and young adults (TYAs) with cancer exceed 80%, they are living longer post treatment, yet often experience prolonged health and quality of life concerns. Many TYAs also experience unmet support needs. This study aimed to identify TYAs support needs following treatment at a UK hospital and explore how and when TYAs prefer to receive support. This study involved two phases: Phase 1 involved semi-structured interviews with 16 TYAs, 1–6 years post-treatment, aged 16–25 years at time of treatment completion and examined their experiences of support services, and preferences for future care. Phase 2 consisted of co-design workshops with eight TYAs and feedback from five healthcare/allied professionals (HCAPs) to refine and develop recommendations. Phase 1 findings revealed six key themes: (1) survivorship as disrupted continuity; (2) negotiating legitimacy and relational safety in help seeking; (3) support offered vs. support sought: pathways of referral and self-initiation; (4) emotional readiness as context dependent and non-linear; (5) support as an ecosystem, not a moment; and (6) personalised autonomy in support engagement. Phase 2 findings informed recommendations that emphasise the importance of flexible, personalised, and accessible post-treatment support, with pathways of care/support that can adapt to TYAs changing needs and preferences over time. Full article

Background/Objective: Stair falls are a major health concern for older adults, particularly those wishing to age in place. Despite extensive laboratory research on the causes of stair falls and the effectiveness of prevention interventions, there is limited understanding of how acceptable interventions are to end-users and key stakeholders in real-world home environments. This study explored older adults’ and professionals’ attitudes toward stair-fall prevention interventions, including intervention acceptability, barriers and facilitators to adoption, and priorities for implementation in home settings. Methods: This study employed a sequential mixed-method design, including a survey of 359 UK community-dwelling older adults (aged 55+), followed by focus groups with 8 older adults and 11 professionals from healthcare and housing backgrounds. Results: Older adults surveyed perceived home stair falls as a significant risk and priority for prevention but demonstrated less awareness of specific interventions to prevent falls. Focus groups with older adults and professionals established barriers and facilitators to the adoption of 10 specific stair-fall prevention interventions. Barriers included a lack of awareness, financial constraints, reluctance to alter home environments and stigma. Facilitators included raising awareness through education, clear guidance on intervention benefits and installation, practical and financial support, personalised approaches, social encouragement, and endorsement by professionals. Focus groups found the most acceptable stair-fall prevention interventions included education and skill training, improved staircase lighting and additional handrails. Conclusions: Interventions that are low-disruption, cost-effective, backed by empirical evidence, and endorsed by trusted professionals are more likely to be accepted and implemented. Further research should focus on targeted educational strategies to overcome barriers to adoption. Full article

The pharmaceutical industry faces mounting pressure to reduce its environmental impact while maintaining innovation in drug development. Artificial intelligence (AI) has emerged as a transformative tool across healthcare and drug discovery, yet its potential to drive sustainability by improving molecular design remains underexplored. This review critically examines the applications of AI in molecular design that can support in advancing greener pharmaceutical practices across the entire drug life cycle—from design and synthesis to waste management and solvent optimisation. We explore how AI-driven models are being used to personalise dosing, reduce pharmaceutical waste, and design biodegradable drugs with enhanced environmental compatibility. Significant advances have also been made in the predictive modelling of pharmacokinetics, drug–polymer interactions, and polymer biodegradability. AI’s role in the synthesis of active pharmaceutical compounds, including catalysts, enzymes, solvents, and synthesis pathways, is also examined. We highlight recent breakthroughs in protein engineering, biocatalyst stability, and heterogeneous catalyst screening using generative and language models. This review also explores opportunities and limitations in the field. Despite progress, several limitations constrain impact. Many AI models are trained on small or inconsistent datasets or rely on computationally intensive inputs that limit scalability. Moreover, a lack of standardised performance metrics and life cycle assessments prevents the robust evaluation of AI’s true environmental benefits. In particular, the environmental impact of AI-driven molecules and synthesis pathways remains poorly quantified due to limited data on emissions, waste, and energy usage at the compound level. Finally, a summary of challenges and future directions in the field is provided. Full article

Artificial intelligence (AI) and assistive robotics can transform older-person care by offering new, personalised solutions for an ageing population. This paper outlines recent advances in AI-driven applications and robotic assistance in silver care, emphasising their role in improved healthcare services, quality of life and ageing-in-place and alleviating pressure on healthcare systems. Advances in machine learning, natural language processing and computer vision have enabled more accurate early diagnosis, targeted treatment plans and robust remote monitoring for elderly patients. These innovations support continuous health tracking and timely interventions to improve patient outcomes and extend home-based care. In addition, AI-powered assistive robots with advanced motion control and adaptive response mechanisms are studied to support physical and cognitive health. Among these, companion robots, often enhanced with emotional AI, have shown potential in reducing loneliness and increasing connectedness. The combined goal of these technologies is to offer holistic patient-centred care, which preserves the autonomy and dignity of our seniors. This paper also touches on the technical and ethical challenges of integrating AI/robotics into eldercare, like privacy and accessibility, and alludes to future directions on optimising AI-human interaction, expanding preventive healthcare applications and creating an effective, ethical framework for eldercare in the digital age. Full article

Background/Objectives: Polygenic risk scores (PRSs) have been extensively studied and are increasingly applied in healthcare. One of the most studied and developed areas is predictive medicine for breast cancer, but there is no wider consensus on the indications for the clinical use of PRSs for breast cancer. This current guidance endeavours to articulate the scientific evidence underpinning the clinical utility of PRSs in stratifying breast cancer risk, with a particular emphasis on clinical application. Methods: This guidance has been prepared by a group of experts who have been active in breast cancer PRS research and development, combining a review of the evidence base with expert opinion for indications for clinical use. Results: Based on data from various studies and existing breast cancer prevention and screening services, the indications for clinical use of breast cancer PRSs can be divided into the following scenarios: (1) Management of cancer-free women with a family history of cancer; (2) individual personalised breast cancer prevention and screening in healthcare services; and (3) breast cancer screening programs for more personalised screening. Conclusions: The integration of PRSs into clinical practice enables healthcare providers to deliver more accurate risk assessments, personalised prevention strategies, and optimised screening programmes, thereby improving patient outcomes and enhancing the effectiveness of breast cancer care. PRS testing represents a novel component in clinical breast cancer risk assessment, supporting a personalised, risk-based approach to breast cancer prevention and screening. Full article

Stroke is a leading cause of disability worldwide. The long-term effects of a stroke depend on the location and size of the affected brain area, resulting in diverse disabilities and experiences for survivors. More than 70% of people experiencing stroke suffer upper-limb dysfunction, which can significantly limit independence in daily life. The growing strain on national healthcare resources, coupled with the rising demand for personalised, home-based rehabilitation, along with increased familiarity with digital technologies, has set the stage for developing an advanced therapeutics system consisting of a wearable solution aimed at complementing current stroke rehabilitation to enhance recovery outcomes. Through a user-centred approach, supported by primary and secondary research, this study has developed an advanced prototype integrating electromyography smart sensors, functional electrical stimulation, and virtual reality technologies in a closed-loop system that is capable of supporting personalised recovery journeys. The outcome is a more engaging and accessible rehabilitation experience, designed and evaluated through the participation of stroke survivors. This paper presents the design of the therapeutic platform, feedback from stroke survivors, and considerations regarding the integration of the proposed technology across the stroke pathway, from early days in a hospital to later stage rehabilitation in the community. Full article

Background: Health literacy can impact comprehension, recall, and implementation of stroke-related information, especially in the context of cognitive and communication impairments, cultural-linguistic diversity, or ageing. Yet there are few published lived experience perspectives to inform tailoring of health information. Objectives: We aimed to (i) explore perspectives about the impact of health literacy on information needs and preferences of stroke survivors with diverse characteristics; and (ii) identify ways to better tailor information delivery for stroke survivors with low health literacy. Methods: This qualitative study was conducted using the Ophelia (Optimising Health Literacy and Access) methodology. First, health literacy information was collected from participants. Hierarchical cluster analysis was used to identify different health literacy profiles within the participant sample. Four profiles were identified, from which four case vignettes were created. Second, focus groups and interviews were conducted to explore the health information needs and preferences of the case vignettes. Qualitative data were analysed with reflexive thematic analysis. Results: Nineteen people participated (median (IQR) age = 65 (49, 69), 10 (53%) female); five used interpreters. Participants represented diverse socioeconomic, cultural, and stroke-related characteristics, and generally had low health literacy. Four qualitative themes were generated highlighting the impact of Individual knowledge, capacity, and beliefs about stroke and health services on people’s capacity to engage with stroke-related information; Tailoring and personalisation of information delivery to the patient’s knowledge, capacity, and beliefs; Having a support network to rely on; and patients Feeling like I am in safe hands of clinicians and services. Conclusions: Findings provide several important directions for improving accessible stroke information delivery suitable for people with all levels of health literacy, and to optimise patient understanding, recall, and implementation of healthcare information. Full article

Background/Objectives: The multifactorial nature of immune-mediated inflammatory diseases (IMIDs) requires integrating pathophysiological understanding with subjective patient experiences. Patient-reported outcome measures (PROMs) are a useful tool for incorporating this in routine clinical practice. However, current PROMs do not fully encompass the complete subjective health experiences (SHE) of patients and are thus insufficient for guiding truly personalised care. The SHE model provides insights into SHE through the determinants of disease acceptance and perceived control. While validated across various demographics, its predictive power in IMIDs cohorts remains unexplored. This study aims to assess whether acceptance and perceived control in the SHE model predict health experiences in patients with IMID and how these immunological conditions compare. Methods: Questionnaires regarding health perception, acceptance, control, and subjective health experiences were distributed to 450 Dutch citizens. Descriptive statistics, reliability checks, and partial least squares structural equation modelling were used to examine relationships between variables. Results: Health perception strongly predicts SHE through acceptance and control. Across all conditions, the pathway moves from health perception to control, then to acceptance, and finally to SHE. However, the roles of acceptance and control differ by condition. In burdensome diseases like inflammatory bowel disease and rheumatoid arthritis, acceptance plays a greater role, while control has a stronger influence in conditions like psoriasis. Conclusions: This study supports the predictive validity of the SHE model for IMIDs, showing that disease acceptance and control affect health experiences differently across conditions. These insights improve the understanding of psychological factors in health experiences and call for tailored interventions for patients with IMID. Full article

COPD is one of the leading causes of death worldwide, so it represents a significant public health challenge. Over the years, new effective therapies have been proposed. However, the burden of COPD is still conditioned by frequent acute events defined as exacerbations (exacerbation of COPD-ECOPD), which have a significant impact not only on the patient’s quality of life but also on the progression of the disease, morbidity, and mortality. Related to the severity of the condition, ECOPD may require hospital admission and often repeatedly more admissions (readmission). The phenomenon of readmissions is a significant problem, contributing substantially to the utilisation of healthcare resources and the economic burden of COPD. Related contributing factors are still poorly understood, and managing the patients readmitted to the hospital with ECOPD may be challenging. Hospital readmissions should be optimally managed, including supporting and preventive strategies. Although early readmissions (30 days from discharge) are a marker of the quality of the patient’s care, we need to consider COPD patients globally. It is not sufficient to address just the acute events, so multidimensional management is necessary, able to follow the patient over time to identify, by a personalised approach, the correct treatment during and post hospitalisation and intercept any factor affecting the natural history of the disease, comprising the risk of hospital readmissions. In the context of the literature concerning respiratory medicine, particularly COPD patients, our narrative review analyses recent evidence regarding the current management of COPD hospital readmissions, aiming to propose preventive strategies helpful in clinical practice. The proposed strategies can potentially improve clinical outcomes and reduce healthcare costs when effectively implemented in practice. Full article

With the rapid rise in technological advancements, health can be tracked and monitored in multiple ways. Tracking and monitoring healthcare gives the option to give precise interventions to people, enabling them to focus more on healthier lifestyles by minimising health issues concerning long screen time. Artificial Intelligence (AI) techniques like the Large Language Model (LLM) technology enable intelligent smart assistants to be used on mobile devices and in other cases. The proposed system uses the power of IoT and LLMs to create a virtual personal assistant for long-time screen users by monitoring their health parameters, with various sensors for the real-time monitoring of seating posture, heartbeat, stress levels, and the motion tracking of eye movements, etc., to constantly track, give necessary advice, and make sure that their vitals are as expected and within the safety parameters. The intelligent system combines the power of AI and Natural Language Processing (NLP) to build a virtual assistant embedded into the screens of mobile devices, laptops, desktops, and other screen devices, which employees across various workspaces use. The intelligent screen, with the integration of multiple sensors, tracks and monitors the users’ vitals along with various other necessary health parameters, and alerts them to take breaks, have water, and refresh, ensuring that the users stay healthy while using the system for work. These systems also suggest necessary exercises for the eyes, head, and other body parts. The proposed smart system is supported by user recognition to identify the current user and suggest advisory actions accordingly. The system also adapts and ensures that the users enjoy proper relaxation and focus when using the system, providing a flexible and personalised experience. The intelligent screen system monitors and improves the health of employees who have to work for a long time, thereby enhancing the productivity and concentration of employees in various organisations. Full article

Objective: This qualitative study sought to explore patient experiences with technologies used in the Community Health in a Virtual Environment (Co-HIVE) pilot trial. Technology is becoming increasingly prevalent in mental healthcare, and user acceptance is critical for successful adoption and therefore clinical impact. The Co-HIVE pilot trialled a model of care whereby community-dwelling patients with symptoms of depression utilised virtual appointments and remote monitoring for the assessment and management of their condition, as an adjunct to routine care. Methods: Using a qualitative descriptive design, participants for this study were patients with symptoms of moderate to severe depression (based on the 9-item Patient Health Questionnaire, PHQ-9), who had completed the Co-HIVE pilot. Data was collected via semi-structured interviews that were audio-recorded, transcribed clean-verbatim, and thematically analysed using the Framework Method. Results: Ten participants completed the semi-structured interviews. Participants reported experiencing more personalised care, improved health knowledge and understanding, and greater self-care, enabled by the remote monitoring technology. Additionally, participants reported virtual appointments supported the clinician–patient relationship and improved access to mental health services. Conclusions: This experience of participants with the Co-HIVE pilot indicates there is a degree of acceptance of health technologies for use with community mental healthcare. This acceptance demonstrates opportunities to innovate existing mental health services by leveraging technology. Full article