Acceptability of artificial intelligence (AI)-enabled chatbots, video consultations and live webchats as online platforms for sexual health advice

Objectives Sexual and reproductive health (SRH) services are undergoing a digital transformation. This study explored the acceptability of three digital services, (i) video consultations via Skype, (ii) live webchats with a health advisor and (iii) artificial intelligence (AI)-enabled chatbots, as potential platforms for SRH advice. Methods A pencil-and-paper 33-item survey was distributed in three clinics in Hampshire, UK for patients attending SRH services. Logistic regressions were performed to identify the correlates of acceptability. Results In total, 257 patients (57% women, 50% aged <25 years) completed the survey. As the first point of contact, 70% preferred face-to-face consultations, 17% telephone consultation, 10% webchats and 3% video consultations. Most would be willing to use video consultations (58%) and webchat facilities (73%) for ongoing care, but only 40% found AI chatbots acceptable. Younger age (<25 years) (OR 2.43, 95% CI 1.35 to 4.38), White ethnicity (OR 2.87, 95% CI 1.30 to 6.34), past sexually transmitted infection (STI) diagnosis (OR 2.05, 95% CI 1.07 to 3.95), self-reported STI symptoms (OR 0.58, 95% CI 0.34 to 0.97), smartphone ownership (OR 16.0, 95% CI 3.64 to 70.5) and the preference for a SRH smartphone application (OR 1.95, 95% CI 1.13 to 3.35) were associated with video consultations, webchats or chatbots acceptability. Conclusions Although video consultations and webchat services appear acceptable, there is currently little support for SRH chatbots. The findings demonstrate a preference for human interaction in SRH services. Policymakers and intervention developers need to ensure that digital transformation is not only cost-effective but also acceptable to users, easily accessible and equitable to all populations using SRH services

Report of action of financial aid and scholarship subcommittee

Report of action of financial aid and scholarship subcommittee from Francis C. Bayley, Administrator Scholarships and Financial Aids, to Joel Smith, President; Parker B. Lichtenstein, Dean; F. Trevor Gamble, Dean of Students; Members of sub-committee, Larry C. Ledebur, Neil Prentice, Albert W. Davison, and Burton W. Dunfield. Addresses Parents\u27 Confidential Statement and Financial Need Analysis Report. Dated February 2, 1970

Community-linked maternal death review (CLMDR) to measure and prevent maternal mortality: a pilot study in rural Malawi.

In Malawi, maternal mortality remains high. Existing maternal death reviews fail to adequately review most deaths, or capture those that occur outside the health system. We assessed the value of community involvement to improve capture and response to community maternal deaths

Attitudes towards Black American Sign Language

This paper explores how language attitudes and ideologies impact perceptions of language varieties in the American Deaf community, with a particular focus on Black ASL, the variety of ASL developed by African Americans in the South during the era of segregation. Results of multivariate analysis show that on a number of dimensions, Black ASL, particularly as used by signers who attended school before integration, is closer to the standard variety taught in ASL classes and used in ASL dictionaries. Nevertheless, despite evidence that their variety is closer to the standard taught in ASL classes, many of the older signers interviewed felt that white signing was superior. Attitudes among the younger signers were more mixed. While a few younger signers said that white signing was better than Black signing, others said that Black signing was more powerful in expression and movement and it had rhythm and style while white signing was more monotonic and lacked emotion. This paper explores the complex mix of attitudes expressed by study participants in the six Southern states in relation to the historical development of this distinctive variety of ASL

Effects of the COVID-19 lockdown on mental health in a UK student sample

BACKGROUND: The COVID-19 pandemic and the resulting restrictions placed upon society have had a profound impact on both physical and mental health, particularly for young people. AIMS: The current study assesses the impact of COVID-19 on student mental health. METHOD: Four hundred and thirty four first year Undergraduate students completed a battery of self-report questionnaires (PHQ-P, GAD-7 and SAS-SV) to assess for depression, anxiety and mobile phone addiction respectively with data being collected over a 2 year period. The data from each year was compared (216 and 218 students respectively). RESULTS: A MANOVA revealed that COVID-19 had a significant impact on self-reported levels of depression, anxiety and smartphone addiction—which all significantly increased from the 2020 to the 2021 group. The percentage of students who had a score which warranted a classification of clinical depression increased from 30 to 44%, and for anxiety increased from 22 to 27%—those students who showed a comorbidity across the two rose from 12 to 21%. Smartphone addiction levels rose from 39 to 50%. Correlational analysis showed a significant relationship between Smartphone usage and depression and anxiety. CONCLUSIONS: This research suggests that COVID-19 has had a major impact upon student mental health, and smartphone addiction. The importance of identifying predictive factors of depression and anxiety is emphasised, and suggestions for intervention are discussed

Memory consolidation reconfigures neural pathways involved in the suppression of emotional memories

The ability to suppress unwanted emotional memories is crucial for human mental health. Through consolidation over time, emotional memories often become resistant to change. However, how consolidation impacts the effectiveness of emotional memory suppression is still unknown. Using event-related fMRI while concurrently recording skin conductance, we investigated the neurobiological processes underlying the suppression of aversive memories before and after overnight consolidation. Here we report that consolidated aversive memories retain their emotional reactivity and become more resistant to suppression. Suppression of consolidated memories involves higher prefrontal engagement, and less concomitant hippocampal and amygdala disengagement. In parallel, we show a shift away from hippocampal-dependent representational patterns to distributed neocortical representational patterns in the suppression of aversive memories after consolidation. These findings demonstrate rapid changes in emotional memory organization with overnight consolidation, and suggest possible neurobiological bases underlying the resistance to suppression of emotional memories in affective disorders

Knowledge and perceptions of quality of obstetric and newborn care of local health providers: A cross-sectional study in three districts in Malawi

AimQuality of service delivery for maternal and newborn health in Malawi isinfluenced by human resource shortages and knowledge and care practicesof the existing service providers. We assessed Malawian healthcareproviders’ knowledge of management of routine labour, emergencyobstetric care and emergency newborn care; correlated knowledgewith reported confidence and previous study or training; and measuredperception of the care they provided.MethodsThis study formed part of a large-scale quality of care assessment inthree districts (Kasungu, Lilongwe and Salima) of Malawi. Subjects wereselected purposively by their role as providers of obstetric and newborncare during routine visits to health facilities by a research assistant. Researchassistants introduced and supervised the self-completed questionnaire bythe service providers. Respondents included 42 nurse midwives, 1 clinicalofficer, 4 medical assistants and 5 other staff. Of these, 37 were staffworking in facilities providing Basic Emergency Obstetric Care (BEMoC)and 15 were from staff working in facilities providing ComprehensiveEmergency Obstetric Care (CEMoC).ResultsKnowledge regarding management of routine labour was good (80%correct responses), but knowledge of correct monitoring during routinelabour (35% correct) was not in keeping with internationally recognizedgood practice. Questions regarding emergency obstetric care were  answered correctly by 70% of respondents with significant variation depending on clinicians’ place of work. Knowledge of emergency newborn care was poor across all groups surveyed with 58% correct responses and high rates of potentially life-threatening responses from BEmOC facilities. Reported confidence and training had little impact on levels of knowledge. Staff in general reported perception of poor quality of care.ConclusionSerious deficiencies in providers’ knowledge regarding monitoring duringroutine labour and management of emergency newborn care weredocumented. These may contribute to maternal and neonatal deaths inMalawi. The knowledge gap cannot be overcome by simply providingmore training

Sexual healthcare professionals’ views on the rapid provision of remote services at the beginning of the COVID-19 pandemic: a mixed-methods study

Introduction: The COVID-19 pandemic and social distancing measures forced sexual health services to engage with patients remotely. We aimed to understand perceived barriers and facilitators to the provision of digital sexual health services during the first months of the pandemic. Methods: An online survey and qualitative interviews with UK sexual healthcare professionals recruited online and via snowball sampling were conducted in May–July 2020. Results: Amongst 177 respondents (72% female, 86% White, mean age = 46, SD = 9), most utilised telephone and email as their main communication channels; however, their perceived effectiveness varied (94% and 66%, respectively). Most agreed that staff needed additional training (89%), the available technology was not adequate (66%) and health professionals were hesitant to provide online consultations (46%). They had positive attitudes towards digitalisation, improving service quality and cost-effectiveness but were concerned about exacerbating health inequalities. Discussion: The study identifies a need for clear guidelines and training around the use of digital tools as well as a demand for investment in hardware and software required for the provision of remote services. Future research needs to explore the acceptability, safety and effectiveness of various digital tools to narrow health inequalities in sexual health service users

Vélez de Guevara, Luis, La creación del mundo, eds. William R. Manson y C. George Peale, Juan de la Cuesta, Delaware, 2018

Obra ressenyada: Luis VÉLEZ DE GUEVARA ; William R. MANSON y C. George PEALE, Juan DE LA CUESTA (eds.), La creación del mundo. Delaware, 2018

Protein fiber linear dichroism for structure determination and kinetics in a low-volume, low-wavelength couette flow cell

High-resolution structure determination of soluble globular proteins relies heavily on x-ray crystallography techniques. Such an approach is often ineffective for investigations into the structure of fibrous proteins as these proteins generally do not crystallize. Thus investigations into fibrous protein structure have relied on less direct methods such as x-ray fiber diffraction and circular dichroism. Ultraviolet linear dichroism has the potential to provide additional information on the structure of such biomolecular systems. However, existing systems are not optimized for the requirements of fibrous proteins. We have designed and built a low-volume (200 μL), low-wavelength (down to 180 nm), low-pathlength (100 μm), high-alignment flow-alignment system (couette) to perform ultraviolet linear dichroism studies on the fibers formed by a range of biomolecules. The apparatus has been tested using a number of proteins for which longer wavelength linear dichroism spectra had already been measured. The new couette cell has also been used to obtain data on two medically important protein fibers, the all-β-sheet amyloid fibers of the Alzheimer's derived protein Aβ and the long-chain assemblies of α1-antitrypsin polymers