It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
New research shows that Allied Health Professions (AHPs) are significantly underrepresented in senior leadership roles despite being the third largest workforce in the NHS.
Ranging from paramedics to podiatrists, the AHPs encompass various healthcare disciplines, constituting a workforce of 185,000 within the NHS.
However AHPs have historically been underrepresented in strategic leadership positions, often occupied by medical professionals. To address this, NHS England advocated for the establishment of a Chief AHP role in every Trust to harness the untapped potential of this workforce and increase diversity in leadership roles.
A recent study from Staffordshire University published in BMJ Leader provides comprehensive data on the current state of AHP strategic leadership within the NHS.
Gathering responses from 160 out of 217 Trusts and Health Boards, the study reveals that 81% of the surveyed organisations now employ a Chief AHP or equivalent. However, only 14% of these roles have a presence on the executive board of their respective Trusts or Health Boards.
The report identifies 50 diverse job titles associated with Chief AHP roles, with "Director of AHPs" (18.6%), "Lead AHP" (13.9%), and "Chief AHP" (11.6%) being the most frequently reported titles.
The findings also highlight a concerning disparity in the representation of AHP professions within senior AHP leadership, with a significant majority (70%) of these roles held by physiotherapists and occupational therapists.
Senior author Professor Nachi Chockalingam, Director of the Centre for Biomechanics and Rehabilitation Technologies, explained: "This study exposing discrepancies in AHP profession representation, the lack of standardised titles for Chief AHPs, and a significant scarcity of Chief AHPs on executive boards.
“The absence of AHP leaders in key strategic positions poses challenges, hampering the development of AHPs' leadership skills and impeding access to mentors and role models.”
He added: “The inclusion of AHP leaders in planning has been proven to positively impact patient outcomes, whereas their absence can lead to missed opportunities for patients to benefit from essential AHP services.”
While medical and nursing directors are required on NHS Trust executive boards in England, no comparable obligation exists for AHP representation. In contrast, Wales mandates the inclusion of a therapies and health sciences officer on boards.
The report highlights a necessity for a standardised titles for the head of AHPs. The need to mandate the presence of chief AHPs on NHS executive boards, aligning with nursing and medical roles, is also emphasised. Furthermore, identifying barriers to diverse AHP representation and promoting broader inclusion in chief AHP positions are key actions for advancing AHP leadership.
IMAGE: ONE OF THE PARTICIPATING CHILDREN DURING THE STRESS TEST AT THE LAB. (PHOTO: UNIVERSITY OF BASEL, MARIA PATZSCHKE)view more
CREDIT: UNIVERSITY OF BASEL, MARIA PATZSCHKE
The school year has hardly begun and the first exams are already approaching. According to findings by researchers from the University of Basel, school children cope better with the stress if they get plenty of daily exercise.
“Get some exercise!” It’s one suggestion adults frequently hear when they complain about stress in their lives. Exercise helps relieve stress. But does this also apply to children? Does exercise help them manage the pressures to achieve at school? A research team led by Dr. Manuel Hanke and Dr. Sebastian Ludyga from the Department of Sport, Exercise and Health recently examined the effect of physical activity on children’s stress levels. Their findings appear in the Journal of Science and Medicine in Sport.
For their study, they had 110 children between the ages of 10 and 13 wear a sensor tracking their daily movement over the course of a week. They then brought the participants into the lab on two separate occasions to complete a stressful task and a non-stressful control task (see the box). The researchers tested the children’s physical stress reaction via the concentration of the stress hormone cortisol in their saliva.
Less cortisol in active children
“We wanted to determine whether physical activity makes children more resilient under laboratory-controlled circumstances,” explains project director Sebastian Ludyga. The results showed that the participants who got more than an hour of exercise per day, as the World Health Organization (WHO) recommends, did in fact produce less cortisol in the stress task than the children who were less active.
“Regularly active children seem to have a reduced physiological stress reaction in general,” notes Manuel Hanke, lead author of the study. Even in the control task, which involved an unfamiliar situation, making it still somewhat unsettling for the participants, there was a difference in cortisol levels between more and less active children – though overall cortisol levels were lower than in the stress task.
Stress hormone levels increase during exercise
One possible explanation for this finding could be that cortisol levels also increase during exercise, says Sebastian Ludyga. “When children regularly run, swim, climb, etc., the brain learns to associate a rise in cortisol with something positive. The body’s reaction always has a cognitive component as well: this positive association helps to prevent the concentration of cortisol from rising to too high a level in exam situations as well.”
Besides their analysis of the saliva samples, the researchers also examined cognitive reactions to the stress task by recording participants’ brainwaves via electroencephalogram (EEG). The team plans to analyze these data next. “Stress can interfere with thinking. Some of us are familiar with this in its most extreme form – a blackout,” Hanke explains. The team now aims to determine whether physical activity also has an influence on these cognitive effects of stress.
Box: Methodology
For their study, the researchers used the Trier Social Stress Test for Children: the participants had to read a story with an open ending, then had five minutes to prepare before using their notes to tell the rest of the story for a jury. What they didn’t know in advance was that the preparation time was intentionally kept so short so that it would not be sufficient. After about a minute, their notes were mostly exhausted but they still had to fill five minutes and think something up on the spur of the moment. This task was followed by a seemingly simple arithmetic task in which participants were asked to repeatedly reduce a number in the high three digits by a certain value over the course of five minutes. The stress in this task is primarily caused by errors, which require the participant to restart the task from the beginning. In the control task, which was conducted on a separate occasion, the children also had to read a story, but they then discussed general questions about the story with a researcher without any pressure to perform. In both sessions, the researchers took saliva samples at regular intervals before and after the tasks in order to measure cortisol levels.
Moderate-to-vigorous physical activity and reactivity to acute psychosocial stress in preadolescent children
Scientists decipher the fingertip’s ‘memory’
A study has demonstrated that tactile neurons transmit information about previous forces experienced by the fingertip, potentially aiding the brain in navigating daily manual tasks
Scientists have detailed how the activity of tactile neurons in the fingertip in response to an applied force is influenced by the fingertip's mechanical memory of previous forces.
The study, published today as an eLife Reviewed Preprint, provides what the editors call fundamental findings on how the fingertip’s viscoelasticity – its time-dependent mechanical response to an applied force – affects the information relayed by tactile neurons to the brain. The findings emphasise that these neurons not only signal current fingertip force but also the fingertip’s viscoelastic memory of previous loadings. Tactile information about the recent physical state of the skin may help the brain to formulate accurate motor commands to control the hands in object manipulation and haptic tasks.
Everyday tasks we complete with our hands, such as cooking, cleaning, or grasping and transporting objects, require precise and rapidly recurring application of forces to external objects. To effectively accomplish these tasks, the brain relies on information about the forces acting on the fingertips provided by tactile neurons. However, these neurons do not directly signal contact forces; rather, they relay information about the deformations made to the skin by the applied force.
“The viscoelasticity of the human fingertip means that any deformation caused by a force acting on the fingertip lasts longer than the force itself,” explains lead author Hannes Saal, Senior Lecturer in the Department of Psychology, University of Sheffield, UK. “Therefore, residual deformations from previous forces will affect how the fingertip reacts mechanically when subjected to a new force. However, the extent to which this physical memory influences the signalling of tactile neurons during natural hand use is not well understood.”
To investigate this, Saal and colleagues examined how previous fingertip forces affected the responses of first-order tactile neurons when new forces were applied. They used a custom-built robot to stimulate the fingertip with forces that mimicked those typically encountered during natural object interaction. They recorded impulse responses of nearly 200 individual neurons using specially designed electrodes inserted into peripheral nerves of human volunteers. The neurons were categorised as fast-adapting type 1 (FA-1), slowly-adapting type 1 (SA-1), and slowly-adapting type 2 (SA-2).
Forces were applied in different directions to the fingertip in rapid succession. By comparing fingertip deformation and elicited neural responses in stimulation sequences where the directional order of the stimuli was kept constant with sequences where the order was systematically varied, the team analysed effects of the previous force stimulus on the responses of the subsequent one.
First, they noted that varying the loading history resulted in greater variation in fingertip deformation, confirming the viscoelastic memory of the fingertip. Then, they examined whether this increased variability in deformation was mirrored in the responses of the neurons. They found that firing rates during the force applications showed roughly twofold greater variability in FA-1 and SA-1 neurons, and around 70% more variability in SA-2 neurons, when the directional order was varied compared to fixed. This indicated that the fingertip’s viscoelastic memory influenced the responses in the tactile neuron. The difference in effect size between neuron types could stem from type 1 neurons primarily sensing mechanical events in the superficial structures of the skin, while type 2 neurons primarily sense tension states in deeper tissues.
Next, the team investigated whether the increased neuronal response variability could be linked to the fingertip’s viscoelastic memory. To this end, they quantified the information relayed to the brain about the direction of the force, both the current and the previous one. They found that information about the current force direction decreased when the preceding stimulus was systematically varied as compared to when it was consistent. Intriguingly, they also observed considerable diversity in the behaviour of individual neurons within each type: while some neurons primarily signalled information about the current force direction, others signalled both the current and previous direction, and some primarily the preceding direction. Moreover, they discovered that SA-2 neurons, many of which are active even without external stimulation, could signal information about the fingertip’s viscoelastic deformation state even between fingertip loadings.
This diversity of responses suggests that, collectively, first-order tactile neurons relay rich information about the fingertip’s viscoelastic state to the brain, containing within them a memory of past stimulation. Co-author Ingvars Birznieks, Associate Professor at the University of New South Wales Sydney, states: “I am very compelled by the idea that one of the functions of SA-2 neurons might be to signal the overall viscoelastic state of the fingertip, which might enable more accurate interpretation of type-1 neuron input.”
The authors note that there has been no systematic investigation into whether effects of viscoelasticity on tactile sensing impact the performance of manual tasks, so it remains unclear whether viscoelasticity might limit performance, or if the neural information about past stimuli is used by the brain in some capacity. Additionally, as proposed in the eLife public review, the study could gain from a more direct examination of the link between skin deformation and neuron firing, a facet that the authors are currently addressing.
“Our findings suggest that populations of tactile neurons provide a continuous stream of information to the brain about the viscoelastic deformation state of the fingertip,” concludes senior author Roland Johansson, Professor in the Department of Integrative and Medical Biology, Umeå University, Sweden. “It is plausible that the brain employs this information to estimate the fingertip's state during the planning and evaluation of tactile-based actions. Investigating this idea in future research holds intriguing potential.”
eLife transforms research communication to create a future where a diverse, global community of scientists and researchers produces open and trusted results for the benefit of all. Independent, not-for-profit and supported by funders, we improve the way science is practised and shared. In support of our goal, we’ve launched a new publishing model that ends the accept/reject decision after peer review. Instead, papers invited for review will be published as a Reviewed Preprint that contains public peer reviews and an eLife assessment. We also continue to publish research that was accepted after peer review as part of our traditional process. eLife receives financial support and strategic guidance from the Howard Hughes Medical Institute, Knut and Alice Wallenberg Foundation, the Max Planck Society and Wellcome. Learn more at https://elifesciences.org/about.
Memory at your fingertips: how viscoelasticity affects tactile neuron signaling
ARTICLE PUBLICATION DATE
5-Sep-2023
Professor helping young engineers respond to world’s biggest challenges receives ‘Distinguished Woman in Engineering’ award
A University of Warwick professor who is helping young engineers across the world respond to humanity’s biggest challenges, has won the ‘Distinguished Woman in Engineering’ award
A University of Warwick professor who is helping young engineers across the world respond to humanity’s biggest challenges, has won the ‘Distinguished Woman in Engineering’ award.
Hosted by the ‘International Network of Women Engineers and Scientists’ (INWES), the award celebrates Professor Georgia Kremmyda’s achievements in global capacity building (developing and building knowledge and skills internationally) and commitments to the representation of women in STEM.
Professor Kremmyda leads the ENHANCE project – a community-based engineering programme, training young engineers in Asia, in particular in Bangladesh, Indonesia and Vietnam, to tackle humanitarian challenges.
The project helps higher education institutions embed community-based engineering education into their graduate engineering programmes.
It aims to empower the next generation of engineers with the knowledge, skills, and mindset necessary to address real-world challenges in collaboration with local communities, markets, and industries.
The goal is to promote collaboration, ethical and social responsibility, and transformative impact in engineering education – shaping the future of engineering by integrating academic learning with community engagement and fostering a generation of socially conscious engineers.
A Civil Engineer herself, Professor Kremmyda hopes the students will go on to have a positive impact – shaping the future and the world for the better. The project has already included more than 300 modules worldwide – and 6,000 students annually.
Alongside her research, Professor Kremmyda is also instrumental in championing the representation of women in engineering. She leads the planning, organisation and delivery of conferences for INWES – bringing together talented women in STEM from across Europe, Middle East, Asia and Pacific, Africa and North and South America.
INWES is a not-for-profit global network of organizations of women in Science, Technology, Engineering and Mathematics (STEM), representing over 250,000 women from 60 countries around the globe.
INWES is an official non-government organisation partner of UNESCO, holding consultative status with United Nations Economic and Social Council (ECOSOC) and observer status to the UNFCCC (United Nations Framework Convention on Climate Change). INWES supports the work of UN Women and the Commission for the Status of Women.
On winning the award, Professor Kremmyda said: “I am honoured to receive the INWES Distinguished Woman in Engineering award. This recognition reflects my commitment to setting a path for aspiring women engineers and embodying the transformative spirit that shapes our global landscape.
“At the same time, it highlights the impact of powerful organisations like INWES in creating a revolution for women in science and engineering, as we collectively shape a future defined by progress, inclusivity, and extraordinary accomplishment.”
Professor John Murphy, Head of Warwick’s School of Engineering, said: “Professor Kremmyda is a true leader in Engineering education as evidenced by this major international award and her recent National Teaching Fellowship.
“At Warwick, she has pioneered new programmes in Humanitarian Engineering and has been instrumental in the launch of two Engineering Degree Apprenticeships. As Head of Teaching and Deputy Head of Department, the impact of her work on the experience of Engineering students has been substantial.
“The benefits of her work are felt by all, but she has worked particularly hard to dismantle barriers to participation, tackling persistent issues such as the underrepresentation of women, disabled people, those from ethnic minorities and socially disadvantaged groups in STEM”.
President of INWES Jung Sun Kim added: “Prof. Kremmyda is an example of excellent achievement in engineering in terms of research, education and advocacy for women in STEM. Her leadership and trailblazing contributions in Civil Engineering and overall STEM are inspirational”.
Notes to Editors
INWES was established to strengthen the capacity of individuals, organizations, and corporations to influence policies in Science, Technology, Engineering, and Mathematics (STEM) worldwide, and to encourage the education, recruitment, retention, support, and advancement of professional women and students through an international network of organisations and experts.
The goal of INWES is to build a better future worldwide through the full and effective participation of women and girls in all aspects of STEM.
The ENHANCE project was funded by the European Commission under the Erasmus+ Key Action 2 Cooperation for innovation and the exchange of good practices; Capacity Building in the field of Higher Education (598502-EPP-1-2018-1-UK-EPPKA2-CBHE-JP (2018-2582/001-001).
ERC Starting Grant for TU Graz researcher Sonja Wogrin: Innovative data aggregation for decarbonized power systems
Data aggregation for modelling highly complex power systems is usually carried out without a sound theoretical basis and leads to inaccuracies. With her ERC project, Wogrin wants to change this to make the planning of future energy systems more efficient
IMAGE: SONJA WOGRIN HAS HEADED THE INSTITUTE OF ELECTRICITY ECONOMICS AND ENERGY INNOVATION SINCE 2021 AND THE CROSS-FACULTY RESEARCH CENTER ENERGETIC AT TU GRAZ SINCE 2023.view more
CREDIT: LUNGHAMMER - TU GRAZ
Power systems in Europe will be expanded and rebuilt in the coming decades to make them stable and carbon-neutral at the same time. Complex optimisation models are employed to make the right decisions on the path towards decarbonisation. But there is a catch. Models of realistic power systems are usually so large that even supercomputers are pushed towards their performance limits. This means that much input data (such as time series of power demand or capacity factors of renewable energy sources) is aggregated, which makes the models numerically solvable but less accurate. Sonja Wogrin, head of the Institute of Electricity Economics and Energy Innovation at Graz University of Technology (TU Graz), wants to change this with her five-year project “Optimisation and data aggregation for net-zero power systems”, for which she has secured a Starting Grant of almost 1.5 million euros from the European Research Council (ERC).
Existing aggregation methods leave much potential unused
When creating optimisation models, traditional data aggregation usually focuses exclusively on the data itself, without taking into account the specifics of the optimisation model in question. This leaves a lot of aggregation potential unused, which affects the computing time and the quality of the optimisation results. As a result, investment decisions on power plant technologies, locations or grid expansion are suboptimal, so the restructuring of the energy system becomes more expensive. In her project, Wogrin wants to improve data aggregation and develop methods by which researchers can create more meaningful models with the same computing power and thus benefit society immensely. “The global power generation market size was estimated at USD 1.8 trillion in 2022” explains Wogrin. “Even if novel aggregation methods lead to decisions that are only one percent better, the impact is huge.”
Taking into account different supply situations
Wogrin’s research approach does not simply focus on single representative periods where system data is similar. Within these periods you have to differentiate whether the power supply is temporarily guaranteed purely by renewable energy (hydropower, wind, PV), or whether thermal power plants have to be switched on, or whether there could even be situations with an overall loss of load. When data of these time periods are looked at on average, situations of undersupply in the model can be completely overlooked – periods which are critical for reliable planning. Therefore, Sonja Wogrin would like to use her new method to combine situations with similar model outcomes in order to obtain compressed and yet differentiated model data.
“If we want to plan the decarbonised energy system of the future properly, there is no way around reliable modelling. After all, we have to make wise investment decisions. These models and methods should then also be available to everyone,” says Wogrin. “I am convinced that this new way of aggregating data is not only relevant to my field of research, but provides fundamental tools that can help scientists around the world.”
Fiver new positions for researchers
The funding will enable Wogrin to put together a team of probably three PhD students and one or two postdocs. The positions are to be advertised and filled before the end of the year. The ERC awards Starting Grants to researchers who conduct ground-breaking research early in their careers and establish their own independent research groups. Sonja Wogrin's Starting Grant is the eighth Starting Grant awarded to researchers at TU Graz and the first in the Department of Electrical Engineering at TU Graz. In addition, three Consolidator Grants and one Proof of Concept Grant have been obtained in the past.
Personal details: Sonja Wogrinhas headed the Institute of Electricity Economics and Energy Innovation since 2021 and the cross-faculty Research Center ENERGETIC at TU Graz since 2023. Optimisation models for complex systems, energy analytics and the decarbonisation of energy systems are among her central research goals.
This research is anchored in the Field of Expertise "Sustainable Systems", one of five strategic research focuses of TU Graz.
Youth-centered groups, classes may be key in maintaining faith as kids age
Parents have largest influence on children’s religious beliefs, but congregations play integral role
FAITH IS IDEOLOGY THAT'S WHY THERE WERE SOCIALIST SUMMER CAMPS
Parents are an undeniably influential force in their children’s lives. But a new study from the University of Georgia suggests that when it comes to religion, an engaged congregation may also be a deciding factor of whether youth stay involved in their religious practice as they age.
The study found that the way parents live and the conversations they have with their children have the largest impact on whether their kids continue in their faith as they age.
But things like youth groups, Sunday school and attending weekly services make a big difference in youths’ feelings of belonging within their religious community, according to the research. As a result of that, they may be more likely to stay in their faith as they grow.
About three out of 10 Americans currently identify as non-religious, according to the Pew Research Center. And that number is expected to rise.
For parents who are invested in religious tradition and religious community leaders, that may be concerning.
“It used to be just a truism that people stop attending religious services in college and then they came back when they had kids,” said Bill Stanford, lead author of the study and a doctoral graduate of UGA’s College of Family and Consumer Sciences. “But more recent studies have pointed out people aren't coming back after they have kids. The million-dollar question is why.”
1 in 6 kids from religious families say they never discuss religion with parents
The researchers analyzed responses from more than 1,700 youth and their caregivers interviewed over several years as part of the National Study of Youth and Religion. The dataset provides a big picture view of young people’s relationship with religion and spirituality and includes individuals from a variety of faiths, such as Christianity, Islam and Judaism, among others.
More than three out of four of the parents in the study said their faith was either a very or extremely important guide in their daily decisions. And more than half said they went to at least weekly religious services.
But more than one in six of the kids surveyed said they never discussed religion with their parents. Less than half of the youth reported having conversations about religion with their caregivers on a weekly basis.
“It's not something that we commonly talk about, in terms of educating parents on how to help facilitate religiosity and spirituality with their kids,” said Ted Futris, co-author of the study and a professor of human development and family science. “It's often seen as something personal.
“What Bill’s work is showing is that building spirituality in youth is a community process. It’s both parents and the faith-based community working together to help foster that religiosity and spirituality among our young people.”
Only 2 out of 5 youth attend youth group
Although more than 60% of adults said youth ministry was a priority in their faith communities, only two out of five children said they participated in a youth-oriented group.
Almost 30% of youth reported never taking religious education courses, and half said they’d never undergone a rite of initiation into the religious community, such as a baptism or confirmation.
“The role of parents is incredibly powerful in shaping future religiosity in children, but engagement matters,” said Stanford, who is now an associate priest at St. Thomas Anglican Church in Athens, Georgia. “Nonfamilial adult mentorship relationships are extremely important. Integrating youth into the community and connecting them with religious education and the rites of passage—the congregation has an important role to play in helping pass down religious tradition.”
Youth groups, religious education courses lead to more religiosity in young people
Young people in religious organizations that emphasize youth group and religious education and expect kids to regularly attend worship services are more likely to report high levels of personal religious practice, such as fasting and independent study of religious texts.
The study also explored differences between religious denominations. The researchers found some traditions put more of an emphasis on integrating youth into their communities than others.
“What you're doing as parents is you're creating a framework through which to view the world,” Stanford said. “And religion's part of that for a lot of people. Religion becomes part of the scaffolding for how you view the world.
“I would say part of purposefully engaging youth is thinking through, how are we as a congregation coming alongside parents and providing a lens through which the world makes sense? How are we being purposeful about talking through what we believe, why we believe it, how we see it acting in the world?”
LAWRENCE — People have turned to religion and spirituality to deal with crises and critical needs for centuries. Yet little is known how religion plays a role in substance use care. A new publication from the University of Kansas and Georgetown University explored the religious orientation of facilities within the substance use and addiction system of care throughout the Kansas City region, the religiousness of services, where the services are located and differences in services offered.
The study showed facilities that appeared more religious, or where faith or religiousness was centered, often offered a wider range of services and were located in racially diverse communities. The findings can help service providers make better referrals to direct people to places that will best serve their needs. The results also provide a roadmap for other communities to better understand their substance use services and gaps to ultimately help more people on the road to recovery, according to the researchers.
“The strong presence of the faith community in the substance use and recovery collective inspired this strategy of exploring the role of faith-based organizations within this system of care. We wanted to understand this topic deeper and contribute the literature by systematically considering the value faith can add in a person’s journey,” said Amittia Parker a KU alumna now with Georgetown University who was part of the services census and lead author of the publication. “Especially in communities of color where seeking mental health and substance use help is stigmatized. Faith-based services are often preferred sources of support for many in those communities.”
Researchers surveyed substance use and addiction services across a continuum including prevention, treatment, recovery and supportive services throughout the metro area, across 10 counties and two states. The facilities were asked how they identify their organizational designation and to what extent faith or religiousness was involved in their organization or service offering. Researchers documented the centrality of religiousness within the organization and in spaces that were faith-centered or permeated — there were usually religious art, scriptures/texts, symbols and personnel such as pastors, rabbis, imams or others as part of their services. This is one of the few studies that collected this type of information and mapped the location of the facilities within the service sector.
The findings showed that a high density of faith-based or faith centered services were located in communities of color. That may mean that the organizations are potentially addressing service gaps, as those communities have traditionally been under-resourced and underserved, the researchers wrote. Findings also showed a range of services offered and an association between the number of services offered and religious orientation.
“We found faith-based services were more prevalent in more urban areas, and they were also more likely to provide a variety of services within the continuum of care,” Parker said.
The services offered at the faith-based organizations often went beyond substance or mental health treatments, including housing. However, the same facilities were less likely to provide housing for individuals who identify as transgender and expressed ambivalence about medication-assisted treatment. Faith-based organizations are known to provide free or low-cost services for low-income individuals or those without insurance.
“This brought up for us that there are gaps in the service sector and likely people not being well-served. There are a growing number of people who do not identify as religious or spiritual, and also may be under-resourced or uninsured under-resourced,” Parker said. “This research on the service sector, religious orientation and gaps in services can hopefully open conversations about the service offerings across facilities in the community and who may or may not be the best fit at these respective facilities.”
More secular organizations were also found to often offer specialized services, such as hospital-based inpatient detox, partial hospitalization and intensive outpatient services. It is clear that secular and faith-based organizations are contributing to the service sector in unique ways, the researchers wrote.
Among facilities that identified as religious, the majority were Judeo-Christian based, which can leave a gap for followers of other religions or individuals who are spiritual but not in a traditional religious sense, according to the researchers.
The study is not intended to promote one type of service over another but to meet the goal of social work in helping people achieve access to the services and supports that they desire and prefer, and optimal health as they define it, Parker and Kepple wrote. That can help facilitate a match of services that results in satisfaction and increased likelihood of recovery.
“This can lead to a misfit or negative interaction,” Parker said of making referrals without considering individual needs. “When people are in that moment where they are ready to seek help, it is a very critical time. This study helps elevate the idea that there are many things to consider when helping people seek help, and understanding the religious orientation of the facility or organization can help reduce the risk of the client being uncomfortable and having a negative experience.”
The findings offer not only a better understanding of what is available in the Kansas City area but a roadmap other communities can use to determine what is available in their area. Additionally, it helps point out that facilities can collaborate, whether faith-based or not, to ensure individuals are getting the best possible services for their needs.
“It is necessary to continue to examine the integration of (or lack of) FBOs (faith-based organizations) within the system of care, and especially within the substance use system of care. This study provides insights into where FBOs may assist in addressing services gaps within the substance use system of care in addition to existing limitations,” Parker and Kepple wrote. “Understanding how FBOs continue to respond to the needs within communities, where FBOs are located and provide services, as well as the service offerings and serve access gaps, will remain important into the future.”
JOURNAL
Journal of Religion & Spirituality in Social Work Social Thought
IMAGE: (A) RIGHT MEDIOLATERAL OBLIQUE UNADULTERATED MAMMOGRAM SHOWS AN 8-MM ILL-DEFINED MASS (ARROWHEAD), WHICH, AFTER BIOPSY, WAS DETERMINED TO BE A HISTOLOGIC GRADE 2 DUCTAL CARCINOMA OF NO SPECIAL TYPE. (B) MAMMOGRAM SHOWS FINDINGS BY HUMAN READERS (BLUE AREAS) AND THE LUNIT INSIGHT MMG ARTIFICIAL INTELLIGENCE (AI) ALGORITHM (RED CROSS). EACH BLUE DOT IS A MARK PLACED BY AN INDIVIDUAL HUMAN READER ON A PERCEIVED ABNORMALITY WHEN THE PERSONAL PERFORMANCE IN MAMMOGRAPHIC SCREENING (PERFORMS) CASE WAS READ. A REGION OF INTEREST (PENTAGON) HAS BEEN ANNOTATED BY THE PERFORMS SCHEME ORGANIZERS AND THEIR EXPERT RADIOLOGY PANEL. AI HAS CORRECTLY MARKED THE REGION OF INTEREST IN THE RIGHT BREAST FOR RECALL. SOURCE: PERFORMS VIA YAN CHEN.view more
CREDIT: RADIOLOGICAL SOCIETY OF NORTH AMERICA
OAK BROOK, Ill. – Using a standardized assessment, researchers in the UK compared the performance of a commercially available artificial intelligence (AI) algorithm with human readers of screening mammograms. Results of their findings were published in Radiology, a journal of the Radiological Society of North America (RSNA).
Mammographic screening does not detect every breast cancer. False-positive interpretations can result in women without cancer undergoing unnecessary imaging and biopsy. To improve the sensitivity and specificity of screening mammography, one solution is to have two readers interpret every mammogram.
According to the researchers, double reading increases cancer detection rates by 6 to 15% and keeps recall rates low. However, this strategy is labor-intensive and difficult to achieve during reader shortages.
“There is a lot of pressure to deploy AI quickly to solve these problems, but we need to get it right to protect women’s health,” said Yan Chen, Ph.D., professor of digital screening at the University of Nottingham, United Kingdom.
Prof. Chen and her research team used test sets from the Personal Performance in Mammographic Screening, or PERFORMS, quality assurance assessment utilized by the UK’s National Health Service Breast Screening Program (NHSBSP), to compare the performance of human readers with AI. A single PERFORMS test consists of 60 challenging exams from the NHSBSP with abnormal, benign and normal findings. For each test mammogram, the reader’s score is compared to the ground truth of the AI results.
“It’s really important that human readers working in breast cancer screening demonstrate satisfactory performance,” she said. “The same will be true for AI once it enters clinical practice.”
The research team used data from two consecutive PERFORMS test sets, or 120 screening mammograms, and the same two sets to evaluate the performance of the AI algorithm. The researchers compared the AI test scores with the scores of the 552 human readers, including 315 (57%) board-certified radiologists and 237 non-radiologist readers consisting of 206 radiographers and 31 breast clinicians.
“The 552 readers in our study represent 68% of readers in the NHSBSP, so this provides a robust performance comparison between human readers and AI,” Prof. Chen said.
Treating each breast separately, there were 161/240 (67%) normal breasts, 70/240 (29%) breasts with malignancies, and 9/240 (4%) benign breasts. Masses were the most common malignant mammographic feature (45/70 or 64.3%), followed by calcifications (9/70 or 12.9%), asymmetries (8/70 or 11.4%), and architectural distortions (8/70 or 11.4%). The mean size of malignant lesions was 15.5 mm.
No difference in performance was observed between AI and human readers in the detection of breast cancer in 120 exams. Human reader performance demonstrated mean 90% sensitivity and 76% specificity. AI was comparable in sensitivity (91%) and specificity (77%) compared to human readers.
“The results of this study provide strong supporting evidence that AI for breast cancer screening can perform as well as human readers,” Prof. Chen said.
Prof. Chen said more research is needed before AI can be used as a second reader in clinical practice.
“I think it is too early to say precisely how we will ultimately use AI in breast screening,” she said. “The large prospective clinical trials that are ongoing will tell us more. But no matter how we use AI, the ability to provide ongoing performance monitoring will be crucial to its success.”
Prof. Chen said it’s important to recognize that AI performance can drift over time, and algorithms can be affected by changes in the operating environment.
“It’s vital that imaging centers have a process in place to provide ongoing monitoring of AI once it becomes part of clinical practice,” she said. “There are no other studies to date that have compared such a large number of human reader performance in routine quality assurance test sets to AI, so this study may provide a model for assessing AI performance in a real-world setting.”
Left mediolateral oblique mammogram. Unadulterated mammogram shows an asymmetric density (arrowhead) which, after biopsy, was determined to be a histologic grade 2 ductal carcinoma. (B) Artificial intelligence (AI) has correctly marked the region of interest in the left breast for recall (red cross) when set at a recall threshold of 2.91 or higher to match average human specificity, demonstrating a true-positive case. (C) AI has not marked the region of interest in the same breast when set at a recall threshold of 3.06 or higher, indicating a false-negative case. Blue dots indicate findings identified by the human readers. This shows how modifying the threshold for recall can impact the sensitivity of the AI model. Source: Personal Performance in Mammographic Screening via Yan Chen.
CREDIT
Radiological Society of North America
“Performance of a Breast Cancer Detection AI Algorithm Using the Personal Performance in Mammographic Screening Scheme.” Collaborating with Dr. Chen were Adnan G. Taib, B.M.B.S., Iain T. Darker, Ph.D., and Jonathan J. James, FRCR.
In 2023, Radiology is celebrating its 100th anniversary with 12 centennial issues, highlighting Radiology’s legacy of publishing exceptional and practical science to improve patient care.
Radiology is edited by Linda Moy, M.D., New York University, New York, N.Y., and owned and published by the Radiological Society of North America, Inc. (https://pubs.rsna.org/journal/radiology)
RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org)
For patient-friendly information on breast cancer screening, visit RadiologyInfo.org.
JOURNAL
Radiology
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Performance of a Breast Cancer Detection AI Algorithm Using the Personal Performance in Mammographic Screening Scheme
