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The authors propose a blockchain platform for managing clinical trial data to enhance data validity, integrity, trust and transparency in the pharmaceutical research process. The authors also provide an extensive review of how blockchain technology supports the business processes of clinical trials.

A systematic literature review was conducted to identify the existing applications of blockchain in pharmaceutical process management. A conceptual design for a blockchain infrastructure to address clinical trial challenges is developed by outlining the entire clinical trial value chain and identifying the coordination and communication among its stakeholders. A stakeholder analysis is conducted to ensure that the clinical trial processes satisfy the requirements and preferences of each stakeholder.

The proposed blockchain platform offers a promising solution for enhancing integrity, trust and transparency in the clinical trial process. Additionally, blockchain can help streamline communication and collaboration between stakeholders by enabling multiple parties to access and share data in real time, lowering the possibility of delays or errors in data analysis and reporting.

The proposed blockchain platform can benefit patients by empowering them to have better-controlled access to their data and by allowing researchers to maintain adherence to reporting requirements. Additionally, the platform can benefit granting agencies, researchers and decision-makers by ensuring the integrity of clinical trial data and streamlining communication and collaboration between stakeholders.

This study builds on existing blockchain applications in pharmaceutical process management by developing a blockchain framework that can address clinical trial concerns from an integrated perspective.

Psychotherapy and clinical supervision outcomes are influenced by client and supervisee factors, one of which is cultural identity. Those with diverse racial and ethnic minoritised identities often experience disparities in therapy outcomes. Therapists and supervisors need to be responsive to the identity of those they support. The multicultural orientation (MCO) framework is an emerging concept in psychotherapy and clinical supervision that may offer these practitioners a framework to be responsive.

A preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews was conducted. Six databases, PubMed, Scopus, Embase, Academic Search Complete, Web of Science and PsychInfo, were searched for peer-reviewed literature published in English between the years 2000 and 2023.

A total of 1,553 sources were identified, of which (n = 42) are included in this review. Findings suggest that MCO is still in its infancy as applied to therapy and clinical supervision. Most of the research has been conducted in America, using quantitative methodologies with white western populations. Cultural humility is the most studied MCO pillar, and variables such as reductions in psychological stress, the working alliance and microaggressions are reported on as outcomes. MCO applied to the group therapy process is an emerging finding of interest. However, more research is needed, especially experiential designs across different and diverse populations and contexts.

MCO is an emerging therapy and clinical supervision process that has the potential to improve the outcomes for therapy clients and supervisees. Further research is needed to replicate current studies, and further research with diverse populations, countries and contexts should be undertaken as a priority.

Why is it that highly trained and seasoned executives fail? On the surface, this doesn’t make sense because they are very successful; yet research in the organization sciences provides no shortage of evidence to prove just that. From the classic Mann Gulch fire disaster of Weick’s famous collapse of sensemaking study, to studies of myopia of learning, escalation of commitment, threat-rigidity, dominant logic, the architecture of simplicity, the Icarus Paradox, to core competencies turning into core rigidities, and navigating new competitive markets using “old” cognitive maps, and many more such examples point to a ubiquitous phenomenon where highly trained and experienced professionals find themselves “stuck” in the heat of battle, unable to move and progress. On the one hand, for some, there is a desperate need for change, but are unable to do so, due to their trained incapacities. On the other hand, some simply cannot see the need for change, and continue with their “business as usual” mentality. For both, their visions of the world shrink, they have a tendency to cling onto their past habitual practices and oversimplify the complexity of the situation. In moments like these: DROP YOUR TOOLS and UNLEARN! This book chapter introduces a framework (grounded in clinical psychology) that has had consistent success in helping seasoned executives and key decision-makers open up the alternatives whenever they find themselves stuck with complexity.

Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.

In this chapter, the author critically examines the deeply entrenched practices and theories within counselor education, revealing their roots in historically dominant, Eurocentric, and often racially oppressive assumptions. This study brings to light the pervasive impact of these traditional approaches, illuminating their role in perpetuating racial oppression and disparities in mental health care. The author presents a compelling argument for adopting Critical Race Theory (CRT) as an effective pedagogical and clinical practice framework in the counseling profession, a step toward its much-needed liberation. CRT's tenets are examined as a robust alternative, promoting socially just outcomes in counseling and psychotherapy. The article highlights CRT's capacity to address the well-established relationship between racism, white supremacy, and minority mental health. It proposes a groundbreaking model for praxis, predicated on CRT, which holds potential not only to challenge and disrupt oppressive structures but also to pave the way for the liberation of both the oppressed and the oppressor. This seminal work prompts a re-envisioning of counselor education, asserting a call for a transformative shift toward a liberation-based, social justice pedagogy.

Many psychiatrists and trainees in Aotearoa New Zealand used telepsychiatry during COVID-19 lockdowns, despite minimal experience and training in the area. Research on a culturally safe telepsychiatry framework is lacking in Aotearoa. This study aims to provide a better understanding of telepsychiatry in the Aotearoa context and identify potential gaps with the current practice, with a focus on exploring telepsychiatry use with Maori, Pacific peoples and Asians.

This qualitative study was guided by the principles of the Kaupapa Maori methodology and the “Give Way Rule” from Pan-Pacific studies, to ensure culturally appropriate analysis and outcomes. Semi-structured interviews were conducted with a sample of psychiatrists and trainees recruited from Aotearoa members of the Royal Australian and New Zealand College of Psychiatrists. The qualitative data were then analysed using general inductive thematic analysis to identify the major themes.

In total, 18 participants were interviewed. Three key themes were identified: cultural safety such as preparation for a telepsychiatry session, cultural practices and equity issues; clinical practice such as continuity of care, patient selection and limitations; and process of running a telepsychiatry service.

The analysis of the main themes gives both practical ideas for providing a culturally safe telepsychiatry appointment, as well as a wider base for developing a telepsychiatry service that works particularly for Maori, Pacific and Asians mental health users. Issues around resources and expertise in the field are lacking and further frameworks to support infrastructure and training are needed.

The purpose of this study is to investigate and demonstrate the advancements achieved in the field of chest X-ray image captioning through the utilization of dynamic convolutional encoder–decoder networks (DyCNN). Typical convolutional neural networks (CNNs) are unable to capture both local and global contextual information effectively and apply a uniform operation to all pixels in an image. To address this, we propose an innovative approach that integrates a dynamic convolution operation at the encoder stage, improving image encoding quality and disease detection. In addition, a decoder based on the gated recurrent unit (GRU) is used for language modeling, and an attention network is incorporated to enhance consistency. This novel combination allows for improved feature extraction, mimicking the expertise of radiologists by selectively focusing on important areas and producing coherent captions with valuable clinical information.

In this study, we have presented a new report generation approach that utilizes dynamic convolution applied Resnet-101 (DyCNN) as an encoder (Verelst and Tuytelaars, 2019) and GRU as a decoder (Dey and Salemt, 2017; Pan et al., 2020), along with an attention network (see Figure 1). This integration innovatively extends the capabilities of image encoding and sequential caption generation, representing a shift from conventional CNN architectures. With its ability to dynamically adapt receptive fields, the DyCNN excels at capturing features of varying scales within the CXR images. This dynamic adaptability significantly enhances the granularity of feature extraction, enabling precise representation of localized abnormalities and structural intricacies. By incorporating this flexibility into the encoding process, our model can distil meaningful and contextually rich features from the radiographic data. While the attention mechanism enables the model to selectively focus on different regions of the image during caption generation. The attention mechanism enhances the report generation process by allowing the model to assign different importance weights to different regions of the image, mimicking human perception. In parallel, the GRU-based decoder adds a critical dimension to the process by ensuring a smooth, sequential generation of captions.

The findings of this study highlight the significant advancements achieved in chest X-ray image captioning through the utilization of dynamic convolutional encoder–decoder networks (DyCNN). Experiments conducted using the IU-Chest X-ray datasets showed that the proposed model outperformed other state-of-the-art approaches. The model achieved notable scores, including a BLEU_1 score of 0.591, a BLEU_2 score of 0.347, a BLEU_3 score of 0.277 and a BLEU_4 score of 0.155. These results highlight the efficiency and efficacy of the model in producing precise radiology reports, enhancing image interpretation and clinical decision-making.

This work is the first of its kind, which employs DyCNN as an encoder to extract features from CXR images. In addition, GRU as the decoder for language modeling was utilized and the attention mechanisms into the model architecture were incorporated.

The purpose of this paper was to gain a qualitative view of the participant experience of using home-based transcranial direct current stimulation (tDCS). Acceptability impacts patient preference, treatment adherence and outcomes. However, acceptability is usually assessed by rates of attrition, while multifaceted constructs are not reflected or given meaningful interpretations. tDCS is a novel non-invasive brain stimulation that is a potential treatment for major depressive disorder (MDD). Most studies have provided tDCS in a research centre. As tDCS is portable, the authors developed a home-based treatment protocol that was associated with clinical improvements that were maintained in the long term.

The authors examined the acceptability of home-based tDCS treatment in MDD through questionnaires and individual interviews at three timepoints: baseline, at a six-week course of treatment, and at six-month follow-up. Twenty-six participants (19 women) with MDD in a current depressive episode of at least moderate severity were enrolled. tDCS was provided in a bifrontal montage with real-time remote supervision by video conference at each session. A thematic analysis was conducted of the individual interviews.

Thematic analysis revealed four main themes: effectiveness, side effects, time commitment and support, feeling held and contained. The themes reflected the high acceptability of tDCS treatment, whereas the theme of feeling contained might be specific to this protocol.

Qualitative analysis methods and individual interviews generated novel insights into the acceptability of tDCS as a potential treatment for MDD. Feelings of containment might be specific to the present protocol, which consisted of real-time supervision at each session. Meaningful interpretation can provide context to a complex construct, which will aid in understanding and clinical applications.

The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance.

A total of 15 professionals with a role in serious incident management, from five mental health trusts in England, were interviewed using a semi-structured interview guide. Thematic analysis and qualitative description were used to analyse the data.

Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings.

The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks.

The purpose of this paper is to critique and evaluate need-driven dementia compromised behavior theory and the health behavioral model using Meleis’ (2010) criteria of theory evaluation.

Theory critique using Meleis’ (2010) criteria of theory evaluation.

This paper provides a conclusion about each theory in terms of agitation in the elderly. Meleis’s (2010) criteria will be used for both theories to evaluate different components such as the relationship between structure and function, diagram of the theory, circle of the contagiousness, usefulness and external components.

The critique of the two theories broadened the nurses’ understanding of the connection between the NDB model and the behavior symptoms, including agitation and its related issues. Further studies need to be conducted to shed light on the other aspects of the behavioral symptoms in elderly with dementia that supports the results of this study, like its specific causes, trigger factors and other intervention strategies. Nurses should be able not only to understand the patient’s behavior symptoms but also to decode them into communication signals to meet their needs in a more effective way.