Tony Robinson

Anxiety disorders are highly prevalent, driving the development of digital mental health technologies and raising important socio-anthropological questions. This study examines the representations and practices surrounding these tools among individuals experiencing anxiety, carers, and healthcare professionals across six European countries. Drawing on qualitative analysis of 100 focus group participants, this study explores lived experiences and perspectives on integrating digital technologies into mental health care. Participants valued the potential of digital tools to foster social connexion, reduce isolation, and empower users, viewing them as complementary to, rather than a substitute for, human interaction due to their limitations in addressing complex needs. Concerns about data security, intrusiveness, and the risk of dehumanising care were also prominent. Cross-country differences highlighted how healthcare policies, socioeconomic conditions, and cultural norms shape attitudes and usage patterns. Individuals experiencing anxiety expressed optimism, while professionals adopted a more cautious stance, emphasising personalisation and ethical oversight. These findings highlight the importance of designing digital mental health tools that are inclusive, equitable, and sensitive to users’ material conditions and needs. This study contributes to sociological debates on health digitalisation, by demonstrating how such technologies can both mitigate and reinforce existing inequalities.

To inform community‐based stress monitoring tools and supportive interventions, this study aimed to understand caregiver stress as experienced by a diverse group of informal caregivers guided by the Pearlin’s stress process model. We used a qualitative descriptive design conducting semistructured interviews with informal caregivers (≥ 18 years) currently or previously caring for an adult with health issues at home. Data were analysed using the framework approach. We recruited 27 caregivers (19 current and 8 former) from various geographic locations within the United Kingdom. In terms of background and context, poor caregiver health increased stress whereas prior employment in health or social care, and access to trusted supports and resources reduced stress. Common primary stressors included rapidly changing or palliative care care‐recipient needs, loneliness and loss (i.e., loss of their normal life, or of the life and future plans they had expected). Family conflict, occupational/economic strains and social/recreational life constraints were important secondary stressors. Guilt contributed to intrapsychic strain resulting in low self‐esteem and feelings of role captivity. Few participants discussed positive elements of caregiving such as mastery or gain. Stress mediators included coping strategies such as taking control, humour, taking brief respite, social activities, access to peer and other forms of social support, and trusted support for caring. Common outcomes of stress included exhaustion, physical injuries, weight loss, difficulty sleeping, depression and anxiety. Despite growing recognition of issues facing informal caregivers and policies or services put in place to support them, our data indicate key stressors remain. Future supportive initiatives should reflect dynamic and individual caregiver needs, thereby enabling caregivers to prioritise their mental and physical wellbeing and receive brief respite from caregiving responsibilities. Stress monitoring tools and accompanying supportive interventions, if codesigned with caregivers with lived experience, offer the potential to identify high‐stress periods, enable timely interventions and guide more efficient resource allocation.

Background: Generalized anxiety disorder (GAD) is common among university students due to academic pressure and financial uncertainty, among other challenges. Despite the need, the receipt of available psychological services is often low. Objective: This study investigates the feasibility of a digital unguided cognitive behavioral therapy (CBT)–based mobile app, Cerina, and examines the likely effects of this intervention in reducing GAD symptoms compared to the waitlist control group. Methods: Eligible students (n=158) with mild to moderate GAD symptoms were self-assessed through web-based questionnaires and were randomly allocated to the intervention group (n=79) or to the waitlist control group (n=79) following their informed consent. The intervention group had direct access to Cerina and followed CBT-based interactive sessions for 6 weeks. The waitlist control group participants had access to optional on-campus well-being services, and they were given access to Cerina 6 weeks after their randomization. Participants completed assessments on anxiety, depression, worry, and usability at three time points. Additionally, upon completing the intervention, they were invited to a web-based interview to understand the implementation of the intervention in more depth. Results: On average, 13% (10/79) intervention group participants dropped out, 61% (36/69) completed the core clinical content (2 sessions), and 12% (7/69) completed the desired number of sessions (6 or 7 sessions). Analyses of the completers (2 or more sessions) revealed significant group differences in GAD (mean 8.4, SD 3.7; t42=–2.25; P=.03; d=–0.7) and worry symptoms (mean 42.3, SD 10.8; t42=–2.50; P=.02; d=–0.8), as well as functional impairment (mean 16.7, SD 2.44; t42=–2.12; P=.04; d=–0.6) in favor of the intervention group at posttest with medium to large effect sizes. The intention-to-treat analyses confirmed significant group differences in GAD (mean 8.47, SD 2.7; t156=–2.23; P=.03; d=–0.4), and there were marginally nonsignificant group differences in worry symptoms (mean 41.5, SD 8.40; t156=–1.94; P=.05; d=–0.3) in favor of the intervention group at posttest with medium effect sizes. These results suggest that the intervention had a meaningful impact on reducing GAD symptoms and a modest impact on reducing worry symptoms among participants. Conclusions: The Cerina app showed promising results in reducing GAD symptoms among students. This result supports findings from other randomized controlled trials showing that digital CBT-based interventions are effective and feasible for a wide range of age groups and populations experiencing GAD symptoms. The low number of participants completing the recommended number of sessions suggests a usability issue. To address this, the intervention could be refined through an iterative design process informed by user feedback, and the long-term impact of specific engagement features in improving usability and retention could be assessed through extended evaluations. Trial Registration: ClinicalTrials.gov NCT06146530; https://clinicaltrials.gov/study/NCT06146530 International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2023-083554

Printed electronics using flexible substrates are an emerging area, allowing next-generation electronics to conform and flex with different surfaces, from human skin to clothing. In the hybrid integration, or sea-of-rigids, approach, conventional microchips are mounted onto (generally) plastic substrates such as polyethylene naphthalate (PEN), with (typically) printed silver tracks for interconnections between components. An ongoing research direction is to replace plastic substrates with biodegradable substrates and to replace silver tracks with non-heavy metal-based tracks. While the substrates and tracks form only part of an overall system, replacing them is a step towards increased sustainability and helps to meet net-zero goals for printed electronic systems. Previously, several papers have investigated printed carbon tracks for low-frequency analog sensing applications. This paper explores the feasibility of using printed carbon tracks on biodegradable substrates for high-frequency applications such as digital signaling over a Serial-Peripheral Interface (SPI). We investigate the printability, thermal stability, and electrical conductivity of carbon ink screen-printed onto six commercially available sustainable and flexible substrates. Our results demonstrate that multi-layer screen printing substantially reduced the electrical resistance of carbon tracks, enabling SPI communication at frequencies up to 16 MHz with three layers of carbon ink. A Natureflex™ substrate provided the best balance of printability, thermal stability, and electrical performance. Substrates such as greaseproof paper and ClearFilm PU showed potential for flexible electronics, but require further optimization. This study provides valuable insights into selecting and optimizing biodegradable substrates for high-frequency digital systems, supporting the move towards more sustainable printed electronics.

Background: Family caregivers provide essential care in the home to millions of individuals around the globe annually. However, family caregiving results in considerable burden, financial hardship, stress, and psychological morbidity. Identifying and managing stress in caregivers is important as they have a dual role in managing their own health as well as that of the person they care for. If stress becomes overwhelming, a caregiver may no longer be able to perform this essential role. Digital methods of stress monitoring may be 1 strategy for identifying effective interventions to relieve caregiver burden and stress. Objective: This study aims to explore the perceived acceptability, challenges, and opportunities of using digital and biosensing technologies to measure caregiver stress. Methods: We conducted a descriptive qualitative study using semistructured interviews with an interview guide structured to obtain qualitative data addressing our study aims. We used reflexive thematic analysis methods. We recruited adult family caregivers (aged 18 years and older) currently or previously caring for an adult in the home with significant health issues. Interview questions focused on stress monitoring more generally and on ecological momentary assessment, remote monitoring technologies such as smartwatches, and fluid biosensors. Results: We recruited 27 family caregivers of whom 19 (70%) were currently in a caregiving role, and the remainder were previously in a caregiving role. We identified 3 themes with 10 subthemes addressing elements of acceptability, challenges, and opportunities of using digital and biosensing technologies to measure caregiver stress The themes comprised “providing meaningful data” with subthemes of “monitoring without action is pointless,” “monitoring that enables self-management,” and “seeing the bigger picture”; “low-burden monitoring” with subthemes of “low effort,” “practical alongside daily routines,” and “retaining control over monitoring”; and “inadvertent harms of stress monitoring” with subthemes of “stigma of stress,” “need for discretion,” “contributing to stress,” and “trust.” Conclusions: In this descriptive qualitative study examining the perspectives of a diverse sample of family caregivers on methods of stress monitoring, we identified 3 themes addressing elements of acceptability, challenges, and opportunities. These provide useful considerations for the use of stress monitoring and implementation of interventions to ameliorate family caregivers’ stress of relevance to social care and community teams, researchers, and policy makers. These include providing meaningful situationally specific data resulting in action, that does not contribute to caregiver burden, or inadvertent harm to either the caregiver or the care recipient.

BACKGROUND Generalized anxiety disorder (GAD) is common among university students due to academic pressure and financial uncertainty, among other challenges. Despite the need, the receipt of available psychological services is often low. OBJECTIVE This study investigates the feasibility of a digital unguided cognitive behavioral therapy (CBT)–based mobile app, Cerina, and examines the likely effects of this intervention in reducing GAD symptoms compared to the waitlist control group. METHODS Eligible students (n=158) with mild to moderate GAD symptoms were self-assessed through web-based questionnaires and were randomly allocated to the intervention group (n=79) or to the waitlist control group (n=79) following their informed consent. The intervention group had direct access to Cerina and followed CBT-based interactive sessions for 6 weeks. The waitlist control group participants had access to optional on-campus well-being services, and they were given access to Cerina 6 weeks after their randomization. Participants completed assessments on anxiety, depression, worry, and usability at three time points. Additionally, upon completing the intervention, they were invited to a web-based interview to understand the implementation of the intervention in more depth. RESULTS On average, 13% (10/79) intervention group participants dropped out, 61% (36/69) completed the core clinical content (2 sessions), and 12% (7/69) completed the desired number of sessions (6 or 7 sessions). Analyses of the completers (2 or more sessions) revealed significant group differences in GAD (mean 8.4, SD 3.7; t42=–2.25; P=.03; d=–0.7) and worry symptoms (mean 42.3, SD 10.8; t42=–2.50; P=.02; d=–0.8), as well as functional impairment (mean 16.7, SD 2.44; t42=–2.12; P=.04; d=–0.6) in favor of the intervention group at posttest with medium to large effect sizes. The intention-to-treat analyses confirmed significant group differences in GAD (mean 8.47, SD 2.7; t156=–2.23; P=.03; d=–0.4), and there were marginally nonsignificant group differences in worry symptoms (mean 41.5, SD 8.40; t156=–1.94; P=.05; d=–0.3) in favor of the intervention group at posttest with medium effect sizes. These results suggest that the intervention had a meaningful impact on reducing GAD symptoms and a modest impact on reducing worry symptoms among participants. CONCLUSIONS The Cerina app showed promising results in reducing GAD symptoms among students. This result supports findings from other randomized controlled trials showing that digital CBT-based interventions are effective and feasible for a wide range of age groups and populations experiencing GAD symptoms. The low number of participants completing the recommended number of sessions suggests a usability issue. To address this, the intervention could be refined through an iterative design process informed by user feedback, and the long-term impact of specific engagement features in improving usability and retention could be assessed through extended evaluations. CLINICALTRIAL ClinicalTrials.gov NCT06146530; https://clinicaltrials.gov/study/NCT06146530 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2023-083554

BACKGROUND Family caregivers provide essential care in the home to millions of individuals around the globe annually. However, family caregiving results in considerable burden, financial hardship, stress, and psychological morbidity. Identifying and managing stress in caregivers is important as they have a dual role in managing their own health as well as that of the person they care for. If stress becomes overwhelming, a caregiver may no longer be able to perform this essential role. Digital methods of stress monitoring may be 1 strategy for identifying effective interventions to relieve caregiver burden and stress. OBJECTIVE This study aims to explore the perceived acceptability, challenges, and opportunities of using digital and biosensing technologies to measure caregiver stress. METHODS We conducted a descriptive qualitative study using semistructured interviews with an interview guide structured to obtain qualitative data addressing our study aims. We used reflexive thematic analysis methods. We recruited adult family caregivers (aged 18 years and older) currently or previously caring for an adult in the home with significant health issues. Interview questions focused on stress monitoring more generally and on ecological momentary assessment, remote monitoring technologies such as smartwatches, and fluid biosensors. RESULTS We recruited 27 family caregivers of whom 19 (70%) were currently in a caregiving role, and the remainder were previously in a caregiving role. We identified 3 themes with 10 subthemes addressing elements of acceptability, challenges, and opportunities of using digital and biosensing technologies to measure caregiver stress The themes comprised “providing meaningful data” with subthemes of “monitoring without action is pointless,” “monitoring that enables self-management,” and “seeing the bigger picture”; “low-burden monitoring” with subthemes of “low effort,” “practical alongside daily routines,” and “retaining control over monitoring”; and “inadvertent harms of stress monitoring” with subthemes of “stigma of stress,” “need for discretion,” “contributing to stress,” and “trust.” CONCLUSIONS In this descriptive qualitative study examining the perspectives of a diverse sample of family caregivers on methods of stress monitoring, we identified 3 themes addressing elements of acceptability, challenges, and opportunities. These provide useful considerations for the use of stress monitoring and implementation of interventions to ameliorate family caregivers’ stress of relevance to social care and community teams, researchers, and policy makers. These include providing meaningful situationally specific data resulting in action, that does not contribute to caregiver burden, or inadvertent harm to either the caregiver or the care recipient.

Rationale: Common mental health disorders (CMD) (anxiety, depression, and sleep disorders) are among the leading causes of disease burden globally. The economic burden associated with such disorders is estimated at $2.4 trillion as of 2010 and is expected to reach $16 trillion by 2030. The UK has observed a 21-fold increase in the economic burden associated with CMD over the past decade. The recent COVID-19 pandemic was a catalyst for adopting technologies for mental health support and services, thereby increasing the reception of personal health data and wearables. Wearables hold considerable promise to empower users concerning the management of subclinical common mental health disorders. However, there are significant challenges to adopting wearables as a tool for the self-management of the symptoms of common mental health disorders. Aims: This review aims to evaluate the potential utility of wearables for the self-management of sub-clinical anxiety and depressive mental health disorders. Furthermore, we seek to understand the potential of wearables to reduce the burden on the healthcare system. Methodology: a systematic review of research papers was conducted, focusing on wearable devices for the self-management of CMD released between 2018–2022, focusing primarily on mental health management using technology. Results: We screened 445 papers and analysed the reports from 12 wearable devices concerning their device type, year, biometrics used, and machine learning algorithm deployed. Electrodermal activity (EDA/GSR/SC/Skin Temperature), physical activity, and heart rate (HR) are the most common biometrics with nine, six and six reference counts, respectively. Additionally, while smartwatches have greater penetration and integration within the marketplace, fitness trackers have the most significant public value benefit of £513.9 M, likely due to greater retention.

Summary: The significant decline in the cost of genome sequencing has dramatically changed the typical bioinformatics pipeline for analysing sequencing data. Where traditionally, the computational challenge of sequencing is now secondary to genomic data analysis. Short read alignment (SRA) is a ubiquitous process within every modern bioinformatics pipeline in the field of genomics and is often regarded as the principal computational bottleneck. Many hardware and software approaches have been provided to solve the challenge of acceleration. However, previous attempts to increase throughput using many-core processing strategies have enjoyed limited success, mainly due to a dependence on global memory for each computational block. The limited scalability and high energy costs of many-core SRA implementations pose a significant constraint in maintaining acceleration. The Networks-On-Chip (NoC) hardware interconnect mechanism has advanced the scalability of many-core computing systems and, more recently, has demonstrated potential in SRA implementations by integrating multiple computational blocks such as pre-alignment filtering and sequence alignment efficiently, while minimizing memory latency and global memory access. This article provides a state of the art review on current hardware acceleration strategies for genomic data analysis, and it establishes the challenges and opportunities of utilizing NoCs as a critical building block in next-generation sequencing (NGS) technologies for advancing the speed of analysis.