Chris Froome has raced across contintents but Rwanda’sField of Dreams Cycling Centre left him deeply moved and inspired.
When the four-time Tour de France saw the newly built compound in the highlands of Bugesera in Rwanda’s eastern province, he was visibly impressed and delivered an emotional speech.
The two-time Olympic bronze medallist called the academy “a game changer”. He acknowledged the joy on the faces of the many kids who had gathered there, hoping to be selected for an opportunity to join the academy and realise their dreams of becoming professional cyclists one day.
That was in February of 2023.
Since then, the centre has grown. The number of participants has risen exponentially and there is every sense that over the next few years that figure could soar.
The global attention is likely to rise even more when the UCI Road World Championships are being staged in Rwanda later this month
There has been a lot of interest in the sport from the community. Bugesera, Rwanda’s fast rising district, is just 44km southeast of the capital with the inhabitants mainly farmers and livestock keepers. The roads are lined with tall trees; the people live very simple lives.
The district’s capital, Nyamata, has a miniature genocide memorial that serves a reminder of the horrific killings of 1994. For many of the inhabitants, the horrors of that time subtly flow through the town.
The cycling academy has become a beacon of hope for many of the children.
Started in 2019 by the Gasore Serge Foundation and the Bugesera district, the main aim was to support vulnerable kids and transform their lives through education. So far, it has gone to plan. They have 180 young people who they feed, clothe, provide education for and give free bicycles to train with.
“When we want to get children into the academy, we go to the local schools, find the kids interested in the sport, then we contact their parents. The parents who are with it allow us to enrol their children to the academy,” the coordinator at the Field of Dreams Cycling centre, Vivien Mutangana, told Olympics.com.
The landscape at the centre is beautiful. There is a brick one-storey building that stretches for about 400m, serving as classrooms, dining area and a clinic for the students.
In the heart of the centre, there is a basketball court, a pump track for those who want to learn bike stunts and an undulating race track built into the valleys that surrounds the whole centre.
WASHINGTON (AP) — In a sign of how unusual this week’s Federal Reserve meeting is, the decision it will make on interest rates — usually the main event — is just one of the key unknowns to be resolved when officials gather Tuesday and Wednesday.
For now, it’s not even clear who will be there. The meeting will likely include Lisa Cook, an embattled governor, unless an appeals court or the Supreme Court rules in favor of an effort by President Donald Trump to remove her from office. And it will probably include Stephen Miran, a top White House economic aide whom Trump has nominated to fill an empty seat on the Fed’s board. But those questions may not be resolved until late Monday.
Meanwhile, the U.S. economy is mired in uncertainty. Hiring has slowed sharply, while inflation remains stubbornly high.
So a key question for the Fed is: Do they worry more about people who are out of work and struggling to find jobs, or do they focus more on the struggles many Americans face in keeping up with rising costs for groceries and other items? The Fed’s mandate from Congress requires it to seek both stable prices and full employment.
For now, Fed Chair Jerome Powell and other Fed policymakers have signaled the Fed is more concerned about weaker hiring, a key reason investors expect the central bank will reduce its benchmark interest rate by a quarter point on Wednesday to about 4.1%.
Still, stubbornly high inflation may force them to proceed slowly and limit how many reductions they make. The central bank will also release its quarterly economic projections Wednesday, and economists project they will show that policymakers expect one or two additional cuts this year, plus several more next year.
WATCH: How Trump’s attempts to control Federal Reserve board threaten its long-held independence
Ellen Meade, an economics professor at Duke University and former senior economist at the Fed, said it’s a stark contrast to the early pandemic, when it was clear the Fed had to rapidly reduce rates to boost the economy. And when inflation surged in 2021 and 2022, it was also a straightforward call for the Fed, which moved quickly to raise borrowing costs to combat higher prices.
But now, “it’s a tough time,” Meade said. “It would be a tough time, even if the politics and the whole thing weren’t going on the way they are, it would be a tough time. Some people would want to cut, some people would not want to cut.”
Amid all the economic uncertainty, Trump is applying unprecedented political pressure on the Fed, demanding sharply lower rates, seeking to fire Cook, and insulting Powell, whom he has called a “numbskull,” “fool,” and “moron.”
Loretta Mester, a former president of the Federal Reserve Bank of Cleveland and finance professor at the University of Pennsylvania’s Wharton School, said that Fed officials won’t let the criticisms sway their decisions on policy. Still, the attacks are unfortunate, she said, because they threaten to undermine the Fed’s credibility with the public.
“Added to their list of the difficulty of making policy because of how the economy is performing, they also have to contend with the fact that there may be some of the public that’s skeptical about how they’ve gone about making their decisions,” she said.
David Andolfatto, an economics professor at the University of Miami and former top economist at the Federal Reserve Bank of St. Louis, said that presidents have pressured Fed chairs before, but never as personally or publicly.
“What’s unusual about this is the level of open disrespect and just childishness,” Andolfatto said. “I mean, this is just beyond the pale.”
There are typically 12 officials who vote on the Fed’s policies at each meeting — the seven members of the Fed’s board of governors, as well as five of the 12 regional bank presidents, who vote on a rotating basis.
If a court rules that Cook can be fired, or Miran isn’t approved in time, then just 11 officials will vote on Wednesday. Either way, there ought to be enough votes to approve a quarter-point cut, but there could be an unusual amount of division.
Miran, if he is on the board, and Governor Michelle Bowman may dissent in opposition to a quarter-point reduction in favor of a steeper half-point cut.
There could be additional dissenting votes in the other direction, potentially from regional bank presidents who might oppose any cuts at all. Beth Hammack, president of the Fed’s Cleveland branch, and Jeffrey Schmid, president of the Federal Reserve Bank of Kansas City, have both expressed concern that inflation has topped the Fed’s 2% target for more than four years and is still elevated. If either votes against a cut, it would be the first time there were dissents in both directions from a Fed decision since 2019.
“This degree of division is unusual, but the circumstances are unusual, too,” Andolfatto said. “This is a situation central banks really don’t like: The combination of inflationary pressure and labor market weakness.”
Hiring has slowed in recent months, with employers shedding 13,000 jobs in June and adding just 22,000 in August, the government reported earlier this month. And last week a preliminary report from the Labor Department showed that companies added far fewer jobs in the year ending in March than previously estimated.
At the same time, inflation picked up a bit last month and remains above the Fed’s 2% target. According to the consumer price index, core prices — excluding food and energy — rose 3.1% in August compared with a year earlier..
With inflation still elevated, the Fed may have to proceed slowly with any further cuts, which would likely further frustrate the Trump White House.
“When you get to turning points, people can reasonably disagree about when to go,” Meade said.
We’re not going anywhere.
Stand up for truly independent, trusted news that you can count on!
Microsoft is adding the free Microsoft 365 Copilot Chat and agents to Office apps for all Microsoft 365 business users today. Word, Excel, PowerPoint, Outlook, and OneNote are all being updated with a Copilot Chat sidebar that will help draft documents, analyze spreadsheets, and more without needing an additional Microsoft 365 Copilot license.
“Copilot Chat is secure AI chat grounded in the web—and now, it’s available in the Microsoft 365 apps,” explains Seth Patton, general Manager of Microsoft 365 Copilot product marketing. “It’s content aware, meaning it quickly understands what you’re working on, tailoring answers to the file you have open. And it’s included at no additional cost for Microsoft 365 users.”
While this free version of Copilot will rewrite documents, provide summaries, and help create slides in PowerPoint, the $30 per month, per user Microsoft 365 Copilot license will still have the best integration in Office apps. The Microsoft 365 Copilot license is also not limited to a single document, and can reason over entire work data.
“Users with a Microsoft 365 Copilot license get priority access to features like file upload and image generation, along with the latest technology like GPT-5, including faster response times and more consistent availability—even during peak usage periods,“ explains Patton.
Microsoft previously bundled its AI-powered Copilot features into Office apps for consumer Microsoft 365 plans earlier this year, but it raised the prices of subscriptions at the same time. Microsoft isn’t doing any price adjustments for businesses with Copilot Chat being added to Office apps. Microsoft is also getting ready to bundle its sales, service, and finance Copilots into the Microsoft 365 Copilot subscription in October, reducing the price for some businesses that rely on Microsoft’s latest AI tools.
The architect Sir Nicholas Grimshaw, who designed the Eden Project in Cornwall and the original Eurostar terminal at Waterloo in London, has died aged 85.
His company, Grimshaw, founded in 1980, was responsible for a series of groundbreaking buildings, the first of which was the Financial Times’s Printworks, which opened in 1988 and won several awards. It was Grade-II listed in 2016.
With buildings that were innovative in both design and engineering, Grimshaw was regarded as a forerunner of architecture’s hi-tech movement along with Norman Foster, Richard Rogers and Renzo Piano. However, he disliked the term, telling the Guardian in 2018: “Hi-tech sounds like a stylistic movement. We see ourselves as very solidly grounded in Paxton and Brunel” – the great architects of the Victorian era.
His work, however, looked anything but Victorian. The Eden Project, which was built in a disused clay pit, is made up of a series of interlocking geodesic domes supported by tubular steel and housing 5,000 varieties of plant life.
The geodesic domes of the Eden Project opened to the public in 2001. Photograph: John Barratt/Alamy
The Eurostar terminal, dominated by a sinuously curving, 400 metre-long roof, won both the Mies van der Rohe award and the Riba building of the year award (now the Stirling prize) when it opened in 1994. “It seems run-of-the-mill now,” Grimshaw told the Guardian’s architecture critic Oliver Wainwright in 2018, “but it was a huge emotional thrill at the time, to be connected to Europe like this. I suppose it’s particularly ironic now, given the absolutely crazy decision to leave the EU.”
Grimshaw’s firm won a second Stirling prize last year for its work on the Elizabeth line in London. It designed the underground parts of the stations in collaboration with AtkinsRéalis, which was responsible for the engineering, as well as the firms Maynard and Equation. The architect said he believed there was “something heroic” about railway stations, “with the excitement of departure and the exhilaration of arrival”.
He was knighted for his services to architecture in 2002, served as the president of the Royal Academy from 2004 to 2011 and was awarded the Riba gold medal in 2018. His firm, which announced his death, described him as “a man of invention and ideas” who had an “extraordinary ability to convince others that daring ideas were possible”.
Though other architects explored stylistic avenues such as postmodernism, Grimshaw strove to make his work as lightweight, sustainable and pure as possible. “I see the practice of architecture as similar to boat-building,” he said. “It’s about materials and structures doing real things, as opposed to decorative things.”
EXCLUSIVE: Michaela McManus (You) has joined Fox‘s forthcoming drama series Memory of a Killer, from writers Ed Whitmore and Tracey Malone, in a heavily recurring role opposite Patrick Dempsey, Michael Imperioli, Richard Harmon and Odeya Rush.
Inspired by the award-winning 2003 Belgian film De Zaak Alzheimer (La Memoire Du Tueur), Memory of a Killer stars Dempsey as a hitman, Angelo Doyle, leading a dangerous double life while hiding an even deadlier personal secret — he has developed early onset Alzheimer’s. Imperioli co-stars as Dutch, Angelo’s oldest friend and an accomplished chef whose restaurant is a front for criminal enterprise.
McManus will portray Nicky, the manager of the Silverstrand Club, a gathering place for mobsters on the take. Motivated by a secret agenda of her own, Nicky and Angelo fall into a dangerous romance.
Set for a midseason premiere, the show is being produced by Warner Bros Television and Fox Entertainment. Whitmore and Malone are exec producing alongside Cathy Schulman of Welle Entertainment and David Schulner, as well as Arthur Sarkissian, Martin Campbell, and Peter Bouckaert of Eyeworks.
Seen on shows like You, The Orville, and SEAL Team, McManus most recently starred in the indie sci-fi thriller Redux Redux, which premiered at SXSW earlier this year. She was a series regular on NBC’s The Village, Aquarius, and Awake, and was a season regular on shows like The Vampire Diaries, Law & Order: Special Victims Unit, and One Tree Hill. Additional TV credits include guest star roles on 9-1-1: Lone Star, Hawaii Five-0, Castle, Necessary Roughness, and both CSI franchises.
On the film side, McManus has starred in Netflix’s horror pic The Block Island Sound and led the indie thriller 13 Cameras. Her film work also includes roles in Into the Grizzly Maze, Funeral Kings, and Café opposite Jennifer Love Hewitt. She is repped by Strand Entertainment and CESD.
I first became aware of the work of Drummond Rennie almost by accident: By borrowing his office. It was the summer of 1997, and as a rising fourth-year medical student, I was spending a month at JAMA as the co-editor-in-chief of its then-medical student section, Pulse. Rennie, who was deputy editor of the journal at the time, was mostly traveling, so the staff installed me in his office, overflowing with books and manuscripts.
Rennie, who died on September 12, was a towering figure in scientific publishing. Trained as a nephrologist, he joined the staff of the New England Journal of Medicine in 1977, and later, JAMA, where he remained for decades. He was known for promoting improved standards in medical journals, and for organizing the first Peer Review Congress, held in 1989 and nine more times since, most recently earlier this month.
In 2013, we were just a few years into the work of Retraction Watch, and thought talking about what we’d learned so far at the Congress would be a good idea. We submitted an abstract outlining what we wanted to talk about, writing that we’d gather data by the time of the meeting.
That wasn’t going to work.
“We cannot go further unless we have some research in the form of data,” Rennie wrote to us in his characteristically sharp but highly constructive way. “The reviewers thought your abstract was pretty thin, and I agree. We know that you have the data and you have to think hard about what you are trying to say, remembering that the Peer Review Congresses were set up to present research, and not opinion.”
We ended up withdrawing the abstract because we didn’t have time to do the work that we agreed was necessary. But we also learned a lot, enough to be successful in being part of a few presentations in a later Congress. And we were always grateful when Rennie cited the work of Retraction Watch in calls for papers for the meeting.
Others will recount his work in other areas, but here, we wanted to share several passages of Rennie’s that illustrate his gift for a well-turned phrase in service of a sharp opinion or insight. Rest in peace, Drummond.
“There seems to be no study too fragmented, no hypothesis too trivial, no literature citation too biased or too egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too self-serving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print.”
“And it’s true that bringing in the peers does seem to make the process more democratic, though most editors would dislike the idea that they were not benign despots. But editors, most of whose working hours are spent oiling, balancing, and tuning the mechanisms of peer review, have a conflict of interest: symphonic conductors would probably be as much in favor of the retention of orchestras.”
“Scientists, however, seem to have been less able to accept the revelations than the general public, and a great deal less than members of Congress. Perhaps the difference can be explained by the fact that the Congress is composed largely of lawyers, who are not taught to trust easily. Our representatives correctly view themselves as custodians of the public purse and see plenty of evidence to counter the notion, seemingly prevalent among researchers, that scientific degrees endow their holders with the attributes of rectitude and honesty.”
“The ORI has neither the mandate nor the resources to lead the task of correcting a scientific literature polluted by fraudulent research. This responsibility lies with the community of scientists. When an ORI investigation ends with a finding of misconduct, the work is just beginning. Following the investigation, the community must identify all of a fraudulent author’s articles, publish retractions, and rid the literature of references to the fraudulent articles.”
“I arrived at the New England Journal of Medicine in September 1977, at the same time as its new Editor-in-Chief, Dr. Arnold Relman. It took 4 months before we met our first ethical issue. A physician wrote to point out that, on the same day that we had published an article to show that patients with chronic paranoid schizophrenia had low levels of monoamine oxidase in their platelets (Berger et al. 1978), another journal had published an article to show that levels in such patients were the same as in normals and other schizophrenics (Potkin et al. 1978). She also pointed out that though neither article referenced the other, they had two authors in common. When we challenged the authors, they justified their practice by asserting that it was not their custom to refer to unpublished work in a publication. (Wyatt and Murphy 1978). They, and no one else, had possessed information that completely undermined both their publications, so this disingenuous claim demonstrated at the very least a startling contempt for the process of publication.
It was, for me at the New England Journal of Medicine, the first of many. Adopting Jules Pfeiffer’s phrase, I came to call such academic tricks ‘‘little murders’’—not deserving to be hanging offenses, but destructive of the delicate web of trust between colleagues that keeps the whole enterprise functioning and afloat.”
“At a larger level, our question is this: if the coauthors cannot understand the data, how can the reader? Isn’t it the duty of those on the collaboration to understand it well enough to stand behind it?
We don’t wish to suggest that it is easy to fulfill the obligations of a co-author or mentor. In reality, given the complexities of interpersonal relationships and the trust science requires, it can be difficult and daunting. Still, it’s the job.”
Like Retraction Watch? You can make a tax-deductible contribution to support our work, follow us on X or Bluesky, like us on Facebook, follow us on LinkedIn, add us to your RSS reader, or subscribe to our daily digest. If you find a retraction that’s not in our database, you can let us know here. For comments or feedback, email us at [email protected].
Processing…
Success! You’re on the list.
Whoops! There was an error and we couldn’t process your subscription. Please reload the page and try again.
Who needs the 2025 Emmys when you have the after party? Last night, Olivia Rodrigo and Iris Apatow eschewed red carpet glamour for a casual, yet celebratory fête at Vas J Morgan’s post-Emmys soiree. (Also with them was Apatow’s boyfriend, The White Lotus’s Sam Nivola.)
Rodrigo opted for a monochromatic look for her night out. The singer wore a scoopneck black babydoll dress with a ruffled peasant short sleeve and a bow affixed to the empire waist. To further lengthen her legs, she styled her thigh-grazing minidress with a pair of heeled black patent leather Mary-Janes. Over her shoulder, Rodrigo carried a black JW Anderson Bumper bag. The only hint of color in her look was her pinkish-red lip.
The Daily Stardust / BACKGRIDUSA
Rodrigo and Apatow, it seems, conferred on their LBDs ahead of their night out (we love fashionable BFFs!). Apatow, for her part, wore a black ankle-length tank dress, black peep-toe heels, and matched her red lip to her red quilted Chanel bag.
While she’s wearing all black for now, we may be seeing more of Rodrigo in a different color soon. In August, at the Osheaga Festival in Montreal, Rodrigo revealed a red T-shirt with a rhinestone-encrusted number 3, a nod at a forthcoming third album. While Guts was largely defined by lilac, Olivia Rodrigo is using black as a palette cleanser before her red era begins.
Although considered nonserious, adverse events (AEs) following pneumococcal vaccination occurred predominantly during the first 30 days after administration, according to a study published in Frontiers in Cellular and Infection Microbiology.1 The main safety concerns identified included injection site reactions, erythema, crying, swelling, skin warmth, and cellulitis.
“The rising incidence of antimicrobial-resistant bacterial variants has led to significant reductions in the clinical effectiveness of existing antibiotic regimens, necessitating the development of novel treatment approaches,” wrote the authors of the study. “Concurrently, large-scale implementation of vaccination programs has been identified as an essential component in addressing this global health challenge.”
Streptococcus pneumoniae remains a leading cause of mortality across all countries and age groups throughout the globe.1 Despite these mortality risks and the annual rates of S. pneumoniae reaching nearly 1 million adults, the National Foundation for Infectious Diseases reports that 46% of high-risk patients are unaware of pneumococcal disease.2
Researchers focused on adverse events from vaccination, a specific aspect of pneumococcal vaccine uptake and the reasons in which patients may be hesitant to receive one. | image credit: Kamitana / stock.adobe.com
On top of this prominent lack of awareness regarding the virus, patients with antimicrobial resistance have led researchers to further develop pneumococcal vaccines with higher valencies than before. Furthermore, with the S. pneumoniae pathogen accounting for significantly increased risks among pediatric patients as well as adults, the structured development of pneumococcal vaccines has been a must in various patient populations requiring different needs.1
READ MORE: Capvaxive Shows Immune Responses to All 21 Serotypes for Children, Adolescents
“PCVs have been integrated into national childhood immunization programs worldwide,” wrote the authors of a study published in Pneumonia.3 “Nevertheless, despite the success of PCVs [pneumococcal conjugate vaccines] in reducing pneumococcal carriage and invasive disease, particularly in children, as well as in high-risk adults, acquisition of a broadly serotype-independent vaccine remains the ‘holy grail’ of pneumococcal vaccine development, albeit a challenging and difficult endeavor.”
Pneumococcal conjugate vaccines, or PCVs, are 1 of 2 types of pneumococcal vaccines available for patients in the US, along with pneumococcal polysaccharide vaccines (PPSVs). While the 13-valent PCV (PCV13) has shown significantly successful results in protecting children and older adults against pneumococcal disease, researchers have been developing PCV15, PCV20, and PCV21 as the need for higher valencies and protection against various serotypes arises.4
Researchers conducting the current study, however, wanted to focus on a specific aspect of pneumococcal vaccine uptake and the reasons why patients may be hesitant to receive one: potential AEs.
“Our study employs comprehensive data mining of [vaccine adverse event reporting system] (VAERS) reports across multiple pneumococcal vaccine formulations to systematically characterize post-vaccination safety profiles, thereby establishing evidence-based risk stratification to inform clinical vaccination strategies,” they wrote.1
As part of the study, researchers explored the VAERS database for all AEs in conjunction with reports of pneumococcal vaccines from January 1990 to March 2025. To further understand the severity and prominence of pneumococcal AEs, researchers also used the European Medicines Agency’s 62 preferred term codes to categorize designated medical events (DMEs) throughout the study period.
Among a total of 157,244 patients (54.29% women, 38.2% under the age of 18) receiving the pneumococcal vaccine included in the study, there were 632,481 AEs detected. For all study participants with documented clinical outcomes, the most common were complete recovery (44.2%) and hospitalization due to AEs (14.94%).
Furthermore, highlighting researchers’ key study finding, 77.11% of participants experienced AEs during the first 30 days after receiving a pneumococcal vaccine. The mean time it took for patients to develop AEs was 4.2 days, with a median onset of 0 days.
“To our knowledge, this pharmacovigilance study is the first to comprehensively integrate safety signals across multiple pneumococcal vaccines using the US VAERS database,” continued the authors.1 “This study assessed post-licensure pneumococcal vaccines’ safety using VAERS database disproportionality assessments and DME list monitoring. It is noteworthy that this study observed 77.11% of AE reports clustering within the 0- to 30-day window following pneumococcal vaccination.”
As researchers have previously mentioned, the development of pneumococcal vaccines has presented a variety of challenges and complexities due to the sheer variance in patient populations that require protection against the disease. While the “holy grail” of pneumococcal vaccines has yet to be identified, studies like this will continue to inform the development of these vaccines and the necessary pharmacovigilance of future investigations.
“The majority of AEs occurred within the initial 30-day post-vaccination period,” they concluded.1 “These findings offer critical insights for clinical safety surveillance of pneumococcal vaccines and inform decision-making by regulatory agencies and health care professionals regarding risk mitigation strategies.”
READ MORE: Pneumococcal Resource Center
Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.
REFERENCES
1. Zheng X, Liu M, Ding A, et al. Post-marketing safety surveillance of pneumococcal vaccines: a real-world pharmacovigilance study using the U.S. vaccine adverse event reporting system (VAERS) database. Front Cell Infect Microbiol. 2025;15. https://doi.org/10.3389/fcimb.2025.1635180
2. Many at risk for pneumococcal disease are unaware. National Foundation for Infectious Diseases. November 12, 2019. Accessed September 15, 2025. https://www.nfid.org/many-at-risk-for-pneumococcal-disease-are-unaware/
3. Musher DM, Anderson R, Feldman C. The remarkable history of pneumococcal vaccination: an ongoing challenge. Pneumonia (Nathan). 2022 Sep 25;14(1):5. doi: 10.1186/s41479-022-00097-y.
4. Types of pneumococcal disease. CDC. September 12, 2024. Accessed September 15, 2025. https://www.cdc.gov/pneumococcal/vaccines/types.html
Josh MacAlister says people in west Cumbria have been let down by the loss of the Yewdale Ward
A decision to close an acute mental health ward without re-running a public consultation is a “betrayal”, an MP has claimed.
The 16-bed Yewdale Ward at the West Cumberland Hospital in Whitehaven has shut, with services transferred 40 miles (65km) away.
Josh MacAlister, who represents the Workington and Whitehaven constituency, said the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) was ignoring the findings of an independent report calling for it to review the process it followed.
However, CNTW said it felt staging another consultation was unlikely to lead to a different outcome as worries would remain around safety and staffing.
Twelve new beds are being provided at the Carleton Clinic in Carlisle, with a further four to open at the planned Hope Haven centre in Whitehaven.
‘Angry and frustrated’
A review carried out by the North East and North Cumbria Integrated Care Board found CNTW had “undertaken substantial work to demonstrate the viability” of moving services to Carlisle.
But it warned there was “insufficient evidence” other options had been explored.
It said CNTW had attempted to reach as wide an audience as possible to ensure it met its statutory duty, but also highlighted concerns the consultation had taken place “late in the decision-making process”.
In its recommendations, the board said “commissioners and providers should collaborate closely to review and, if necessary, re-run the options development and appraisal process” ensuring all possibilities were “thoroughly explored and assessed”.
It also called on CNTW to “meaningfully involve patients and the public in this process”.
Labour MP MacAlister said he was “extremely angry and frustrated” the trust had “decided not to act”.
Describing it as a “a betrayal of west Cumbria”, he argued the decision allowed CNTW “to get away with running a flawed and seemingly pre-determined process to close Yewdale ward”.
‘Significant problems’
In response, the trust acknowledged there were “strong feelings” and said it had listened to the views of more than 1,000 people.
A spokesman said: “In spite of the hard work and dedication of existing staff, the service in the form it was operating was always likely to face significant problems.
“It was mixed sex, and as the only service of its kind on the site it had long-standing and serious difficulty in recruiting enough of the highly trained staff it needed to run safely.
“We do not feel that re-running the entire public engagement process in full would be likely to lead to a different outcome as safety, staffing and quality concerns would continue to be a major problem.”
Researchers at Lund University in Sweden have developed a digital cognitive test for diagnosing Alzheimer’s disease that is intended for use in primary care.
“This digital test, which patients perform on their own with minimal involvement from healthcare personnel, improves the primary care physician’s ability to determine who should be further examined by blood tests for Alzheimer’s pathology early in the investigation phase,” says Professor Oskar Hansson, who led the study alongside Pontus Tideman.
The study in brief:
Clinical memory research // quantitative study, applied research // cross-sectional study // 2 groups with 223 and 403 patients, respectively
The researchers have designed a digital cognitive test, BioCog, intended for use in primary care as a first step in the investigation process for Alzheimer’s disease.
The test is self-administrated and tests the patient’s cognitive abilities, primarily memory but also attention, and can show whether cognition is impaired. Patients whose tests show impaired cognition continue the assessment process with additional blood tests to determine whether Alzheimer’s pathology is the cause of the impairment.
Alzheimer’s disease is the most common cause of dementia. As new disease-modifying treatments for Alzheimer’s disease are now becoming available, both early and accurate diagnosis in a resource-efficient assessment process are becoming increasingly important, as not everyone responds to the new drugs. Seeking medical care for cognitive impairment is not necessarily the result of Alzheimer’s disease – it can for example be caused by depression, fatigue or other dementias.
Primary care does not have the resources, time or specialist knowledge to investigate possible Alzheimer’s disease in the same way as specialised memory clinics. And this is where a digital cognitive test can make the biggest difference.”
Oskar Hansson, professor of neurology, Lund University
Unlike pen-and-paper tests, which are generally used to assess cognitive impairment, digital tests provide a more detailed picture. More aspects and new variables that could not previously be measured as easily are included.
“The vast majority of people who experience memory loss will first seek treatment at their health centre. Our new digital test provides a first objective picture – at an earlier stage and with greater precision – of which patients have cognitive impairment indicative of Alzheimer’s disease. This indicates who should proceed with the blood test that measures the level of phosphorylated tau and is able to detect Alzheimer’s pathology in the brain with high accuracy,” says Pontus Tideman, doctoral student in the research group, Clinical Memory Research at Lund University and psychologist at the Memory Clinic, Skåne University Hospital.
At the moment, these blood tests are only available in specialised clinics/memory clinics in hospitals. In the long term, they will also be available in primary care, but doing blood tests on all patients presenting with cognitive problems is not the intention.
The researchers believe that the digital tool could be of great benefit, as it is currently very challenging to diagnose Alzheimer’s disease during a 15 to 20-minute patient encounter. This is where digital tools, which measure cognitive skills in an objective way, can make a big difference:
“The unique aspect of our BioCog test is that unlike other digital tests, it has been evaluated in a primary care population, i.e. patients seeking treatment at a health centre because they are experiencing cognitive problems, such as memory problems. Combining the results of the digital test and the blood test increases the accuracy of diagnosing Alzheimer’s disease. The purpose of the test is to make things easier for primary care doctors,” says Linda Karlsson, MSc in engineering physics and doctoral student in the research group, Clinical Memory Research at Lund University.
About the test
The digital test is done by the patient individually on a tablet computer. The test measures:
memory (memorising ten words)
cognitive processing speed and attention (how quickly or slowly they process information)
recognition (among 30 words, recognise the ten words previously memorized)
The test measures aspects and variables that could not easily be measured in the past using pen-and-paper tests, such as how long it takes the patient to search among the words or how quickly they tap the screen. The combination of the sub-tests produces a result that is highly likely to indicate whether or not the patient has a cognitive impairment and can help the physician to decide which patients to take a blood test from, and ultimately which patients may benefit from the new drug treatments for Alzheimer’s disease.
Source:
Journal reference:
Tideman, P., et al. (2025). Primary care detection of Alzheimer’s disease using a self-administered digital cognitive test and blood biomarkers. Nature Medicine. doi.org/10.1038/s41591-025-03965-4
