<![CDATA[Artemis astronauts spotlight psychiatric medication, mental health support, and trust—revealing why psychiatry’s village mindset strengthens care, leadership, and ethics.]]>
<![CDATA[Artemis astronauts spotlight psychiatric medication, mental health support, and trust—revealing why psychiatry’s village mindset strengthens care, leadership, and ethics.]]>

Opinion: Don’t believe headlines saying that vaccine skepticism is widespread

Two years ago, I wrote in the New England Journal of Medicine that one of the greatest threats to childhood vaccination is the normalization of skepticism, even though it isn’t actually the norm. When credible outlets, trusted voices, and social media algorithms tell the public that most Americans doubt vaccines, some may start to wonder if they should, too. I watched that play out this week.

On Monday, Politico published a poll on vaccine attitudes titled, “More Americans doubt vaccine safety than trust it, Politico Poll finds,” followed by the subhead, “Health Secretary Robert F. Kennedy Jr.’s views are commonplace across the land.” I consider Politico a reputable news outlet, so this headline stopped me in my tracks.

Read the rest…

Making AI operational in constrained public sector environments

The AI boom has hit across industries, and public sector organizations are facing pressure to accelerate adoption. At the same time, government institutions face distinct constraints around security, governance, and operations that set them apart from their business counterparts. For this reason, purpose-built small language models (SLMs) offer a promising path to operationalize AI in these environments.  

A Capgemini study found that 79 percent of public sector executives globally are wary about AI’s data security, an understandable figure given the heightened sensitivity of government data and the legal obligations surrounding its use. As Han Xiao, vice president of AI at Elastic, says, “Government agencies must be very restricted about what kind of data they send to the network. This sets a lot of boundaries on how they think about and manage their data.”

The fundamental need for control over sensitive information is one of many factors complicating AI deployment, particularly when compared against the private sector’s standard operational assumptions.

Unique operational challenges

When private-sector entities expand AI, they typically assume certain conditions will be in place, including continuous connectivity to the cloud, reliance on centralized infrastructure, acceptance of incomplete model transparency, and limited restrictions on data movement. For many state institutions, however, accepting these conditions could be anything from dangerous to impossible. 

Government agencies must ensure that their data stays under their control, that information can be checked and verified, and that operational disruptions are kept to an absolute minimum. At the same time, they often have to run their systems in environments where internet connectivity is limited, unreliable, or unavailable. These complexities prevent many promising public sector AI pilots from moving beyond experimentation. “Many people undervalue the operating challenge of AI,” Xiao says. “The public sector needs AI to perform reliably on all kinds of data, and then to be able to grow without breaking. Continuity of operations is often underestimated.” An Elastic survey of public sector leaders found that 65 percent struggle to use data continuously in real time and at scale. 

Infrastructure constraints compound the problem. Government organizations may also struggle to obtain the graphics processing units (GPUs) used to train and access complex AI models. As Xiao points out, “Government doesn’t often purchase GPUs, unlike the private sector—they’re not used to managing GPU infrastructure. So accessing a GPU to run the model is a bottleneck for much of the public sector.” 

A smaller, more practical model

The many nonnegotiable requirements in the public sector make large language models (LLMs) untenable. But SLMs can be housed locally, offering greater security and control. SLMs are specialized AI models that typically use billions rather than hundreds of billions of parameters, making them far less computationally demanding than the largest LLMs.

The public sector does not need to build ever-larger models housed in offsite, centralized locations. An empirical study found that SLMs performed as well or better than LLMs. SLMs allow sensitive information to be used effectively and efficiently while avoiding the operational complexity of maintaining large models. Xiao puts it this way: “It is easy to use ChatGPT to do proofreading. It’s very difficult to run your own large language models just as smoothly in an environment with no network access.” 

SLMs are purpose-built for the needs of the department or agency that will use them. The data is stored securely outside the model, and is only accessed when queried. Carefully engineered prompts ensure that only the most relevant information is retrieved, providing more accurate responses. Using methods such as smart retrieval, vector search, and verifiable source grounding, AI systems can be built that cater to public sector needs. 

Thus, the next phase of AI adoption in the public sector may be to bring the AI tool to the data, rather than sending the data out into the cloud. Gartner predicts that by 2027, small, specialized AI models will be used three times more than LLMs.

Superior search capabilities

“When people in the public sector hear AI, they probably think about ChatGPT. But we can be much more ambitious,” says Xiao. “AI can revolutionize how the government searches and manages the large amounts of data they have.”

Looking beyond chatbots reveals one of AI’s most immediate opportunities: dramatically improved search. Like many organizations, the public sector has mountains of unstructured data—including technical reports, procurement documents, minutes, and invoices. Today’s AI, however, can deliver results sourced from mixed media, like readable PDFs, scans, images, spreadsheets, and recordings, and in multiple languages. All of this can be indexed by SLM-powered systems to provide tailored responses and to draft complex texts in any language, while ensuring outputs are legally compliant. “The public sector has a lot of data, and they don’t always know how to use this data. They don’t know what the possibilities are,” says Xiao.

Even more powerful, AI can help government employees interpret the data they access. “Today’s AI can provide you with a completely new view of how to harness that data,” says Xiao. A well-trained SLM can interpret legal norms, extract insights from public consultations, support data-driven executive decision-making, and improve public access to services and administrative information. This can contribute to dramatic improvements in how the public sector conducts its operations.

The small-language promise

Focusing on SLMs shifts the conversation from how comprehensive the model can be to how efficient it is. LLMs incur significant performance and computational costs and require specialized hardware that many public entities cannot afford. Despite requiring some capital expenses, SLMs are less resource-intensive than LLMs, so they tend to be cheaper and reduce environmental impact. 

Public sector agencies often face stringent audit requirements, and SLM algorithms can be documented and certified as transparent. Some countries, particularly in Europe, also have privacy regulations such as GDPR that SLMs can be designed to meet.

Tailored training data produces more targeted results, reducing errors, bias, and hallucinations that AI is prone to. As Xiao puts it, “Large language models generate text based on what they were trained on, so there is a cut-off date when they were trained. If you ask about anything after that, it will hallucinate. We can solve this by forcing the model to work from verified sources.”

Risks are also minimized by keeping data on local servers, or even on a specific device. This isn’t about isolation but about strategic autonomy to enable trust, resilience, and relevance.

By prioritizing task-specific models designed for environments that process data locally, and by continuously monitoring performance and impact, public sector organizations can build lasting AI capabilities that support real-world decisions. “Do not start with a chatbot; start with search,” Xiao advises. “Much of what we think of as AI intelligence is really about finding the right information.”

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

Public Perceptions of AI in Medicine and Implications for Future Medical Education: Cross-Sectional Survey

Background: The integration of artificial intelligence (AI) into clinical practice is contingent on public trust. This trust often depends on physician oversight, yet a significant gap exists between the need for AI-competent physicians and the current state of medical education. While the perspectives of students and experts on this gap are known, the views of the US general public remain largely unquantified. Objective: This study aimed to assess US public perceptions regarding AI in medicine and the corresponding emergent needs for medical education. We specifically sought to quantify public trust in different diagnostic scenarios, concerns about physician overreliance on AI, support for mandatory AI education, and priorities for the future focus of medical training. Methods: We conducted a cross-sectional, web-based survey of adults in the United States in November 2025. Participants (N=524) were recruited via SurveyMonkey Audience. We calculated descriptive statistics, frequencies, proportions (percentages), and 95% CIs for all main survey items. Results: A total of 524 participants completed the survey. Most (n=329, 62.8%; 95% CI 58.6%‐66.9%) placed the most trust in a physician’s diagnosis based on their expertise alone; only 7.8% (n=41; 95% CI 5.5%‐10.1%) trusted an AI-first diagnostic model. Trust was highly contingent on training: 93.9% (n=492) of participants rated formal physician training on AI limitations as “essential” or “very important.” Widespread concern about physician overreliance on AI was reported, with 81.1% (n=425) being “very concerned” or “extremely concerned.” Consequently, 85.1% (n=446) agreed or strongly agreed that training on AI use, ethics, and limitations should be mandatory in medical school. When asked about future educational priorities, 70.2% (n=368; 95% CI 66.3%‐74.1%) believed that medical education should focus on human-centered skills (eg, empathy and communication) over clinical skills. Conclusions: The US public expressed conditional trust in medical AI, strongly preferring physician-led and critically supervised models. These findings reveal a clear public mandate for medical education reform. The public expects future physicians to be mandatorily trained to appraise AI, understand its limitations, and refocus their professional development on the human-centered skills that technology cannot replace.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/3874abd2d5f25c78f21987a16f3af6be" />

The conversing military chaplain: time allocation, task salience, and competencies among Swedish military chaplains

Military chaplaincy is an established yet multifaceted practice within military organizations and is exposed to particular stressors such as the use of violence, ethical dilemmas, loss, and existential vulnerability. This study examines how a Swedish normative framework for Military Soul Care (ACCES: advisory role, command and crisis support, ceremonies, education, and soul care conversations) interacts with Swedish military chaplains’ own experiences of what they perceive as most important and meaningful in their mission. The empirical material consists of qualitative questionnaire data collected in 2025 from 50 military chaplains. The material was analyzed using an abductive approach and organized thematically. The results show that conversations constitute the task to which the greatest amount of time is devoted across both main categories of military chaplains, and that conversations are understood broadly, ranging from informal everyday interactions to confidential individual soul care conversations. Various forms of ceremonies and crisis support related to death and grief were experienced as particularly meaningful and reflect a clearly articulated priestly identity. Educational tasks varied between categories, with time constraints and organizational priorities limiting opportunities depending on context. A central finding is that presence within the organization, aimed at building relationships and trust, emerges as a decisive prerequisite and contributes to many chaplains working beyond their contracted hours. The importance of presence is not explicitly articulated in the ACCES framework but rather permeates the mission implicitly. Against the backdrop of a changed security environment, the findings illustrate that ecclesial priestly competencies related to crisis response, death, grief, and funeral expertise constitute a particularly vital resource in situations of crisis and war.

Opinion: Hosting the ‘intellectual wrestling match’ between MAHA, public health

The deep distrust between public health and the Make America Healthy Again movement may seem impossible to heal. But the podcast “Why Should I Trust You?” is trying to do just that by facilitating conversation between people who often view each others as enemies.

Brinda Adhikari and Tom W. Johnson launched “Why Should I Trust You?” in 2025. Since then, they’ve hosted big names from MAHA, the Trump administration, the anti-vaccine movement, and traditional health. They also bring on everyday Americans trying to keep their families healthy while navigating a confusing information ecosystem. “Everyone, when they come on the show, no matter what their quote unquote, expertise, they’re all equals. Everyone gets time to speak,” Adhikari said.

Read the rest…

Building trust in the AI era with privacy-led UX

The practice of privacy-led user experience (UX) is a design philosophy that treats transparency around data collection and usage as an integral part of the customer relationship. An undertapped opportunity in digital marketing, privacy-led UX treats user consent not as a tick-box compliance exercise, but rather as the first overture in an ongoing customer relationship. For the companies that get it right, the payoff can bring something more intangible, valuable, and durable than simple consent rates: consumer trust.

The opportunities of privacy-led UX have only recently come into focus. Adelina Peltea, the chief marketing officer at Usercentrics, has seen enterprise sentiment shift: “Even just a few years ago, this space was viewed more as a trade-off between growth and compliance,” she says. “But as the market has matured, there’s been a greater focus on how to tie well-designed privacy experiences to business growth.”

And it turns out that well-designed, value-forward consent experiences routinely outperform initial estimates.
Touchpoints for privacy-led UX often include consent management platforms, terms and conditions, privacy policies, data subject access request (DSAR) tools, and, increasingly, AI data use disclosures.

This report examines how data transparency builds trust with customers; how this, in turn, can support business performance; and how organizations can maintain this trust even as AI systems add complexity to consent processes.

Key findings include the following:

  • Privacy is evolving from a one-time consent transaction into an ongoing data relationship. Rather than asking users for broad permissions up front, leading organizations are introducing data-sharing decisions gradually, matching the depth of the ask to the stage of the customer relationship. Companies that take this tack tend to gather both a larger quantity and higher quality of consumer data, the value of which often compounds over time.
  • Privacy-led UX is a prerequisite for AI growth. The consumer data that organizations gather is rapidly becoming a core foundation upon which AI-powered personalization is built. Organizations that establish clear, enforceable privacy and data transparency policies now are better positioned to deploy AI responsibly and at scale in the future. This starts with correctly configured consent mode across ad platforms.
  • Agentic AI introduces new levels of both complexity and opportunity. As AI systems begin acting on users’ behalf, the traditional consent moment may never occur. Governing agent-generated data flows requires privacy infrastructure that goes well beyond the cookie banner.
  • Realizing the advantages of privacy-led UX requires cross-functional collaboration and clear leadership. Privacy-led UX touches marketing, product, legal, and data teams—but someone must own the strategy and weave the threads together. Chief marketing officers
  • (CMOs) are often best positioned for that role, given their visibility across brand, data, and customer experience.
  • A practical framework can support businesses in getting it right. Organizations must define their data collection and usage strategies and ensure their UX incorporates data consent, including a focus on banner design. Following a blueprint for evaluating and improving privacy-led UX supports consistency at every consent touchpoint.

Download the report.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.