Critical Statements Research Articles

Percutaneous cryoablation in soft tissue tumor management: an educational review

Abstract Background Percutaneous cryoablation (PCA), having shown effectiveness in treating liver, lung, prostate, breast, and kidney tumors, is now gaining attention for the treatment of soft tissue tumors. PCA functions by freezing tissue, which induces ice crystal formation and cell death without damaging collagen structures. Technical considerations include the selection and handling of cryoprobes and cryogenic agents, procedural duration, and choice of image guidance for precision. This review aims to synthesize the mechanisms, applications, and technical aspects of PCA in the treatment of soft tissue tumors. Methods Adhering to PRISMA 2020 guidelines, a review was conducted of studies published prior to March 2024 that investigated PCA of soft tissue tumors. The review focused on technical and procedural aspects of cryoablation, cryobiological principles, cellular and tissue responses to extreme cold, intra- and post-procedure physiological mechanisms during and post-procedure, and main clinical applications. Results PCA is efficient in treating soft tissue tumors, including desmoid tumors, vascular malformations, and abdominal wall endometriosis. Several cryobiological mechanisms are involved, notably ice crystal formation, cellular dehydration, osmotic effects, and the inflammatory response, all of which contribute to its efficacy. Key technical aspects include the choice of cryoprobes, cryogenic agents (argon gas or liquid nitrogen), and the duration and control of freezing/thawing cycles. PCA also frequently outperformed traditional treatments like surgery and radiotherapy in terms of pain reduction, tumor size reduction, and patient outcomes. Moreover, its nerve sideration properties make it effective under local anesthesia. Conclusion Demonstrating substantial pain reduction, tumor size decrease, and high technical success rates, PCA offers a promising and minimally invasive alternative for soft tissue tumor treatment. Critical relevance statement Percutaneous cryoablation provides a minimally invasive, precise alternative for soft tissue tumor management, advancing clinical radiology by offering effective treatment with reduced patient risk and enhanced outcomes through image-guided procedures. Key Points Percutaneous cryoablation (PCA) offers a promising, minimally invasive alternative for managing soft tissue tumors. PCA employs image-guided techniques to accurately target and treat tumors, ensuring high precision and control. PCA preserves structures like collagen, reduces pain, decreases tumor size, and generally enhances patient outcomes. Graphical Abstract

Constructing and exploring neuroimaging projects: a survey from clinical practice to scientific research.

Over the past decades, numerous large-scale neuroimaging projects that involved the collection and release of multimodal data have been conducted globally. Distinguished initiatives such as the Human Connectome Project, UK Biobank, and Alzheimer's Disease Neuroimaging Initiative, among others, stand as remarkable international collaborations that have significantly advanced our understanding of the brain. With the advancement of big data technology, changes in healthcare models, and continuous development in biomedical research, various types of large-scale projects are being established and promoted worldwide. For project leaders, there is a need to refer to common principles in project construction and management. Users must also adhere strictly to rules and guidelines, ensuring data safety and privacy protection. Organizations must maintain data integrity, protect individual privacy, and foster stakeholders' trust. Regular updates to legislation and policies are necessary to keep pace with evolving technologies and emerging data-related challenges. CRITICAL RELEVANCE STATEMENT: By reviewing global large-scale neuroimaging projects, we have summarized the standards and norms for establishing and utilizing their data, and provided suggestions and opinions on some ethical issues, aiming to promote higher-quality neuroimaging data development. KEY POINTS: Global neuroimaging projects are increasingly advancing but still face challenges. Constructing and utilizing neuroimaging projects should follow set rules and guidelines. Effective data management and governance should be developed to support neuroimaging projects.

Roles of MRI evaluation of pelvic recurrence in patients with rectal cancer.

Developments in the multidisciplinary treatment of rectal cancer with advances in preoperative magnetic resonance imaging (MRI), surgical techniques, neoadjuvant chemoradiotherapy, and adjuvant chemotherapy have had a significant impact on patient outcomes, increasing the rates of curative surgeries and reducing pelvic recurrence. Patients with pelvic recurrence have worse prognoses, with an impact on morbidity and mortality. Although local recurrence is more frequent within 2 years of surgical resection of the primary tumor, late recurrence may occur. Clinical manifestations can vary from asymptomatic, nonspecific symptoms, to pelvic pain, bleeding, and fistulas. Synchronous metastatic disease occurs in approximately 50% of patients diagnosed with local recurrence. MRI plays a crucial role in posttreatment follow-up, whether by identifying viable neoplastic tissues or acting as a tool for therapeutic planning and assessing the resectability of these lesions. Locally recurrent tissues usually have a higher signal intensity than muscle on T2-weighted imaging. Thus, attention is required for focal heterogeneous lesions, marked contrast enhancement, early invasive behavior, and asymmetric appearance, which are suspicious for local recurrence. However, postsurgical inflammatory changes related to radiotherapy and fibrosis make it difficult to detect initial lesions. This study therefore aimed to review the main imaging patterns of pelvic recurrence and their implications for the surgical decision-making process. CRITICAL RELEVANCE STATEMENT: MRI plays a crucial role in the posttreatment follow-up of rectal cancer, whether by identifying viable neoplastic tissues or by acting as a tool for therapeutic planning. This study reviewed the main imaging patterns of pelvic recurrence. KEY POINTS: MRI aids in surgical planning and the detection of pelvic recurrence and postoperative complications. Being familiar with surgical techniques enables radiologists to identify expected MRI findings. Patterns of rectal cancer recurrence have been categorized by pelvic compartments. Neoplastic tissue may mimic postsurgical and postradiotherapy changes. Resectability of pelvic recurrence is highly related to lesion location.

Combining 2.5D deep learning and conventional features in a joint model for the early detection of sICH expansion.

The study aims to investigate the potential of training efficient deep learning models by using 2.5D (2.5-Dimension) masks of sICH. Furthermore, it intends to evaluate and compare the predictive performance of a joint model incorporating four types of features with standalone 2.5D deep learning, radiomics, radiology, and clinical models for early expansion in sICH. A total of 254 sICH patients were enrolled retrospectively and divided into two groups according to whether the hematoma was enlarged or not. The 2.5D mask of sICH is constructed with the maximum axial, coronal and sagittal planes of the hematoma, which is used to train the deep learning model and extract deep learning features. Predictive models were built on clinic, radiology, radiomics and deep learning features separately and four type features jointly. The diagnostic performance of each model was measured using the receiver operating characteristic curve (AUC), Accuracy, Recall, F1 and decision curve analysis (DCA). The AUCs of the clinic model, radiology model, radiomics model, deep learning model, joint model, and nomogram model on the train set (training and Cross-validation) were 0.639, 0.682, 0.859, 0.807, 0.939, and 0.942, respectively, while the AUCs on the test set (external validation) were 0.680, 0.758, 0.802, 0.857, 0.929, and 0.926. Decision curve analysis showed that the joint model was superior to the other models and demonstrated good consistency between the predicted probability of early hematoma expansion and the actual occurrence probability. Our study demonstrates that the joint model is a more efficient and robust prediction model, as verified by multicenter data. This finding highlights the potential clinical utility of a multifactorial prediction model that integrates various data sources for prognostication in patients with intracerebral hemorrhage. The Critical Relevance Statement: Combining 2.5D deep learning features with clinic features, radiology markers, and radiomics signatures to establish a joint model enabling physicians to conduct better-individualized assessments the risk of early expansion of sICH.

Indian Society of Critical Care Medicine Position Statement: Approach to a Patient with Poisoning in the Emergency Room and Intensive Care Unit.

Rungta N, Ray B, Bhalla A, DP Samaddar, Paul G, Prasad S, et al. Indian Society of Critical Care Medicine Position Statement: Approach to a Patient with Poisoning in the Emergency Room and Intensive Care Unit. Indian J Crit Care Med 2024;28(S2):S217-S232.

The Indian Society of Critical Care Medicine Position Statement on the Management of Sepsis in Resource-limited Settings.

Juneja D, Nasa P, Chanchalani G, Cherian A, Jagiasi BG, Javeri Y, et al. The Indian Society of Critical Care Medicine Position Statement on the Management of Sepsis in Resource-limited Settings. Indian J Crit Care Med 2024;28(S2):S4-S19.

Comparison of the performance of naive bayes and support vector machine in sirekap sentiment analysis with the lexicon-based approach

The general public often uses the SiRekap application to see the progress of the election and to provide critical statements. Policies made by the government have good and bad outcomes, and users end up leaving their reviews and ratings on the Google Play Store, where the app can be downloaded. These reviews can be collected and processed into useful information such as sentiment analysis using Naïve Bayes and Support Vector Machine methods. Both methods have differences during training and during evaluation. The difference in results from the various scenarios tested was not much different. When training the Support Vector Machine model is able to process comment data labeled with a lexicon 10% better than the Naïve Bayes model by looking at the results of the accuracy of the two models. During the accuracy evaluation process, the two models produce the same accuracy of 72%. Although both models get the same accuracy during the evaluation process, there are differences in precision, recall, and f1 score. The difference is that the Support Vector Machine model is 5% better for precision, 8% for recall, and 3% for f1-score compared to the Naïve Bayes model. This research is limited to only knowing the performance of two machine learning models, namely the use of naive bayes and svm by using a label lexicon. The results obtained can be improved for the better. Improving the evaluation results can be done by adding data or using text data augmentation and there is creation from experts related to language sentiment.

Philosophy of Complexity and Its Critics

Philosophy of complexity is considered by the authors as a set of subject-specific philosophical projects aimed at transforming the modern scientific worldview. The paper analyses ways of understanding complexity developed in such projects. The authors also present critical provisions existing in domestic and foreign research literature that call into question the validity and meaningfulness of projects of the «philosophy of complexity». It is shown that despite the fact that many of the critical statements are completely justified, this does not negate the possibility of considering complexity as an object of philosophical reflection, but raises the question of its justified forms and possibilities. Based on the review, the authors make the assumption that the eclecticism and speculative character of the “philosophy of complexity” projects constitute their intrinsic features. Overcoming them will determine the prospects for the development of the idea of complexity from a philosophical perspective.

Russian Criminal Procedure to Protect the Rights and Legitimate Interests of Entrepreneurs

The article discusses changes in Russian criminal procedural legislation related to criminal proceedings on crimes in the economic sphere committed by entrepreneurs in connection with their entrepreneurial or other economic activities. It is noted that these changes are due to the general policy of the state aimed at increasing the economic activity of the population and accelerated economic development of the country as a whole. In this regard, the author provides critical statements by the country’s leaders regarding the current law enforcement practices. The article consistently sets out individual institutions of criminal procedural law affected by these changes. Thus, the features of initiating criminal cases for certain crimes in the economic sphere classified as cases of private-public prosecution are described. The general rules for conducting investigative actions, including those related to the seizure of electronic storage media in cases of this category, are described. Considerable attention is paid to the selection of preventive measures against entrepreneurs and general restrictions on the use of detention against them. Special grounds for termination of criminal prosecution of entrepreneurs in connection with their compensation for damage are described. The author notes that the process of improving legislation in this area is far from complete and will continue depending on the needs of practice.

Inpatient treatment of people with psychogenic non-epileptic seizures in epilepsy centers? A critical statement

Inpatient treatment of people with psychogenic non-epileptic seizures in epilepsy centers? A critical statement

Appreciation for Agriculture in Public Communication. A Content Analysis of the Influence of the First Lockdown on Reporting About Agriculture in the Mass Media

The call for greater societal appreciation of agriculture has been a recurring theme in recent years, both within and outside the sector. The following article examines the extent to which social value communication can be found in media articles compared to other evaluative statements about agriculture and the effects that occurred at the beginning of the Coronavirus crisis. Using quantitative analysis and based on a theoretical concept of recognition, statements of social esteem and disrespect are collected and contrasted with acceptable and critical statements in issues of the mainstream, regional and farming press in 2019 and 2020 and evaluated in terms of their authorship and references to agricultural issues. In this context, it can be shown that even before the Coronavirus crisis, the level of social esteem accorded to agriculture in public communication was higher than the level of disrespect. It then increased during the first pandemic lockdown, combined with a significantly higher number of references to the issue of security of supply. At the same time, it is clear that the type of statement most often published in the media is not a direct expression of social esteem or disrespect, but rather a perception of disrespect for agriculture. The sources of these statements most often come from the agricultural sector itself.

THE CLUB OF ROMAN AND MODERN NARRATIVES OF KAZAKHSTAN

Roza Muratova E-mail: rose1950@mail.ru Doctor of Economic Sciences, Chief Assistant Prof. PhD Kazakh National University named after Al-Farabi Almaty, Kazakhstan https://orcid.org/0000-0002-5382-0024 Mariana Petrova E-mail: m.petrova@ts.uni-vt.bg Doctor of Economic Sciences, professor, St. Cyril and St. Methodius University of Veliko Tarnovo Veliko Tarnovo, Bulgaria https://orcid.org/0000-0003-1531-4312 Dana Baigojaeva E-mail: 020950d@gmail.com ICHR, Novotel Almaty, Kazakhstan https://orcid.org/0009-0008-4607-8299 Abstract: The Club of Rome is an international non-governmental organization that unites world-famous scientists and public figures from different countries. The contribution of the Club of Rome is best known for its report “The Limits to Growth”, which was a turning point in addressing the challenges of sustainable development. In the article we examine the background to the creation of the Club of Rome and the contradictions that arise during the club’s activities. We also provide critical statements about the conspiracy theory of the activities of the Club of Rome. The article proves that conspiracy theories and the activities of the Club of Rome do not have a specific logical connection. In the article, we set the task of reforming the economy, the task of gradually moving away from measuring the level of economics with GDP indicators, as not meeting the tasks of assessing the level of social well-being of the country, since the formation of GDP is based on the world price environment of products and services. The main hypotheses of our research are an attempt to substantiate the transition to an objective measure of the state economy. Our article attempts to analyze a new approach to human economics as an element of the biosystem. The article poses the problems of transition to a regenerative economy and management, and notes therelevance of solving these problems for Kazakhstan, in particular the issues of regenerative agriculture and regenerative urbanism. We also analyzed ideas for implementing the principles of the “donut economy.” The work presents the directions of modern research of the Club of Rome and work, in continuation of “The Limits to Growth” 50 years later. We also noted that the activities of the Club of Rome do not lose their relevance and the solution of global issues of global development are of a local nature for Kazakhstan. The use of the research results is possible in the educational process and in scientific research of the world economy. Keywords: reports to the Club of Rome, global issues, planetary boundaries, regenerative governance and economics, social developmentJEL classification: F47

Significant milestones in the history of world and domestic transfusiology

The formation of transfusiology in our country, in particular the foundation by Alexander A. Malinovsky (Bogdanov) the world first special Institute of blood transfusion, could not have happened without a “strong foundation” accumulated over centuries of trial and error. The article chronologically reconstructs the pathway of the development of the use of blood for medicinal purposes, starting from ancient times and the Middle Ages, when there were mentions of the use of drinks from human blood, until October 1, 1926 (the beginning of the real clinical and research work of the Institute of Blood Transfusion), which directly became the “foundation” for the emergence and development of transfusion blood in Russia already in modern times. The most “saturated” period in the development of transfusiology is considered — the New Time, at the beginning of which the prejudices of past eras about the benefits of drinking drinks from human blood were still preserved. W. Harvey discovered blood circulation, published an Anatomical study of the movement of the heart and blood in animals, which refuted the then dominant teaching of Galen. The English theologian Potter, who was present at the experience of W. Harvey, expressed the idea of blood transfusion. There have been critical statements questioning the benefits of blood transfusion. D. Blundell together with G. Klein began to study the effect of transfusion from person to person, which allowed D. Blundell to be considered the founder of modern transfusiology. The period of the late XIX–early XX centuries is analyzed, including the discovery of K. Landsteiner and the experiences of our compatriots — 
 V.A. Yurevich, N.K. Rosenberg, V.N. Shamov and others. After the discovering blood circulation by W. Harvey, there is a gradual transition first to experiments on blood transfusion from one animal to another, then from animal to human and from human to human, and further use of blood for medicinal purposes, naturally, with “varying success”.

The Failure of Liberal Interventionism: Deconstructing Afghan Identity Discourses of “Modern” and “Tradition”

In Afghanistan, the crisis of liberal intervention unfolded in the failure to establish democratic structures as a solution to terrorism and extremism in the aftermath of 9/11. Following the emergency withdrawal of US and NATO forces from Afghanistan on August 30, 2021, President Ashraf Ghani discreetly left Kabul, enabling the Taliban to regain control and form a new government in the country. The recurrent pattern of intervention and the subsequent return of the Taliban highlights a failure of the liberal project, which is a significant concern addressed in this article as the main question: Why has liberal intervention failed in Afghanistan? The answer lies in deconstructing the hegemonic discourse of “modern” Afghan to understand how it was resisted and replaced by the alternative discourse of “tradition,” subsequently, leading to the failure of the liberal project. The “modern” discourse, rooted in the US social context, aimed to civilise the perceived primitive and traditional Afghans. Conversely, the Taliban, drawing upon the Afghan social context, contested the “modern” discourse with an alternative discourse of “tradition” portraying liberals and their supporters as “occupiers” and “oppressors,” thus, justifying their armed resistance (jihad) against occupying forces. Framed within a critical social constructivism, the text, interviews, speeches, and statements of prominent Taliban leaders and the US presidents, apprise how specific identities have been employed to naturalise the “modern” discourse as justification for intervention. Critical discourse analysis explicates how the “tradition” discourse denaturalised the former and, subsequently, facilitated the establishment of the Taliban’s power in Afghanistan.

Canadian Critical Care Society position statement on reconciliation, decolonization, and Indigenous engagement.

Canadian Critical Care Society position statement on reconciliation, decolonization, and Indigenous engagement.

Solidarity in the Museum: Practices of Representation of Social Problems in Russian Institutions of Contemporary Art

In 2021, 95.5 million people visited Russian museums, and this is sufficient reason to consider the role of museums more than just the collection, storage and demonstration of heritage. Are museums a space of solidarity — do they represent social problems, do they articulate social interests, commonalities and differences of groups? It is especially important to apply this to the institutions of contemporary art in Russia, which over the past 30 years have found their audience and confirmed the reputation of independence, rejection of the canons, and problematization of everyday life. Using the example of two private metropolitan and one well-known state non-capital museum, the author analyzed the content of expositions for 2020-2021 using two methods. The theoretical framework of the study is social constructionism and post-structuralism. The purpose of the article is to characterize the forms and degree of criticality of artistic expression on the example of contemporary art institutions. The author's typology of models for the representation of social problems by museums is used — classical, critical and participatory. Based on empirical data on the expositions of three museums of contemporary art, a conclusion is made about the poorly realized potential of museums of contemporary art as an institution of solidarity — it has clearly not developed. The data demonstrate quantitative differentiation in the representation of critical statements at exhibitions of various institutions — from a third to a half of the exhibitions do not have a critical orientation, do not involve the viewer in the discussion of social problems. The initial nature of the study indicates the need to supplement the methodology with expert assessments, substantiate the measuring model for studying the sphere of culture in general and the museum in particular as an institution of solidarity.

Meta-synthesis of Research on Green Port Performance Evaluation Criteria

The green port concept refers to measures preventing ports’ negative effects on the environment. Ports are expected to adopt green measures within the framework of environmental concerns and sustainable development goals. To analyze if a port’s processes adopt the green concept, evaluation criteria should be defined. Existing literature handles this topic from regional perspectives or in terms of relations with other concepts. This study, which is the meta-synthesis of related articles (n=22), aimed to propose a common list of green port evaluation criteria for the development and operating sequences of a port. As the result of the meta-synthesis, it was revealed that the evaluation of green ports is based on six main criteria: environmental, energy and resources, management, social, ecological, and economical. Twenty-two sub-criteria were identified that are linked to the main criteria. By using the critical statements in the reviewed articles, the codes supporting these sub-criteria were determined. This model has revealed that a port adopting the green concept should consider all the dimensions of sustainability (economic, environmental, and social).

ECHOES OF THE «PRAGUE SPRING» OF 1968 IN TRANSCARPATHIA: ACCORDING TO THE MATERIALS OF THE STATE ARCHIVE OF THE TRANSCARPATHIAN REGION

The article highlights the question of the reaction of the party and Soviet leadership, as well as the population of the Transcarpathian region to the events in Czechoslovakia in 1968. The study is based on the materials of the State Archive of the Transcarpathian Region, which were not previously published. We note that the archive did not include the main documents - the materials of the 3rd plenum of the regional committee of the Communist Party of Ukraine, which considered the issue of events in Czechoslovakia. This happened at the level of acquisition of the fund in October 1990. In total, 25 cases P-1 have been withdrawn from the description of 6 funds. Some materials are preserved in the «Soviet» fund R-195. We are talking about the certificates and information that the party and Soviet leadership sent to the republican center, as well as letters from the chairman of the regional executive committee of the Transcarpathian regional council V. Rusin and the head of the culture department of the Transcarpathian regional executive committee V. Kerechanin to the first secretary of the Transcarpathian regional committee of the Communist Party of Ukraine Yu. Ilnitsky. The Soviet leadership saw the events in Czechoslovakia as a direct threat to the socialist system. Therefore, the propagandists were entrusted with the task of «correctly» conveying the party's policy for members of the CPSU, as well as broad segments of the population. For this, special information letters were sent in the region of the Ukrainian SSR. Researchers have identified at least two propaganda campaigns to interpret the «Prague Spring»: the first (summer 1968) – aimed at supporting the official position of the USSR on the events in Czechoslovakia; the second – in August 1968 – from the «popular» discussion of the TASS message about «fraternal assistance» – the introduction of troops of the Warsaw Pact Organization into Czechoslovakia. Under special supervision was the Transcarpathian region – the territory that in 1920-1930. was an integral part of Czechoslovakia. Here, state security agencies especially closely monitored the reaction of the population to events in Czechoslovakia. A significant number of the recorded 1,182 cases of critical statements and assessments of the situation from «anti-Soviet positions», were in Transcarpathia. The leadership of the region was entrusted with a number of tasks: through the exchange of delegations through party, Soviet, Komsomol, trade union bodies, public organizations, cultural and sports societies, journalists to communicate with the leadership of the East Slovak region, to receive the necessary information from them regarding the development of events in Czechoslovakia; inform the senior republican leadership; restrict access to information that came from Czechoslovakia through radio, television, the press; propaganda processing of ordinary members of the CPSU and the population of the Transcarpathian region.

„Swój” i „obcy”, Polak i nie-Polak w wybranych tekstach obowiązkowych i uzupełniających podstawy programowej dla szkoły podstawowej (klasy VII–VIII)

The current core curriculum for primary school classes was the subject of many critical statements by educators and teachers. Its incompatibility with the needs and expectations of contemporary socio-cultural reality is also connected with the Polonocentric vision of the world embedded in it, based on the exclusion of what is foreign, different, what goes beyond the traditionally understood identity discourse based on the uncritical affirmation of Polishness in opposition to what is Europeanness is becoming synonymous with the idea of being open to cultural diversity and axiological pluralism. The existence of this direction of thinking is revealed in the arbitrary selection of compulsory school reading in primary schools, especially in grades 7–8. Critical analysis of this list shows a picture that embodies the aforementioned cultural tendencies, which are implemented on the educational level in the core curriculum, which is crucial for the education system. This text exemplifies these educational trends based on the analysis of the reading material to be discussed in the highest grades of primary school.

Perceived Psychological Preparedness of the New Tertiary Curriculum Graduates in Taking the Professional Board Examination

This study was conducted to explore the perceived psychological preparedness of the selected graduates from the psychology department of the University of Cebu-Main Campus. It described the participants` preparedness in taking the psychometrician board examination. The way the participants adapt to the challenges experienced while reviewing, the experiences encountered by the participants through the factors, and the different coping strategies used to enhance and prepare for the upcoming board examination. The study utilized the qualitative method. There were sixteen (16) participants in this study, and they were selected through non-probability sampling, specifically purposive sampling. In data collection, an interview with a semi-structured interview guide has been used. In analyzing the qualitative data, thematic analysis by Boyatzis is being used. Codes, categories, and finding common themes were identified from the transcript of in-depth interviews. Eleven (11) emergent themes were created based on the participant's responses, which were classified under three (3) primary themes that provided answers to the sub-problems in this research. The emergent themes were extracted from the significant critical statements of the key participants. The description provided by the participants on their preparedness for taking the professional board examination, Factors that Influenced the Participants` Preparedness, has four (4) emergent themes categorized as: On Motivation; On Academic Factors; On Individual Factors; On Environmental Factors. For the challenges faced by the graduate participants about preparedness, the overarching theme is Challenges experienced by the Participants. The preparation has five (5) emergent themes: Lack of Academic Preparation, the Impact on Overall Health, High Expectations, Poor Study Habits, And Self-Confidence. The ways or strategies the participants used to cope with the difficulties faced in the examination preparation, the overarching theme is Participants’ Cope with the Challenges Met has two (2) emergent themes identified: By Ways of Addressing Challenges; By Seeking Social Support. The findings and recommendations derived from the study were used to improve the preparedness of the new tertiary curriculum graduates in taking the professional board examination.