Level Of Experience Research Articles

Context dependent preferences in prestige bias learning about vaccination in rural Namibian pastoralists

Extensive work in the social sciences suggests that vaccination decisions are subject to incentives, biases, and social learning processes, including prestige bias transmission. High status figures, like doctors and public health officials, can be effective messengers for vaccination information and uptake under certain conditions. In communities where there is significant medical mistrust and less interaction with markets and formal medical systems, prestige bias social learning may operate through different channels. Here, we examine the role of prestige bias on vaccine decisions in two ethnic groups (Himba and Herero) with varying levels of market integration and experiences with formal healthcare systems. Participants completed a ranking task, comparing the influence of four prestigious individuals on vaccine decisions and a survey on medical mistrust. Using Plackett-Luce models, we compare the influence of location, ethnic affiliation, and other covariates on rankings. A multi-level model compared the influence of those within and outside one's ethnic group, as well as specialist (doctor/healer) and generalist (chief/governor) prestige figures. Results indicate changes in the rank of prestigious individuals across the rural-urban gradient. Our results demonstrate significant variability in prestige-biased social learning about vaccine decision making. Medical mistrust did not impact rankings. Contrary to previous work, we find that whether a prestigious individual is locally prominent is more important than their expertise in the relevant domain (health and healing). These findings emphasize the need for more context-specific studies of prestige bias, which can improve our understanding of healthcare decision-making and guide public health messaging across diverse contexts.

Expert and Novice Teachers’ Cognitive Neural Differences in Understanding Students’ Classroom Action Intentions

Objectives: Teachers’ intention understanding ability reflects their professional insight, which is the basis for effective classroom teaching activities. However, the cognitive process and brain mechanism of how teachers understand students’ action intention in class are still unclear. Methods: This study used event-related potential (ERP) technology to explore the cognitive neural differences in intention understanding ability among teachers with different levels of knowledge and experience. The experiment used the comic strips paradigm to examine the ability of expert and novice teachers to understand students’ normative and non-normative classroom actions under different text prompts (“how” and “why”). Results: The results revealed that in the late time window, expert teachers induced larger P300 and LPC amplitudes when they understood students’ classroom action intentions, while the N250 amplitudes induced by novice teachers in the early time window were significantly larger. In addition, for both types of teachers, when understanding the intentions behind students’ normative actions, the N250 amplitude was the most significant, while the P300 and LPC amplitudes were more significant for non-normative actions. Conclusions: This study found that teachers at varying professional development stages had different time processing processes in intention understanding ability, which supported teachers’ brain electrophysiological activities related to social ability.

Ultrasound radiomics: evaluating early nerve injury and its relationship with leprosy reactions in patients with leprosy

Objectives: Leprosy is an infectious disease that can be accompanied by disability caused by peripheral neuropathy. The prevalence of grade 2 disability leprosy in 2023 has reached 0.012-55.429 per million people worldwide. Early detection of leprosy is essential to reduce its debilitating sequelae. Radiomics is an emerging field related to the extraction and quantification of information, which may provide new solutions for early detection of leprosy. The present study is the first to combine radiomics and ultrasonography to evaluate nerve damage in the early stages of leprosy in China by September 2024. Methods: Patients were enrolled at the Wenshan Prefecture Institute of Dermatology between October 2018 and December 2022. High-resolution ultrasound imaging of the peripheral nerves was performed. Quantitative ultrasound features were extracted from the follow-up imaging. Radiomic features were selected for a comparative analysis of the disease course using a linear mixed-effects model to control for potential confounding effects. Results: Nine patients with leprosy were enrolled in this study. After treatment, ultrasonography at different nerve sites showed partial improvement in nerve density (mean, skewness), recovery of the fascicular structure (kurtosis), and a decrease in abnormal morphological characteristics in some of the detected sites (P ≤ 0.05). Patients with type 1 leprosy reactions exhibited a lower mean and skewness, higher kurtosis, and increased quantitative morphological characteristics. Conclusion: The study provided the feasibility of ultrasound radiomics to digitally visualize the progression of nerve damage in leprosy patients, and ultrasound radiomics circumvented the adverse influence of different operators with differing levels of experience. The study provided the evidence of ultrasound radiomics as a low-cost method with high-throughput characteristics for clinical use of early nerve injury detection of leprosy.

Machine-learning models to predict the risk of recurrent VT following catheter ablation in patients with structural heart disease

Abstract Background Ventricular tachycardia (VT) is a life-threatening arrhythmia that can complicate structural heart disease. While catheter ablation is effective in treating this condition, the recurrence of VT after the procedure continues to be a concern. Consequently, there is a need for a reliable system to evaluate the likelihood of arrhythmia recurrence following an ablation. Objective To predict recurrence or repeat ablation after a VT catheter ablation procedure using machine learning (ML) models. Methods We conducted a single-center, retrospective study of all patients undergoing catheter ablation for scar-related VT between 2012 and 2022. Data collected included demographics, comorbidities, medications, relevant laboratory abnormalities, electrocardiograms, echocardiograms, detailed procedural characteristics, and outcomes. Python version 3.8.5 for exploratory data analysis (EDA) and visualization. Using six different ML models from the training set (90:10 split), we used 34 variables to predict the primary outcome, including VT recurrence or repeat catheter ablation. The accuracy of these models was compared using ROC curves based on their performance on the test set. Results Out of 508 VT ablation procedures, 261 experienced a recurrence. Support Vector Classifier (SVM) performed the best, having an AUC of 0.73, followed by logistic regression at 0.69 (Figure A). SVM yielded sensitivity, specificity, positive and negative predictive values of 0.73, 0.73, 0.79, and 0.67, respectively. The F1 score was 0.70. Among the factors with the highest feature importance in the model, the most influential variable was the proceduralist’s experience level, followed by QRS width at baseline, LVEF, and patient’s age (Figure B). Conclusion Our model can predict recurrent VT after ablation with reasonable accuracy, outperforming the existing clinical risk scores significantly. Larger training sample sizes will help achieve more robust ML models and improve predictive accuracy further.Figure A: ROC curve depicting the AUROCB. Feature importance graph

The physician-AI relationship: partnering for precision medicine via clinical decision support

Abstract Background Clinical decision support systems (CDSSs) can enhance physician decision-making, but successful adoption depends on positive user attitudes. Understanding Israeli physicians’ attitudes toward CDSSs is crucial for overcoming implementation barriers and refining training. Methods Semi-structured interviews explored knowledge, experiences, perceived benefits/drawbacks, and potential barriers/facilitators to CDSS use among 25 Israeli physicians across specialties, roles, settings, and experience levels selected via stratified sampling. Individual 45-minute video interviews were conducted in January-July 2023. Results Familiarity and CDSS experience varied substantially across medical specialties. While risk calculators, information systems, and expert systems disseminating contemporary research insights are widespread, AI-based system adoption is relatively low outside radiology. Physicians expressed positive attitudes, recognizing CDSSs’ potential to enhance clinical work, reduce errors, and alleviate burdens. However, concerns included AI systems’ impact on workload, patient relationships, skill erosion, and overreliance. Key implementation barriers involved technological infrastructure, organizational processes, physician perceptions, and system features. Facilitating factors included tailored design, focused training, continuous accuracy/reliability validation, and clear autonomy/liability guidelines. Conclusions Addressing key concerns around transparency, trustworthiness and responsible use is crucial for AI-CDSS to fulfill its promise of enhancing quality and outcomes. Insights from Israeli clinicians provide guidance on priorities like transparency of data and algorithms as well as ensuring AI behaves ethically. Collaboration among technology designers, healthcare professionals and stakeholders can help develop systems that physicians trust to improve care while safeguarding patients. Ongoing evaluation is also needed to optimize AI-CDSS over time. Key messages • Understanding physician attitudes is key to overcoming barriers to clinical decision support system adoption and optimizing training protocols. • Addressing transparency, trustworthiness, and ethical considerations around AI clinical decision support systems is crucial for enhancing quality care.

Mental health matters: Evaluating the preparedness of sport psychologists to incorporate within their role.

Mental health has become increasingly important for the applied sport psychologist, a factor which may include screening, promoting literacy, individual support, and educational programs. However, despite of this importance, few checks have been made on the perceived preparedness of sport psychologists to undertake this work and whether differences may exist between those recently qualified compared to experienced practitioners. Underpinned by the theoretical domains framework, 62 Health and Care Professions Council registered practitioner sport and exercise psychologists (30 females: age: M=46.13years and SD=10.44years and 32 males: age: M=43.25years and SD=10.47years) completed an online survey to assess whether they felt equipped to address the mental health dimension of their work. The survey comprised three sections: Demographic and background information, a series of statements (n=31) adapted from the determinants of implementation behavior questionnaire, and three questions with space for free text comments, inviting participants to explain their level of preparedness to incorporate and deliver mental health interventions. A 6×12 analyses of variance yielded significant differences between domain ratings but not across levels of experience or interactions. Data from free text comments were analyzed thematically and categorized into the following three themes: (a) complementing the performance role, (b) awareness of professional boundaries, and (c) importance of further continued professional development. Combined, although practitioners emphasized importance, preparedness ratings ranged from neutral to somewhat agree, calling for further specific sport psychology-based mental health training.

Out of The Box, Onto the Screen: Insights from an OOBE Study of the Xbox Adaptive Controller

This study investigates the Out-of-Box Experience (OOBE) of the Xbox Adaptive Controller and Logitech Gaming Kit, focusing on users with varying levels of disability and gaming experience. Fifteen participants were recruited from a university population and had varying levels of gaming and disability experienced. The study observed participants’ interactions with the packaging, instructions, and setup process for both the controller and the switch kit. The Xbox Adaptive Controller received positive feedback for its easy-to-open packaging, aesthetically pleasing design, and a relatively easy setup and use process. However, weaknesses included a lack of clear information on functionalities of additional switches, difficulties with cable management, and unclear instructions with a reliance on diagrams Incorporating individuals with diverse gaming backgrounds and experience with disability throughout the design process can help identify challenges and opportunities for a wider range of users.

Re-Categorization and Risk of Malignancy of Atypical Effusions According to the International System for Reporting Serous Fluid Cytopathology (TIS): An Institutional Experience.

Serous effusion fluids serve as crucial cytological materials in diagnosing the underlying causes of fluid accumulation in various body cavities. The International System for Reporting Serous Fluid Cytopathology (TIS) outlined atypia of undetermined significance (AUS) and suspicious for malignancy (SFM) as two intermediate categories for atypical fluids. In our study, cases diagnosed as "atypical" by an experienced cytopathologist in the Hacettepe University Department of Pathology, between 2014 and 2023, were re-categorized according to TIS. The risk of malignancy (ROM) for AUS and SFM categories was calculated. Additionally, cases were re-evaluated according to the 5-tier categorical system by two observers with different level of experience. A total of 3501 effusion fluids were included in the study, evaluated between 2014 and 2023. 50.7% of the cases were male, and 49.3% were female. 55.2% of the cases were pleural fluid, 41.5% were peritoneal fluid, and 3.3% were pericardial fluid. Two hundred sixty five cases (7.6%) were non-diagnostic, 2160 (61.7%) were negative for malignancy, 111 (3.2%) were AUS, 83 (2.4%) were SFM, and 883 (25.2%) were malignant (M). ROM calculated 27% for AUS, 49% for SFM 49%. The interobserver agreement for AUS was 46% with kappa value of 0.162, and 42% for SFM with kappa value of 0.188. The differentiation of atypical cases into AUS and SFM is effective in determining the ROM. The interobserver agreement tends to be lower in intermediate categories compared to others, emphasizing the potential significance of clinical expertise in diagnosis.

Augmented reality guidance improves accuracy of orthopedic drilling procedures

In several orthopedic procedures, the accurate use of surgical power tools is critical to avoid damage to surrounding tissues. As such, various guidance techniques and safety measures were developed. Augmented reality (AR) guidance shows promise but requires validation. We evaluated a new approach using an inside-out infrared tracking solution for the HoloLens to compensate for its limited tracking performance. Eighteen participants with varying levels of experience (student, trainee, expert) each drilled twelve trajectories (six perpendicular, six oblique) in equidimensional wooden logs. Three different techniques were evaluated: freehand drilling; proprioception-guided drilling towards the contralateral index finger; and AR-guided drilling using a tracked drill and a virtual overlay of the log with predefined guidance vectors. The angular errors between planned and performed trajectories were compared using a mixed-design ANOVA. The results demonstrated that guidance technique (p < 0.001) and drilling direction (p < 0.001) significantly affected drilling accuracy, while experience (p = 0.75) did not. AR outperformed both other techniques, particularly for oblique trajectories (p < 0.001). For perpendicular trajectories, it only outperformed proprioception guidance (p = 0.04). Target plots revealed an important scatter perpendicular to the longitudinal axis of the log during freehand and proprioception-guided drilling, especially for oblique trajectories. This inaccuracy disappeared during AR-guided drilling. As such, we were able to conclude that AR guidance using inside-out infrared tracking reduced angular uncertainty during directional drilling, resulting in improved drilling accuracy. This improvement was particularly noticeable for complex trajectories and angles. The benefits of AR guidance were observed across all experience levels, highlighting its potential for orthopedic applications. We believe this study opens the way for the methodical evaluation of AR guidance in specific orthopedic use cases.

Construction Cost-Influencing Factors: Insights from a Survey of Engineers in Saudi Arabia

Cost overruns represent a continuous challenge within the construction industry, frequently affecting the success of projects. This study explores the factors influencing cost during the construction phase in Saudi Arabia, utilizing data from a survey of 1076 engineers working in the Saudi construction industry. The results identify a number of cost-related factors, including inadequate project management, poor cost estimation, and design errors. Interestingly, some factors, such as currency exchange rate fluctuations and social and cultural influences, were found to have a limited impact on construction costs. Furthermore, the study highlights the role of experience and education level in shaping engineers’ perceptions of these cost factors. The study employs statistical analysis, including Pearson’s chi-squared test, to demonstrate associations between demographics, project characteristics, and cost-influencing factors. The findings suggest the need for refined project management practices, enhanced technical training, and the implementation of digital technologies such as Construction 4.0 to mitigate cost-related risks. This research provides significant insights for construction professionals and policymakers seeking to enhance cost management within the Saudi construction sector, thereby contributing to the ongoing development initiatives aligned with Saudi Arabia’s Vision 2030.

Assessment of Inter-observer Reproducibility of the Residual Cancer Burden Index and Neoadjuvant Chemotherapy Response in Breast Carcinoma

Background : Locally advanced breast cancers are nowadays treated with neoadjuvant chemotherapy (NAC) to downstage the tumor. One way to assess the NAC response is to use “Residual cancer burden index (RCB).” The aim of the study was to assess inter-pathologist reproducibility of residual cancer burden index and to evaluate different clinico-pathological parameters that determine the pathological response. Methods: In this retrospective cohort study, surgically excised specimens of 49 NAC treated breast cancer were examined by histopathology and immunohistochemistry over a period of one and half years. Four pathologists with different level of experience reviewed the reports (unaware of original RCB index) and slides and assigned the RCB indices for each case. Clinical, histopathological and immunohistochemical parameters were evaluated.. Fleiss- Kappa statistics was applied to assess interobserver reproducibility of RCB index. Results: No significant relationship was observed between RCB index (of original report) with age, largest tumor dimension and number of chemotherapy cycles . The RCB index of 49 cases as assigned by four pathologists was calculated by Fleiss-kappa statistics and it showed good overall agreement (82.6%). Conclusion: It has been observed that there is no significant relation between pathological response to NAC with age, largest tumor dimension and number of chemotherapy cycles of breast carcinoma. It can also be concluded that RCB can be reliably used to report neoadjuvant chemotherapy treated specimens of breast cancer.

Serving up Success: Assessing and Improving Tennis Athlete Development Pathways

The primary purpose of this study was to look into what makes tennis players develop and succeed, as well as the most significant problems and obstacles they face on their way to becoming better. Using a mix of methods, numeric and qualitative data were gathered from 526 tennis players from various school programs and levels of experience. The quantitative data was technical, primarily training, tactical skills, mental preparation, competitive experience, teaching, and support networks. On the other hand, the qualitative conversations looked into how athletes felt about these things on a deeper level and perceptions of the coaches on their view of the current development of atheletes and how they could be improved were also the focus of this study. Meanwhile, the players who answered were male and female, from various school backgrounds, and most of them had competed for one to two years. The study found that athletes liked all parts of training but needed more access to expert coaches. These training sites required to be updated had more chances to compete and had trouble balancing their athletic and academic obligations. Qualitative results showed more problems, such as mental stress from high-level racing and not enough help for recovering from injuries. Results showed that there are significant holes in the current growth paths for tennis players. It stressed the importance of making it easier for them to get tools, mental health support, and up-to-date training devices. Based on these results, a complete program was created to remove these obstacles and improve athletic growth.

Unlocking proactive socialization dynamics: investigating work engagement through social capital resources, the interplay of proactive personality and perceived organizational support

PurposeThis study aims to explore the relationship between proactive socialization behaviors (PSBs) and work engagement, with a specific focus on the mediating role of social capital resources (SCRs). Additionally, it investigates how proactive personality and perceived organizational support (POS) moderate the organizational assimilation of newcomers in Punjab, Pakistan, through the lens of self-determination theory.Design/methodology/approachA cross-sectional survey design was employed, with data collected from diverse organizations across cities in Punjab, Pakistan, including Bhimber, Gujrat, Gujranwala, Lahore, Jhelum, Kharian, Kotla, Mandi Bahauddin, and Sialkot. A total of 1,000 questionnaires were distributed, resulting in 619 valid responses. The sample primarily consisted of individuals with varying levels of work experience, contributing to the diversity of the data. SEM was utilized to analyze the relationships between the studied variables.FindingsResults indicated a significant positive association between PSBs and work engagement among newcomers. SCRs were found to mediate this relationship, suggesting that proactive behaviors help newcomers accumulate social capital, which enhances work engagement. Moreover, the study reveals that proactive personality and POS significantly moderate the relationship between PSBs and work engagement, with stronger positive associations observed among proactive individuals and those perceiving higher organizational support.Practical implicationsThe study underscores the importance of encouraging proactive socialization behaviors and strengthening organizational support systems to foster newcomer engagement and facilitate successful assimilation.Social implicationsUnderstanding these dynamics can lead to the creation of more inclusive and supportive organizational environments, enhancing both individual well-being and organizational effectiveness.Originality/valueThis research offers new insights into the mechanisms through which PSBs impact work engagement, particularly through the accumulation of SCRs, and highlights the importance of proactive personality and organizational support as moderators.

How to catch prospective use? A comparative study of virtual environment movie and guided imaginary for projecting future users in a public space

Focusing on the design of a public space, we propose a methodological contribution to integrate possible future users to studies in prospective ergonomics. Our objective is to establish a rigorous protocol for comparing two methods of projecting potential usage. First, a projection interview based on a virtual environment movie and second, a Guided Imaginary Projection interview. We sought to determine to what extent these two methods provide participants with the ability to live a ‘quasi-experience’ of the space. This ‘quasi-experience’ is measured by a questionnaire inspired by the concepts of presence and absorption and by the analysis of the embodiment level of the discourse produced during the interviews, from embodied to general discourse. The results show that while the two methods produce similar results in terms of the level of projection experience, the virtual environment movie projection produces significantly more general discourse.

Assessment of physiotherapists’ sensitivity to palpation pressure

Aim: This study was planned to investigate the pressure sensitivity applied by physiotherapists during palpation and the effect of their experience on palpation sensitivity. Methods: 62 physiotherapists with an age of 31.06 ± 5.29 years and a working experience of 6.88 ± 4.76 years were included in the study. The physiotherapists were divided into two groups: those working in the field of manual therapy and those not working. The participants were asked to apply pressure on an electronic scale with four different weights (500 gr, 1000 gr, 2000 gr, and 4000 gr, respectively). The display screen of the scale on which the measurement was made was blinded to the physiotherapists. After the first measurements, a short training was given and the same measurements were repeated randomly. Results: In the first evaluation made before the training, it was found that there was a statistical difference between the two groups in the application of 500 grams of pressure (p=0.003). However, no significant difference was found between the two groups in the measurements made after the training (p&gt;0.05). It was observed that the level of professional experience did not significantly affect pressure sensitivity (p&gt;0.05). Conclusion: This study demonstrates that manual therapy physiotherapists had increased palpation sensitivity when using smaller weights. It is therefore advised that physiotherapists undergo training to enhance their palpation sensitivity, as this is an effective diagnostic and therapeutic technique.

A self-regulation perspective on L2 grit development and its impact on language achievement

Evidence from recent studies has shown that sustained perseverance and passion for long-term goals in the domain of second language (L2) learning – a personality trait called L2 grit – is associated with various aspects of language learning, including positive psychological attributes (e.g. motivation, beliefs, and emotions), actions (e.g. learning efforts and strategy use), and achievement (e.g. course and task performance). Meanwhile, relatively little has been written about the mechanism through which such relationships emerge. Expanding upon L2 grit’s association with self-regulated learning (SRL) behaviors and SRL-related psychological variables, this study explores the development of L2 grit and its role in language achievement using the SRL framework. One hundred and eight English majors in Japan responded to a questionnaire, granted permission to access their L2 class records, and completed a standardized L2 test. The main findings include: (1) the psychological attributes that facilitate SRL may play a critical role in increasing levels of L2 grit, (2) the relationship between L2 grit and achievement in language classes was mediated by behavioral self-regulation (intensified learning efforts), and (3) L2 grit may promote different types of self-regulatory behaviors depending on learners’ status (i.e. learning experience and proficiency levels) and learning situations (e.g. learning content and goals). The results provide one explanation for the superior performance of gritty learners in L2 classes observed in previous studies.

Robotic spine systems: overcoming surgeon experience in pedicle screw accuracy: a prospective study.

Prospective single-center study. To compare the accuracy of pedicle screws placed by freehand and under fluoroscopy and robotic assistance with intraoperative image acquisition. Pedicle screws are the most commonly used spinal anchors owing to their ability to stabilize all three spinal columns. Various techniques such as freehand, fluoroscopy-assisted, and navigation-assisted pedicle screw placements have been used with varying degrees of accuracy. Most studies on robotic-assisted pedicle screw placement have utilized preoperatively acquired computed tomography scans. To our knowledge, this is the only study in the literature that compared freehand with fluoroscopy-guided and robotic-assisted pedicle screw insertion with freehand and fluoroscopy. In this prospective study, a total of 1,120 pedicle screws were placed in the freehand group (n=175), 1,250 in the fluoroscopyassisted group (n=172), and 1,225 in the robotic-assisted group (n=180). Surgical parameters and screw accuracy were analyzed between the three groups. The preoperative plan overlapped with the postoperative O-arm scan to determine if the screws were executed as planned. The frequency of clinically acceptable screw placement (Gertzbein-Robbins grades A and B) in the freehand, fluoroscopy-assisted, and robotic-assisted groups were 97.7%, 98.6%, and 99.34%, respectively. With robotic assistance, an experience-neutralizing effect implied that surgeons with varying levels of experience achieved comparable pedicle screw accuracy, blood loss, O-arm time, robot time, and time per screw. No significant difference in these parameters was found between surgeries commencing before and after 2 PM. No significant differences were noted between the planned and executed screw trajectories in the robotic-assisted group irrespective of surgical experience. The third-generation robotic-assisted pedicle screw placement system used in conjunction with intraoperative threedimensional O-arm imaging consistently demonstrates safe and accurate screw placement with an experience-neutralizing effect.

Voice coding experiences for developers with physical impairments

PurposeThis research explores the current working practices of voice coders with physical impairments and investigates their perceptions of a research prototype utilising a fixed grammar speech coding approach.Design/methodology/approachSemi-structured interviews were initially conducted with seven voice coders with physical impairments to understand their development practices, followed by an exploratory user study with five disabled voice coders to obtain their feedback on a fixed grammar voice coding system.FindingsInterviews provided new insights around the tools voice coders utilise, the need for multimodal coding approaches, as well as experiences in working within mixed ability development teams. Findings from the user evaluation elicited views around the need for distinct monosyllable voice commands, as well as other requirements to support efficient voice coding (e.g. command chaining, intuitive navigation, and custom command definition).Research limitations/implicationsThe research was conducted with experienced voice coders which may have influenced perceptions of the voice coding prototype. The system was also evaluated over a single evaluation session, whereas longitudinal research with novice voice coders could also present additional insights.Practical implicationsFurther research is required into customisable multimodal voice coding approaches for developers with physical impairments who may have varying levels of experience in coding via alternative methods.Originality/valueThe findings present new insights around the working practices and unique requirements of voice coders with physical impairments and highlights important new avenues for future research.

Exploring the use of point-of-care ultrasound by pelvic health physiotherapists in the UK

National and international surveys have highlighted point-of-care ultrasound (PoCUS) as an emergent technology that is being utilized by physiotherapists across a variety of clinical specialities. It confers advantages beyond traditional physiotherapy assessment and increases treatment options for patients with pelvic health conditions. What is not known is how pelvic health physiotherapists are routinely using PoCUS, or the barriers and enablers to its use that exist specifically within this population. The aim of this service evaluation was to explore the current use of PoCUS by pelvic health physiotherapists who are part of the POGP professional network to identify barriers and enablers to wider use within clinical practice across the UK. An online survey with both multiple-choice and free-text responses was shared. Questions covered four domains of interest: (1) demographic and professional characteristics; (2) current use of PoCUS; (3) perceived barriers and enablers; and (4) training. One hundred and two pelvic health physiotherapists with varied levels of experience responded from different sectors and areas of the UK. Only 30.4% reported routine use of PoCUS in their clinical practice despite consensus that PoCUS is an important tool for the rehabilitation of pelvic health conditions. Most barriers to the use of PoCUS identified could be linked to resource limitations, training or lack of support, and were also reflected in suggestions for enablers. Most users had formal training and felt that this had been sufficient to be competent in using PoCUS in their service. Physiotherapists recognize the advantages that PoCUS offers for rehabilitation in pelvic health populations, but are often unable to access the equipment or training required. Ongoing support after training is needed to ensure that users maintain confidence and competence, especially as many work as independent practitioners and are without a direct peer network. Updates to national recommendations or guidelines to include PoCUS as a recommended tool within rehabilitation may provide the impetus needed to support its adoption across more public healthcare settings.

A comparison of general surgery training programmes across 11 countries: improving understanding of the experience level of international medical graduates in the UK.

Within the past five years there has been a significant increase in the number of international medical graduates (IMGs) joining the United Kingdom's (UK) workforce. Having mentors and supervisors who understand the needs of IMGs and clinical and cultural differences in the workplace can benefit in the transition to working in a new country. Improving knowledge of and understanding differences between general surgical training programmes and grades across different countries could therefore aid in the support of IMGs within the UK. Data on general surgical training programmes of the top ten countries for the primary medical qualifications of IMGs in the UK were collected to provide comparison with the UK training programme. The following countries were included: UK, India, Pakistan, Nigeria, Egypt, Ireland, Sudan, Sri Lanka, Romania, Iraq and South Africa. Training programme lengths ranged from 3 to 10 years. Only some training programmes provide additional training and qualification in sub-specialisation in general surgery. Other differences included a requirement for internship/non specialist training prior to training, differences in lengths of time spent in other surgical specialties and a requirement for research. Understanding the training programmes of other countries may help UK surgeons to understand the prior experience of IMGs and enable them to provide better training and support.