Adenomyosis is challenging to diagnose with transvaginal ultrasound (TVUS) and requires operator expertise to recognize its sonographic features; however, little is known about the learning curve for trainees. This study aimed to assess the learning curve of inexperienced residents in diagnosing adenomyosis and identifying its key ultrasound signs using the learning curve-cumulative summation test (LC-CUSUM) method. This prospective cohort study was conducted in 2 tertiary care centers specializing in endometriosis and adenomyosis. Women aged 18-50 undergoing routine outpatient gynecological visits and ultrasound examinations between April 2023 and February 2024 were included. TVUS exams were initially performed by residents without prior formal training in adenomyosis diagnosis. Each scan was subsequently repeated by an expert sonographer, who provided immediate feedback to the trainee. Concordance between residents and experts was assessed for the presence of adenomyosis, its classification, and specific sonographic features. LC-CUSUM analysis was used to construct learning curves and determine when proficiency was achieved. A total of 150 patients were evaluated by 3 residents (50 each), with the sample size predetermined based on prior studies. All residents achieved diagnostic proficiency by the end of their training, requiring 16, 17, and 23 scans, respectively. LC-CUSUM analysis indicated that approximately 20 scans are needed to reach proficiency. While most key features were correctly identified, subendometrial lines/buds and diffuse inner myometrial involvement were more difficult to recognize consistently. Residents without prior experience can achieve proficiency in diagnosing and classifying adenomyosis after approximately 20 TVUS exams, though some features remain more challenging to detect.

A comprehensive mixed-methods usability evaluation of COVID-19 home test kits: focusing on effectiveness, efficiency, and satisfaction.

Comparing Virtual Reality Trauma Training Across Diverse Clinical Backgrounds: A Mixed-Methods Study in Canada And India.

This qualitative study explores the experiences of Israeli therapists implementing the FOCUS (Families OverComing Under Stress) intervention. Originally developed for US military families, the FOCUS model was adapted to support civilian families exposed to chronic trauma. Through in-depth interviews with 13 therapists, the study identified three main themes: the shift from individual to family trauma-focused care, acquisition of new therapeutic tools, and challenges in implementation. Therapists emphasized the importance of addressing trauma within the family system but reported lacking appropriate tools before using FOCUS. The program offered structured yet adaptable methods to help families reconstruct a shared narrative and strengthen resilience. Challenges included the need for prior family therapy experience, intensive supervision, and difficulties recruiting all family members. The findings support the integration of trauma-informed care and family therapy, highlighting the need for further research on FOCUS's long-term effects and adaptability in diverse settings involving all family members.

Cross-views between the roles of the therapist and the expert in forensic psychology/psychiatry: A qualitative study.

Understanding the diverse vocational functioning profiles of individuals with disabilities is crucial for effective, person-centered practice in vocational rehabilitation. To identify latent profiles of vocational functioning on the basis of Work Rehabilitation Questionnaire (WORQ) scores of individuals with disabilities in Turkey and to investigate demographic predictors of profile membership. Cross-sectional study using online survey methods. Online data collection. A total of 522 adults (67.8% male), ages 18-64 yr, literate, and possessing a health report confirming a disability rating of more than 40% were recruited. Latent profile analysis was used to identify distinct vocational functioning profiles. Multinomial logistic regression examined predictors of profile membership. Latent profiles were derived from participant scores on the WORQ subdomains: Emotion, Cognition, Dexterity, and Mobility. Predictors included gender, education, and work experience. Three distinct latent profiles were identified: Class 1 (n = 199), with the lowest scores across all subdomains; Class 2 (n = 83), with higher Emotion and Cognition scores but lower Dexterity and Mobility scores; and Class 3 (n = 240), with higher Dexterity and Mobility scores but lower Emotion and Cognition scores. Prior work experience significantly predicted membership likelihood between profiles (p = .031). Individuals with disabilities exhibit distinct vocational functioning profiles, highlighting significant heterogeneity beyond diagnostic labels. These findings underscore the need for individualized assessment and intervention in vocational rehabilitation, tailoring approaches to profile characteristics. The profiles can guide goal setting and intervention planning, although further research is needed to explore links with specific diagnoses and employment outcomes. Plain-Language Summary: Understanding the different work-related strengths and challenges people with disabilities face is important to help them succeed in employment. This study identified three common patterns, or profiles, of individuals with disabilities on the basis of their self-reported emotional, thinking, physical movement, and fine motor skills related to work. One group had lower scores overall, another had stronger emotional and thinking skills but weaker physical skills, and the third had stronger physical skills but weaker emotional and thinking skills. Knowing these profiles can help occupational therapists tailor vocational rehabilitation programs to better meet each person's specific needs, focusing on the areas in which they need the most support to find and keep meaningful work.

Introduction: preoperative patient readiness is the fundamental cornerstone of surgical safety. Adequate preoperative knowledge plays a crucial role in reducing anxiety, improving cooperation, and preventing postoperative complications, including surgical site infections (SSI). However, patient understanding varies and is thought to be influenced by individual characteristics. This study aims to examine the relationship between patient characteristics and the level of preoperative knowledge. Method: the research employed a comparative cross-sectional design involving 300 patients scheduled for elective surgery across several hospitals in the Greater Bandung area, Indonesia, using accidental sampling. Data were collected through questionnaires and analyzed using the chi-square test, followed by binary logistic regression with odds ratio (OR) and 95% confidence interval (CI). Results: the findings indicate that age, gender, and history of previous surgery were significantly associated with patients’ levels of preoperative knowledge. Significant factors influencing preoperative knowledge included age (p=0.012), gender (p=0.047), and surgical history (p=0.024). Fasting preparation scored highest (91.38), while physical preparation was lowest (80.16). Younger patients, males, and those with prior surgical experience tended to have better understanding. Conversely, education level, occupation, and type of anesthesia to be administered showed no significant association. Preoperative readiness is not solely determined by social or educational background but is more influenced by demographic factors and personal experience. Conclusion: these findings highlight the need for personalized preoperative education, particularly for older, female patients, and those without prior surgical history. Such tailored interventions have great potential to enhance surgical safety and reduce the risk of surgical site infections.

Residents as Leaders: Creating a Trauma Team Leader Nontechnical Skills Simulation Workshop.

Bedside lower‑limb vascular assessment commonly relies on pedal pulse palpation or hand‑held Doppler, yet their relative time‑efficiency and the reliability of Doppler measurements in novices are unclear. Twenty healthy adults were examined by three undergraduate raters without prior Doppler experience. For dorsalis pedis, anterior tibial, and posterior tibial arteries, each rater performed three trials with palpation and with a hand‑held continuous‑wave Doppler. Primary outcomes were time‑to‑identification and identification success; for Doppler, peak systolic velocity (PSV) reliability was evaluated (intra‑ and inter‑rater intraclass correlation coefficients [ICC] and Bland-Altman). Differences were defined as Doppler-palpation (positive values indicate longer time for Doppler). Palpation was faster than Doppler for dorsalis pedis (Hodges-Lehmann +6.47 s, 95% confidence interval [CI]: 2.40-8.00; p = 0.004) and posterior tibial arteries (+6.38 s, 1.10-13.61; p = 0.012). The anterior tibial artery was never identified by palpation but was identified by Doppler in all participants (exact McNemar p = 1.91 × 10⁻⁶). Doppler reliability for dorsalis pedis PSV was excellent within raters (ICC [3.1]: 0.926-0.971) and between raters (ICC [2.1]: 0.966), with small mean biases and narrow limits of agreement. In healthy adults, palpation enables faster identification of dorsalis pedis and posterior tibial pulses, whereas the deeper anterior tibial artery is consistently detected only with Doppler. Doppler‑derived PSV shows excellent reproducibility even among novice examiners. These findings provide methods-level evidence to inform protocol design and training; validation in patient populations is required before any workflow recommendations.

Opioid agonist therapies (OAT) reduce adverse outcomes of illicit opioid use, with individual preferences potentially improving treatment outcomes. We explored preferences for OAT and associated factors in a national sample of people with opioid dependence. This cross-sectional study recruited 400 participants (October 2020-April 2021) across Australia (excluding Tasmania) through snowball sampling. Participants completed an interviewer-administered questionnaire on sociodemographic and drug use characteristics. Multivariable logistic regression assessed factors associated with methadone preference (vs. buprenorphine). Among all participants (median age 45, 41% female, 87% ever received OAT), 92% (n = 366) indicated a preference for receiving OAT (vs. not receiving OAT) and 96% of those (n = 352) preferred a particular type of OAT. Among 366 with a stated preference, 61% (n = 216) preferred methadone and 39% (n = 136) preferred buprenorphine. Among those preferring buprenorphine (n = 136), 50% (n = 68) preferred buprenorphine ± naloxone and 50% (n = 68) preferred long-acting injectable buprenorphine. Independent correlates of preferring methadone included past month heroin use (aOR 1.78, 95% CI 1.06-3.00) and non-prescribed pharmaceutical opioid use (aOR 2.23, 95% CI 1.07, 4.95), and any prior receipt of methadone treatment (aOR 6.54, 95% CI 2.66, 17.91). Among those receiving OAT, a higher proportion of people currently receiving buprenorphine preferred their medication (61/66, 92%) compared to methadone recipients (180/235, 77%). Nearly all participants preferred OAT, mostly reflecting prior experiences, underscoring the need for expanded access to OAT in Australia. Given the multiple stated preferences, OAT options should include a variety of treatment options aligned with patient preferences, including expanded take-home options.

Clear communication with international teams is essential in emergency and disaster management, yet language barriers often complicate coordination. This study explores the foreign language training needs of Emergency Aid and Disaster Management (EADM) students and field professionals from Disaster and Emergency Management Authority (DEMA) in one Turkish province and examines participants’ perceptions of how a Virtual Reality (VR)-supported serious-games approach could address these gaps. Using a descriptive survey design with quantitative and qualitative data, we surveyed 51 participants to assess current language proficiency, prior experience with international disaster communication, and perceptions of VR-supported training. Findings indicate that most participants had little or no experience working with foreign teams, and those who did reported low English proficiency. While formal language training was minimal, participants strongly favoured hands-on and simulation-based learning methods and expressed significant interest in VR-supported training as a practical approach to developing crisis-communication skills. Overall, these findings identify substantial language-skill gaps in this context and suggest that innovative, technology-enhanced training may warrant further investigation to improve preparedness for international disaster response.

ABSTRACT The 9-valent human papillomavirus (9vHPV) vaccine targets human papillomavirus (HPV) types 6/11/16/18/31/33/45/52/58. Although its use in pregnant women is not recommended, inadvertent exposures during early pregnancy could occur as the indicated age range includes the ages of child-bearing potential. A pregnancy registry was created as a post-marketing regulatory commitment using spontaneous reports of 9vHPV vaccine exposure during pregnancy that were received from the United States (from December 2014 through March 2021) and followed through the completion of pregnancy. Primary pregnancy outcomes included congenital anomalies, live births, fetal deaths, elective terminations, and miscarriages. Enrolled prospective reports were used for rate calculations. Of the 180 prospectively enrolled pregnancies, 70 had known outcomes. There were 66 live births that resulted in 67 live born infants (95.7%; one twin pregnancy), one elective termination, and three miscarriages (estimated rate, 4.3% [3/69] of known outcomes excluding elective terminations). All three miscarriages occurred in the first trimester in women who had been vaccinated prior to detection of pregnancy. There were three major birth defects among the prospective reports, with an estimated rate of 4.5% (3/67). Findings from this analysis of the US 9vHPV vaccine pregnancy registry do not suggest an increased risk of major birth defects and miscarriage in women who received the vaccine. There is no apparent pattern of congenital anomalies to suggest potential adverse effects of exposure to the 9vHPV vaccine during pregnancy. This analysis is consistent with prior clinical trial experience and post-licensure observational data with the quadrivalent HPV and 9vHPV vaccines.

While numerous studies have highlighted the benefits of AI in language education, the research examining its effectiveness through the lens of personality factors remains limited. Individual personality traits shaping how learners perceive and utilize technology play a critical role in AI-based learning outcomes. This study investigated the relationship between personality traits and AI efficacy in Arabic language learning, framed within the Big Five Personality Traits model (extraversion, openness, conscientiousness, agreeableness, and neuroticism). Through a qualitative survey approach, the data were collected from 27 university students with prior Arabic learning experience (2–4 years) and AI familiarity. Participants included 26 students (96.3%) from pesantren (Islamic boarding schools) and 1 student (3.7%) from a madrasah, all of whom completed questionnaires assessing their perceptions of AI’s role in learning across personality dimensions. Findings reveal that AI enhances learning comfort, adapts to diverse styles, improves grammatical and lexical mastery, and boosts motivation while fostering traits like independence, diligence, and creativity. However, its effectiveness depends on users’ digital literacy, intrinsic motivation, and capacity for reflective learning. The study highlighted the necessity of personalized AI integration in language education, emphasizing adaptive pedagogical support to address individual differences. These insights contributed to the discourse on AI-driven education by bridging personality psychology with technology-enhanced learning, offering practical implications for designing inclusive and effective AI tools in higher education.

Passive voice remains a key grammatical structure for English learners, particularly in academic writing, yet many students struggle to use it accurately. This study analyzes the types of passive voice errors made by 19 fifth-semester students in the English Education Study Program at Tadulako University. Specifically, it addresses two questions: (1) How do classroom interaction patterns such as teacher-centered grammar instruction, limited student negotiation of meaning, or feedback practices shape students’ understanding and use of passive voice, and to what extent might these dynamics contribute to the dominance of developmental errors? (2) In what ways do students’ sociocultural backgrounds, prior educational experiences, and exposure to English outside the classroom influence their difficulties with auxiliary verbs and tense agreement, and how do these factors mediate tensions between Indonesian linguistic norms and English academic writing conventions? A quantitative design was employed, with a test focusing on passive constructions in present continuous, past continuous, and past perfect tenses. Students’ responses were categorized using Dulay et al.'s (1982) comparative taxonomy of developmental and interlingual errors. Results revealed developmental errors as the most prevalent (89.9%), mainly involving incorrect auxiliary verbs (is, am, are, being, been), past participle formation, and tense agreement. These findings highlight the need for targeted grammar instruction on auxiliary patterns and participles, alongside enhanced practice, corrective feedback, and adjustments to classroom interactions and sociocultural considerations to boost accuracy.

ABSTRACT Cervical cancer remains a significant global public health threat, particularly in low- and middle-income countries, like Ethiopia. The Human Papillomavirus (HPV) vaccination is the most effective tool to prevent HPV transmission and reduce cervical cancer-related mortality, but the vaccine uptake remains suboptimal. The public perception of the HPV vaccine is marked by fear and doubt. Although girls are the primary targets of HPV vaccination, little is known about their perspectives, especially in low- and middle-income countries (LMICs). This study addressed the research question: How do adolescent girls perceive the HPV vaccine, and what factors influence their confidence and uptake? The aim was to explore girls’ perceptions and to identify the challenges and factors that shape girls HPV vaccine confidence and uptake. This is a qualitative study that used eight 30 minutes focus group discussions (FGD) with 9 to 10 girls each for a total of 76 girls aged 12 to 15 from selected schools in Addis Ababa. Three trained researchers facilitated the discussion. From using reflexive thematic analysis (RTA), four key themes were created. The FGDs revealed that rumors, misinformation, and poor communication fueled girls’ fear and limited their engagement in the vaccination campaign. Their decisions were influenced by parents, peers, and prior COVID-19 vaccination experiences, while minimal involvement hindered awareness and informed choices. Inconclusion, the study underscored the importance of effective communication and involving girls in vaccination campaigns to reduce misinformation, improve awareness, and increase vaccine uptake.

The role of structured musical participation in fostering inclusion and social engagement among children living in residential childcare is examined. The research was conducted in cooperation with a Czech children’s home and the Harmony Foundation, which operates an orchestra inspired by El Sistema model. A participatory qualitative design was employed, combining sustained observation, semi-structured interviews with children and educators and reflective team discussions. Data were analyzed through interpretative phenomenological analysis and systematic coding. The findings indicate that regular collective music-making enhanced emotional regulation, self-confidence and perseverance. Children showed a greater willingness to collaborate and form positive peer relationships, while educators observed more cohesive group dynamics and increased motivation. Public performances strengthened the sense of belonging and personal accomplishment, particularly among children with prior experiences of instability and social exclusion. The results provide empirical evidence that music-based programmes can effectively promote inclusion and social participation in residential childcare and should be regarded as an integral component of holistic educational support within this context.

<p>Artificial intelligence (AI) is increasingly embedded in higher education, yet the role of psychological factors such as self-efficacy in shaping students’ readiness to use AI remains underexplored. This study examines how self-efficacy influences AI literacy levels, defined as students’ ability to understand, apply, and critically evaluate AI tools, among university students at a historically disadvantaged South African institution. Guided by Bandura’s self-efficacy theory, a quantitative survey was conducted with 153 students using a structured questionnaire measuring mastery experiences, vicarious experiences, social persuasion, and emotional states. Results show that more than 70% of students expressed confidence in understanding AI concepts, while 78% reported being able to learn new AI tools with ease. Patterns in the descriptive statistics further suggest that students who reported prior experience with AI, encouragement from peers and lecturers, and low levels of anxiety tended to express higher confidence in using AI. These findings indicate that self-efficacy is a critical enabler of AI literacy, with psychological readiness complementing technical competence. The unique contribution of this study lies in its focus on students from a resource-constrained, historically disadvantaged university and its integration of Bandura’s four self-efficacy dimensions into the study of AI literacy. The results suggest that interventions such as peer mentoring programs, hands-on AI workshops, and structured feedback sessions can enhance both confidence and competence, thereby supporting equitable AI adoption in higher education..</p>

The ability to follow another's gaze direction is a foundational skill in human cognition that underpins more complex social abilities. Other primate species also exhibit a variety of gaze-following behaviors, but previous experimental work has focused only on captive populations. Studies of cognition in wild animals are crucial to understanding the biological context of different psychological processes, as well as to characterize developmental change in cognition in animals interacting in natural social groups. We therefore conducted field experiments with wild chimpanzees (Pan troglodytes schweinfurthii) ranging from infancy to old age in Kibale National Park, Uganda. Chimpanzees observed a human demonstrator who either looked up on test trials or down on control trials across up to four trials presented on different days. We found that wild chimpanzees reliably followed the actor's gaze, looking up more often during test trials where she looked up compared to control trials where she looked down. We further characterized the development of this skill and found that whereas juveniles and younger adults consistently followed the demonstrator's gaze, infants and older adults did not. Our findings show that even chimpanzees without a history of social interactions with humans will reliably follow gaze, providing the first evidence that wild primates show such co-orienting responses. This work further provides support for the hypothesis that chimpanzees show distinct developmental trajectories for gaze-following compared to humans, even in wild social contexts. SUMMARY: Gaze-following is a foundational social cognitive skill shared with several other primate species, but all studies to date have been conducted with captive populations. We conducted the first test of gaze-following through field experiments on wild chimpanzees. We found that wild chimpanzees, who do not have a history of social interactions with humans, follow a human demonstrator's gaze even in the absence of prior experience. Robust gaze-following did not emerge until the juvenile period, providing support for the hypothesis that chimpanzees show developmental patterns of co-orienting that are distinct from human trajectories.

Teachers who intend to use artificial intelligence (AI) in their classrooms are expected to possess the necessary competencies and provide appropriate support to their students. Therefore, identifying pre-service teachers’ attitudes and perspectives toward AI is essential for training teachers who can effectively utilize modern technologies. The aim of this study is to determine pre-service teachers’ attitudes toward AI, analyze them across various variables, and reveal the importance of AI use in education from the perspective of the sample. The study was conducted in two sequential phases using a descriptive survey model. In the first phase, the General Attitude Towards Artificial Intelligence Scale was administered to 658 pre-service teachers. In the second phase, a group of 90 pre-service teachers selected from the initial sample received a structured AI training program focused on AI literacy, the integration of AI into educational settings, instructional design with AI, and sample classroom applications. Following the training program, the AI Integration Reflection Form, consisting of four open-ended questions, was administered to these 90 participants. While the quantitative data collected from the scale were analyzed using statistical methods, the responses to the AI Integration Reflection Form were analyzed through content analysis. The findings indicated that pre-service teachers had high levels of positive attitudes and low levels of negative attitudes toward AI. In terms of gender, male participants demonstrated more positive attitudes than female participants. The analysis of the open-ended responses revealed that pre-service teachers mainly emphasized the benefits of AI integration in education. Additionally, it was found that although many participants had prior experience with AI, they were positively influenced by the training and believed it would contribute to improving their performance. Furthermore, pre-service teachers reported that they did not perceive AI as a threat in learning environments and believed that it operated with minimal errors.

There is a known disconnect between scientific knowledge and its application in routine practice, known as the research-practice gap. A potential strategy to encourage research engagement among end-users is embedding researchers within an organization. This study set out to understand the views and experiences of senior managers, middle managers, and frontline staff in one department accessing and using research in a large organization with embedded researchers. We also investigated staff capacity to engage with research to identify opportunities to strengthen the use of research-based evidence in practice. We conducted 14 semi-structured in-depth interviews between November 2022 and April 2023 with senior managers, middle managers, and frontline staff working in the blood collection department at Australian Red Cross Lifeblood. Directed qualitative content analysis and the SPIRIT Action Framework were used to interpret the data. Capacity to engage with and use research varied greatly between participants and appeared to be affected by their role, training, and prior work experience. Participants valued research highly. However, only a few felt confident in their knowledge and skills to engage with research. Participants described a lack of visibility of research within the organization as well as systems and structures to access research. Experiences with accessing research, generating research, and interacting with researchers were mostly limited to senior managers. Research was chiefly used by senior managers to support changes, followed by understanding blood collection issues, and informing policy development. Although present, research use was often not visible to frontline staff. To increase research engagement and use, organizations should invest in strengthening their tools and systems, providing opportunities to increase individual knowledge and skills to engage with research, and increase the visibility of research and how it has been used.