Qualified Practitioners Research Articles

The legality and appropriateness of keeping Korean Medical Licensing Examination items confidential: a comparative analysis and review of court rulings.

This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees' abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

Ocular disorders and compliance to protective eyewear among quarry workers in Akamkpa local government area of cross river state, Nigeria

The quarry industry over time has played a pivotal role in the transformation of the physical environment but with attendant negative effects on workers. This study ascertained the pattern of work related ocular disorders and compliance to protective eye devices among quarry workers in Akamkpa LGA, Cross River State Nigeria. This descriptive cross sectional study employed the use of a structured interview followed by a comprehensive external examination of the eyes of the subjects by qualified eye care practitioners. Data generated was analysed using the Statistical Product for Service Solution (SPSS) version 25.0. Results were presented descriptively using tables and figures. The study took place in 8 quarry sites located in 4 communities randomly selected and involved 184 subjects randomly selected comprising of 140 (76.09%) males and 44 (23.91%) females. The age of the participants ranged from 18-60 years with a mean age of 32.03±2.23 (SD). The study revealed that predominant ocular symptoms experienced were blurry vision (31.5%), itchy eyes (27.94%), ocular irritation/ grittiness (15.55%), eye/ headaches (12.46%) and discharges (9.61%). The most common ocular surface anomalies observed were pterygium (41.80%), corneal scar/ ulceration (18.03%) and allergic conjunctivitis (16.39%), while the most frequent type of eye injuries reported were superficial foreign bodies, blunt trauma and superficial ocular abrasion accounting for 50.92%,30.06% and 11.04% respectively. Injuries due to quarrying activities were more common among labourers (41.10% and 29.45% among stone crushers and stone processors respectively), while workers with less than 5 years work experience reported more work related eye injury (74.85%) with broken stones (80.39%) accounting for most of the injuries. Similarly, a majority (94.7%) of the participants had knowledge of Personal Protective Eye Devices (PPEDs) only 26.44% had the appropriate PPEDs and just 30.43% of them complied regularly with their usage during work. There was a statistically significant association between work experience and the occurrence of work related ocular injuries (p>0.001) but the use of PPEDs has no statistically significant association with the occurrence of eye injuries. The study concluded that workers at the Akamkpa quarry, Nigeria suffered various types of work related ocular anomalies and while a majority of them had prior knowledge of the benefits of PPEDs, the level of availability and utilization is relatively low and recommended health education and strict enforcement of safety regulations.

Primary care quality and provider disparities in China: a standardized-patient-based study

BackgroundPrimary health care is the foundation of high-performing health systems. Achieving an improved primary care system requires a thorough understanding of the current quality of care among various providers within the system. As the world’s largest developing country, China has made significant investments in primary care over the past decade. This study evaluates the quality of primary care across different provider types in China, offering in- sights for enhancing China’s primary care system. MethodsWe merged data from four standardized patient (SP) research projects to compare the quality of five major primary care providers in China: rural clinics, county hospitals, migrant clinics, urban community health cen- ters (CHCs), and online platforms. We evaluated quality of care across process quality (e.g., checklist completion), diagnosis quality (e.g., diagnostic accuracy), and case management (e.g., correct medication), employing multiple regression analyses to explore quality differences by provider type, and their associations with physician characteristics. FindingsWe document a poor quality of primary care in China, with no- table disparities across different providers. CHCs emerge as relatively reliable primary care providers in terms of process quality, diagnostic accuracy, and cor- rect medication prescriptions. Online platforms outpace rural clinics, county hospitals, and migrant clinics in many areas, showcasing their potential to en- hance access to quality healthcare resources in under-resourced rural regions. We observe a positive association between the qualifications of physicians and the quality of primary care, underscoring the necessity for a greater presence of more highly qualified practitioners. InterpretationPrimary care quality in China varies greatly among providers, reflecting inequalities in healthcare access. While online platforms indicate po- tential for improving care in under-resourced areas, their high referral rates suggest they cannot completely substitute traditional care. The findings em- phasize the need for more qualified practitioners and stringent regulation to enhance care quality and reduce unnecessary treatments. FundingNo founders had a role in the study design, data collection, data analysis, data interpretation, or writing of the report. We have acknowledged this in the revised manuscript.

Healthcare-Seeking Behavior of Coastal Women in Bangladesh

Background: Healthcare seeking behavior encompasses actions taken by individuals who perceive themselves to be ill in an attempt to find appropriate remedies. For women, particularly in regions like coastal Bangladesh, socio-cultural and economic barriers often impede their ability to access and utilize healthcare services effectively. Understanding these behaviors is crucial for developing strategies to improve healthcare access and utilization. Objective: To assess the healthcare-seeking behavior of coastal women in Bangladesh, evaluating the quality of services provided and identifying barriers to effective healthcare utilization. Method: This descriptive, community-based cross-sectional study was conducted from June 1, 2019, to August 31, 2019, in three randomly selected villages in coastal Bangladesh. A sample of 200 women aged 20 years and above was surveyed using a pre-designed, semi-structured questionnaire. The study analyzed sociodemographic data and healthcare-seeking behavior, including preferences for healthcare practices and decision-making autonomy. Results: The study revealed that 35% of participants had inhibitions about discussing health issues with family members, and 42% required family permission to access healthcare services. Conversely, 65.5% were able to make their own healthcare decisions. Regarding first-choice healthcare practices, 60.5% preferred visiting qualified medical practitioners, while 19.5% consulted Registered Medical Practitioners (RMPs), and 15.5% relied on home remedies. Notably, married women (71.6%) were more likely to make their own healthcare decisions compared to unmarried (53.2%) and widowed (68.2%) women. Literate women showed greater awareness of available health centers (80.6%) compared to illiterate women (56.7%). Conclusion: The findings underscore significant barriers in healthcare access among coastal women, including the need for family permission and reliance on non-qualified practitioners. Socioeconomic ......

The use and ethics of dental photography and social media at an oral healthcare training centre in South Africa.

The ethics surrounding the use and sharing of photographs on social media has come under the spotlight as the Protection of Personal Information Act (POPI Act) has come into play. The aim is to determine the use, ethical practice and sharing of dental photography on social media among qualified and undergraduate oral health practitioners at a dental school in South Africa. A cross-sectional study design was used on staff and students at the University of the Western Cape's Dental Faculty in 2022. Chi-squared and Fisher's exact tests were used to determine associations between the different graduation statuses and various demographic factors. From the 80 undergraduate students and 46 qualified oral healthcare practitioners, the majority were aware that photography could be used in dentistry, and 87.3% (n = 110) took photographs of the dental treatments performed on their patients. Only 60.3% of the participants attended an ethical course that addressed issues with social media and digital photography. Almost 80% (n = 100) of the participants did not feel that they needed to mention all the social media platforms that they would use with their patients' photographs before sharing. Dental photography is being used and sometimes shared on social media platforms by some students and staff at university level. Not all participants have attended an ethical course on clinical photography. Dental training needs to include an ethical course on dental photography and the use of sharing photographs on social media. Good ethical practice regarding clinical photographs in all undergraduate and postgraduate curriculums, to eliminate any uncertainty.

Nutrition and Physical Activity Interventions for Adults in the General Population: A Position Paper of the Academy of Nutrition and Dietetics and the American Council on Exercise

It is the position of the Academy of Nutrition and Dietetics and the American Council on Exercise that nutrition and physical activity interventions delivered by qualified nutrition and exercise practitioners, within their scopes of practice, can improve lifestyle behaviors and cardiometabolic risk factors for adults in the general population. Effective interventions require client-centered, evidence-based care provided by skilled practitioners using inclusive, dynamic methods, and collaboration with an interprofessional team, as appropriate. Increased access to evidence-based nutrition and physical activity interventions is necessary to improve public health and should be a target for policymakers, health care systems, and practitioners. Adults who attain a nutritious diet and adequate physical activity have improved overall health compared with their counterparts. However, most adults do not meet population recommendations. Qualified nutrition and exercise practitioners can collaborate with clients and interprofessional teams to provide nutrition and physical activity interventions and improve outcomes. However, recent guidelines have identified a need for guidance on best practices for delivering behavioral lifestyle counseling, referring to other practitioners, and improving access to disease prevention services. This Academy of Nutrition and Dietetics Position Paper aims to address common barriers for nutrition and exercise practitioners providing nutrition and physical activity interventions for adults in the general population, and best practices for overcoming these barriers. Collective action from interprofessional practitioners and implementation partners can increase access to high-quality, individualized services to prevent disease and improve health and well-being on a population level. This position was approved in July 2024 and will remain in effect until December 31, 2031.

The Chartered Institute of Ergonomics and Human Factors at 75: perspectives on contemporary challenges and future directions for Ergonomics and Human Factors

As the UK’s Chartered Institute of Ergonomics and Human Factors (CIEHF) celebrates its 75th anniversary, it is worth reflecting on our discipline’s contribution, current state, and critical future endeavours. We present the perspectives of 18 EHF professionals who were asked to respond to five questions regarding the impact of EHF, contemporary challenges, and future directions. Co-authors were in agreement that EHF’s impact has been only limited to date and that critical issues require resolution, such as increasing the number of suitably qualified practitioners, resolving the research-practice gap, and increasing awareness of EHF and its benefits. Frequently discussed future directions include advanced emerging technologies such as artificial intelligence, the development of new EHF methods, and enhancing the quality and reach of education and training. The majority felt there will be a need for EHF in 75 years; however, many noted that our methods will need to adapt to meet new needs. Practitioner statement: This article provides the perspectives of 18 Ergonomics and Human Factors (EHF) professionals on the impact of EHF, contemporary challenges and critical future directions, and changes that are necessary to ensure EHF remains relevant in future. As such, it provides important guidance on future EHF research and practice.

The changing shape of English general practice: a retrospective longitudinal study using national datasets describing trends in organisational structure, workforce and recorded appointments

ObjectiveTo describe trends in the organisational structure, workforce and recorded appointments by role in English general practice.DesignRetrospective longitudinal study.SettingEnglish general practice.Data sources and participantsNHS England, Office for Health Improvement and...

Gender income differences among general practitioners with compulsory services in early career stage in underdeveloped areas: evidence from a prospective cohort study in China

BackgroundGender equality and the gender income gap in medicine are long-standing global problems. Although gender-related differences have been widely studied in developed countries, they remain unclear in underdeveloped regions. In 2010, China initiated a national compulsory service program (CSP) to train qualified general practitioners in rural and remote areas. This study aimed to evaluate gender income differences for early career CSP and non-CSP (NCSP) graduates in underdeveloped areas.MethodsA cohort study was conducted with 3620 CSP and NCSP graduates from four medical universities in Central and Western China. Baseline surveys and six follow-up surveys were conducted between 2015 and 2022. Incomes, including monthly mean income and proportion of performance-based income, were measured as the key outcome variables. Multivariate linear regression models were used to identify the gender income gap.ResultsNCSP graduates had higher average monthly incomes than CSP graduates. In the seventh year after graduation, the average monthly income for NCSP graduates was 7859 CNY while was 5379 CNY for CSP graduates. After controlling for demographic characteristics, the gender monthly income gap for CSP graduates was expanded from the fourth year (3.0%) to the sixth year (5.9%) after graduation, and that for NCSP graduates was expanded from the fifth year (11.9%) to the seventh year (16.3%) after graduation. Regarding performance-based income, it was 58.9% for NCSP graduates and 45.8% for CSP graduates in the seventh year after graduation. After controlling for performance-based income proportion, the gender income gap was reduced from 5.9 to 4.0% in the sixth year after graduation for CSP graduates, and from 16.3 to 14.4% for NCSP graduates in the seventh year after graduation.ConclusionAn extensive and ever-increasing gender income gap exists among young doctors in the early stages of their careers in underdeveloped areas of China. The high proportion of performance-based income among men is one of the main explanations for the observed difference. A more explicit compensation system must be established to enhance support for female health workers.

The role of a Medical Examiner Service in an acute NHS hospital: Perspectives from doctors and next of kin.

A new Medical Examiner system was introduced in England and Wales in 2019 to scrutinise all non-coronial deaths. The three key roles of independent Medical Examiner scrutiny are to establish accurate causes of death, determine whether coronial referral is required and identify any care concerns. This is the first published service evaluation exploring the views of doctors and next of kin with whom Medical Examiner Services interact. The aims were to understand whether the Medical Examiner Service was achieving its three main roles. Surveys were sent electronically to the qualified attending practitioners, and by post to the next of kin, of a consecutive series of deceased patients reviewed by an acute NHS hospital Medical Examiner Service in the East of England. Recruitment took place over a five month period in 2023. Results are based on 100 returned surveys from doctors (response rate 35%) and 179 completed by next of kin (response rate 65%). Findings suggest the Medical Examiner Service was successfully achieving its three key roles and well received by both doctors and next of kin. Service user feedback is clearly important as Medical Examiner Services continue to develop into the statutory phase during 2024, when they are anticipated to review approximately 400,000 deaths per annum in England and Wales. This study demonstrates such feedback is not only useful for service development, but also eminently possible.

Examining the Effectiveness of Social Media for the Dissemination of Research Evidence for Health and Social Care Practitioners: Systematic Review and Meta-Analysis.

Social media use has potential to facilitate the rapid dissemination of research evidence to busy health and social care practitioners. This study aims to quantitatively synthesize evidence of the between- and within-group effectiveness of social media for dissemination of research evidence to health and social care practitioners. It also compared effectiveness between different social media platforms, formats, and strategies. We searched electronic databases for articles in English that were published between January 1, 2010, and January 10, 2023, and that evaluated social media interventions for disseminating research evidence to qualified, postregistration health and social care practitioners in measures of reach, engagement, direct dissemination, or impact. Screening, data extraction, and risk of bias assessments were carried out by at least 2 independent reviewers. Meta-analyses of standardized pooled effects were carried out for between- and within-group effectiveness of social media and comparisons between platforms, formats, and strategies. Certainty of evidence for outcomes was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. In total, 50 mixed-quality articles that were heterogeneous in design and outcome were included (n=9, 18% were randomized controlled trials [RCTs]). Reach (measured in number of practitioners, impressions, or post views) was reported in 26 studies. Engagement (measured in likes or post interactions) was evaluated in 21 studies. Direct dissemination (measured in link clicks, article views, downloads, or altmetric attention score) was analyzed in 23 studies (8 RCTs). Impact (measured in citations or measures of thinking and practice) was reported in 13 studies. Included studies almost universally indicated effects in favor of social media interventions, although effect sizes varied. Cumulative evidence indicated moderate certainty of large and moderate between-group effects of social media interventions on direct dissemination (standardized mean difference [SMD] 0.88; P=.02) and impact (SMD 0.76; P<.001). After social media interventions, cumulative evidence showed moderate certainty of large within-group effects on reach (SMD 1.99; P<.001), engagement (SMD 3.74; P<.001), and direct dissemination (SMD 0.82; P=.004) and low certainty of a small within-group effect on impacting thinking or practice (SMD 0.45; P=.02). There was also evidence for the effectiveness of using multiple social media platforms (including Twitter, subsequently rebranded X; and Facebook), images (particularly infographics), and intensive social media strategies with frequent, daily posts and involving influential others. No included studies tested the dissemination of research evidence to social care practitioners. Social media was effective for disseminating research evidence to health care practitioners. More intense social media campaigns using specific platforms, formats, and strategies may be more effective than less intense interventions. Implications include recommendations for effective dissemination of research evidence to health care practitioners and further RCTs in this field, particularly investigating the dissemination of social care research. PROSPERO International Prospective Register of Systematic Reviews CRD42022378793; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378793. RR2-10.2196/45684.

Careers in languages: Awareness by Grade 12 Tshivenḓa learners in Thembisa, Gauteng

Home language learners exhibit negative attitudes towards South African indigenous languages. These languages are perceived as languages that are not beneficial in terms of upward mobility in the workplace. Being aware of the possibilities of studying South African indigenous languages can be a good motivation for learners. A positive attitude towards careers through South African indigenous languages could help to maintain and promote these languages, Tshivenḓa in particular. The study’s objective was to explore if learners and teachers from selected high schools in Thembisa, Gauteng province, were aware of careers that can be pursued through Tshivenḓa, and thus to help determine their perceptions towards their home language as a subject at schools. The study adopted a qualitative approach and a case study design that purposively sampled 16 participants. The findings indicated that Tshivenḓa learners are not exposed to possible language careers that can be pursued through South African indigenous languages. On the other hand, the findings revealed that teachers were aware of the possible careers in these languages. This study concluded that research must be undertaken to make high school learners aware of the available language careers in South African indigenous languages.Contribution: The study closes the gap in career awareness by making learners and teachers in general, and Tshivenḓa L1 learners and teachers in particular, aware of possible careers that exist in South African indigenous language qualifications. The study highlights the need for producing more qualified language practitioners to promote previously marginalised South African indigenous languages and encourage learners to consider pursuing careers in these languages. It also encourages teachers to put more effort into the teaching of South African indigenous languages and for government departments to do more to promote South African indigenous languages by making sure that services are provided to the citizens in the languages that they understand better; as a result, this would create more job opportunities for language graduates, especially regarding the Tshivenḓa language.

Application of Machine Learning Techniques for the Diagnosis of Obstructive Sleep Apnea/Hypopnea Syndrome.

Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a condition linked to severe cardiovascular and neuropsychological consequences, characterized by recurrent episodes of partial or complete upper airway obstruction during sleep, leading to compromised ventilation, hypoxemia, and micro-arousals. Polysomnography (PSG) serves as the gold standard for confirming OSAHS, yet its extended duration, high cost, and limited availability pose significant challenges. In this paper, we employ a range of machine learning techniques, including Neural Networks, Decision Trees, Random Forests, and Extra Trees, for OSAHS diagnosis. This approach aims to achieve a diagnostic process that is not only more accessible but also more efficient. The dataset utilized in this study consists of records from 601 adults assessed between 2014 and 2016 at a specialized sleep medical center in Colombia. This research underscores the efficacy of ensemble methods, specifically Random Forests and Extra Trees, achieving an area under the Receiver Operating Characteristic (ROC) curve of 89.2% and 89.6%, respectively. Additionally, a web application has been devised, integrating the optimal model, empowering qualified medical practitioners to make informed decisions through patient registration, an input of 18 variables, and the utilization of the Random Forests model for OSAHS screening.

Impact of the Communities That HEAL Intervention on Buprenorphine-Waivered Practitioners and Buprenorphine Prescribing

Buprenorphine significantly reduces opioid-related overdose mortality. From 2002 to 2022, the Drug Addiction Treatment Act of 2000 (DATA 2000) required qualified practitioners to receive a waiver from the Drug Enforcement Agency to prescribe buprenorphine for treatment of opioid use disorder. During this period, waiver uptake among practitioners was modest; subsequent changes need to be examined. To determine whether the Communities That HEAL (CTH) intervention increased the rate of practitioners with DATA 2000 waivers and buprenorphine prescribing. This prespecified secondary analysis of the HEALing Communities Study, a multisite, 2-arm, parallel, community-level, cluster randomized, open, wait-list-controlled comparison clinical trial was designed to assess the effectiveness of the CTH intervention and was conducted between January 1, 2020, to December 31, 2023, in 67 communities in Kentucky, Massachusetts, New York, and Ohio, accounting for approximately 8.2 million adults. The participants in this trial were communities consisting of counties (n = 48) and municipalities (n = 19). Trial arm randomization was conducted using a covariate constrained randomization procedure stratified by state. Each state was balanced by community characteristics including urban/rural classification, fatal opioid overdose rate, and community population. Thirty-four communities were randomized to the intervention and 33 to wait-list control arms. Data analysis was conducted between March 20 and September 29, 2023, with a focus on the comparison period from July 1, 2021, to June 30, 2022. Waiver trainings and other educational trainings were offered or supported by the HEALing Communities Study research sites in each state to help build practitioner capacity. The rate of practitioners with a DATA 2000 waiver (overall, and stratified by 30-, 100-, and 275-patient limits) per 100 000 adult residents aged 18 years or older during July 1, 2021, to June 30, 2022, were compared between the intervention and wait-list control communities. The rate of buprenorphine prescribing among those waivered practitioners was also compared between the intervention and wait-list control communities. Intention-to-treat and per-protocol analyses were performed. A total of 8 166 963 individuals aged 18 years or older were residents of the 67 communities studied. There was no evidence of an effect of the CTH intervention on the adjusted rate of practitioners with a DATA 2000 waiver (adjusted relative rate [ARR], 1.04; 95% CI, 0.94-1.14) or the adjusted rate of practitioners with a DATA 2000 waiver who actively prescribed buprenorphine (ARR, 0.97; 95% CI, 0.86-1.10). In this randomized clinical trial, the CTH intervention was not associated with increases in the rate of practitioners with a DATA 2000 waiver or buprenorphine prescribing among those waivered practitioners. Supporting practitioners to prescribe buprenorphine remains a critical yet challenging step in the continuum of care to treat opioid use disorder. ClinicalTrials.gov Identifier: NCT04111939.

A qualitative analysis of Swedish sport psychology practitioners' experience of a continued professional development program.

Although sport psychology practitioners and researchers acknowledge the importance of continued professional development (CPD) for professional effectiveness and excellence, few studies have explored the influence of CPD activities on the practitioners' practice and thinking. This study examined qualified Swedish sport psychology practitioners' experiences of engaging in a CPD program and how it impacted their professional development. The Swedish Sports Confederation offers a CPD program that targets performance enhancement services and psychotherapy for sport psychology practitioners. We explored the influence of this CPD program on the professional development of 13 graduates (five females; age in years: M = 41.2, SD = 8.3) via semi-structured interviews. Our stance involved a realist ontology and constructionist epistemology. We followed the six-step Reflexive Thematic Analysis procedures to analyze data. We identified four themes of CPD: (1) Critique (participants decided to do the CPD program because of perceived gaps in their knowledge and skills), (2) Change (participants discussed several changes as a result of the CPD program), (3) Context (participants discussed the aspects of the CPD program that promoted change), and (4) Challenge (participants mentioned issues related to having completed the program). The study provides insights into the value of CPD activities for sport psychology practitioners, advances current knowledge on practitioner maturation, and illustrates how CPD fits within a practitioner's lifelong learning. Future research could investigate the professional development of mid-career sport psychology practitioners engaging in other CPD programs to confirm or extend this work.

Assessment of Knowledge, Perception, and Practices Regarding Probiotics and Prebiotics Among Clinicians in Saudi Arabia: A Pilot Study.

Probiotics and prebiotics are important in preventing different diseases such as irritable bowel syndrome (IBS), which is a functional bowel disorder characterized by changes in bowel habits. Considering the limited studies on this topic, the present study was conducted to assess both gastroenterologist (GI) physicians' and dietitians' practices in recommending probiotics and prebiotics for IBS patients, as well as to measure their professional educational history on probiotics and prebiotics. A descriptive cross-sectional study was performed to investigate the knowledge, use, and perceptions of probiotics and prebiotics of GI physicians and dietitians at governmental hospitals in Jeddah, Saudi Arabia. A validated questionnaire was sent to 42 participants of both genders selected randomly, who were all qualified healthcare practitioners. The majority of GI physicians demonstrated high levels of knowledge about the health benefits of probiotics and prebiotics (76.2%). In contrast, most dietitians had lower levels of knowledge (52.4%), representing a significant difference between both groups (p<0.01). 83.3% of GI physicians believed that the use of probiotics and prebiotics was required for IBS patients, as compared with 50.0% of dietitians. In conclusion, GI physicians were shown to be more knowledgeable and believed more in the benefits of using probiotics and prebiotics in IBS patients than dietitians, but most participants were not aware of the probiotic products that are available in pharmacies in Saudi Arabia.

‘When it goes well, it works fantastically’: motivations to train and their impact on the practice of CBT

Abstract Cognitive behavioural therapy training courses recruit individuals from a wide range of professional backgrounds; however, little is known about the motivations of individuals to train in CBT, compared with other therapeutic modalities. Previous research has found that role transition generates multiple intrapersonal conflicts for trainees, therefore it is of interest to better understand the impact of motivational factors on the experience of learning and practising CBT. Forty-three qualified CBT practitioners completed an online questionnaire with the data analysed using a grounded theory approach. A core category of ‘Alignment with CBT’ was drawn from the data, characterised by two distinct groups of therapists – ‘CBT endorsers’ and ‘career enhancers’. A model was developed consisting of universal and group specific factors related to motivation. The findings add to the literature on the impact of therapist characteristics on CBT practice. Practical applications of the model for trainers and supervisors are discussed. Key learning aims As a result of reading this paper, readers should: (1) Understand how various motivations to train in CBT affect engagement with theories and interventions; (2) Be able to identify some of their own intrapersonal challenges in the application of CBT formulations and interventions; (3) Recognise training and supervision strategies that might assist with identifying and managing challenges related to epistemic style and theoretical orientation.

Transitioning From Traditional Sport to Esport: Exploring Sport Psychology Practitioners’ Experiences

Sport psychology practitioners are increasingly operating in the esport domain. Yet it remains unclear how practitioners who have exclusively been trained in traditional sport develop a contextually grounded understanding of their practice in esport. This study, framed from an ontological relativism and epistemological interpretivism approach, involved semistructured interviews with 10 qualified practitioners (three female, seven male) who transitioned from traditional sport to esport. Data were analyzed using reflexive thematic analysis and presented via three composite vignettes: (a) My wish was to feel a part of the team, but there’s no team; (b) To be honest, did I have assumptions going into esport? Absolutely!; and (c) Esport is the wild, wild west. Our findings offer insights on the hurdles associated with transitioning from traditional sport to esport, thus highlighting the important role that esport organizations, training routes, and educational institutions have in supporting practitioners to ethically and effectively work in this domain.

Development and External Validation of an Artificial Intelligence-Based Method for Scalable Chest Radiograph Diagnosis: A Multi-Country Cross-Sectional Study.

Problem: Chest radiography is a crucial tool for diagnosing thoracic disorders, but interpretation errors and a lack of qualified practitioners can cause delays in treatment. Aim: This study aimed to develop a reliable multi-classification artificial intelligence (AI) tool to improve the accuracy and efficiency of chest radiograph diagnosis. Methods: We developed a convolutional neural network (CNN) capable of distinguishing among 26 thoracic diagnoses. The model was trained and externally validated using 795,055 chest radiographs from 13 datasets across 4 countries. Results: The CNN model achieved an average area under the curve (AUC) of 0.961 across all 26 diagnoses in the testing set. COVID-19 detection achieved perfect accuracy (AUC 1.000, [95% confidence interval {CI}, 1.000 to 1.000]), while effusion or pleural effusion detection showed the lowest accuracy (AUC 0.8453, [95% CI, 0.8417 to 0.8489]). In external validation, the model demonstrated strong reproducibility and generalizability within the local dataset, achieving an AUC of 0.9634 for lung opacity detection (95% CI, 0.9423 to 0.9702). The CNN outperformed both radiologists and nonradiological physicians, particularly in trans-device image recognition. Even for diseases not specifically trained on, such as aortic dissection, the AI model showed considerable scalability and enhanced diagnostic accuracy for physicians of varying experience levels (all P < 0.05). Additionally, our model exhibited no gender bias (P > 0.05). Conclusion: The developed AI algorithm, now available as professional web-based software, substantively improves chest radiograph interpretation. This research advances medical imaging and offers substantial diagnostic support in clinical settings.

Harnessing the Power of Ayurveda for Diabetes Management: A Narrative Review

Ayurveda, an age-old medical tradition originating from India, provides a comprehensive method for addressing diabetes mellitus. Diabetes, marked by increased blood sugar levels, is a persistent metabolic condition posing a widespread health challenge worldwide. Ayurveda, drawing upon principles of balance and individualised treatment, addresses diabetes through a multifaceted lens. In Ayurveda, diabetes is classified under the term “Madhumeha,” where an imbalance in the body’s doshas (Vata, Pitta, and Kapha) disrupts the normal functioning of the pancreas and impairs insulin production. The approach to diabetes management in Ayurveda involves a personalised assessment of an individual’s constitution (Prakriti) and the identification of imbalances (Vikriti). Lifestyle modifications, dietary changes, herbal supplements, and therapeutic practices like yoga and meditation are integral components of Ayurvedic interventions. Plants like bitter melon (Momordica charantia), fenugreek (Trigonella foenum-graecum), and turmeric (Curcuma longa) are essential components in Ayurvedic remedies designed to address diabetes. These herbs are believed to have hypoglycaemic properties, helping regulate blood sugar levels. Additionally, practices like Panchakarma, a detoxification process, are employed to eliminate toxins and restore balance in the body. Ayurveda emphasises the importance of maintaining a sattvic (balanced) lifestyle, incorporating mindful eating habits, regular exercise, and stress management. While Ayurvedic interventions for diabetes have shown promise, it is essential to consult qualified practitioners to ensure personalised and safe approaches. As the global burden of diabetes continues to rise, exploring complementary strategies like Ayurveda provides a holistic perspective on diabetes management that aligns with the principles of balance and wellbeing.