Socio-demographic and behavioural profile of HIV positive patients visiting ICTC at a tertiary care hospital in North India

Background: Fast track approach is being followed by UNAIDS in order to achieve the aim of ending AIDS epidemic by 2030. It is important to keep a check on new infections and gather information about the HIV trends of the new cases. This study was planned to analyze the socio-demographic details, associated high risk behaviours and common routes of transmission of new cases. Methods: Data of new HIV positive patients coming to the ICTC centre during the study period was collected. The HIV positive patients were counselled by the counsellor after taking informed consent. The socio demographic details of the patients were shared by the counsellor. Results: Total 92 HIV positive patients were enrolled. Out of 92, 64 were males and 28 were females. Out of 92, 12 were illiterate. Most common route of transmission was found to be heterosexual route followed by blood transfusion. Of 92 patients, 36 were direct walk in clients and 56 were referred to ICTC. Most common high risk behaviour amongst HIV positive people is unsafe sexual practice with non-regular/casual partners, and homemakers are mostly secondarily infected from their reactive spouses. Conclusions: The most common high-risk behaviour (HRB) amongst HIV positive people is unsafe sexual practice with non-regular/casual partners, and innocent homemakers are mostly secondarily infected from their reactive spouses. Thus, there is a need to further spread awareness amongst women about the HRB and risk of HIV. Sharing of results between partners needs to be encouraged in order to prevent HIV transmission.

Implementing dietary counselling in family practice for diabetes control and prevention

The importance of dietary counselling in family practice for managing and preventing diabetes is the focal point of this review, highlighting its integral role in chronic disease management. With diabetes increasingly prevalent worldwide, there is a critical need for effective management strategies, with dietary interventions playing a key role. Family practitioners, often the initial point of contact for patients, have a unique opportunity to implement these dietary changes, which are pivotal in influencing diabetes outcomes and averting long-term complications. Despite facing challenges such as limited time and the need for specialized knowledge, dietary counselling in family practice stands as a proactive measure focused on prevention and early intervention. It adopts a patient-centered approach, where dietary habits and preferences are assessed, and personalized, evidence-based advice is provided. The inclusion of dietitians in primary care teams, utilization of technology for support, and advocacy for policy reforms are recommended to enhance the effectiveness of dietary counselling. Despite various obstacles, integrating dietary counselling into routine care remains a significant advantage, promoting healthier lifestyle choices and effectively managing the increasing burden of chronic diseases.

A comparative study on child birth experience of mothers at tertiary care hospital

Background: Women's childbirth experience can profoundly impact their overall well-being and health. Evaluating maternal satisfaction with childbirth services is essential for assessing the quality of healthcare. Childbirth satisfaction is multifaceted, influenced by antepartum, intrapartum, and postpartum factors. Midwives play a pivotal role in guiding women's birthing choices. Aim was to assess the impact of antepartum, intrapartum, and postpartum interventions on maternal satisfaction in a tertiary care teaching hospital.Methods: A prospective cohort study was conducted with 126 women divided into two groups: Group A (Booked) and Group B (Unbooked). Group A received comprehensive care, including antenatal exercises, breastfeeding counselling, education on alternative birthing positions, and non-pharmacological pain management during labor, leading to deliveries in alternative positions. Group B received standard antenatal care, delivered in the conventional lithotomy position, and used pharmacological pain management.Results: Midwife-led counselling during antepartum, intrapartum, and postpartum phases positively influenced childbirth experiences. Group A showed lower postpartum pain scores, quicker initiation of breastfeeding, reduced episiotomy needs, shorter second-stage labour, and higher antepartum satisfaction compared to Group B.Conclusions: Among healthy pregnant women, midwife-led care, including antenatal counselling, alternative birthing positions, exercises, and non-pharmacological pain management, correlated with shorter labor duration, decreased pain levels, higher satisfaction, reduced episiotomy rates, earlier breastfeeding initiation, and better APGAR scores. This underscores the positive impact of midwives in delivering patient-centered care and enhancing overall care quality.

Factors associated with exclusive breastfeeding knowledge and practices in a tertiary hospital of Central India

Background: Breastfeeding is a behavioural act of the mother, one that is affected by demographic, socioeconomic, and faith factors as well as by cultural traditions and beliefs. However, there is little scientific literature on potential gaps between knowledge and standard practices regarding exclusive breastfeeding and its predictors among mothers in central India.Methods: A cross sectional study was conducted to explore the knowledge, perceptions, practices, and the associated factors of exclusive breastfeeding among urban and rural mothers at a tertiary hospital of central India.Results: A total of 500 post-natal mothers at the study hospital were interviewed to assess their knowledge and practices of exclusive breastfeeding. The study revealed that knowledge of exclusive breastfeeding was 47% while breastfeeding practices for up to six months of babies was reported by only 15% of participants. Breastfeeding within one hour of birth was reported by 31% of mothers. About 62% did not feed colostrum, while 57% fed their baby pre-lacteal feed. Mothers belonging to a rural community, living in joint family, literate, employed, better-off economic status, multigravida, having a previous history of vaginal delivery, and male child, and those counselled regarding breastfeeding during ANC visits had higher knowledge and better practices of exclusive breastfeeding.Conclusions: The findings of the study suggest an urgent need for regular counselling in ANC clinics to promote exclusive breastfeeding among women and their family caregivers. Breastfeeding awareness education programs for all pregnant women are recommended to ensure that mothers learn best practices regarding breastfeeding and its benefits.

Impact of pharmacist counseling on the clinical outcomes in the management of type 2 diabetes mellitus outpatients admitted to a hospital

Background: Type 2 Diabetes mellitus remains a global health problem due to its poor clinical outcomes, high morbidity, and mortality caused by many complicated problems, one of which is the ineffective role of pharmacists in providing counselling to DM patients Methods: This pre and post cohort study analyzed the impact of pharmacist counselling on the blood glucose level and glycosylated hemoglobin (HbA1C) of T2DM outpatients (n=88) admitted to Asahan General Hospital period June to December 2022. Counselling provided comprised the importance of medication adherence and non-pharmacological approaches. Characteristics, BGLs and HbA1C of the patients were extracted from their medical records before and after counselling using a predetermined questionnaire. Characteristics of the patients were descriptively analyzed. Results: The significance of the counselling on these outcomes was analyzed by applying Wilcoxon test (p <0.05 was considered significant). The mean age of the patients was 57.89±9.75 (years). Most (57.95%) of them were female. Proportion of the patients with controlled BGLs (%): before counselling, 27.7; after counselling, 89.8. Proportion of the patients with controlled HbA1C (%): before counselling, 27.3; after counselling, 89.8. Pharmacist counselling significantly improved the clinical outcomes of T2DM patients, p=0.000. Conclusions: Pharmacist counselling plays an important role to improve BGLs and HbA1C in T2DM patients which can finally improve their quality of life

Effect of pharmacist counselling on patients with type 2 diabetes mellitus in reducing blood sugar levels: a systematic literature review

Type 2 diabetes mellitus is one of the most common chronic diseases worldwide, and one approach to managing T2DM is through patient counselling. The aim of this study is to conduct a systematic literature review to identify the impact of pharmacist counselling on patients with T2DM in reducing blood sugar levels. This research utilized the systematic literature review method. Research data were sourced from published literature, retrieved from databases like PubMed and Google Scholar. The collected data were then qualitatively analysed. The results show that, based on 15 journal literatures reviewed, pharmacist counselling in patients with Type 2 Diabetes Mellitus significantly impacts the reduction of blood sugar levels (both glucose and HbA1c levels). The average blood sugar level decreased from 225.69 to 190.98, while another study reported fasting blood glucose levels dropping from 274.5 mg/dl to 239.8 mg/dl. However, there was one study that indicated counselling only managed to slow down the rate of glucose level increase in patients with Type 2 Diabetes Mellitus. Overall, these findings underscore the vital role of pharmacist counselling in the management and control of blood sugar levels in T2DM patients, contributing to better diabetes care and potentially reducing direct medical costs associated with the condition.

Genetic counselling for inborn error of metabolism

Inborn error of metabolic (IEM) disorders being an important contributor for neonatal morbidity and mortality require unique and multidisciplinary health care including genetic counselling to reduce the burden of these disorders and to improve the quality of life of the patient. Genetic counselling, besides its basic elements, clinical genetic aspects and management of IEMs; also helps to understand family's knowledge and attitude towards the disorder, to motivate them to accept and adapt to the situation. Through this paper we are sharing our experience of providing genetic counselling to patients of metabolic disorders and emphasizing the role of counselling in imparting right directive care and to find possible ways to face the formidable challenges.

What do women with epilepsy know about pregnancy?

Background: Understanding the intersection of epilepsy and pregnancy, including knowledge gaps and healthcare access for women with epilepsy (WWE), is critical. This study evaluated WWE knowledge gaps and information needs concerning epilepsy's impact on their sexual and reproductive health during pregnancy and examined healthcare system factors affecting their access to information, aiming to identify areas for improvement in educational and healthcare strategies to enhance health management for WWE. Methods: From July 2022 to June 2023, 111 WWE aged 18 to 40 years were recruited from the family medicine and internal medicine outpatient departments at Steve Biko Academic Hospital, Tembisa Tertiary Hospital (TTH), and Kalafong Hospital. Interviews assessed various aspects related to epilepsy in pregnancy and contraceptive use. Results: The study found strong links between WWE, their demographics, and their awareness of pregnancy-related epilepsy issues. Participants from TTH showed notably higher awareness (85.5%) of risks from epilepsy and AED during pregnancy (p < 0.05). Age and education significantly influenced pregnancy planning and understanding of medication risks. Younger women (20­25 years) were more inclined towards future pregnancies, and those with more education were better informed about medication risks (p < 0.05); and 68.5% had received counselling on AED and contraceptive interactions, yet only 16.2% knew AED could reduce contraceptive effectiveness. Conclusion: The study reveals significant knowledge gaps in WWE regarding the impact of epilepsy and AED on pregnancy, suggesting tailored educational and counselling initiatives to improve WWE health outcomes and quality of life, advancing chronic disease management and public health objectives. Contribution: The study highlights substantial knowledge gaps in epilepsy during pregnancy among WWE, urging tailored counselling and information to empower informed decisions.

Impact of educational intervention on breastfeeding practices of mother undergoing institutional delivery

Background: Existing literature shows that education and supportive interventions, both for breast-feeding mothers as well as for healthcare professionals, can increase the proportion of women that use exclusive breast-feeding. Healthy nursing practise can be encouraged by offering mothers the proper guidance from medical professionals and by designing educational programmes that explicitly target women with low levels of education and few resources. Aims was to study the effect of structured educational intervention for improving appropriate breastfeeding practices at 6-8 weeks of birth and to evaluate the factors causing deviation from recommended breastfeeding norms.Methods: An interventional study was done to assess breastfeeding knowledge, attitude and practices of mother undergoing institutional delivery in the Department of Paediatrics, D. Y. Patil University School of Medicine, Nerul, Navi Mumbai. Continuous Data was presented as mean, median, and standard deviation. Categorical data were presented as frequency and percentages. Statistical analysis was carried out with the help of statistical test such as Chi-square test to know the significant relationship and software used was SPSS 26. The level of significance was set at 5%. All p values less than 0.05 was treated as significant.Results: We found that additional educational intervention over and above to routine counselling significantly improved knowledge of not using pre-lacteal feeds in intervention group (p=0.0003), the understanding of importance of colostrum (p=0.001). Most importantly, Group 1 had exclusive breastfeeding rate of 74.5% (149/200) as compared to group 2 with additional intervention; who had exclusive breastfeeding rate of 93.5% (187/200) (p<0.0001).Conclusions: We could conclude that educational interventions in a structured format in the postnatal period can increase the exclusive breastfeeding rates and sustain it further lowering the mortality significantly.

Nutrition education and counselling by frontline health and nutrition care workers is associated with improved iron adherence among pregnant women: evidence from the National Family Health Surveys, 2015-21

Background: Anaemia is a global public health problem affecting developing and developed countries with major consequences for human health and social and economic development. Methods: This paper attempted to understand the determinants of iron adherence among women of reproductive age during their last pregnancy in India and states/union territories, the iron deficiency being associated with anaemia, using multiple logistic regression analyses of data from the fourth (2015-16) and fifth (2019-21) rounds of the India National Family Health Survey. The individual unit-level data were analysed using Stata 17 software. Results: After adjusting for standard covariates, it was found that those who reported receiving counselling by a frontline health worker and/or antenatal care visits were much more likely to consume at least 90 days of iron-containing supplements. Results shows that for NFHS-4 women who had received counselling from a frontline health and nutrition care worker were 1.489 times (95% CI: 1.429-1.553) to adhere to at least 90 days of iron tablets or syrup after adjusting for potential confounders and for NFHS-5 women who had received counselling from a frontline worker were 1.162 times (95% CI :1.124-1.200) more likely to adhere to IFA supplements or syrup for at least 90 days. Conclusions: Based on insights from these analyses, it appears that counselling seems to be effective in making women aware of the benefits of IFA, thus increasing the likelihood of intake of iron-containing supplements. Counselling seems to be an important predictor of adherence to iron intake in India.

Assessment of Mental Wellness Amongst the Faculty and Students of an Educational Institute in the State of Himachal Pradesh, India — Post Lockdown during COVID-19

Background: The COVID-19 pandemic had a significant effect on the mental health of human beingsworld wide. There is a lack of information pertaining to the mental wellness of students and faculty in dental institutions in India. This study aimed to assess the overall mental well being of students and faculty of dental institution after return to normalcy post-lockdown period during COVID-19. Material & Methods: A self reporting online questionnaire was designed by the authors after speaking with various therapists and mental health coaches. This questionnaire was anonymously filled out by 492 participants which included under graduate students, post graduate students, academic staff, paramedical and clerical staff in a dental institution. Results: Majority of the subjects felt the need for counseling in their work place (53.4%). A greater number felt they were getting insufficient sleep (48.3%) and (31.5%) of the participants experienced depression and anxiety which further affected their emotional well being and their day to day activities. One-fifth (16.8%) of the participants perceived that mental health affected their relationships and 20.1% observed that physical health restricted their day to day activities. Mental wellness of females was significantly more affected than males. Additionally marital status also influenced the mental wellness of the subjects. Conclusion: Literary evidence suggests that mental wellness is not given enough importance in our country in general. This study only proved the ramifications of COVID-19 on mental wellness and suggested the provision of counselling which could’ve protected the participants from slipping into a negative frame of mind.

Is Liver Frailty and functional capacity associated with severity of liver disease in patients awaiting Liver Transplantation? - A prospective Observational Study

Background: Liver is a major metabolic organ, interfering with the function of all organs and systems. So, the patients with severe liver disease may display wide manifestations of metabolic disorders, loss of muscle mass and function. Combination of these factors leads to decreased exercise tolerance and physical inactivity and it may be exaggerated with increasing severity of liver disease. The functional capacity could be severely affected due to multiple physiological derangements in these population. Hence, a liver transplant is the only cure for end stage liver disease. Currently only few literature are available that evaluated and described the status of frailty and functional capacity in these population. So we have tried to evaluate the same in Indian Population. Methodology: After ethical commttee approval and written inform consent, 85 cirrhotic atients who fulfilled the Inclusion and Exclusion criteria were included in the study. Disease specific history, Severity of Liver disease, Physical evalution of frailty via Hand grip strength, Balance and time taken to do 5 chair stands , subjective functional capacity evaluation was done through Duke activity status Index (DASI). Result: In 85 patients, the average Hand grip strength was 23.70 ± 10.60kg in males and 15.02± 5.08kg in females , average value of timed chair stands (TCS) was 18.18± 6.60 in males and 14.18± 8.65 in females , average balance score was 28.00 ±4.99 in males and 29.33± 2.58 in females and the average value of MELDNa was 22.2± 6.9. Conclusion: When compared with normal Indian standard Liver cirrhotic patient, form of frailty and reduced functional capacity non predominant. That stressed emphasis on rehabilitation and nutritional counselling during waiting period for Transplantation.

Assessment of the need and effectiveness for nutritional counselling through Swasthya Poushan webportal for mothers of under five in Mysuru

Background: Child growth and development is multifactorial influenced by the environment, living conditions, socio-demography and various other demographic factors. Infant feeding practices breastfeeding practices are important components to be addressed. Therefore, online counselling provides a good service for mothers to access useful information. Objectives of the study were: to assess the need and effectiveness of an online nutritional web portal for under five mothers, and to find the barriers in the usage of the website. Methods: It was a quasi-experimental study, for a duration of one month. It was conducted in JSS urban primary health centre, under the department of community medicine in Medhar bloc. Necessary consents from the participants were taken. An online self-structured questionnaire was assessed pre and post the intervention. Study duration was for one month. Results: The major findings from the study shows that only the educated class of mothers, i.e. 6 of the 30 mothers went through one round of online nutritional counselling. They did find counselling useful for further practices and there was an increase in their knowledge. Among those who didn’t access the website, they cited housework, not aware and discomfort with the website as their reasons not to use. Conclusions: There is surely a need for online nutritional counselling for mothers with under five, as it will provide them quick access to valuable information regarding feeding. There are many barriers, one is awareness and education on website usage and linking it to the individual needs.

Role of Counselling and its Impact on the Dietary Habits, Glycemic Control and Diabetic Awareness of Newly Diagnosed Type 2 Diabetes Mellitus Patients

Background : Type 2 Diabetes Mellitus is a lifestyle disorders and it leads to complications that are life threatening which can be prevented by proper Counselling and Diet monitoring of patients. Objective : To evaluate effect of Counselling on the Glycemic control, Dietary habits and Diabetes awareness of type 2 DM patients. Method : A randomized clinical trial was conducted at a tertiary hospital. 96 subjects were randomized and baseline data was gathered from all patients included in the study. Out of these 48 patients were given Counselling on various aspects of Diabetes including diet, complications, medication, lifestyle modifications, exercise etc. Lab investigations and Diet calculations were done on first and 4 months later to measure the effect of Counselling on patient抯 Diet and Glycemic control and Diabetes awareness. Results : Diabetic awareness was measured in terms of number of correct responses which increased from 325 to 542 in Intervention group and from 357 to 402 in Control group. The increase in intervention group (22.60%) was more than that of the Control group (4.59%). The amount of calories in the diet of intervention and control group was respectively 2322�1 and 2334�0. Post Intervention it was 2344�0 and 2056�7respectively. Before intervention the difference in the amount of Calories, FBS, PP2BS between the 2 groups was statistically insignificant. But after intervention the difference with reference to total calories (p=0.0003), FBS (p=0.01) and PP2BS (p=0.0001) became statistically significant. Conclusion : Counselling led to a significant improvement in the Diabetic awareness, Glycemic control and Dietary habits of patients in terms of caloric intake.

LATCH Score for Identification and Correction of Breastfeeding Problems- A Prospective Observational Study

Objective: To determine early breastfeeding problems using LATCH tool, and analyze the impact of breastfeeding supportive measures in improving LATCH score. Methods: This prospective study included all inborn term neonates born at our center between September, 2019 and March, 2020. Breastfeeding problems were identified by LATCH score at 6-12h after birth, and were addressed by the study team providing breastfeeding support, education and training to mothers. LATCH scores were reassessed at 24-48h. Results: Among 400 mother-infant dyads, 399 (99.7%) required support to position the neonate, 190 (47.5%) had poor latch and 52 (13%) had nipple problems during initial assessment. Breastfeeding supportive measures improved the LATCH score [median (IQR) 7 (5,8) vs 8 (8,8) at 6-12 and 24-48 hours, respectively; P <0.001], and reduced the number of mothers with LATCH score <8 [288 (72%) vs 63 (15.8%); P <0.001]. Conclusion: LATCH is a comprehensive yet simple tool to identify breastfeeding problems. Given the high incidence of breastfeeding problems during early postpartum period, systematic assessment of breastfeeding related problems using LATCH tool can help timely intervention and improvement in the breastfeeding technique.

Challenges faced by the HIV testing system in low- and middle-income countries

Introduction: Determining the HIV status of some individuals remains challenging due to multidimensional factors such as flaws in diagnostic systems, technological challenges, and viral diversity. This report pinpoints challenges faced by the HIV testing system in Cameroon. Case presentation: A 53-year-old male received a positive HIV result by a rapid testing algorithm in July 2016. Not convinced of his HIV status, he requested additional tests. In February 2017, he received a positive result using ImmunoComb® II HIV 1 & 2 BiSpot and Roche cobas electrochemiluminescence assays. A sample sent to France in April 2017 was positive on the Bio-Rad GenScreen™ HIV 1/2, but serotyping was indeterminate, and viral load was < 20 copies/mL. The Roche electrochemiluminescence immunoassay and INNO-LIA HIV I/II Score were negative for samples collected in 2018. A sample collected in July 2019 and tested with VIDAS® HIV Duo Ultra enzyme-linked fluorescent assay and Geenius™ HIV 1/2 Confirmatory Assay was positive, but negative with Western blot; CD4 count was 1380 cells/mm3 and HIV proviral DNA tested in France was 'target-not-detected'. Some rapid tests were still positive in 2020 and 2021. Serotyping remained indeterminate, and viral load was 'target-not-detected'. There were no self-reported exposure to HIV risk factors, and his wife was HIV-seronegative.Management and outcome: Given that the patient remained asymptomatic with no evidence of viral replication, no antiretroviral therapy was initiated. Conclusion: This case highlights the struggles faced by some individuals in confirming their HIV status and the need to update existing technologies and develop an algorithm for managing exceptional cases.

Fortificación domiciliaria con polvos de micronutrientes. Lineamientos técnicos para el personal de salud

Introducción: La fortificación domiciliaria de los alimentos con polvos de micronutrientes se considera una intervención efectiva para reducir la anemia por deficiencia de hierro y otras carencias en la población infantil. Objetivo: Establecer los lineamientos técnicos para el personal de salud en el nivel primario de atención, en apoyo a la suplementación con polvos de micronutrientes a niños y niñas entre 6 y 23 meses de edad. Métodos: Se conformó el equipo técnico. Se revisaron las formulaciones utilizadas en la región y experiencia acumulada en intervenciones realizadas en provincias orientales, además, se elaboró el documento sustentado en evidencia científica con base en las recomendaciones nutricionales en esta población. Resultados: El suplemento permitió la prevención de las carencias nutricionales debido a que lograban cubrir la brecha de su requerimiento. Estuvieron disponibles los lineamientos técnicos dirigidos al personal de salud en los diferentes niveles de atención para asegurar el éxito de la consejería nutricional a la familia cubana, y el uso adecuado del suplemento. Conclusiones: Este trabajo brinda elementos y orientaciones técnicas para la capacitación del personal de salud con el fin de socializar, divulgar y brindar herramientas técnicas en el uso del suplemento como una medida costo efectiva para la prevención de las deficiencias de micronutrientes.

Introduction: Home fortification of food with micronutrient powders is considered an effective intervention to reduce iron deficiency anemia and other deficiencies in the child population. Objective: To provide technical guidelines for health personnel at the primary healthcare level to support the supplementation of children between 6 and 23 months of age with micronutrient powders. Methods: The technical team was established. The formulations used in the region and the experience gained in interventions conducted in eastern provinces were reviewed. Moreover, a document on scientific evidence was prepared based on the nutritional recommendations for this population. Results: The supplement allowed the prevention of nutritional deficiencies as it could cover the gaps in their requirement. Technical guidelines directed to health personnel at different healthcare levels were available to ensure the success of nutritional counselling to the Cuban family, and the adequate use of the supplement. Conclusions: This work provides elements and technical guidelines for the training of health personnel to socialize, disseminate and provide technical tools in the use of the supplement as a cost-effective measure for the prevention of micronutrient deficiencies.

A Study of Effect of Knowledge, Attitude, And Practice on The Diabetic Patient with Counselling as Intervention – A Non-Randomized Community-Based Trial from Gujarat

Introduction: Lifestyle modification is key to management of diabetes. Behavioural change is key to adopt lifestyle modification. The current study was planned with objective to assess the impact of coun-selling on knowledge, attitude, and practices among patients with diabetes mellitus in rural and urban areas of Gujarat. Method: It was a non-randomized interventional study conducted in the state of Gujarat, India. Known cases of diabetes were enrolled for the study. Two equal size groups of study participants from urban and rural area were divided equally for intervention group (N=77; 28 urban +49 Rural) and control group (N=77; 28 urban +49 Rural). Regular counselling on role of diet in DM management, self-care, deaddiction, role of physical activity, and drug compliance was given by community physician for three months to 6 months. Pre and post intervention KAP score was collected and evaluated. Result: The knowledge, attitude and practice score were increased among counselling group in compar-ison to traditional treatment group in both urban and rural area. The score increased from 5.4 to 10.4 in knowledge; 3.07 to 5.07 in attitude and 5.07 to 8.92 in practice among urban participants. Similarly, the score increased from 4.14 to 7.16 in knowledge, 2.57 to 3.67 in attitude and 4.73 to 7.42 in practice among rural participants. Conclusion: With counselling the knowledge, practice and attitude of chronic patients are improving. The study recommended that counselling services should be available to all diabetes patients. It should be available to patients at their doorstep if possible as study depict

Cortical Reorganization Following Psychoeducational Counselling and Residual Inhibition Therapy (RIT) in Individuals with Tinnitus

Abstract Introduction Psychoeducational counselling and residual inhibition therapy (RIT) are traditional approaches used in many clinics to manage tinnitus. However, neurophysiological studies to evaluate posttreatment perceptual and functional cortical changes in humans are scarce. Objectives The present study aims to explore whether cortical auditory-evoked potentials (CAEPs; N1 and P3) reflect the effect of modified RIT and psychoeducational counselling, and whether there is a correlation between the behavioral and electrophysiological measures. Methods Ten participants with continuous and bothersome tinnitus underwent a session of psychoeducational counselling and modified RIT. Perceptual measures and CAEPs were recorded pre- and posttreatment. Further, the posttreatment measures were compared with age and gender-matched historical control groups. Results Subjectively, 80% of the participants reported a reduction in the loudness of their tinnitus. Objectively, there wasasignificant reductioninthe posttreatment amplitude of N1 and P3, with no alterations in latency. There was no correlation between the perceived difference in tinnitus loudness and the difference in P3 amplitude (at Pz). Conclusion The perceptual and functional (as evidenced by sensory, N1, and cognitive, P3 reduction) changes after a single session of RIT and psychoeducational counselling are suggestive of plastic changes at the cortical level. The current study serves as preliminary evidence that event-related potentials (ERPs) can be used to quantify the physiological changes that occur after the intervention for tinnitus.

Tutoría y proyecto formativo del alumnado universitario: la importancia de comenzar bien / Projeto de tutoria e formação para universitários: a importância de começar bem / Tutoring and training project for university students: the importance of starting well

En el artículo se analiza la importancia de la tutoría universitaria en la definición del proyecto formativo-profesional del alumnado. Empleando cuestionarios y entrevistas se registran y analizan las opiniones que 410 estudiantes de 4 promociones hicieron de los Planes de Orientación y Acción Tutorial. Los resultados confirman que los/as tutores/as son un referente importante para el alumnado y la tutoría una estrategia relevante de acompañamiento desde el momento en que inicia sus estudios y a lo largo de su trayectoria formativa. Se concluye que es necesario reforzar la institucionalización de la tutoría, promoviendo modelos activos, integrales e inclusivos de aprendizaje. Estos datos son relevantes para la práctica educativa y para la puesta en práctica de programas de orientación al alumnado.

O artigo analisa a importância da tutoria universitária na definição do projeto formativo-profissional do aluno. Por meio de questionários e entrevistas, foram registradas e analisadas as opiniões de 410 alunos de 4 promoções realizadas nos Planos de Orientação e Ação Tutorial. Os resultados confirmam que os tutores são uma importante referência para os alunos e a tutoria uma estratégia de apoio relevante desde o início dos estudos e ao longo da sua carreira escolar. Conclui-se que é necessário reforçar a institucionalização da tutoria, promovendo modelos de aprendizagem ativos, integrais e inclusivos. Esses dados são relevantes para a prática educacional e para a implementação de programas de orientação estudantil.

The article analyzes the importance of university tutoring in the definition of the student's training-professional project. Using questionnaires and interviews, the opinions that 410 students from 4 promotions made of the Orientation Plans and Tutorial Action were recorded and analyzed. The results confirm that tutors are an important reference for students and tutoring is a relevant support strategy from the moment they start their studies and throughout their educational career. It is concluded that it is necessary to reinforce the institutionalization of tutoring, promoting active, comprehensive and inclusive learning models. These data are relevant for educational practice and for the implementation of student orientation programs.