Assessing the Efficacy of Contextualized Group Counseling Education in Asia: A Mixed Methods Study.

Many experiential learning teaching models are developed in Western cultures, with their efficacy not tested in non-Western cultures, especially in counseling education. This study examined the learning experiences of students (n = 52) enrolled in a culturally contextualized experiential teaching method implemented across a 3-year period in a Malaysian university Masters-level group counseling course. The course changes included group demonstrations by lecturers and peers, live group participation and observation, group dynamics map drawing and debriefing, paired group proposal writing and presentation, and group note- taking. This study adopted a mixed method approach with a short survey consisting of both standardized scales and open-ended questions, administered at the beginning and end of each 12-week semester. Archival data on students' evaluation was also retrieved from the year before the intervention, to compare with the 3 years of intervention. Results showed a statistically significant improvement in students' perceived group leadership skills and leadership characteristics at the end of the course. Students' overall satisfaction with the course quality also improved significantly from the year prior to the implementation of the new teaching method. Qualitative coding identified three major themes-active learning classroom that led to confidence in group counseling knowledge and skills; experiential activities in the tutorial sessions, with opportunities to carry out their proposed group activities; and formative feedback given throughout the semester during tutorial settings contributing to the higher course satisfaction rate. To conclude, we discuss the implications of contextualized experiential learning for higher education counseling pedagogy in the Asian region. Supplementary information: The online version contains supplementary material available at 10.1007/s10447-022-09471-3.

Applicability of explicit potentially inappropriate medication lists to the Australian context: A systematic review.

OBJECTIVES: To determine i) the similarity of potentially inappropriate medications specified in and between existing explicit lists and ii) the availability in Australia of medications included on existing lists to determine their applicability to the Australian context. METHODS: This systematic review identified explicit potentially inappropriate medication lists that were published on EMBASE (1974 - April 2021), MEDLINE (1946 - April 2021) and Elsevier Scopus (2004 - April 2021). The reference lists of seven previously published systematic reviews were also manually reviewed. Lists were included if they were explicit, and the most recent version and the complete list were published in English. Lists based on existing lists were excluded if no new items were added. Potentially inappropriate medications identified on each list were extracted and compared to the medications available on the Australian Register of Therapeutic Goods and Australian Pharmaceutical Benefits Schemes. RESULTS: Thirty-five explicit published lists were identified. A total of 645 unique potentially inappropriate medications were extracted, of which 416 (64%) were available in Australia and 262 (41%) were subsided by the general Pharmaceutical Benefits Scheme. Applicability of each explicit list ranged from 50-96% according to medications available in Australia and 25-83% according to medications available under subsidy. CONCLUSIONS: Pooling data from different lists may help to identify potentially inappropriate medications that may be applicable to local settings. However, if selecting a list for use in the Australian context, consideration should also be given to the intended purpose and setting for application.

Regulation of feeding by somatostatin neurons in the tuberal nucleus.

The tuberal nucleus (TN) is a surprisingly understudied brain region. We found that somatostatin (SST) neurons in the TN, which is known to exhibit pathological or cytological changes in human neurodegenerative diseases, play a crucial role in regulating feeding in mice. GABAergic tuberal SST (TNSST) neurons were activated by hunger and by the hunger hormone, ghrelin. Activation of TNSST neurons promoted feeding, whereas inhibition reduced it via projections to the paraventricular nucleus and bed nucleus of the stria terminalis. Ablation of TNSST neurons reduced body weight gain and food intake. These findings reveal a previously unknown mechanism of feeding regulation that operates through orexigenic TNSST neurons, providing a new perspective for understanding appetite changes.

Green tea (-)-epigallocatechin-3-gallate counteracts daytime overeating induced by high-fat diet in mice.

SCOPE: High-fat diet (HFD) induces overeating and obesity. Green tea (-)-epigallocatechin-3-gallate (EGCG) reduces HFD-induced body weight and body fat gain mainly through increased lipid metabolism and fat oxidation. However, little is known about its effect on HFD-induced alterations in feeding behavior. METHODS AND RESULTS: Three diet groups of wildtype C57B/6j male mice at 5 months old were fed on normal chow diet, 1 week of HFD (60% of energy) and 3 months of HFD (diet-induced obesity (DIO)) prior to EGCG supplement in respective diet. EGCG had no effect on feeding behavior in normal chow diet group. Increased daytime feeding induced by HFD was selectively corrected by EGCG treatment in HFD groups, including reversed food intake, feeding frequency and meal size in HFD + EGCG group, and reduced food intake and feeding frequency in DIO + EGCG group. Moreover, EGCG treatment altered diurnally oscillating expression pattern of key appetite-regulating genes, including AGRP, POMC, and CART, and key circadian genes Clock and Bmal1 in hypothalamus of DIO mice, indicating its central effect on feeding regulation. CONCLUSION: Our study demonstrates that EGCG supplement specifically counteracts daytime overeating induced by HFD in mice, suggesting its central role in regulating feeding behavior and energy homeostasis.

Hypothalamic NUCKS regulates peripheral glucose homoeostasis.

Nuclear ubiquitous casein and cyclin-dependent kinase substrate (NUCKS) is highly expressed in the brain and peripheral metabolic organs, and regulates transcription of a number of genes involved in insulin signalling. Whole-body depletion of NUCKS (NKO) in mice leads to obesity, glucose intolerance and insulin resistance. However, a tissue-specific contribution of NUCKS to the observed phenotypes remains unknown. Considering the pivotal roles of insulin signalling in the brain, especially in the hypothalamus, we examined the functions of hypothalamic NUCKS in the regulation of peripheral glucose metabolism. Insulin signalling in the hypothalamus was impaired in the NKO mice when insulin was delivered through intracerebroventricular injection. To validate the hypothalamic specificity, we crossed transgenic mice expressing Cre-recombinase under the Nkx2.1 promoter with floxed NUCKS mice to generate mice with hypothalamus-specific deletion of NUCKS (HNKO). We fed the HNKO and littermate control mice with a normal chow diet (NCD) and a high-fat diet (HFD), and assessed glucose tolerance, insulin tolerance and metabolic parameters. HNKO mice showed mild glucose intolerance under an NCD, but exacerbated obesity and insulin resistance phenotypes under an HFD. In addition, NUCKS regulated levels of insulin receptor in the brain. Unlike HNKO mice, mice with immune-cell-specific deletion of NUCKS (VNKO) did not develop obesity or insulin-resistant phenotypes under an HFD. These studies indicate that hypothalamic NUCKS plays an essential role in regulating glucose homoeostasis and insulin signalling in vivo.

Increased biogenesis of glucagon-containing secretory granules and glucagon secretion in BIG3-knockout mice.

OBJECTIVE: Although both insulin and glucagon are intimately involved in the regulation of glucose homeostasis, the intrinsic control of glucagon secretion, including the biogenesis and exocytosis of glucagon-containing granules, is far less understood compared with that of insulin. As Brefeldin A-inhibited guanine nucleotide exchange protein 3 (BIG3) is a negative regulator of insulin-granule biogenesis and insulin secretion, we investigated whether BIG3 plays any role in alpha-cells and glucagon secretion. METHODS: We examined the expression of BIG3 in islet cells by immuno-fluorescence and confocal microscopy, and measured glucagon production and secretion in BIG3-depleted and wild-type mice, islets and cells. RESULTS: BIG3 is highly expressed in pancreatic alpha-cells in addition to beta-cells, but is absent in delta-cells. Depletion of BIG3 in alpha-cells leads to elevated glucagon production and secretion. Consistently, BIG3-knockout (BKO) mice display increased glucagon release under hypoglycemic conditions. CONCLUSIONS: Together with our previous studies, the current data reveal a conserved role for BIG3 in regulating alpha- and beta-cell functions. We propose that BIG3 negatively regulates hormone production at the secretory granule biogenesis stage and that such regulatory mechanism may be used in secretory pathways of other endocrine cells.

NUCKS is a positive transcriptional regulator of insulin signaling.

Although much is known about the molecular players in insulin signaling, there is scant information about transcriptional regulation of its key components. We now find that NUCKS is a transcriptional regulator of the insulin signaling components, including the insulin receptor (IR). Knockdown of NUCKS leads to impaired insulin signaling in endocrine cells. NUCKS knockout mice exhibit decreased insulin signaling and increased body weight/fat mass along with impaired glucose tolerance and reduced insulin sensitivity, all of which are further exacerbated by a high-fat diet (HFD). Genome-wide ChIP-seq identifies metabolism and insulin signaling as NUCKS targets. Importantly, NUCKS is downregulated in individuals with a high body mass index and in HFD-fed mice, and conversely, its levels increase upon starvation. Altogether, NUCKS is a physiological regulator of energy homeostasis and glucose metabolism that works by regulating chromatin accessibility and RNA polymerase II recruitment to the promoters of IR and other insulin pathway modulators.

Fathering agency staff members' perspectives on domestic violence perpetration.

PURPOSE: To describe the perspectives of fathering staff regarding domestic violence (DV) perpetration. MATERIALS AND METHODS: A cross-sectional survey of 85 fathering staff members was conducted to identify behaviors and barriers regarding inquiry about DV perpetration. RESULTS: Almost half (47.1%) of the surveyed staff reported never having identified DV perpetration. Routine inquiry was less likely if staff perceived low prevalence rates among their clients (odds ratio [OR] = 0.11, p = .001), did not have standard ways of asking (OR = 0.11, p < .001), or if they had never identified family violence before (OR = 0.07, p < .001). Increased years as a provider (OR = 6.62, p = .001) and DV training (OR = 7.29, p = .003) increased rates of DV perpetration inquiry. CONCLUSIONS: Staff of fathering agencies do not routinely screen for DV perpetration likely due to the interplay between individual and agency-level barriers. Appropriate training interventions can address identified barriers.

MotherSafe: review of three years of counselling by an Australian Teratology Information Service.

BACKGROUND: MotherSafe was established in January 2000 at the Royal Hospital for Women as Australia's first 'purpose-built' Teratogen Information Service and since then has received over 75,000 calls regarding exposures during pregnancy and lactation. AIM: To describe the patterns of use of MotherSafe over a three-year period. METHODS: Retrospective descriptive epidemiological study using data from the database established at MotherSafe. Records from all the calls logged at MotherSafe between January 2005 and December 2007 were analysed to determine total number of calls, demographic characteristics of callers, including age, caller category and postcode, reason for call, source of referral and type of exposure. RESULTS: A total of 47,138 calls were recorded to the MotherSafe service from January 2005 to December 2007. The majority of calls were regarding exposures in pregnancy (55%) and breast-feeding (38%). Average age of patients was 32.3 years. Of the calls made, 81.9% (38,485 of 46,968) were by consumers (the pregnant or lactating woman herself or a relative). The most common primary exposure categories were: over-the-counter medications (11.3%), psychotropic medication (9.0%), herbal or vitamin products (8.2%), antibiotics (7.0%), gastrointestinal medications (6.8%) and topical products (6.6%). Forty per cent of callers enquired about multiple exposures. CONCLUSIONS: The utilisation of MotherSafe by consumers and general practitioners continues to increase, reflecting the strong demand for a teratogen counselling service that provides high-quality, evidence-based information on exposures during pregnancy and lactation.

Prevalence of cognitive impairment amongst Singapore's elderly Chinese: a community-based study using the ECAQ and the IQCODE.

OBJECTIVES: This study examined the prevalence of cognitive impairment in the elderly Chinese living in the Queenstown district of Singapore using two locally-validated cognitive screening instruments: the Elderly Cognitive Assessment Questionnaire (ECAQ), and the Informant Questionnaire on the Cognitive Decline of the Elderly (IQCODE). METHODS: 234 elderly Chinese subjects were randomly selected from the Queenstown district and administered the ECAQ, while their principal relatives were administered the IQCODE. The screening instruments' respective cut-off scores to identify cognitive impairment indicative of dementia were based on local validation work. RESULTS: The prevalence of cognitive impairment was computed based on the percentage of failed scores on the two screening instruments. We found the prevalence of cognitive impairment to be 7.7% by ECAQ (95% Confidence Intervals (CI): 4.6%-10.1%) and 13.2% by IQCODE (95% CI: 9.4%-17.7%). A similar study in 1990 using ECAQ on elderly Chinese from the Henderson district in Singapore showed a cognitive impairment prevalence of 4%. This ECAQ-based variation between the two studies, likely indicates a true difference in prevalence rates between the two communities. On the other hand, the different ECAQ and IQCODE prevalence rates within our Queenstown study probably reflect spectrum bias, with IQCODE detecting earlier stages of dementia than ECAQ. CONCLUSION: We have found the prevalence of cognitive impairment amongst Singapore's elderly to be higher than previously reported. These findings imply that current resources may be inadequate for the effective care and management of the cognitively-impaired elderly in our aging community.

Psychometric identification of early Alzheimer disease in an elderly Chinese population with differing educational levels.

In this study, the authors (1) validated a concise neuropsychologic assessment battery to identify early Alzheimer disease (AD) in an elderly Chinese population, (2) studied how the level of literacy in this cohort influenced the psychometric test performance, (3) determined the best individual and combination of tests from the battery to detect AD, and (4) compared their results with parallel data from Western and other similar Chinese neuropsychologic studies. The psychometric battery was administered to 155 cognitively healthy elderly Chinese and 72 predominantly mild AD patients. Results showed that the majority of tests in this neuropsychologic battery validly identified early AD in the elderly Chinese subjects. Correct interpretation of test scores required adjustment for patients' educational attainments. Verbal memory, verbal fluency, and visuospatial functioning were the most important diagnostic domains, and this pattern has broad similarities with findings from the West, supporting the transcultural cognitive manifestation of AD.