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1.
BMC Med Educ ; 22(1): 14, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980095

RESUMEN

BACKGROUND: Firearm injury and death are significant public health problems in the U.S. and physicians are uniquely situated to help prevent them. However, there is little formal training in medical education on identifying risk for firearm injury and discussing safe firearm practices with patients. This study assesses prior education, barriers to counseling, and needs for improved training on firearm safety counseling in medical education to inform the development of future education on clinical strategies for firearm injury prevention. METHOD: A 2018 survey administered to 218 residents and fellows at a large, academic medical center asked about medical training on firearm injury prevention, frequency of asking patients about firearm access, and perceived barriers. RESULTS: The most common barriers cited were not knowing what to do with patients' answers about access to firearms (72.1%), not having enough time (66.2%), not feeling comfortable identifying patients at-risk for firearm injury (49.2%), and not knowing how to ask patients about firearm access (48.6%). Prior education on firearm injury prevention was more strongly associated with asking than was personal exposure to firearms: 51.5% of respondents who had prior medical education reported asking compared with who had not received such education (31.8%, p=0.004). More than 90% of respondents were interested in further education about interventions, what questions to ask, and legal mechanisms to separate dangerous people from their firearms. CONCLUSIONS: Education on assessing risk for firearm-related harm and, when indicated, counseling on safe firearm practices may increase the likelihood clinicians practice this behavior, though additional barriers exist.


Asunto(s)
Armas de Fuego , Internado y Residencia , Heridas por Arma de Fuego , Consejo , Humanos , Seguridad , Encuestas y Cuestionarios , Heridas por Arma de Fuego/epidemiología , Heridas por Arma de Fuego/prevención & control
2.
BMC Health Serv Res ; 22(1): 88, 2022 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-35042482

RESUMEN

BACKGROUND: Educators who train healthcare students to provide behavioral health services in primary care settings frequently encounter challenges as they work to ensure that students acquire the knowledge and skills to effectively function on interprofessional practice teams. This has become increasingly important during COVID-19, as interprofessional collaborative practice is needed more than ever to address the interrelated health, mental health, and social structural issues linked to the pandemic. METHODS: We used qualitative focus groups to understand the experiences of 6 interprofessional teams (comprised of graduate social work, nursing, and rehabilitation counseling students; n = 19) providing behavioral health services in primary care settings before and after the immediate start of COVID-19. To triangulate data and enrich findings, one focus group with students' faculty supervisors was also conducted; n = 5). Data were analyzed using thematic analysis. RESULTS: Four themes highlighted student participants' need to assert themselves at the beginning of their educational experience, to communicate and learn from one another to develop positive team dynamics, to contend with role confusion and missed opportunities for collaboration, and to manage the emotional impact of COVID-19 on learning. CONCLUSION: Findings indicate that educators should work with clinical faculty and agency supervisors to orient students to ensure they have role clarity within the agency. Graduate students providing behavioral health services should also learn to work collaboratively within their scopes of practice to serve patients virtually, especially in preparation for public health emergencies.


Asunto(s)
COVID-19 , Conducta Cooperativa , Consejo , Humanos , Relaciones Interprofesionales , SARS-CoV-2 , Servicio Social , Estudiantes
5.
Indian J Ophthalmol ; 70(1): 266-270, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34937252

RESUMEN

Physicians have to play the role of a team leader and counselor and take written informed consent for high-risk surgeries in many cases. This is the first step toward initiating a mutually trustworthy relationship with the patient and family. The situation is more sensitive when vulnerable patients like small premature babies or the elderly are under consideration. In the event of a death, leadership and processes in place become extremely critical. We share our experience and practice pattern during this process, especially suited to India, but the broad principles would apply to most human situations. Hopefully, some of these can be incorporated into the existing training curriculum for team building and the art of effective physician-patient communication that should be intricately woven into the curriculum for the Science of Ophthalmic care.


Asunto(s)
Anestesia , Médicos , Anciano , Consejo , Humanos , Consentimiento Informado , Relaciones Médico-Paciente
6.
Support Care Cancer ; 30(1): 497-509, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34331589

RESUMEN

PURPOSE: Cancer-related fatigue (CRF) is the most frequent and debilitating symptom in patients with advanced cancer. There are limited effective treatments for CRF. The objective of this prospective longitudinal study was to evaluate the change in CRF at Day 43 after treatment with combination therapy of oral Anamorelin 100 mg daily with physical activity and nutrition counseling. METHODS: In this study, patients with CRF [≤ 34 Functional Assessment of Chronic Illness Therapy-Fatigue subscales(FACIT-F)] received Anamorelin 100 mg orally daily with standardized physical activity and nutrition counseling for 43 days. Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Anorexia Cachexia(FAACT-ACS), Multidimensional Fatigue Symptom Inventory-Short Form(MFSI-SF), Patient-Reported Outcomes Measurement Information System(PROMIS-Fatigue), body composition, and physical performance tests were assessed at baseline, Day 15, 29, and 43. Frequency and type of side effects were determined by NCI CTAE 4.0.(NCT03035409). RESULTS: 28/45 (62%) of patients dosed were evaluable at Day 43. The mean, SD for FACIT-F subscale improvement from baseline was 4.89 (± 13.07), P = .058, MFSI-SF (G) - 3.46 (± 6.86), P = 0.013, PROMIS-fatigue - 4.14 (± 7.88), P = 0.010, FAACT ACS 3.48 (± 8.13), P = 0.035. Godin Liesure-Time physical activity questionnaire 7.41 (± 16.50), P = 0.038. Weight (kg) 1.81 (± 2.63), P = 0.005, and Lean Body Mass 1.54 (± 1.85), P = 0.001, IGF-1 36.50 (± 48.76), P = 0.015. There was no significant improvement in physical performance outcomes. No adverse events > grade 3 related to the study drug were reported. CONCLUSION: The use of the combination therapy was associated with improvement of CRF (FACIT-F fatigue, PROMIS-fatigue, MFSI-SF-general), activity (Godin-leisure time), anorexia (FAACT), body composition, and IGF-1 levels. Further studies using combination therapy for CRF are justified.


Asunto(s)
Fatiga , Neoplasias , Consejo , Ejercicio Físico , Fatiga/tratamiento farmacológico , Fatiga/etiología , Humanos , Hidrazinas , Estudios Longitudinales , Neoplasias/complicaciones , Oligopéptidos , Estudios Prospectivos
7.
Support Care Cancer ; 30(1): 793-803, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34386885

RESUMEN

PURPOSE: (1) To test the short-term impact of Helping Us Heal (HUSH), a telephone-delivered counseling program for spouse caregivers of women with breast cancer. (2) To compare outcomes from HUSH with outcomes from a historical control group which received the same program in-person. METHODS: Two-group quasi-experimental design using both within- and between-group analyses with 78 study participants, 26 in the within-group and 52 in the between-group analyses. Spouse caregivers were eligible if the wife was diagnosed within 8 months with stage 0-III breast cancer and were English-speaking. After obtaining signed informed consent and baseline data, 5 fully scripted telephone intervention sessions were delivered at 2-week intervals by patient educators. Spouses and diagnosed wives were assessed on standardized measures of adjustment at baseline and immediately after the final intervention session. RESULTS: Within-group analyses revealed that spouses and wives in HUSH significantly improved on depressed mood and anxiety; spouses improved on self-efficacy and their skills in supporting their wife. Additionally, wives' appraisal of spousal support significantly improved. Between-group analyses revealed that outcomes from HUSH were comparable or larger in magnitude to outcomes achieved by the in-person delivered program. CONCLUSIONS: A manualized telephone-delivered intervention given directly to spouse caregivers can potentially improve adjustment in both spouses and diagnosed wives but study outcomes must be interpreted with caution. Given the small samples in the pilot studies and the absence of randomization, further testing is needed with a more rigorous experimental design with a larger study sample.


Asunto(s)
Neoplasias de la Mama , Esposos , Neoplasias de la Mama/terapia , Cuidadores , Comunicación , Consejo , Femenino , Humanos , Teléfono
8.
Arq Bras Oftalmol ; 85(1): 13-18, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34586224

RESUMEN

PURPOSE: To collect data on the rate and efficacy of tobacco counseling sessions delivered by ophthalmologists under the setting of patients with thyroid eye disease. METHODS: We analyzed the electronic medical records of a digital cohort of patients who visited ophthalmologists at the University of Pennsylvania Health System from 2012 to 2017 with reference to the International Classification of Disease (ICD) codes for Graves' disease, thyrotoxic exophthalmos, and/or thyroid eye disease. Tobacco histories were recorded at the first and last ophthalmology office visits or the most temporally proximal encounter in packs/day (ppd), and each ophthalmology visit note was analyzed to validate the occurrence of tobacco counseling. RESULTS: A total of 435 patients met our study inclusion criteria, of which 72 (16.6%) were active smokers at the time of their first visit. Only 57 (79.2%) of these active smokers had recorded smoking burdens, 34 (59.6%) of which received at least one form of recorded tobacco counseling session. Nine (26.5%) of the subjects who received tobacco counseling and 1 (4.3%) of those who did not have a recorded counseling, quit smoking (risk difference of 22.1%; 95% CI, [1.7%, 39.1%]; p=0.04). In addition, 17 (50.0%) of the subjects who received counseling and 7 (30.4%) of those who did not have a recorded counseling, reduced their ppd consumption (risk difference of 19.6%; 95% CI [-6.3%, 41.3%]; p=0.18). Overall, 14 (25.5%) out of the 55 ophthalmologists who were active smokers had recorded evidence of tobacco counseling. CONCLUSIONS: Our cumulative results provide the consequence of both missed opportunities for tobacco counseling as well as its efficacy in the setting of thyroid eye disease.


Asunto(s)
Oftalmopatía de Graves , Cese del Hábito de Fumar , Consejo , Humanos , Fumar , Tabaco
9.
Midwifery ; 104: 103166, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34717242

RESUMEN

OBJECTIVE: the possibility of experiencing adverse reactions is an important aspect of contraceptive decision-making and information about this topic is highlighted as an essential aspect of contraceptive counseling. The aim of this study was to explore experiences of contraceptive counseling about potential adverse reactions of intrauterine contraception. DESIGN: exploratory qualitative study of messages in discussion boards, analyzed with inductive qualitative content analysis. SETTING: two large public Swedish web-based discussion boards about sexual and reproductive health. PARTICIPANTS: threads related to the aim were identified through searches in the discussion boards during 2019 and 2020, resulting in in 43 included posters who had written 140 messages in total. FINDINGS: the themes 'difficulties making an informed decision due to insufficient and untrustworthy information about adverse reactions' and 'feeling dismissed when communicating about experienced adverse reactions' illustrate the results. Posters emphasized the importance of sufficient information about adverse reactions. However, professionals were perceived as overly optimistic regarding intrauterine contraception and focusing on mild or common reactions. The importance of feeling that their adverse reactions were acknowledged was articulated, but posters felt that some professionals dismissed the reactions when being told about it, resulting in frustration and dissatisfaction with care. The discussion boards contained narratives describing a resistance among professionals to send in a formal report about the adverse reaction. KEY CONCLUSIONS: according to statements made by posters who have experience of adverse reactions of intrauterine contraception, contraceptive counseling have room for improvement in regard to inclusion of comprehensive information about adverse reactions. The findings illustrate the importance that clients who experience adverse reactions of intrauterine contraception feel they are acknowledged and offered adequate support. IMPLICATIONS FOR PRACTICE: echoing guidelines for high-quality contraceptive counseling, the narratives provide further weight that professionals need to have adequate training and resources to offer comprehensive information about adverse reactions of intrauterine contraception. The findings call attention to the importance of follow-up services for clients who experience adverse reactions.


Asunto(s)
Anticoncepción , Servicios de Planificación Familiar , Anticonceptivos , Consejo , Humanos , Internet
10.
Med Clin North Am ; 106(1): 153-168, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34823728

RESUMEN

Methods to prevent substance use disorders (SUDs) act on the individual risk factors for addiction. Most adults with SUD initiated substance use during their teenage years, so preventive interventions during adolescence are critical. Antisubstance use messaging, routine screening, and pathways for referral to treatment can be extended into all settings whereby trusted adults interact with adolescents such as sports, mentoring programs, child protective services, and juvenile justice settings. Pediatric primary care is an ideal place to incorporate preventive counseling and screening for substance use. Evidence-based technologic interventions for primary, secondary, and tertiary prevention are needed.


Asunto(s)
Conducta Adictiva/psicología , Tutoría/métodos , Deportes/psicología , Detección de Abuso de Sustancias/normas , Trastornos Relacionados con Sustancias/prevención & control , Adolescente , Conducta Adictiva/terapia , Niño , Servicios de Protección Infantil/métodos , Consejo/métodos , Medicina Basada en la Evidencia/métodos , Femenino , Humanos , Masculino , Atención Primaria de Salud/métodos , Derivación y Consulta , Factores de Riesgo , Trastornos Relacionados con Sustancias/etnología , Trastornos Relacionados con Sustancias/terapia , Estados Unidos/epidemiología , Adulto Joven
11.
Med Clin North Am ; 106(1): 201-217, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34823731

RESUMEN

Harm reduction is an approach to reduce the risk of harms to an individual using substances without requiring abstinence. This review discusses substance-specific interventions for opioids, alcohol, and stimulants that can minimize harms for individuals who use these substances. Topics discussed include overdose prevention, infection prevention, and low-barrier substance use disorder treatment.


Asunto(s)
Atención a la Salud/métodos , Sobredosis de Droga/prevención & control , Trastornos Relacionados con Opioides/prevención & control , Trastornos Relacionados con Sustancias/prevención & control , Consumo de Bebidas Alcohólicas/efectos adversos , Analgésicos Opioides/efectos adversos , Conducta Adictiva/terapia , Estimulantes del Sistema Nervioso Central/efectos adversos , Consejo/métodos , Fentanilo/uso terapéutico , Reducción del Daño , Humanos , Control de Infecciones/métodos , Masculino , Naloxona/uso terapéutico , Antagonistas de Narcóticos/uso terapéutico , Narcóticos/uso terapéutico , Profilaxis Pre-Exposición/métodos
12.
Med Clin North Am ; 106(1): 99-112, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34823737

RESUMEN

Tobacco use disorder is highly prevalent; more than a billion individuals use tobacco worldwide. Popular views on the addictive potential of tobacco often underestimate the complex neural adaptations that underpin continued use. Although sometimes trivialized as a minor substance, effects of nicotine on behavior lead to profound morbidity over a lifetime of exposure. Innovations in processing have led to potent forms of tobacco and delivery devices. Proactive treatment strategies focus on pharmacotherapeutic interventions. Innovations on the horizon hold promise to help clinicians address this problem in a phenotypically tailored manner. Efforts are needed to prevent tobacco use for future generations.


Asunto(s)
Morbilidad/tendencias , Nicotina/efectos adversos , Tabaquismo/epidemiología , Tabaquismo/terapia , Conducta Adictiva/psicología , Bupropión/farmacología , Bupropión/uso terapéutico , Terapia Combinada , Consejo/métodos , Quimioterapia/métodos , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Humanos , Neurobiología/métodos , Agonistas Nicotínicos/farmacología , Agonistas Nicotínicos/uso terapéutico , Fenotipo , Prevalencia , Cese del Hábito de Fumar/métodos , Agentes para el Cese del Hábito de Fumar/farmacología , Agentes para el Cese del Hábito de Fumar/uso terapéutico , Dispositivos para Dejar de Fumar Tabaco/efectos adversos , Tabaquismo/complicaciones , Tabaquismo/prevención & control , Estados Unidos/epidemiología , Vareniclina/farmacología , Vareniclina/uso terapéutico
13.
Pediatrics ; 149(1)2022 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34972226

RESUMEN

Most sexually active youth in the United States do not believe that they are at risk for contracting HIV and have never been tested. Creating safe environments that promote confidentiality and respect, obtaining an accurate sexual and reproductive health assessment, and providing nonstigmatizing risk counseling are key components of any youth encounters. Pediatricians can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing and prophylaxis to adolescent and young adult (youth) patients. In light of persistently high numbers of people living with HIV in the United States and documented missed opportunities for HIV testing, the Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend universal and routine HIV screening among US populations, including youth. Recent advances in HIV diagnostics, treatment, and prevention help support this recommendation. This clinical report reviews epidemiological data and recommends that routine HIV screening be offered to all youth 15 years or older, at least once, in health care settings. After initial screening, youth at increased risk, including those who are sexually active, should be rescreened at least annually, and potentially as frequently as every 3 to 6 months if at high risk (male youth reporting male sexual contact, active injection drug users, transgender youth; youth having sexual partners who are HIV-infected, of both genders, or injection drug users; youth exchanging sex for drugs or money; or youth who have had a diagnosis of or have requested testing for other sexually transmitted infections). Youth at substantial risk for HIV acquisition should be routinely offered HIV preexposure prophylaxis, and HIV postexposure prophylaxis is also indicated after high-risk exposures. This clinical report also addresses consent, confidentiality, and coverage issues that pediatricians face in promoting routine HIV testing and HIV prophylaxis for their patients.


Asunto(s)
Consejo/métodos , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Prueba de VIH , Pediatras , Rol del Médico , Profilaxis Pre-Exposición , Adolescente , Confidencialidad , Humanos , Consentimiento Informado de Menores , Cobertura del Seguro , Educación del Paciente como Asunto , Conducta de Reducción del Riesgo , Conducta Sexual , Adulto Joven
14.
J Homosex ; 69(1): 14-40, 2022 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-32910748

RESUMEN

In promoting social equality in the name of democratic citizenship, counseling discourses on social justice are largely disconnected from their U.S. colonial heritage. As history is typically erased from theoretical developments and research in counseling generally speaking, this essay mobilizes multiple disciplines in order to establish a conjuncture between the way counseling discourses on social justice address inequality and the way they inadvertently sustain the inequalities they seek to abolish. By grounding into U.S. colonialism as a form of imperial pragmatism in empire building, this essay explicates counseling as another technology of social control for which intimacy and care become categorically encased.


Asunto(s)
Colonialismo , Justicia Social , Consejo , Humanos , Conducta Sexual
15.
Health Promot Int ; 36(6): 1530-1538, 2021 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-34942003

RESUMEN

Psychological distress in university students represents a rising public health concern. The complexity of this phenomenon calls for a more in-depth scrutiny, in order to address the wide diversity of mental health issues that may arise in this population. The instrument designed for the purpose of measuring the student-specific distress is needed. An appropriate tool is the Counseling Center Assessment of Psychological Symptoms 62 (CCAPS-62), multidimensional scale widely used at many universities. The objective of the present study was to translate, culturally adapt and psychometrically validate CCAPS-62 in Serbian student population. A total of 1326 Belgrade University students were recruited from twelve different faculties. Considering the possible culturally conditioned differences in the quality of distress both exploratory and confirmatory factor analyses were performed. The results of the exploratory factor analysis supported the eight-factor model with the item composition of the factors different to a certain extent from the original version. This measurement model was verified by confirmatory factor analysis. Findings demonstrated good internal consistency for the total scale as well as for the eight subscales applied among Serbian students. Implications are discussed with respect to the cultural context of mental health concerns in student population.


Asunto(s)
Consejo , Comparación Transcultural , Humanos , Psicometría , Reproducibilidad de los Resultados , Serbia , Encuestas y Cuestionarios
16.
PLoS One ; 16(12): e0260794, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34962913

RESUMEN

OBJECTIVE: To assess the effects of peri-abortion contraceptive counseling interventions. METHODS: We performed a systematic review of randomized controlled trials (RCTs) that compared the effect of different types of peri-abortion contraceptive counseling interventions and were published as original papers in scientific journals. The literature search was performed in June 2021 in PubMed, Central Cochrane Library (CENTRAL), Scopus, and Google Scholar; without restrictions in language or publication date. Two independent authors identified studies that met the inclusion and exclusion criteria and extracted the data. The risk of bias was assessed using the Cochrane tool, and evidence certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Whenever possible, meta-analyses were performed. The protocol was registered at PROSPERO (CRD42020187354). RESULTS: Eleven RCTs were eligible for inclusion (published from 2004 to 2017), from which nine compared enhanced versus standard counseling. Pooled estimates showed that, compared to standard counseling, enhanced counseling was associated with a higher incidence of effective contraceptive use (>3 months) (relative risk [RR], 1.12; 95% confidence interval [CI], 1.09-1.16), although no significant difference was found in the incidence of long-acting reversible contraceptive use (RR, 1.25; 95% CI, 0.68-2.29), contraceptive uptake (RR, 1.06; 95% CI, 0.98-1.15), and obstetric event occurrence (RR, 0.91; 95% CI, 0.57-1.47). Certainty of evidence was very low for all outcomes. In addition, two studies compared contraceptive counseling provided by physicians versus that provided by non-physicians, which did not show significant differences. CONCLUSIONS: Enhanced contraceptive counseling may favor effective contraceptive use but may not affect the rate of obstetric event occurrence. Also, the studies did not find a difference in the effects of counseling interventions given by different providers. Since evidence certainty was very low, future well-designed RCTs are needed to make informed decisions. REGISTRATION: The study protocol was registered at PROSPERO (CRD42020187354).


Asunto(s)
Aborto Inducido , Anticonceptivos , Consejo , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Sesgo de Publicación , Riesgo
17.
Gac Sanit ; 35 Suppl 2: S140-S144, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34929797

RESUMEN

OBJECTIVE: There is a declining trend in the use of modern contraception in the community. The stagnation of family planning services is due to the lack of optimal family planning counseling. Family Planning Balanced Counseling Strategy (FP-BCS) is a family planning counseling that is practical, interactive, and encourages client participation. This study aimed to analyze the influence of the FP-BCS on attitudes, subjective norms, and intentions on modern contraception in the working area of Singgani Health Center, Palu, Indonesia. METHOD: This research was a quasi-experimental with non-randomized pretest-posttest along to control group design. The sample of the study was third-trimester pregnant women who did antenatal care in the working area of the Singgani Community Health Center. The total sample was 17 respondents for each group; intervention group (treated by Maternal and Child Health (MCH) book and FP-BCS) and control group (treated by MCH Book without FP-BCS). The influence of FP-BCS toward attitudes, subjective norms, and intentions on modern contraception was statistically analyzed using the Wilcoxon Signed Rank Test, McNemar, Mann-Whitney, and Chi-Square. RESULT: The Wilcoxon Signed Rank Test and McNemar analysis on the intervention group showed an increase in attitude (p=0.000), subjective norms (p=0.000), and intention (p=0.000). The control group showed an increase in intention (0.031), subjective norms (p=0.005), but there was no increase in attitude (p=0.081). The Mann-Whitney and Chi-Square analysis showed differences in attitudes (p=0.000), subjective norms (p=0.021), and intentions (p=0.010) between groups, which were given an FP-BSC and those not given an FP-BCS. CONCLUSION: All in all, it is expected that Family Planning-Balanced Counseling Strategy will be an option in providing family planning counseling.


Asunto(s)
Conducta Anticonceptiva , Servicios de Planificación Familiar , Actitud , Niño , Anticoncepción , Consejo , Femenino , Humanos , Intención , Embarazo , Salud Pública
18.
Artículo en Inglés | MEDLINE | ID: mdl-34948802

RESUMEN

We present the opportunities and challenges of Open Up, a free, 24/7 online text-based counselling service to support youth in Hong Kong. The number of youths served more than doubled within the first three years since its inception in 2018 in response to increasing youth suicidality and mental health needs. Good practice models are being developed in order to sustain and further scale up the service. We discuss the structure of the operation, usage pattern and its effectiveness, the use of AI to improve users experience, and the role of volunteer in the operation. We also present the challenges in further enhancing the operation, calling for more research, especially on the identification of the optimal number of users that can be concurrently served by a counsellor, the effective approach to respond to a small percentage of repeated users who has taken up a disproportional volume of service, and the way to optimize the use of big data analytics and AI technology to enhance the service. These advancements will benefit not only Open Up but also similar services across the globe.


Asunto(s)
Salud Mental , Envío de Mensajes de Texto , Adolescente , Consejo , Hong Kong , Humanos , Ideación Suicida , Adulto Joven
19.
Chirurgia (Bucur) ; 116(500): S136-S139, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34967305

RESUMEN

Ductal carcinoma in situ (DCIS) is a heterogenous group of intraductal proliferations, without a known natural history and predictability and without being considered an obligatory precursor of invasive ductal cancer. Lack of biological markers of predictability makes its evolution uncertain. Because DCIS is not an obligatory precursor of invasive breast cancer, counselling will not be made like in invasive cancer. Counselling must recognize the uncertainty of progression toward invasive disease and every patient must be correctly and empathically informed so that she is as involved as possible in the decision-making process.


Asunto(s)
Neoplasias de la Mama , Carcinoma in Situ , Carcinoma Ductal de Mama , Carcinoma Intraductal no Infiltrante , Consejo , Femenino , Humanos , Resultado del Tratamiento
20.
Ann Agric Environ Med ; 28(4): 639-644, 2021 Dec 29.
Artículo en Inglés | MEDLINE | ID: mdl-34969223

RESUMEN

INTRODUCTION AND OBJECTIVE: A criterion for the efficacy of dietetic counseling is a change in patients' health behaviours. The patient-centred counseling approach in dietetics is believed to successfully induce behaviour changes. The aim of the study was to verify the assumption that students of dietetics at medical universities declare a preference for the ways of practicing dietetics which require direct work with patients, revealing a personality profile that allows implementation of the indicated approach. MATERIAL AND METHODS: Materials and method. A cross-sectional study was conducted among 427 dietetics students aged 19-31 (M = 21.44, SD = 2.21) at medical universities. Those declaring preference for the ways of practicing dietetics that entail direct contact with patients made up the criterion group. The control group was composed of students declaring preference for career paths not implying direct work with patients. The study employed Polish versions of the NEO-FFI Personality Inventory and the Schwartz Value Survey. RESULTS: Results. There are four predictors of choosing career options entailing work with patients: agreeableness and conscientiousness (personality traits) and openness to change and self-transcendence (value meta-categories). When agreeableness and conscientiousness rise by 1 SD, the odds for a declared choice of working with patients increase by 151% and 139%, respectively. In turn, an increase in openness to change and self-transcendence by 1 SD translates into a decline in the chances of choosing this option by 40% and 38%, respectively. CONCLUSIONS: Conclusions. Dietetics students at medical universities declaring a preference for direct work with patients show a personality predisposition to carefully perform professional tasks at 'technical level', and a poor predisposition to implement the patient-centred counseling approach.


Asunto(s)
Dietética , Estudiantes de Medicina , Selección de Profesión , Consejo , Estudios Transversales , Humanos , Personalidad , Polonia , Estudios Prospectivos , Universidades
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