Patient experiences on the quality of cerebrovascular diseases counselling using digital solutions in hospital-A qualitative research study.

AIM: To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease. DESIGN: A descriptive, qualitative approach. METHODS: Semi-structured in-person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis. RESULTS: The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two-way communication. CONCLUSION: New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered. IMPACT: The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs. REPORTING METHOD: We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION: Patients were involved as the study population.

Barriers to surgical menopause counseling in gynecologic cancers: a quantitative and qualitative study of patients and providers.

OBJECTIVE: The objective of this study is to identify factors associated with receiving surgical menopause counseling in gynecologic cancer patients, as well as patient and provider perspectives, regarding surgical menopause counseling and management. METHODS: We conducted a single-institution mixed-method study combining retrospective chart review and patient and provider surveys. Patients younger than 51 years who experienced surgical menopause after gynecologic cancer treatment from January 2017 to December 2019 were surveyed in April 2021 about experiences with menopause counseling, barriers to care, and quality of life. We then reviewed charts of only patients who fully completed surveys. All gynecologic oncology providers were surveyed about surgical menopause practices. Logistic regression identified factors associated with receiving counseling. RESULTS: Sixty-six of 75 identified met inclusion criteria and received survey invitations. Thirty-five (53%) completed surveys. Sixty percent had documented surgical menopause counseling. Patients who were counseled were younger (43 vs 48.5 years, P = 0.005), more likely to have referrals for menopause care (12 vs 9, P = 0.036), more likely to have menopause providers other than oncology providers (14 vs 8, P = 0.001), and had fewer comorbidities. Decreasing age at surgery increased odds of counseling. Most reported continued menopause symptoms and quality of life disturbances. Half were satisfied with menopause care. Majority preferred counseling from oncology providers. Most providers always counseled on surgical menopause but cited lack of time as the primary obstacle for complete counseling. CONCLUSIONS: Younger age at surgery increased odds of receiving surgical menopause counseling. Gynecologic cancer patients experienced significant menopause-related disturbances. Improved understanding of patient and provider preferences and greater emphases on surgical menopause and survivorship will improve care for gynecologic oncology patients.

Assessing quality of family planning counseling and its determinants in Kenya: Analysis of health facility exit interviews.

BACKGROUND: Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya achieved a modern contraceptive prevalence rate of 60% in 2018, surpassing its 2020 target of 58%. With the high prevalence, focus is geared towards improved quality of family planning services. The objective of this study is to examine the quality of family planning counseling and its associated factors in health facilities in Kenya. METHODS: We conducted a secondary analysis of the 2019 Kenya Performance Monitoring and Action, client exit data of women who had received family planning services. Quality of counseling was assessed using the Method Information Index Plus. We conducted a multivariable ordinal logistic regression analysis of data from 3,731 women to establish determinants of receiving quality family planning services. RESULTS: The Method Information Index Plus score for higher-quality counseling was 56.7%, lower-quality counseling 32.4%, and no counseling 10.9%. Women aged 15-24 years (aOR = 0.69, 95% CI = 0.56-0.86, p = 0.001) had lower odds of receiving better counseling compared to women aged 35 years and above. Those with no education (aOR = 0.52, 95% CI = 0.33-0.82, p = 0.005), primary (aOR = 0.56, 95% CI = 0.44-0.71, p<0.001) and secondary (aOR = 0.79, 95% CI = 0.65-0.98, p = 0.028) were less likely to receive better counseling compared to those with tertiary education. Women who received long acting and reversible contraception methods (aOR = 1.75, 95% CI = 1.42-2.17, p<0.001), and those who were method switchers (aOR = 1.24, 95% CI = 1.03-1.50, p = 0.027), had a higher likelihood of receiving better quality of counseling as compared to those on short-term methods and those who were continuers, respectively. CONCLUSION: The quality of family planning counseling in Kenya is still sub-optimal considering that some women receive no form of counseling at service delivery point. There is need to review the existing FP guidelines and training packages to increase focus on the quality of counseling services offered by health providers. Social accountability strategies that empower women to demand quality services should be included in community-level family planning interventions.

Mothers' perception of prenatal counseling following diagnosis of congenital anomalies of the urinary tract.

Congenital abnormalities of the genitourinary tract are the most common sonographically identified malformations. Although prenatal diagnosis seldom modifies perinatal management, it can cause significant anxiety in parents. We aimed to assess how parents perceived the prenatal counseling they had received in our institution. Using a questionnaire, we evaluated by phone the mothers of 78 children diagnosed prenatally with urological tract anomalies between January 2018 and May 2019. Overall, mothers were satisfied and reassured by the prenatal counseling they received, although 19% of the mothers found the time from diagnosis to specialist consultation to be too long. Forty percent of the responders stated that the most important information they needed to hear during the specialist consultation was management and not diagnosis. Specialist counseling should focus on explaining postnatal management, should be offered as soon as possible, and should include practical aspects, especially concerning outpatient care.

Aconselhamento sobre alimentação saudável para idosos / Advice on healthy eating for the elderly

Contexto: O aconselhamento é uma abordagem para auxiliar o indivíduo a selecionar e programar comportamentos desejáveis de nutrição e estilo de vida. Ele é indicado na implementação de políticas públicas e pressupõe que os profissionais de saúde tenham habilidades de escuta, compreensão e apoio para adesão de práticas mais benéficas à saúde. Nesse sentido, cabe aos profissionais de saúde orientar a população idosa em relação à alimentação de acordo com as singularidades dessa fase do ciclo de vida e, em casos específicos, encaminhar ao nutricionista para planejamento da ação conjunta. Pergunta: Qual é a eficácia do aconselhamento sobre alimentação saudável ou da suplementação com vitaminas e minerais para a saúde de pessoas idosas? Métodos: Seguindo protocolo prévio, buscas por revisões sistemáticas (RS) foram realizadas em sete bases eletrônicas da literatura, em julho de 2021. Utilizando atalhos de rapid review para simplificar o processo, foram realizadas seleção e extração dos dados com posterior avaliação da qualidade das RS. Em seguida, os resultados foram reunidos em síntese narrativa conforme similaridade de desfechos avaliados. Resultados: De 2.428 registros recuperados das bases de dados, após processo de seleção e elegibilidade, sete RS foram incluídas. Quatro RS foram consideradas de confiança baixa e três de confiança criticamente baixa. As intervenções, em sua maioria, combinaram aconselhamento a outras estratégias, sendo realizadas sobretudo por nutricionistas. Os participantes dos estudos foram idosos acometidos por hipertensão, declínio cognitivo ou algum tipo de fragilidade. Os desfechos analisados nos estudos foram: alimentação; capacidade física/funcional; função cognitiva e psicológica; medidas antropométricas; eventos cardiovasculares; e qualidade de vida. Os resultados, em geral, mostraram não haver diferenças entre as intervenções envolvendo aconselhamento comparadas às outras intervenções. Considerações finais: Poucos estudos foram identificados sobre efeitos do aconselhamento para alimentação saudável ou uso de suplementos de vitaminas e minerais entre pessoas idosas. Desse modo, as evidências são insuficientes para tecer comentários sobre a efetividade do aconselhamento para esta população. É importante ressaltar as falhas metodológicas das revisões sistemáticas incluídas, que comprometem a confiança nos achados. Além disso, os estudos mostraram grande heterogeneidade, particularmente com relação aos desfechos analisados.

Context: Counseling is an approach to assisting the individual in selecting and programming desirable nutrition and lifestyle behaviors. It is indicated in the implementation of public policies and assumes that health professionals have listening skills, understanding and support for adherence to practices that are more beneficial to health. In this sense, it is up to health professionals to guide the elderly population in relation to food according to the singularities of this phase of the life cycle and, in specific cases, refer them to the nutritionist for joint action planning. Question: How effective is healthy eating counseling or vitamin and mineral supplementation for the health of older people? Methods: Following a previous protocol, searches for systematic reviews (SR) were carried out in seven electronic databases of the literature, in July 2021. Using rapid review shortcuts to simplify the process, data selection and extraction were performed with subsequent evaluation of the quality of the LOL. Then, the results were gathered in narrative synthesis according to the similarity of the evaluated outcomes. Results: Of the 2,428 records retrieved from the databases, after the selection and eligibility process, seven RS were included. Four SRs were considered low confidence and three critically low confidence. The interventions, for the most part, combined counseling with other strategies, being carried out mainly by nutritionists. Study participants were elderly people affected by hypertension, cognitive decline or some type of frailty. The outcomes analyzed in the studies were: diet; physical/functional capacity; cognitive and psychological function; anthropometric measurements; cardiovascular events; and quality of life. The results, in general, showed no differences between interventions involving counseling compared to other interventions. Final considerations: Few studies were identified on the effects of healthy eating counseling or use of vitamin and mineral supplements among older people. Thus, the evidence is insufficient to comment on the effectiveness of counseling for this population. It is important to highlight the methodological flaws of the systematic reviews included, which compromise confidence in the findings. In addition, the studies showed great heterogeneity, particularly with regard to the outcomes analyzed.

Viral Venereal Diseases of the Skin.

Viral venereal diseases remain difficult to treat. Human papilloma virus (HPV) and herpes simplex virus (HSV) are two common viral venereal diseases. HPV infections are characterized by anogenital warts and less commonly by premalignant or malignant lesions. HSV infections classically present as grouped vesicles on an erythematous base with associated burning or pain; however, immunosuppressed patients may have atypical presentations with nodular or ulcerative lesions. This review discusses the epidemiology, diagnosis, and management of anogenital HPV and HSV infections with an emphasis on treatment modalities for the practicing dermatologist. Diagnosis of these diseases typically relies on clinical assessment, although multiple diagnostic techniques can be utilized and are recommended when diagnosis is uncertain or evaluating an individual with increased risk of malignancy. Management of HPV and HSV infections involves appropriate counseling, screening, and multiple treatment techniques. Particularly for HPV infections, a practitioner may need to use a combination of techniques to achieve the desired outcome.

Measuring quality of family planning counselling and its effects on uptake of contraceptives in public health facilities in Uttar Pradesh, India: A cross-sectional analysis.

BACKGROUND: Quality of care in family planning traditionally focuses on promoting awareness of the broad array of contraceptive options rather than on the quality of interpersonal communication offered by family planning (FP) providers. There is a growing emphasis on person-centered contraceptive counselling, care that is respectful and focuses on meeting the reproductive needs of a couple, rather than fertility regulation. Despite the increasing global focus on person-centered care, little is known about the quality of FP care provided in low- and middle- income countries like India. This study involves the development and psychometric testing of a Quality of Family Planning Counselling (QFPC) measure, and assessment of its associations with contraceptives selected by clients subsequently. METHODS: We analyzed cross-sectional survey data from N = 237 women following their FP counselling in 120 public health facilities (District Hospitals and Community Health Centers) sampled across the state of Uttar Pradesh in India. The study captured QFPC, contraceptives selected by clients post-counselling, as well as client and provider characteristics. Based on formative research and using Principal Component Analysis, we developed a 13-item measure of quality of FP counselling. We used adjusted regression models to assess the association between QFPC and contraceptive selected post-counselling. RESULTS: The QFPC measure demonstrated good internal reliability (Cronbach alpha = 0.80) as well as criterion validity, as indicated by client reports of high QFPC being significantly more likely for clients with trained versus untrained counsellors. We found that each point increase in QFPC, including increasing quality of counselling, is associated with higher odds of clients selecting an intrauterine device (IUD) (aRR:1.03; 95% CI:1.01-1.05) and sterilization (aRR:1.06; 95% CI:1.03-1.08), compared to no method selected. CONCLUSIONS: High-quality FP counselling is associated with clients subsequently selecting more effective contraceptives, including IUD and sterilization, in India. High-quality counselling is also more likely among FP-trained providers, highlighting the need for focused training and monitoring of quality care. TRIAL REGISTRATION: CTRI/2015/09/006219. Registered 28 September 2015.

Guidance regarding gamete and embryo donation.

This document provides the latest recommendations for the evaluation of potential sperm, oocyte, and embryo donors as well as their recipients, incorporating recent information about optimal screening and testing for sexually transmitted infections, genetic diseases, and psychological assessments. This revised document incorporates recent information from the US Centers for Disease Control and Prevention, US Food and Drug Administration, and American Association of Tissue Banks, which all programs offering gamete and embryo donation services must be thoroughly familiar with, and replaces the document titled "Recommendations for gamete and embryo donation: a committee opinion," last published in 2013.

Guidance on qualifications for fertility counselors: a committee opinion.

This guidance document was developed by the Mental Health Professional Group (MHPG) in partnership with the Practice Committee of the American Society for Reproductive Medicine (ASRM) to help determine the qualifications and training of mental health professionals working in reproductive medicine. This document replaces the document titled "ASRM Qualification Guidelines for Infertility," last published in March 2015 and originally developed in 1995.

Fast-track treatment initiation counselling in South Africa: A cost-outcomes analysis.

INTRODUCTION: In 2016, under its new National Adherence Guidelines (AGL), South Africa formalized an existing model of fast-track HIV treatment initiation counselling (FTIC). Rollout of the AGL included an evaluation study at 24 clinics, with staggered AGL implementation. Using routinely collected data extracted as part of the evaluation study, we estimated and compared the costs of HIV care and treatment from the provider's perspective at the 12 clinics implementing the new, formalized model (AGL-FTIC) to costs at the 12 clinics continuing to implement some earlier, less formalized, model that likely varied across clinics (denoted here as early-FTIC). METHODS: This was a cost-outcome analysis using standard methods and a composite outcome defined as initiated antiretroviral therapy (ART) within 30 days of treatment eligibility and retained in care at 9 months. Using patient-level, bottom-up resource-utilization data and local unit costs, we estimated patient-level costs of care and treatment in 2017 U.S. dollars over the 9-month evaluation follow-up period for the two models of care. Resource use and costs, disaggregated by antiretroviral medications, laboratory tests, and clinic visits, are reported by model of care and stratified by the composite outcome. RESULTS: A total of 350/343 patients in the early-FTIC/AGL-FTIC models of care are included in this analysis. Mean/median costs were similar for both models of care ($135/$153 for early-FTIC, $130/$151 for AGL-FTIC). For the subset achieving the composite outcome, resource use and therefore mean/median costs were similar but slightly higher, reflecting care consistent with treatment guidelines ($163/$166 for early-FTIC, $168/$170 for AGL-FTIC). Not surprisingly, costs for patients not achieving the composite outcome were substantially less, mainly because they only had two or fewer follow-up visits and, therefore, received substantially less ART than patients who achieved the composite outcome. CONCLUSION: The 2016 adherence guidelines clarified expectations for the content and timing of adherence counseling sessions in relation to ART initiation. Because clinics were already initiating patients on ART quickly by 2016, little room existed for the new model of fast-track initiation counseling to reduce the number of pre-ART clinic visits at the study sites and therefore to reduce costs of care and treatment. TRIAL REGISTRATION: Clinical Trial Number: NCT02536768.

Effectiveness of Group Counseling with a Client-Centered Approach Based on the GATHER Principles on Sexual Satisfaction in Women with Multiple Sclerosis: A Randomized Clinical Trial.

Background: Multiple sclerosis (MS) is the most prevalent progressive sensory/neurological disability in young adults, with important psychological consequences. The present study was designed to assess the effectiveness of group counseling with a client-centered approach based on the GATHER principles on sexual satisfaction in women with MS. Methods: In this clinical trial, conducted from January 2018 to May 2019, in the MS Referral Center of Tehran (Iran), 72 eligible participants were assigned to intervention and control groups (36 in each group) via simple randomization. The intervention group received group counseling based on the client-centered approach, while the control group received routine counseling. Data were collected using the Larson Sexual Satisfaction Questionnaire (LSSQ) at three different time points: before the intervention, after the final session, and one month after the intervention. The collected data were analyzed in SPSS software (version 19). In order to analyze the obtained data, independent t test, Mann-Whitney U test, paired t test, Wilcoxon test, Chi-square test, Fisher exact test, and Friedman test were used. Results: The mean score of sexual satisfaction before the intervention showed no statistically significant difference between the two groups. Based on the Friedman test in the intervention group, the trend of changes in the mean score of sexual satisfaction had a significant difference before the intervention, after the final session, and one month after the intervention (P=0.001); however, no significant difference was observed in the control group. Conclusion: Our results showed the effectiveness of group counseling with a client-centered approach based on the GATHER principles on sexual satisfaction and intimacy among women with MS. Trial Registration Number IRCT20180110038302N3.

Discordance Between Perinatal Alcohol Use Among Women and Provider Counseling for Alcohol Use: An Assessment of the Pregnancy Risk Assessment Monitoring System.

OBJECTIVE: In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US women. METHODS: State health departments collected data for the Pregnancy Risk Assessment Monitoring System Phase 7 during 2012-2015, and we restricted the sample to a complete case analysis (N = 135 111). The 3 dichotomous outcomes were preconception alcohol use (3 months before pregnancy), prenatal alcohol use (during last 3 months of pregnancy), and prenatal alcohol counseling. Predictor variables were age, race, Hispanic ethnicity, education, marital status, health insurance status, and previous live births. We estimated survey-weighted logistic regression models for each outcome. RESULTS: Half (56.0%) of pregnant women reported preconception alcohol use, 70.5% received prenatal alcohol counseling, and 7.7% reported prenatal alcohol use during the last 3 months of pregnancy. Black women were significantly less likely than White women (odds ratio [OR] = 0.49; 95% CI, 0.46-0.52) and Hispanic women were significantly less likely than non-Hispanic women (OR = 0.62; 95% CI, 0.58-0.66) to report preconception alcohol use. We found similar patterns for prenatal alcohol use among Black women. Black women were significantly more likely than White women (OR = 1.66; 95% CI, 1.55-1.77) and Hispanic women were significantly more likely than non-Hispanic women (OR = 1.51; 95% CI, 1.40-1.61) to receive prenatal alcohol counseling. We found similar patterns for age, education, and health insurance status. CONCLUSION: Disparities in alcohol counseling occurred despite the national recommendation for universal screening and counseling prenatally. Continued integration of universal screening for alcohol use during pregnancy is needed.

Oncologic Considerations for Safe Gender-Affirming Mastectomy: Preoperative Imaging, Pathologic Evaluation, Counseling, and Long-Term Screening.

SUMMARY: There remain significant gaps in the evidence-based care of patients undergoing gender-affirming mastectomy with regard to implications for breast cancer development and screening. The current clinical evidence does not demonstrate an increased risk of breast cancer secondary to testosterone therapy in transgender patients. Gender-affirmation mastectomy techniques vary significantly with regard to the amount of residual breast tissue left behind, which has unknown implications for the incidence of postoperative breast cancer and need for screening. Subcutaneous mastectomy should aim to remove all gross breast parenchyma, although this is limited in certain techniques. Tissue specimens should also be routinely sent for pathologic analysis. Several cases of incidental breast cancer after subcutaneous mastectomy have been described. There is little evidence on the need for or types of postoperative cancer screening. Chest awareness is an important concept for patients that have undergone subcutaneous mastectomies, as clinical examination remains the most common reported method of postmastectomy malignancy detection. In patients with greater known retained breast tissue, such as those with circumareolar or pedicled techniques, consideration may be given to alternative imaging modalities, although the efficacy and cost-utility of these techniques must still be proven. Preoperative patient counseling on the risk of breast cancer after gender-affirming mastectomy in addition to the unknown implications of residual breast tissue and long-term androgen exposure is critical. Patient awareness and education play an important role in shared decision-making, as further research is needed to define standards of medical and oncologic care in this population.

Spouse caregivers' attributed gains from a skill-based counseling program.

OBJECTIVE: To describe spouse caregivers' perceived gains in their own words from participating in a fully manualized 5-session educational counseling program whose goals were to enhance their self-care and skills to interpersonally support their wife with breast cancer. METHODS: Interviews from 81 spouses obtained 7 months after exiting from a fully manualized educational counseling program, Helping Her Heal, were content analyzed using inductive coding methods adapted from grounded theory. Trustworthiness of study results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail. RESULTS: Analysis yielded 3 conceptual domains: Giving Me Structure; Adding Skills to Help Her and Us; and Gaining Insights into Myself and My Wife, all of which reflected practical things on which spouses could take action and ways they could take care of themselves, support their wife, and from which they gained insight into their own and their wife's response to the breast cancer. CONCLUSIONS: Findings suggest that short-term, fully manualized counseling programs can provide opportunities and practical ways spouse caregivers are able to gain interpersonal communication, self-care skills, and personal insights. This scripted model of counseling is a way in which to deliver educational counseling with self-reported benefits, even though the program is fully scripted and not uniquely fashioned for each caregiver's unique experience. CLINICAL TRIAL REGISTRATION NUMBERS: NCI-2013-01838 .

Research orientations related to guidance and counselling programmes: A content analysis study / Orientaciones de investigación relacionadas con los programas de orientación y asesoramiento: un estudio de análisis de contenido

Guidance and psychological counselling services, which are seen as an integral part of the education system, refer to the whole of systematic services offered in line with a certain plan and programme. Guidance and counselling programmes (G&CP) are of considerable importance in the provision of these services based on data and evidence and in obtaining the expected efficiency from the services. The aim of this study is to evaluate the studies on G&CP in terms of content analysis, to reveal the current situation and to determine the scientific research orientations related to these studies. With this study, it was aimed that field staff, educators and researchers should recognise the gaps in the G&CP field, gain different perspectives on their fields of study and shed light on new research in this field. The data related to this study, which was designed according to the descriptive survey model using qualitative research methodology, were obtained by document review method. In connection with the topic of re-search, 105 graduate thesis studies in the ProQuest Dissertations and Theses database between 2007 and 2019 and 133 journal articles in the Web of Science database were examined. The obtained data were evaluated using the descriptive content analysis method. Studies on the subject have in-creased in recent years and more than half of the research has been carried out in the United States. It was observed that experimental studies were conducted using the most quantitative research methodology, that more emphasis was placed on the programme evaluation process and that sample groups at different levels, especially school counsellors, were studied. Additionally, there are some findings supporting that there are more studies concerning community-based preventive and intervention programmes than school-based studies, and also supporting the fact that school-related researches are especially paying attention to investigate the effects of the programme, perceptions and experiences of the programme, programme design and programme evaluation. Finally, the results from the research findings were interpreted and the recommendations for the researchers were presented

Los servicios de orientación y asesoramiento psicológico, que se consideran parte integrante del sistema educativo, se refieren al conjunto de servicios sistemáticos que se ofrecen de acuerdo con un determinado plan y programa. Los programas de orientación y asesoramiento (POA) son de considerable importancia en la prestación de estos servicios basados en datos y pruebas y en la obtención de la eficiencia esperada de los servicios. El objetivo de este estudio es evaluar los estudios sobre POA en términos de análisis de contenido, revelar la situación actual y determinar las orientaciones de investigación científica relacionadas con estos estudios. Con este estudio, se pretendía que el personal de campo, los educadores y los investigadores reconocieran los desajustes en el campo de POA, obtengan diferentes perspectivas sobre sus campos de estudio y arrojen luz sobre nuevas investigaciones en este campo. Los datos relacionados con este estudio, que fue diseñado según el modelo de encuesta descriptiva utilizando metodología de investigación cualitativa, se obtuvieron mediante el método de revisión de documentos. En relación con el tema de investigación, se examinaron 105 estudios de tesis de posgrado en la base de datos de tesis y disertaciones de ProQuest entre 2007 y 2019, y 133 artículos de revistas en la base de datos de Web of Science. Los datos obtenidos se evaluaron mediante el método de análisis de contenido descriptivo. Los estudios sobre el tema han aumentado en los últimos años y más de la mitad de las investigaciones se han realizado en Estados Unidos. Se observó que los estudios experimentales se realizaron utilizando la metodología de investigación más cuantitativa, que se puso más énfasis en el proceso de evaluación del programa y que se estudiaron grupos de muestra de diferentes niveles, especialmente orientadores escolares. Además, hay algunos hallazgos que respaldan que hay más estudios sobre programas de intervención y prevención basados en la comunidad que estudios basados en la escuela, y también respaldan el hecho de que las investigaciones relacionadas con la escuela están prestando especial atención a investigar los efectos, las percepciones y experiencias, el diseño y la evaluación del programa. Finalmente, se interpretaron los resultados de los hallazgos de la investigación y se presentaron las recomendaciones para los investigadores

Triplet pregnancy: What do we tell the prospective parents.

Experience managing triplet pregnancies has increased over the past few decades as the incidence has changed related to assisted reproductive practices. Physicians caring for women carrying triplets cannot predict an individual outcome or pregnancy course but must educate patients about the challenges related to these high risk pregnancies. Obstetric providers can describe the wide range of risks associated with triplet gestations, and the general plan for management, but ultimately parents must make decisions with potentially lifelong consequences. Here, we present the diagnostic criteria, common complications, and management options for triplet pregnancies, to help obstetricians counsel patients on the medical and psychosocial consequences of triplet pregnancy, potential complications, and multifetal reduction.

Improving how positive newborn screening results are communicated to parents of children with sickle cell disease.

Sickle cell disease, the most common inherited disorder at birth in the UK, has been included in the UK newborn screening programme since 2006. For parents, receiving the news that their newborn has a serious long-term condition can trigger reactions such as shock, disbelief and guilt. Guidelines on sickle cell disease provide clear screening pathways, but there is variation in how and by whom positive results are communicated to parents. The way in which this is done is crucial, not only for parents' acceptance of the diagnosis but also for their future therapeutic relationships with healthcare professionals and therefore for their child's future health outcomes. Being given reliable and relevant information by confident and knowledgeable staff gives parents hope that their child will achieve a good quality of life. Based on the literature and on the author's experience as a haemoglobinopathy nurse specialist, this article discusses how to improve the communication of positive newborn screening results to parents of children with sickle cell disease.

"Where is the relationship" revisited: Using actor-partner interdependence modeling and common fate model in examining dyadic working alliance and session quality.

Building on previous studies (e.g., Kivlighan, 2007), we explored the application of actor-partner interdependence modeling (APIM) and the common fate model (CFM) in a multilevel framework to examine the dyadic multilevel associations between therapists' and clients' perceptions of working alliance and session quality. Forty-four therapists and their 284 adult community clients completed measures of working alliance and session quality after every session (a total of 8,188 sessions included in this study). We used APIM to unravel the mutual interdependence between therapist and client perceptions and used CFM to model both the shared and individual perceptions of the therapists and clients. APIM analyses showed that, at the between-session level, therapist and client perception of the session quality each was significantly predicted by the other's perception of the working alliance. At the between-client level, only therapist perception of the session quality was significantly predicted by the client's perception of the working alliance. There were no significant partner effects at the between-therapist level. CFM analyses showed that therapist-client shared perceptions of working alliance significantly predicted their shared perception of session quality at all three levels. In contrast, individual perceptions of working alliance correlated with individual perceptions of session quality for therapists only at the between-therapist and between-session levels, and for clients only at the between-client and between-session levels. Theoretical, methodological, and practical implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline Part I.

PURPOSE: The summary presented herein represents Part I of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part I outlines the appropriate evaluation of the male in an infertile couple. Recommendations proceed from obtaining an appropriate history and physical exam (Appendix I), as well as diagnostic testing, where indicated. MATERIALS/METHODS: The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January, 2000 through May, 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table 1[Table: see text]). This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology. RESULTS: This Guideline provides updated, evidence-based recommendations regarding evaluation of male infertility as well as the association of male infertility with other important health conditions. The detection of male infertility increases the risk of subsequent development of health problems for men. In addition, specific medical conditions are associated with some causes for male infertility. Evaluation and treatment recommendations are summarized in the associated algorithm (figure[Figure: see text]). CONCLUSION: The presence of male infertility is crucial to the health of patients and its effects must be considered for the welfare of society. This document will undergo updating as the knowledge regarding current treatments and future treatment options continues to expand.

Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline PART II.

PURPOSE: The summary presented herein represents Part II of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part II outlines the appropriate management of the male in an infertile couple. Medical therapies, surgical techniques, as well as use of intrauterine insemination (IUI)/in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) are covered to allow for optimal patient management. Please refer to Part I for discussion on evaluation of the infertile male and discussion of relevant health conditions that are associated with male infertility. MATERIALS/METHODS: The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January 2000 through May 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table[Table: see text]). This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology. RESULTS: This Guideline provides updated, evidence-based recommendations regarding management of male infertility. Such recommendations are summarized in the associated algorithm (figure[Figure: see text]). CONCLUSION: Male contributions to infertility are prevalent, and specific treatment as well as assisted reproductive techniques are effective at managing male infertility. This document will undergo additional literature reviews and updating as the knowledge regarding current treatments and future treatment options continues to expand.