Community Needs Assessment for a Professional University Health Counselling Course in Cambodia

Developing health and counselling professionals remains an important part of supporting mental health services in Cambodia.This paper aims to identify how the key stakeholders and mental health experts in Cambodia consider how a university level health counselling course could contribute to addressing the needs/treatment gap for mental health services in Cambodia.In order to do this,the study consists of semi-structured interviews with stakeholders,community needs assessment,and community resource mapping.The data were drawn from 15 NGOs,various profit and not-for-profit organizations as well as two key government stakeholders.The participants were invited to take part in a stakeholders/expert semi-structured interview that lasted between 30-60 minutes at the participants’organizations.The findings revealed that all participants believe that a university level health counseling course was crucial in Cambodia to address pressing mental health issues in the country.Most participants believed that a graduate or post-graduate level program such as a B.A.or M.A.was necessary to train qualified counsellors.The program should be internationally benchmarked,with a Cambodian context.Topics should include psychopathology,professional ethics and competencies,counselling theories and interventions,trauma treatment,as well as emotional intelligence and addiction.Other topics might need to include parenting,support system for suicidal patients,self-care,staff wellbeing programs,and school counselor programs.

Enhancing Identity Protection in Metaverse-Based Psychological Counseling System

Non-face-to-face psychological counseling systems rely on network technologies to anonymize information regard-ing client identity.However,these systems often face challenges concerning voice data leaks and the suboptimal communication of the client’s non-verbal expressions,such as facial cues,to the counselor.This study proposes a metaverse-based psychological counseling system designed to enhance client identity protection while ensuring efficient information delivery to counselors during non-face-to-face counseling.The proposed systemincorporates a voicemodulation function that instantlymodifies/masks the client’s voice to safeguard their identity.Additionally,it employs real-time client facial expression recognition using an ensemble of decision trees to mirror the client’s non-verbal expressions through their avatar in the metaverse environment.The system is adaptable for use on personal computers and smartphones,offering users the flexibility to access metaverse-based psychological counseling across diverse environments.The performance evaluation of the proposed system confirmed that the voice modulation and real-time facial expression replication consistently achieve an average speed of 48.32 frames per second or higher,even when tested on the least powerful smartphone configurations.Moreover,a total of 550 actual psychological counseling sessions were conducted,and the average satisfaction rating reached 4.46 on a 5-point scale.This indicates that clients experienced improved identity protection compared to conventional non-face-to-face metaverse counseling approaches.Additionally,the counselor successfully addressed the challenge of conveying non-verbal cues from clients who typically struggled with non-face-to-face psychological counseling.The proposed systemholds significant potential for applications in interactive discussions and educational activities in the metaverse.

Family counseling of dental and oral care for preventing caries of dental during preschool age: a literature review

Incorrect family behavior in caring for the dental and oral health of preschool-aged children can affect the incidence of dental caries in these children and can cause more serious health problems in the future if not treated immediately,so it is important to find the right solution.This study aims to determine the effect of family counseling on dental and oral care for preschoolers.This study uses a narrative literature review method.Search articles using 5 databases(Pubmed,ScienceDirect,SpringerLink,ProQuest,and Google Scholar)to search for articles with the keywords family counseling AND Oral health AND Early Childhood Caries AND Behavior Change AND Family and the article selection process refers to the Flow diagram of the PRISMA Statement 2020.The results showed that there were 7 articles analyzed in this study.The implementation of family counseling has a significant effect in increasing self-efficacy,knowledge,ability,and motivation of the family,as well as the behavior of the child,to reduce the risk of dental caries in preschool-age children,taking into account several conditions.It was determined that family counseling is effective in reducing the incidence of dental caries in preschool children.

A Study on the Impact of Psychological Counseling for Minor Medical Students in Clinical Teaching and Learning

Objective:To explore the impact of psychological counseling for underage medical students in clinical teaching.Methods:24 of the 48 underage medical students who were interned in our hospital from March 2023 to February 2024 were randomly selected to adopt the teaching management method of one-on-one psychological guidance as the observation group;the remaining 24 adopted the traditional teaching management method as the control group.The observation of the effects of psychological detachment on various aspects of underage medical students allows the determination of whether psychological detachment impacts clinical teaching.Results:The observation group’s theoretical examination scores,skill assessment scores,and departmental performance evaluation scale score excellence rate were higher than the control group’s,with P<0.05 being statistically significant.At the same time,the clinical teaching and teaching management ability of the hospital was also improved.Conclusion:Psychological guidance for underage medical students can not only improve the comprehensive quality of medical students but also improve the teaching level,which is conducive to improving the teaching effect,and it is a clinical teaching mode worth promoting.

Classification of osteogenesis imperfecta:Importance for prophylaxis and genetic counseling

Osteogenesis imperfecta(OI)is a genetically heterogeneous monogenic disease characterized by decreased bone mass,bone fragility,and recurrent fractures.The phenotypic spectrum varies considerably ranging from prenatal fractures with lethal outcomes to mild forms with few fractures and normal stature.The basic mechanism is a collagen-related defect,not only in synthesis but also in folding,processing,bone mineralization,or osteoblast function.In recent years,great progress has been made in identifying new genes and molecular mechanisms underlying OI.In this context,the classification of OI has been revised several times and different types are used.The Sillence classification,based on clinical and radiological characteristics,is currently used as a grading of clinical severity.Based on the metabolic pathway,the functional classification allows identifying regulatory elements and targeting specific therapeutic approaches.Genetic classification has the advantage of identifying the inheritance pattern,an essential element for genetic counseling and prophylaxis.Although genotype-phenotype correlations may sometimes be challenging,genetic diagnosis allows a personalized management strategy,accurate family planning,and pregnancy management decisions including options for mode of delivery,or early antenatal OI treatment.Future research on molecular pathways and pathogenic variants involved could lead to the development of genotype-based therapeutic approaches.This narrative review summarizes our current understanding of genes,molecular mechanisms involved in OI,classifications,and their utility in prophylaxis.

A Review of Grief Counselling Practices for Family Members of Oncology Patients in Hospice Care

In cancer patients, especially terminal patients, the family members of the patients will develop more serious sadness and find it difficult to face death rationally, which affects the quality of life and activities. Because of this, in the clinical treatment of oncology patients, strengthening hospice care for family members, doing a good job of death education, assisting them to face and participate in the clinical treatment of oncology in a positive way, and avoiding excessive grief can simultaneously improve the quality of life of patients and their families.

HIV Counseling and Testing Uptake,Knowledge and Attitude and Influencing Factors among Student Nurses and Midwives in The Gambia:An Institutional-based Cross-sectional Study

HIV counseling and testing(HCT)has become paramount in the prevention and control of HIV/AIDS worldwide.However,the uptake of HCT has been very slow globally,especially in sub-Saharan Africa.Student nurses formed the largest group undergoing health care training in the country compared to doctors and other health cadres.According to WHO,they are part of the most vulnerable group to HIV infection,judging by the fact that they interact more with patients/clients than other healthcare professionals.This study aimed to determine the prevalence of HCT uptake,knowledge,and attitude and evaluate influencing factors among student nurses and midwives in public nursing schools.An institutional-based cross-sectional study design was employed to collect data from 305 randomly selected nursing students and midwives using a validated and reliable self-administered questionnaire.Descriptive statistics(percentages,mean and standard deviation)and inferential statistics(chi square,logistics regression,one-way ANOVA and independent samples t-test)were used for data analysis using SPSS version 25.0.A p-value<0.05 was considered for statistical significance.Out of the 305 students recruited for the study,60.98%were females,with a mean age of 25.5 years old.About 58.4%of the participants had tested for HIV in the past.About 95.7%acknowledged the importance of HCT in the prevention and control of HIV/AIDS.HCT uptake among student nurses and midwives was influenced by factors ranging from an individual that are interpersonal challenges(such as concerns of friends),perceived susceptibility to the disease,lack of confidentiality,stigma and discrimination from health service providers.Therefore,these barriers can be addressed through an organized targeted health education intervention and advocacy programs across health training institutions in the Gambia and beyond.

Managerial Counseling

Management is relatively new science and at the new era, when not all managers of the organizations, the organizations need the services of counselor. The work of the counselors includes recommendations of changes in the organizations. Managerial eonsultancy can be assisted by external managerial counselors and by external managerial counselors. Most of the managers prefer the internal managerial counselors. There are seven steps of the counseling practice： Referral, Entry and Contracting, Problem Definition, Data Collection, Analysis and Diagnosis, Presentation and Recommendations, Agreeing on the Strategy Action, Implementation and Follow Up and Termination. Some of these steps are very important： the most important steps are the referral and the implementation and follow up. The counselors can leave the organization when they feel that the change is assimilated, but many times their work continues for a long time.

Support and Companionship in Virtual Communities: Establishing a COVID-19 Counseling Network for Soldiers and the Collective Healing Phenomenon

Counseling people,particularly those in the military engaged in group living,who are in quarantine during the COVID-19 pandemic is a challenge.Therefore,supporting the people in quarantine who are experiencing psy-chological and interpersonal problems has become a new challenge in military mental health.This study’s primary concern was how to overcome the problems caused by physical quarantine.The study subject was a virtual coun-seling network and its operating experience during the quarantine period in Taiwan amidst the global COVID-19 pandemic.For soldiers who mainly live in groups,this study discussed how the virtual counseling network combined with the existing military support group to determine what influence the network had on peo-ple in quarantine.This study found that this group exhibited four types of experiences:togetherness,empathy,confidence,and belonging and cohesion.Such experiences are beneficial for group healing through mutual sup-port and companionship.Collective cohesion and psychological healing can be achieved through a virtual com-munity.This is worthy of attention,particularly in the pandemic or post-pandemic era.Physical isolation has become a fact of life,and such isolation is not just isolation from disease but also between regional boundaries.Counseling and support systems in virtual space or the operation of virtual teams must be considered for the future.

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease(NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODS Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention(based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting(about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound(US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid-and end-interventions and US was repeated at end-intervention.RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients(20%). At the end of the treatment the end-point concerning the weight(i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients(i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme(altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement(P < 0.01) between baseline and end-treatment.CONCLUSION Outcomes of this study further strengthen the hypothesis that Med Diet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

FISH studies of chromosome abnormalities in germ cells and its relevance in reproductive counseling

Chromosome abnormalities are one of the major causes of human infertility. In infertile males, abnormal karyotypes are more frequent than in the general population. Furthermore, meiotic disorders affecting the germ cell-line have been observed in men with normal somatic karyotypes consulting for infertility. In both cases, the production of unbalanced spermatozoa has been demonstrated. Basically addressed to establish reproductive risks, fluorescence in situ hybridization （FISH） on decondensed sperm heads has become the most frequently used method to evaluate the chromosomal constitution of spermatozoa in carriers of numerical sex chromosome abnormalities, carriers of structural chromosome reorganizations and infertile males with normal karyotype. The aim of this review is to present updated figures of the information obtained through sperm FISH studies with an emphasis on its clinical significance. Furthermore, the incorporation of novel FISH-based techniques （Multiplex-FISH; Multi-FISH） in male infertility studies is also discussed. （Asian J Androl 2005 Sep; 7： 227-236）

Prenatal diagnosis and assessment of congenital spinal anomalies: Review for prenatal counseling

The last two decades have seen continuous advances in prenatal ultrasonography and in utero magnetic resonance imaging. These technologies have increasingly enabled the identification of various spinal pathologies during early stages of gestation. The purpose of this paper is to review the range of fetal spine anomalies and their management, with the goal of improving the clinician's ability to counsel expectant parents prenatally.

Repeat HIV Testing and Incident Rates among Individuals Attending Voluntary Counseling and Testing Clinics in Wuxi, China： A Retrospective Study

Objective We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis, and baseline CD4^＋ T cell count among individuals attending HIV voluntary counseling and testing （VCT） clinics in Wuxi, China. Methods A repeat HIV testing within 12 months was recorded if individuals had their first test with negative results, during 2013-2014 and retested within 12 months. An incident HIV diagnosis was recorded if individuals had their first test with negative results, during 2013-2015 and had a subsequent positive result at any point by the end of 2015. Data on HIV testing and diagnosis among individuals attending 32 VCT clinics from 2013 to 2015 and HIV diagnosis from other clinical services in Wuxi, China, were retrieved. A multivariate logistic regression model was used to analyze factors associated with repeat HIV testing. Cox regression was used to evaluate factors associated with incident HIV diagnosis. Results From 2013 to 2014, 11,504 individuals tested HIV negative at their first recorded test, with 655 （5.7%） retesting within 12 months. Higher repeat HIV testing within 12 months was associated with male gender [adjusted odds ratio （a OR） = 1.7, 95% confidence interval （CI）： 1.4-2.2], risk behaviors [commercial heterosexual behaviors （a OR = 1.4, CI： 1.1-1.6）, male-male sexual behaviors （a OR = 3.7, CI： 2.7-4.9）], injection drug use （a OR = 9.9, CI： 6.5-15.1）, and having taken HIV tests previously （a OR = 2.0, CI： 1.6-2.4）. From 2013 to 2015, 1,088 individuals tested negative on HIV test at their visit and at ≥ 2 subsequent tests; of them 30 had incident HIV diagnosis. The overall rate of incident HIV diagnosis among all VCT individuals was 1.6 （95% CI： 1.1-2.1） per 100 person-years. Incident HIV diagnosis was associated with male gender [adjusted hazard ratio （a HR） = 8.5, 95% CI： 1.9-38.1], attending hospital-based VCT clinics （a HR = 7.8, 95% CI： 1.1-58.3）, and male-male sexual behavior （a HR = 8.4, 95% CI： 1.5-46.7）. Individuals diagnosed at VCT clinics had higher CD4＋ T cell count compared with those diagnosed at other clinical services （median 407 vs. 326 copies/mm3, P = 0.003）. Conclusion VCT individuals in Wuxi, China, had a low repeat HIV testing rate and high HIV incidence. VCT-clinic-based interventions aimed at increasing repeat HIV testing are needed to detect more cases at an earlier stage, especially among individuals at high risk for HIV infection such as men who have sex with men.

Family-Based Tuberculosis Counseling Supports Directly Observed Therapy in Armenia: A Pilot Project

Objectives: Non-adherence to tuberculosis (TB) treatment causes development of multi-drug resistance (MDR). In Armenia, about 47% of previously-treated TB patients develop MDR-TB. This pilot intervention intended to explore the feasibility and effectiveness of a family-based-counseling (FBC) that included a psychological component in terms of improved adherence of TB patients to treatment and reduced stigma of TB. Methods: Overall, 136 regular TB patients (55) and their family members (81) participated in a single 90-minute interactive counseling session conducted in each household by the team of professional psychologist and TB nurse. To evaluate FBC effectiveness, we administered baseline and follow-up surveys to 52 TB patients and their 57 family members in 2012 and compared treatment outcomes of the study participants with the national data for 2011 and 2013. Results: We found that the intervention substantially improved the mean knowledge score of TB patients (from 19.2 to 21.6, p Conclusion: The evaluation showed that a low-cost one-time family–based educational intervention with a psychological component can be effective in improving treatment outcomes of TB patients.

Contraceptive Continuation, Pregnancy and Abortion Rate Two Years after Post Abortion Counselling

Objectives: To estimate the contraceptive use rate, pregnancy and abortion rate two years after post abortion counselling. Methods: In this current paper we conducted a cross-sectional study from September to December 2011 among women who participated of original randomized trial. In this study 118 women who had been allocated in the group that received the personalized contraceptive counselling and 103 women who had been allocated in the group that received standard counselling service were contacted by phone. The analyzed variables were the use of contraceptive methods, reasons for not using them, satisfaction in used method, and occurrence of pregnancy and abortion. Results: The pregnancy rate was lower in the personalized counselling group (p = 0.022), whereas abortion (p = 0.543) and contraceptive use rate (p = 0.270) had no difference between groups. The overall contraceptive use rate was high in both groups and the injectable method use rate was higher in personalized counselling group (p?= 0.004). Conclusions: Two years after the intervention the pregnancy rate was lower in personalized counselling group. The contraceptive use rate had no difference between the groups, except for the injectable which the use rate was higher in the personalized counselling group. These results could be encouraging because the intervention improved the uptake of one of the long-acting methods of contraception.

Breastfeeding counsel against cancers

The anticancer potential by breastfeeding is not fully tapped in the light of the present knowledge of the subject. Literature indicates that breastmilk has anticancer action but may underestimate its full capacity. The protective spectrum within breastmilk hints on the need for a more comprehensive understanding of it as an anticancer tool. Exclusive breastfeeding could confer protection from carcinogenesis with a greater impact than realised. A literature review was conducted using four electronic databases. Selected areas were extracted after thorough perusal of the articles. The uninitiated would take exclusive breastfeeding seriously if actively counselled as an anticancer tool. Advice on details of the breastfeeding process and holistic information on breastfeeding may endow a greater impact among the skeptics. Counselling the breastfeeding mother on information sometimes not imparted, such as on maternal nutrition, details of the process of breastfeeding, benefits of direct breastfeeding versus milk expression and her psychosocial well being may make a difference in optimising anticancer action that exists in breastmilk.Additionally, its anticancer potential provides a platform to universally improve physical and psychosocial well being of women who breastfeed. Statistics of protection by breastfeeding in some maternal and childhood cancers are evident. "Bio-geno-immunonutrition" of breastmilk may shield the mother and infant from carcinogenesis in more ways than appreciated. The molecular basis of mother-to-infant signals and their "energies" need to be researched. Breastfeeding as a modifiable behaviour provides cost effective nutrition with potential for both cancer immunoprophylaxis and immunotherapy.

Reasons for non-compliance among patients treated under Revised National Tuberculosis Control Programme(RNTCP) and their treatment outcome after structured counselling

Objective:To judge for reasons of interrupting the treatment as told by patient himself/herself and see for adherence to therapy and treatment outcome after counselling.Methods:All patients with history of interrupting the treatment presenting to chest OPD were included in this study.Counselling was done by medical officer on first interaction and by health care worker(as guidance of medical officer) subsequently.Reasons for interrupting the treatment were noted.Patients and their relatives were counselled about the urgent need for strict adherence to therapy with special focus on reasons for which that particular patient had defaulted.Results:Total 56 patients were included in the study during First Quarter of year 2007.Treatment outcomes of 40 patients were available.6 out of them had interrupted the treatment(15%)(National figures;19%and Maharashtra: 21%),13 patients died during the treatment(5 of them were Cat 2 defaulters).Multiple reasons for interrupting the treatment were present.Most common reasons were alcoholism and feeling of relief with treatment (46.4%).Conclusion:There is an urgent need for stressing upon counselling during Revised National Tuberculosis Control Programme(RNTCP) sensitization and training.Medical officers can play an important role in reducing the defaulter rate by counselling of patient and their relatives.

Comparison of Public Health Nurse’s Lifestyle Counseling Skills for Clients with Different Readiness of Behavior Changes in Primary Care Settings

Purpose: Public health nurses (PHNs) are required to assess the readiness of the clients and provide lifestyle counseling accordingly. The purpose of this study was to compare the lifestyle counseling provided for clients with different levels of readiness based on self-evaluations and independent assessment. Methods: Participants were PHNs with 10 years’ experience or less. Lifestyle counseling skills were measured through a simulated counseling session in a primary setting lasting up to 30 minutes, followed by a review session, where the participant provided self-evaluations, and the simulated client provided others-evaluations, of the session. The simulated clients played the role of clients at either the pre-contemplation or contemplation stage of preparedness as per the stages of behavior change theory. Results: The self-evaluation results showed that the mean scores for five of the six skill categories, are lower in the precontemplation-stage client cases than in the contemplation-stage client cases, and significantly so for two skill categories. The others-evaluations showed significantly lower mean scores for all skill categories in the precontemplation cases than in the contemplation cases. Conclusion: The PHNs and simulated clients agreed that lifestyle counseling skills were inadequate for the precontemplation cases, as compared with the contemplation cases. The lifestyle counseling skills of PHNs with less experience may not be well-adjusted to the readiness of the client, indicating difficulties in supporting less prepared clients.

Role of Rehabilitation Counseling and Psychology in Working with Individuals with Work-related Chronic Pain Injuries: An Interdisciplinary Approach-Chronic Pain and Work Injuries in the United States

This paper addresses the topic of an interdisciplinary approach of chronic pain management from a biopsychosocial perspective. The first section provides an introduction to the definitions and theories of chronic pain and the various contributing factors (psychological, interpersonal/environmental and social support, and vocational). The second section presents the role of various health care professions (medical doctors, nurses, physical therapists, occupational therapists, psychologists and rehabilitation counselors) and the evidence of their treatment effectiveness. The third section discusses the concept of an interdisciplinary pain rehabilitation program (IPRP) and its evidence to support its effectiveness. Finally, the clinical implications of rehabilitation counseling and psychology as part of the inter-disciplinary program in treating individuals with chronic pain will be highlighted.

Frequency of alcohol and smoking cessation counseling in hepatitis C patients among internists and gastroenterologists

Given the overwhelming evidence that both alcoho consumption and smoking accelerate the progression of hepatitis C virus(HCV)-induced liver disease we evaluated the frequency of alcohol and smoking counseling of patients with HCV-induced liver disease by their primary care internists and gastroenterologists.One hundred and twenty-three medical records of consecutive patients with HCV-induced liver disease referred by an internist to a gastroenterologist for its management were reviewed.Patient gender,race,history of and counseling against alcohol and tobacco use by a physician and a gastroenterologist were obtained A database was created using Microsoft Excel.There were 105 African-Americans,12 Caucasians and six patients of other races/ethnicities.Forty-six(37%)pa- tients were daily tobacco users and 34(28%)patients were daily alcohol consumers.There was a statistically significant difference in the frequencies of alcohol(P= 0.0002)and smoking cessation(P=0.0022)between gastroenterologists and internists.This study reveals that internists and gastroenterologists,alike,inadequately counsel patients with hepatitis C about tobacco and alcohol use.