Content Of Counseling Research Articles

Professional secondary education system in Ukraine: legal supply

Problem setting. Nowadays the content of secondary education in Ukraine does not take into account individual characteristics of the students and it is not focused on the formation of creative potential and system of knowledge by interests, the educational process is overburdened with secondary factual material and is overly regulated. It necessitates the search and implementation of new approaches to organization of educational process in high school. One of such approaches is career counselling for secondary school students that provides thourough and specialized general education, access to quality education in accordance with the individual skills and needs of the student youth.Recent research and publications analysis. The problem of career counselling for secondary school students in Ukraine has become the subject of research by Ukrainian scholars. In particular, theoretical and conceptual foundations of career counselling training were investigated by N. Bibik, M. Burda, S. Volyanskaya, O. Adamenko, V. Kizenko, A. Samodrin, B. Fedorishin, G. Vashchenko, M. Goncharov, N. Dmitrenko.Highlighting previously unsettled parts of the general problem. The introduction of specialized secondary education is one of the priorities of public education policy. Therefore, it is advisable to investigate the legal bases for introducing career counselling for secondary education system in Ukraine within the science of public administration.The aim of the article is to analyze the legal support for the introduction of career counselling for secondary education system in Ukraine.Paper main body. According to Article 53 of the Constitution of Ukraine everyone has the right to education. However, the deterioration of indicators of competitiveness and the innovative attractiveness of secondary education system in Ukraine need a thorough reform within the framework of the Concept of Implementation of the State Policy for the Reform of General Secondary Education “New Ukrainian School” for the period up to 2029. The aim of the reform of the education system in Ukraine is to create the conditions for personal development and creative self-realization of every citizen of Ukraine, to create generations capable of learning throughout life, to create and develop the values of civil society.In accordance with the objectives of the first phase of implementation of the Concept (2017 – 2018), a new Law of Ukraine “On Education” was adopted, Article 10 of which defines three levels of secondary education: primary education lasting four years; basic secondary education lasting five years; specialized secondary education lasting three years. At the third stage of the Concept implementation (2023 – 2029), it is planned to introduce a specialized level of secondary education – a process of individual and differentiated learning, the basic ideas of which are the education of students in grades 10 – 12 by: interests; competencies; plans for self-realization.According to the Law of Ukraine “On Education”, obtaining a specialized secondary education involves two directions:– academic – specialized education based on the combination of the content of education which is defined by the standard s of secondary specialized education, and in-depth study of individual subjects taking into account the abilities and educational needs of education recipients focusing on continuing education at higher levels of education;– professional – labor market oriented specialized education based on a combination of educational content defined by the standard of secondary specialized education and a professionally oriented approach to learning taking into account the abilities and needs of students.Conclusions of the research and prospects for further studies.1. The crisis and the challenges of the problem have led to the reform of the content of secondary education in Ukraine on the basis of competent and personally oriented approaches to learning; orientation to the acquisition of skills necessary for successfu students self-realization in their professional activity.2. One of the directions of modernization and improvement of the secondary education system in Ukraine is to ensure the acquisition of appropriate qualitative skills and competences at school needed for work, innovation and active citizenship through the introduction of a specialized link education. The content of career counselling for secondary education involves the introduction of the process of individual and differentiated learning of students in grades 10 – 12 by interests, competencies and plans for self-realization.3. The legal basis for career counselling for secondary education system in Ukraine is the Constitution of Ukraine, the Laws of Ukraine “On Education”, “On Complete General Secondary Education”, the Concept of the implementation of state policy in the field of reforming general secondary education “New Ukrainian School” for the period up to 2029. For the effective reform of the general secondary education with the introduction of the career counselling component it is necessary to implement the provisions of the Law of Ukraine “On comprehensive general secondary education”, to develop and adopt the new Law of Ukraine “On Vocational Education”.The subject of further scientific research in this area will be the content and forms of organization of specialized education in secondary school.

Health Systems Strengthening Efforts Help to Improve the Delivery of Maternal Nutrition Interventions in Antenatal Care in Uttar Pradesh (UP), India but Gaps Remain

Abstract Objectives Frontline workers (FLWs) deliver essential nutrition services to reduce maternal undernutrition in India, but coverage and quality remain sub-optimal. Alive & Thrive aimed to strengthen delivery of interpersonal counselling, community mobilization and micronutrient supplements through the government antenatal care (ANC) platform in UP. We studied pathways through which the nutrition-intensified ANC (I-ANC) was intended to impact FLWs capacity, knowledge, and service delivery, compared to standard ANC (S-ANC). Methods We used a cluster-randomized design with cross-sectional surveys at baseline (2017) and endline (2019), ∼500 FLWs per survey. Differences between I-ANC and S-ANC were compared along six impact pathway components (training, availability of materials, supportive supervision, knowledge, service delivery, and counselling content) using mixed-effects regression adjusted for clustering. Results Training exposure was higher in I-ANC than S-ANC (9 percentage points, pp). Nutrition training topics were low-moderate (30–60%) in both arms. Job aids were more available in I-ANC (70–80%) than S-ANC (30–40%). Supply of iron-folate and calcium supplements were low in both arms, with 10–50% having stock-outs. FLWs in I-ANC were more likely to receive supervision visits (7 pp), but gaps remained in both arms. Compared to S-ANC, FLWs in I-ANC had higher knowledge on diet diversity (6 pp), adequate intake (10 pp), iron-folate (10 pp) and calcium supplements (30 pp), pregnancy weight gain (20–30 pp), and early breastfeeding (5 pp), but similarly low knowledge of exclusive breastfeeding. ANC check-ups by FLWs were 20 pp higher in I-ANC. FLWs in I-ANC did more counselling on adequate diet, supplements, and weight gain (10–20 pp). Counselling on diet diversity and breastfeeding were low in both arms. Conclusions Health systems strengthening efforts helped improve the delivery of maternal nutrition interventions in antenatal care in this context, but gaps remain. Several health system elements along the program pathway – supply chain management, training, supervisory practices – require strengthening to further improve FLW knowledge and nutrition service delivery. Funding Sources Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI 360.

Overview of Physical Activity Counseling in Primary Care

Physical inactivity is a global health burden. Promoting physical activity in primary care through physical activity counseling is an effective intervention. This article provides an overview of and perspectives on physical activity counseling in primary care. The identification of physical inactivity as a health problem may increase the awareness of physical inactivity among patients and primary care providers, which will lead to an action plan. The contents of physical activity counseling should be based on evidence-based recommendations. Safety issues should be evaluated appropriately to optimize the utilization of primary care services. Physical activity counseling methods should be “tailored” for an individual using appropriate counseling methods and setting-specific resources. Multilevel barriers to physical activity counseling in primary care (i.e., healthcare providers, patients, and systems) must be addressed. Setting-specific strategies to overcome these barriers should be implemented to maximize the effectiveness of physical activity counseling in primary care.

Critical Analysis of Nusantara Culture-Based Counseling: Professional Counseling Crisis Phenomenon by Counselor

The quality of counselor performance can be seen from the implementation of professional counseling that is complete and effective. On the other side, Indonesian counselors are struggling with Permendikbud No. 111 of 2014, which provides professional services at a ratio that approves a counselor serving 150 students. This makes it necessary for a counseling model that has a simpler, more concise procedure and immediately shows effective results accompanied by a load of cultural awareness in the implementation process. What has happened so far is that Indonesian counselors are still trapped in counseling models born from Western philosophy, not in accordance with the cultural, social and cultural diversity of Indonesia which often results in incomplete counseling processes. KIPAS counseling is a model of local culture-based counseling, making it effective to be applied in Indonesian counseling services. The reality that appears at this time is, the need for the amount of completion of the counseling implementation completely and effectively and is full of cultural understanding as the point of view of Indonesian counselors. This article uses a qualitative approach with a critical analytical method that aims to criticize the KIPAS counseling content that is reviewed based on the reality of the implementation of professional counseling by counselors in

Mainstream consent programs for genetic counseling in cancer patients: A systematic review

As demand for germline genetic testing for cancer patients increases, novel methods of genetic counseling are required. One such method is the mainstream consent pathway, whereby a member of the oncology team (rather than a genetic specialist) is responsible for counseling, consenting, and arranging genetic testing for cancer patients. We systematically reviewed the literature for evidence evaluating mainstream pathways for patients with breast, ovarian, colorectal, and prostate cancer. Medline, EMBASE, and Cochrane Library were searched for studies that met inclusion and exclusion criteria. Article references were checked for additional studies. Trial databases were searched for ongoing studies. Of the 13 papers that met inclusion criteria, 11 individual study groups were identified (two study groups had two publications each). Ten of the 11 studies evaluated the acceptability, feasibility, and impact of BRCA testing for patients and/or clinicians in different clinical settings in breast and ovarian cancer, while the final study explored the attitudes of colorectal specialists toward genetic testing for colorectal cancer. None involved prostate cancer. Overall, mainstream pathways were acceptable and feasible. Medical oncologist- and nurse-driven pathways were particularly successful, with both patients and clinicians satisfied with this process. Although the content of pretest counseling was less consistent compared with counseling via the traditional model, patients were largely satisfied with the education they received. Further research is required to evaluate the mainstream pathway for men with prostate cancer.

Evaluation of Postpartum Counseling on Future Health Risks Associated with Hypertensive Disorders of Pregnancy

Background: The American College of Obstetricians and Gynecologists and the American Heart Association recommend that women with hypertensive disorders of pregnancy be counseled on lifelong cardiovascular risks and transitioned to primary care for ongoing screening and management. Objective: To assess frequency and content of postpartum counseling regarding cardiovascular risk and follow-up among women with hypertensive disorders of pregnancy. Study Design: A secondary analysis of a randomized trial of women with hypertensive disorders of pregnancy, excluding chronic hypertension, performed at a single tertiary care academic hospital. We abstracted documented counseling on hypertensive disorders from the discharge summary and postpartum visit note in the electronic medical record. We defined counseling as documentation of any one of the following: 1) recommending aspirin in a future pregnancy, 2) follow-up with primary care, or 3) lifelong risk of cardiovascular disease. We used logistic regression models to estimate adjusted odds for receiving counseling. Results: Seventy-four women enrolled in the study. A hypertensive diagnosis was documented for 71 women (96.0%) in the discharge summary, but only 11 (14.9%) had any documented counseling in the discharge summary or postpartum visit note. Of the 11 women counseled, 5 (6.7%) were counseled on taking aspirin in a future pregnancy, 5 (6.7%) were counseled on follow-up with primary care, and only 3 (4.1%) were counseled on the lifelong cardiovascular risk associated with hypertension in pregnancy. Two women (2.7%) were counseled on follow-up with primary care and lifelong cardiovascular risk. There were no participants counseled on all three components. Later gestational age at delivery was associated with lower odds of counseling (adjusted OR 0.49, 95% CI 0.27-0.89). Conclusion: Despite consistent evidence on long-term risks of hypertensive disorders of pregnancy, counseling about those risks is suboptimal. Improved communication of risks is the first step towards improving maternal health in the “fourth trimester” and beyond.

The Impact of a Career Group Counseling Mix Model on Satisfaction of Low-achieving College Students──Specialty-Oriented Career Exploration Group Counseling

The unique feature of the group counseling program in this study is the integration of group counseling, individual counseling and peer tutoring. This study aims to determine the satisfaction level of low-achieving college students, who participated in the "Specialty-oriented Career Exploration" group counseling mix model. This study is an action research that lasts one semester. The research samples are 12 low-achieving freshmen students in the Finance Department of a business university (these students, as recommended by the class mentor, achieved average performance in the last fifth tier in their first semester), who participated in all three phases of career group counseling mix model. The unique feature of the group counseling program instituted in this study is the integration of group counseling, individual counseling and peer tutoring: (1) Phase 1: Group counseling before the mid-term exams, which included the design of structured career group counseling activities that were held eight times in eight weeks; (2) Phase 2: Individual counseling performed after mid-term exams; (3) Peer tutoring added to the process. According to the statistical analysis results of the satisfaction questionnaire, the results of the questionnaire show that they are very satisfied with the appropriateness of the overall planning (M=4.8; S=0.16); and that Specialty-oriented Career Counseling mix model is very helpfulimportant for individuals thinking about future careers (M=4.6; S=0.24).  The preventive measures adopted by the career counseling program received positive responses from students who participated in this career counseling group mix model, that they then became familiar with the counseling center. Group members who had serious emotional and interpersonal problems were willing to seek out counselors in the collage counseling center and continue with individual counseling. This study recommended that individual counseling or peer tutoring can be arranged after specialty-oriented career exploration group counseling, in order to meet the career counseling needs for various low-achieving college students. Lastly, this study offers specific suggestions, based on the research results, for "specialty-oriented career group counseling" in higher education to enhance the diversified contents of college career counseling.

Striving for interrater reliability with a patient counseling assessment rubric: Lessons learned

BackgroundProviding effective patient counseling is an essential pharmacist skill to ensure patients understand how to take medications, prevent medication-related errors, and meet requirements of federal law. This study sought to develop a new patient counseling assessment rubric to minimize interrater variability, deliver a consistent summative competency assessment, and provide students with formative, actionable feedback. ImpactA first attempt to achieve statistically significant interrater reliability was not successful due to incorporation of too many variables into study design and the subjective nature of patient counseling. After reducing study variables (number of different medications, number of evaluators, and number of videos) and consulting a statistician, a second attempt was made to analyze interrater reliability for the rubric. However, even with variables minimized, this attempt did not lead to statistically significant agreement. RecommendationsThe faculty team identified four recommendations (Omnibus Budget Reconciliation Act of 1990): conduct a norming session for graders prior to the assessment (Rantucci, 2006), conduct a post-hoc analysis after grading to reduce interrater variability and increase consistency (Taitel et al., 2012), simplify the rubric to reduce subjectivity and clarify the intent of rubric elements, and (Saranagam et al., 2013) rubrics can be utilized differently in separate courses to target specific learning objectives. DiscussionAlthough the goal of creating a rubric with statistically significant interrater reliability was not achieved, we did learn important lessons about evaluating student pharmacist performance with less subjectivity and more consistency. The authors hope the results and lessons learned will be valuable to our colleagues at other institutions as patient counseling content and rubrics are developed.

Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data

BackgroundAbortion is one of the major direct causes of maternal death, accounting for 7.9% globally. In Africa, 5.5 million women have unsafe abortions annually. Although maternal deaths due to complications of abortion have declined in Ethiopia, women still die from complications. Few studies have focused on providers’ clinical knowledge. This study investigates the level of health workers’ knowledge of comprehensive abortion care and its determinants in Ethiopia.MethodsData from the national emergency obstetric and newborn care (EmONC) assessment was used. A total of 3804 facilities that provided institutional deliveries in the 12 months before the assessment were included. Provider knowledge was assessed by interviewing a single provider from each facility. Criteria for selection included: having attended the largest number of deliveries in the last one or two months. A summary knowledge score was generated based on the responses to three knowledge questions related to immediate complications of unsafe abortion, how a woman should be clinically managed and what the counselling content should contain. The score was classified into two categories (< 50% and > =50%). Logistic regression was used to determine individual and facility-level factors associated with the summary knowledge score.ResultA total of 3800 providers participated and the majority were midwives, nurses and health officers. On average, providers identified approximately half or fewer of the expected responses. The multivariate model showed that midwives and nurses (compared to health officers), being female, and absence of training or practice of manual vacuum aspiration were associated with lower knowledge levels. Important facility level factors protective against low knowledge levels included employment in Addis Ababa, being male and having internet access in the facility.ConclusionTo increase knowledge levels among providers, pre- and in-service training efforts should be particularly sensitive to female providers who scored lower, ensure that more midlevel providers are capable of performing manual vacuum aspiration as well as provide special attention to providers in the Gambella.

The content of patient counseling about interchangeable medicines and generic substitution in Finnish community pharmacies\xa0- a survey of dispensers

BackgroundGeneric substitution aims to increase the use of more affordable generic preparations and restrain the growth of medicine expenditures. Pharmaceutical staff plays an important role in generic substitution by implementing substitution and counseling customers. The aim of this study was to explore how Finnish dispensers inform pharmacy customers about interchangeable medicines and generic substitution and what customers ask dispensers about generic substitution and the reference price system.MethodsA questionnaire was sent to a random sample of dispensers (n = 1054) working in community pharmacies in spring 2018. The data was analyzed using frequencies, percentages and the Chi-square test and Fisher’s exact test. The open-ended questions were analyzed first using inductive content analysis and later with the quantitative methods mentioned above.ResultsThe final study material consisted of 498 questionnaires (response rate 51%). The main topics dispensers always informed customers about were the physician’s record in the prescription not to substitute the medicine (69%) and that the prescribed or purchased interchangeable medicine did not belong in the reference price band (59%). Topics mentioned often by dispensers dealt with customer’s chance to choose their medicine from among several alternative products (68%) and the manufacturer of the interchangeable medicines (66%). Differences in appearance (33%) or in composition (28%) of interchangeable products were the most common topics mentioned only when the customer asked about them. Of the respondents 17.6% always and 51.4% often informed the customer about the least expensive interchangeable product at the point of dispensing. Customers’ questions about the generic substitution and reference price system most commonly (82.4%) concerned the similarity of interchangeable medicines.ConclusionsFinnish dispensers provide customers with a wide range of information about different subjects when dispensing interchangeable medicines. Patient counseling generally meets the legislative requirements, except for price counseling. In future, information about generic substitution and interchangeable medicines should continuously be provided to customers both at pharmacies and elsewhere, e.g. through educational campaigns.

A cross sectional study on knowledge, attitude and practice towards tuberculosis among health care workers

Health care providers play a major role in the management of tuberculosis (TB). The knowledge, attitude and practice towards TB in health care providers will have an impact on the treatment success or failure. Studies have reported that inadequate knowledge of the health care providers led to the delivery of improper counselling content to the recipients. We assessed the knowledge, attitude and practice (KAP) towards tuberculosis among health care workers in and around Chennai. A cross sectional study was conducted among 382 health care workers of the chest and tuberculosis department of government hospitals and directly observed treatment short-course clinics. The principal investigator administered a structured and validated questionnaire to the study participants. Around 500 healthcare workers were approached, and 382 showed interest to sign the informed consent. A majority (70%) of the study participants were between the age group 20-30 years. There was a highly significant difference (P = 0.006) in response to this between participants who had a history of active tuberculosis and undergone treatment for the same, and the participants with no history of TB. There was a significant difference between the study population based on their qualification and profession (P = 0.001 and P = 0.007 respectively) in using the Revised National Tuberculosis Control Program guideline for reference. The knowledge attitude and practice towards TB was good in more than 80% of the respondents, yet there is room to improve. Structured periodic training towards TB will further improve the KAP of health care workers.

Content and accuracy of fertility counseling via asynchronous digital women’s health clinics

Content and accuracy of fertility counseling via asynchronous digital women’s health clinics

Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study.

ObjectiveOur main objective was to examine if parental prenatal preferences predict delivery-room management of extremely preterm periviable infants. The secondary objectives were to describe parental involvement and the content of prenatal counseling given to parents for this prenatal decision.DesignProspective study of neonates liveborn between 22 and 26 weeks of gestation in France in 2011 among the neonates included in the EPIPAGE-2 studySetting18 centers participating in the “Extreme Prematurity Group” substudy of the EPIPAGE-2 study.Patients302 neonates liveborn between 22–26 weeks among which 113 with known parental preferences while parental preferences were unknown or unavailable for 186 and delivery room management was missing for 3.ResultsData on prenatal counseling and parental preferences were collected by a questionnaire completed by professionals who cared for the baby at birth; delivery room (DR) management, classified as stabilization or initiation of resuscitation (SIR) vs comfort care (CC). The 113 neonates studied had a mean (SD) gestational age of 24 (0.1) weeks. Parents of neonates in the CC group preferred SIR less frequently than those with neonates in the SIR group (16% vs 88%, p < .001). After multivariate analysis, preference for SIR was an independent factor associated with this management. Professionals qualified decisions as shared (81%), exclusively medical (16%) or parental (3%). Information was described as medical with no personal opinion (71%), complete (75%) and generally pessimistic (54%).ConclusionParental involvement in prenatal decision-making did not reach satisfying rates in the studied setting. When available, prenatal parental preference was a determining factor for DR management of extremely preterm neonates. Potential biases in the content of prenatal counselling given to parents need to be evaluated.

Content of Infant Safe Sleep Counseling and Maternal Reported Practices in an Urban Clinic

ObjectiveSudden Infant Death Syndrome is a leading cause of mortality in infants, and pediatric providers can influence caregiver infant safe sleep practices. We described the content of safe sleep counseling by pediatric providers and examined pediatric provider and caregiver factors that may be related to the delivery of safe sleep counseling. MethodsA sample of mothers and providers enrolled in the Safe Start Study, a randomized controlled trial assessing a safe sleep intervention, were audio-recorded during the 2-week well child visits (WCV) at a large urban pediatric practice in Baltimore, Maryland from October 2015 to April 2017. Provider counseling content related to infant sleep was transcribed and coded based on American Academy of Pediatrics (AAP) policy statement Grade A recommendations. Maternal reported infant sleep practices were defined by items on an interviewer administered survey. Multivariate logistic regression analyses were used to examine the relation between maternal reported infant sleep practices and provider counseling. ResultsMost, 92%, of WCVs included at least 1 safe sleep topic, but there was inconsistency in content delivered based on AAP recommendations. Yet, only 12% of WCVs included all 4 components of ABC counseling. Maternal report of infant sleeping with a person or an object in sleep space was associated with decreased odds of receiving counseling on alone no person, no objects (adjusted odds ratio: 0.34, 95% confidence interval: 0.13, 0.90). ConclusionsPediatric provider counseling on safe sleep is inconsistent across AAP recommendations demonstrating a need for enhanced provider education and a more standardized approach to assess infant sleep practices.

Development of Nationwide Recommendations to Support Prenatal Counseling in Extreme Prematurity.

To develop a nationwide, evidence-based framework to support prenatal counseling in extreme prematurity, focusing on organization, decision-making, content, and style aspects. A nationwide multicenter RAND-modified Delphi method study was performed between November 2016 and December 2017 in the Netherlands. Firstly, recommendations were extracted from literature and previous studies. Secondly, an expert panel (n = 21) with experienced parents, obstetricians, and neonatologists rated the recommendations on importance for inclusion in the framework. Thirdly, ratings were discussed in a consensus meeting. The final set of recommendations was approved and transformed into a framework. A total of 101 recommendations on organization, decision-making, content, and style were included in the framework, including tools to support personalization. The most important recommendations regarding organization were to have both parents involved in the counseling with both the neonatologist and obstetrician. The shared decision-making model was recommended for deciding between active support and comfort care. Main recommendations regarding content of conversation were explanation of treatment options, information on survival, risk of permanent consequences, impossibility to predict an individual course, possibility for multiple future decision moments, and a discussion on parental values and standards. It was considered important to avoid jargon, check understanding, and provide a summary. The expert panel, patient organization, and national professional associations (gynecology and pediatrics) approved the framework. A nationwide, evidence-based framework for prenatal counseling in extreme prematurity was developed. It contains recommendations and tools for personalization in the domains of organization, decision-making, content, and style of prenatal counseling.

Counselling and knowledge on iron and folic acid supplementation (IFAS) among pregnant women in Kiambu County, Kenya: a cross-sectional study.

Background: The increased demand for iron and folic acid during pregnancy is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: IFAS knowledge, availability, practices, and content of IFAS counselling among pregnant women attending health facilities in Kiambu County, Kenya. Methods: A cross-sectional study involving 364 pregnant women aged 15-49 years. A two stage cluster sampling, including one sub-county and five public health facilities were used. A pre-tested, structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed. Results: Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p <0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents. Conclusion: Less than half of the pregnant women had high IFAS knowledge, IFAS documents were scarce in health facilities, IFAS counselling information in different health facilities was limited and varied, and content of counselling was associated with levels of knowledge on IFAS. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women and standardization of counselling messages to improve compliance and pregnancy outcomes.

Patients' experiences with South Carolina's immediate postpartum Long-acting reversible contraception Medicaid policy

ObjectivesWe sought to examine women's experiences with immediate postpartum LARC counseling and use in the context of South Carolina's Medicaid policy. Study designIn 2016–18, we conducted semi-structured individual interviews with 25 women, ages 18–35, who gave birth within 2 years of the interview in South Carolina while insured by Medicaid and received contraceptive counseling about immediate postpartum LARC during their pregnancies. We analyzed the interviews using a combination of deductive and inductive coding approaches. ResultsParticipants were counseled on immediate postpartum LARC during prenatal care (n=23) and/or while in the hospital for childbirth (n=16). Some expressed dissatisfaction with providers' approaches to contraceptive counseling because they either did not receive enough information to make a fully informed decision or felt they were being pressured to use LARC. Among those who received in-hospital contraceptive counseling, some objected to the timing because they were in labor and/or already had a non-LARC postpartum contraceptive plan. Three out of the 10 participants who elected to receive immediate postpartum LARC later desired removal but encountered barriers. ConclusionsOur findings suggest providers' timing, style, and content of contraceptive counseling about immediate postpartum LARC may not be sufficiently patient-centered. Additionally, lack of access to unfettered LARC removal limits patients' reproductive autonomy. ImplicationsIf providers use a patient-centered approach to immediate postpartum LARC counseling, consistently engage in comprehensive contraceptive counseling during prenatal care, avoid pressuring patients to choose LARC, and collaborate with hospital staff to increase care coordination, they can improve Medicaid recipients' contraceptive care experiences and facilitate informed contraceptive decision-making.

Counselling and knowledge on iron and folic acid supplementation (IFAS) among pregnant women in Kiambu County, Kenya: a cross-sectional study.

Background: The increased demand for iron and folic acid during pregnancy is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: IFAS knowledge, availability, practices, and content of IFAS counselling among pregnant women attending health facilities in Kiambu County, Kenya. Methods: A cross-sectional study involving 364 pregnant women aged 15-49 years. A two stage cluster sampling, including one sub-county and five public health facilities were used. A pre-tested structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed. Results: Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p <0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents. Conclusion: Less than half of the pregnant women had high IFAS knowledge, IFAS documents were scarce in health facilities, IFAS counselling information in different health facilities was limited and varied and content of counselling was associated with levels of knowledge on IFAS. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women and standardization of counselling messages to improve compliance and pregnancy outcomes.

Do pharmacists counsel customers about the effects of sedating antihistamines on driving skills? A survey of community pharmacies in Saudi Arabia

ObjectiveTo investigate the level of counselling regarding the effects of sedating antihistamines on driving skills provided by private community pharmacies in Madinah, Saudi Arabia.MethodsThis study randomly selected private community pharmacies. Mystery shoppers following a similar scenario individually visited these pharmacies. These clients asked for a commonly used brand of sedating antihistamine and noted the counselling offered by the pharmacist. If spontaneous counselling was not offered, necessary information regarding the medication’s use was requested. Finally, the content of counselling was documented.ResultsOf the 100 pharmacies selected, 12 were excluded for various reasons and 88 pharmacies were included in the study. Only 23 pharmacies offered spontaneous counselling. Although 73.9% of pharmacists (65 of 88), spontaneously or upon request, mentioned sedation as a side-effect, only one pharmacist warned the client against driving after taking the medication, and three other pharmacists warned against dealing with hazardous machinery. Other side-effects were almost ignored.ConclusionA life-threatening insufficiency in the quality of counselling at Saudi Arabian private community pharmacies exists. Traffic accidents, secondary to the side-effects of sedating antihistamines, may be avoided if proper counselling is offered. Saudi Arabian authorities should take appropriate actions to ensure optimal practice in community pharmacies.

An Assessment of the Nature and Content of Premarital Counselling in the Bantama Assembly of Christ Apostolic Church International, Ghana

An Assessment of the Nature and Content of Premarital Counselling in the Bantama Assembly of Christ Apostolic Church International, Ghana