Counseling Issues Research Articles

Methodological Foundations of Psychological and Pedagogical Counseling

The article analyzes the theoretical and methodological foundations of psychological and pedagogical counseling in the sphere of today's education in the interdisciplinary aspects, in particular, neuropsychology and neuropedagogy. An attempt to substantiate psychological and pedagogical counseling as a service of providing psychological assistance to the client through training and forming a new experience of adaptive behavior in accordance with the requirements of the educational environment is made. Theoretical and methodological foundations of psychological and pedagogical counseling are analyzed on the basis of the works on the current issues of psychological counseling by foreign and domestic researchers. The importance of psycho-consultative interaction in the conditions of inclusive education and teaching special children, taking into account the competencies of neuropedagogy, neuropsychology and neurophysiology was substantiated. The personal approach in the methodology of today's psychological and pedagogical counseling is defined as the main one, which is integrated with psychological approaches to counseling. The methodological foundations of psychological and pedagogical counseling are defined by theoretical and methodological principles, psychological mechanisms for organizing and conducting counseling work and ethical principles and norms for manifestation of professional competence of a counselor. It was found that psychological approaches such as person-centered, problem-oriented, and professional-competence approaches are most often applied to psychological and pedagogical counseling.

Resident Education and Virtual Medicine: A Faculty Development Session to Enhance Trainee Skills in the Realm of Telemedicine.

COVID-19 accelerated the use of telemedicine. Subsequently, clinical sites began conducting virtual visits. Academic institutions implemented telemedicine for patient care and simultaneously had to teach residents the logistics and best practices. To meet this need, we developed a training session for faculty focused on telemedicine best practices and teaching telemedicine in the pediatric realm. We designed this training session based on institutional and society guidelines and faculty experience with telemedicine. Objectives included telemedicine documentation, triage, counseling, and ethical issues in telemedicine. We conducted all sessions in a 60-minute or 90-minute format over a virtual platform for small and large groups using case scenarios with photos, videos, and interactive questions. A novel mnemonic ABLES (awake-background-lighting-exposure-sound) was created to guide providers during the virtual exam. Following the session, participants completed a survey evaluating content and presenter effectiveness. We presented the training sessions between May 2020 and August 2021 to 120 participants. Participants included pediatric fellows and faculty, reaching 75 participants locally and 45 nationally (at Pediatric Academic Society and Association of Pediatric Program Directors meetings). Sixty evaluations (response rate: 50%) showed favorable results for general satisfaction and content. This telemedicine training session was well received by pediatric providers and addressed the need for training faculty to teach telemedicine. Future directions include adapting the training session for medical students and developing a longitudinal curriculum that applies telehealth skills learned with patients in real time.

Застосування кетогенної дієти в педіатрії: спектр можливостей

Purpose - to describe the possibilities of using a ketogenic diet (KD) in the pediatric population for therapeutic purposes in refractory seizure syndrome and congenital metabolic disorders. The historical aspects of the development of special medical nutrition to achieve stable ketosis in children for the treatment of seizures of various genesis are briefly highlighted; the development of the evidence base for the effectiveness of the KD in children is presented. A review of current data on the multifactorial mechanisms of neuroprotective effects of KD is carried out. In particular, individual ways of modulating fundamental biochemical pathways, presynaptic and postsynaptic changes in vesicular transport and release of excitotoxic and inhibitory substrates at synapses are considered. Four types of diets are described according to the distribution of proteins, fats, and carbohydrates: the classic, modified Atkins diet, medium-chain triglyceride diet, and low glycemic index diet. The indications and contraindications for the appointment of medical ketogenic dietary therapy are considered. The most appropriate age periods of childhood for the type of KD are outlined to achieve maximum effectiveness. The authors describe in detail the main objectives of the stages of preparation of the child and family for the start of dietary treatment, the principles of initiation of KD, laboratory and instrumental monitoring and discontinuation of ketogenic dietary therapy. Particular attention is paid to the issue of counseling a child before starting a KD, the main steps in calculating the proportion of macronutrients and the principles of daily nutrition. The possibilities of prescribing medical ketogenic dietary therapy outside of refractory seizures, in particular, in glucose transaminase 1 deficiency syndrome, pyruvate dehydrogenase deficiency, mitochondrial disorders, heart failure, and brain injury, are analyzed. Available special products for medical purposes (clinical nutrition) for the organization of medical ketogenic therapy in pediatric patients, especially in the first years of life, are presented. No conflict of interests was declared by the authors.

VOCATIONAL COUNSELING IN THE CONTEXT OF EDUCATIONAL PHILOSOPHY

In our age, the importance of raising people with analytical, creative and thought. thoughts is increasing day by day The aim of the modern education is to educate people who can solve problems by centering the person, aim to learn, and are aware of their interests and abilities. Therefore, considering education with a researcher and entrepreneurial spirit, human natural abilities should be developed and conscious guidance should be made about the profession. On of the main purposes of education is to guide people to choose a profession that is suitable for their knowledge and skills by improving their natural abilities. Because the purpose of education is to guide and educate people in line with their own goals. Therefore, education means raising people, disciplining them, imposing values. In addition, another purpose of education is to include teaching activities that include science, art, technique, culture and elements. Therefore, the education that starts with a certain goal continues with information acquisition and vocational teaching activities. In short, if we need to draw the pulley of education it can be said that education is the perfection of man. As Immanuel Kant (1724-1804) expressed, man has a unique equipment in terms of self-education. In the study, the importance of vocational counseling in the context of educational philosophy was once again taken into consideration. During the professional orientation process, the counseling relationship, professional development and issues that should be considered in directing the person in the choice of profession are emphasized.

A Qualitative Study of the Knowledge, Experiences, Perceived Roles, Cultural Barriers, and Skills of Community Pharmacists Dealing with Saudi Patients with Asthma

Background: In Saudi Arabia, asthma is one of the most common chronic respiratory diseases. Previous studies have identified that asthma management can be influenced by patients’ cultural beliefs and levels of asthma education. Therefore, community pharmacists should have good knowledge of both asthma and Saudi cultural beliefs to be able to effectively educate Saudi patients. Objective: The purpose of this study was to explore Saudi community pharmacists’ knowledge, experiences, and perspectives on providing care for Saudi patients with asthma. Materials and Methods: A qualitative method was employed to conduct semistructured interviews in the Eastern Province of Saudi Arabia. Community pharmacists were interviewed on the phone using an interview guide, and participants were recruited purposively. Verbatim transcripts of interviews were then thematically analyzed. Results: Analysis of 22 interviews resulted in five emergent themes: (1) lack of asthma knowledge among community pharmacists; (2) cultural and religious issues; (3) counseling issues; (4) patient medication issues and navigating the healthcare system; and (5) the need for asthma recourse and training. The findings indicate that community pharmacists have unsatisfactory levels of asthma knowledge and lack access to asthma guidelines in Saudi Arabia. It was also evident that the asthma management of Saudi patients was influenced by patients’ cultural and religious beliefs, which pharmacists needed to consider during patient counseling. Conclusions: Due to the lack of knowledge about asthma among our participants, there is an urgent need for asthma training. Furthermore, pharmacists should consider the impact of cultural issues on Saudi asthma patients to achieve better clinical outcomes.

Impact of COVID-19 on People With Aphasia: Emerging Rehabilitation Needs

Purpose:The purpose of this article is to address an emerging issue in rehabilitation counseling: The effect of the COVID-19 pandemic on people with aphasia (PWA).Method:Based upon a review of the literature this article provides an overview of (a) COVID-19 and emergent aphasia-related disability, (b) COVID-19 effects on stroke and aphasia services, (c) COVID-19 effects on mental health and employment of PWA.Results:This review of the impact of COVID-19 on PWA highlights the increased and emerging needs for rehabilitation counseling services related to an anticipated increase in incidence of aphasia related to COVID-19 illness and secondary impact of medical care for this population.Conclusion:The impact of COVID-19 on aphasia care in rehabilitation settings underscores the need for increased interprofessional education and collaboration to address the many gaps in aphasia care. Likewise, interdisciplinary research focused on rehabilitation outcomes in aphasia is needed to provide a foundation for evidence-based practice that conforms to the WHO-ICF framework.

Identification of Biallelic dystrophin gene variants during maternal carrier testing for Becker muscular dystrophy and review of the DMD exon 49-51 deletion phenotype.

Dystrophinopathies are X-linked recessive conditions caused by pathogenic variants in the dystrophin (DMD) gene. In a family that included two boys with Becker muscular dystrophy (BMD) due to a DMD deletion of exons 45-47, maternal carrier testing unexpectedly identified biallelic DMD deletions of exons 45-47 and 49-51. The patient's mild phenotype in the setting of biallelic DMD variants prompted further investigation of the exon 49-51 deletion in particular, via literature review and retrospective chart review of patients who have been evaluated in our institution's comprehensive neuromuscular center and/or diagnosed in our clinical genetic testing laboratory. To our knowledge, this is only the fifth case of confirmed biallelic DMD variants in a female. In males, the DMD exon 49-51 deletion appears to result in a mild BMD phenotype with low or normal creatine kinase levels. This deletion comprised 19% (4/21) of dystrophinopathies diagnosed by chromosomal microarray (CMA) in males during the past ten years in our clinical laboratory. Most individuals identified by chart review were diagnosed through CMA, despite the fact that microarray was genome-wide and not DMD-specific. This case raised important genetic counseling issues. The DMD exon 49-51 deletion appears to cause a variable but generally mild BMD phenotype. Its relatively frequent detection by CMA suggests it may be underdiagnosed.

Counseling the Academically Gifted Children

Statistically, the number of academically gifted children is quite many who are distributed in all areas. The academically gifted children will be beneficial for themselves and other people if they can develop optimally. Many academically gifted children are successful in their lives, however, we can find some of them feel difficulties. Because of that, they need counseling services. There are some important issues in counseling, especially for academically gifted children, such as (1) divergent thinking, (2) excitability, (3) sensitivity, (4) perceptiveness, and (5) entelechy. (6) self-concept, (7) counseling with parents, and (8) underachievement. To help in facing important issues, it is needed social-personal counseling, academic counseling, and career counseling. These three counseling approaches are needed simultaneously and depend on their needs. The models and strategies of counseling for academically gifted children are therapeutic, preventive, and developmental models. The choice of models is strongly determined by the need for effective counseling, to achieve the optimal result. To establish effective counseling, it is needed counseling services conducted by professional counselors.

Oculocutaneous albinism in southern Africa: Historical background, genetic, clinical and psychosocial issues.

Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80% of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programmes are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalisation and stigmatization of people with albinism and to improve their quality of life.

Primary lymphangioma, lymphedema of the lower limb of the fetus in the practice of ultrasound

Scientifically based and experimentally confirmed data on the morphogenesis of the lymphatic system are necessary to clarify critical periods of development characterized by an increased risk of congenital anomalies of the lymphatic system in order to plan and implement effective prevention, diagnosis and correction of related abnormalities. Among the studied anomalies of lymphatic vessels, lymphangioma is most often mentioned — a congenital benign tumor consisting of many cysts of various sizes. Detection of primary fetal lymphangioma in the early stages of intrauterine development is extremely rare. The purpose of the study: to report a case of early diagnosis of congenital cystic lymphangioma and lymphedema of the left lower limb of the fetus. Congenital (primary) peripheral lymphedema, limb lymphangioma is associated with a malformation of the lymphatic system. Taking into account the fact that operative methods of correction of all types of primary lymphedema are considered unreasonable and ineffective, the main attention requires timely detection of this congenital malformation during screening studies of the fetus and the issuance of recommendations for the management of pregnancy, up to termination for medical reasons. It is necessary to raise the issue of genetic counseling of the couple and conducting the necessary genetic studies. The use of modern diagnostic methods allows for the prevention and treatment of abnormalities in the development of the lymphatic system at an earlier stage of the intrauterine period.

Complexities in Genetic Counseling and Testing of Huntington's Disease: A Perspective from India.

Huntington's Disease (HD) is an autosomal dominant, progressive neuropsychiatric illness caused by CAG repeat expansion. The high penetrance of the mutation and limited treatment options make it challenging for patients and caretakers. Proper counseling enables families to cope better and make informed life choices. To explore some complex issues in genetic counseling and testing (GCAT) in HD. Vignettes of patients who underwent genetic testing along with pre and post-test counseling at our GCAT clinic. Case 1: Diagnosis of juvenile HD meant that the healthy parent was an obligate carrier of the mutation. Case 2: Consanguinity resulted in a dense prevalence of HD and >50% risk for the progeny. Case 3: Predictive testing in youth with healthy parents but affected uncles and aunts revealed a HD expansion. HD can present with complex inheritance patterns and proper counseling is necessary for better outcomes.

Perceived Need to Counseling Service and Associated Factors among Higher Education Institutions: The Case of Dilla University, Southern Ethiopia

In the university academic atmosphere, guidance and counseling practices are an efficient and effective way of supporting and helping students deal with problems and issues in educational, career, and personal/social areas. This study aimed to assess the magnitude, perceived need, and associated factors to counseling services of students in Dilla University, Southern Ethiopia. A mixed-study design was employed with both quantitative and qualitative research approaches. Both primary and secondary sources of data were employed. Data collection tools are questionnaires, focus group discussions, and in-depth interviews. The collected data were coded, entered, and analyzed using SPSS version 20 software. Quantitative data were presented as mean, percentage, frequency, and cross-tabulation. The qualitative data were analyzed and interpreted thematically, and the results are presented in narrative form. The finding of the study shows that there are a high number of students who need guidance and counseling at Dilla University from different colleges and departments. The student’s age level, sex, parental marital nature, the department they joined, family economy, occupation, and residence are the main factors that affect positively or negatively their counseling needs in higher education. The identified highest personal counseling needs and indicators in Dilla University students are for maintaining good physical and mental health, handling stress and anxiety in their life, solving personal problems, overcoming procrastination, dealing with stress due to their job, and coping with a broken relationship. The items that were indicated as having the lowest prevalence for concerns in terms of personal needs required by students were concerns about learning how to manage drug addiction, to become overcome insomnia, and reproductive health problems are the lowest need reported by participants of the study. This needs all stakeholders’ attention and support on the issues of guidance and counseling at Dilla University.

Exploring the role of practitioner lived experience of mental health issues in counselling and psychotherapy

AbstractInsights gained from lived experience of mental health issues are increasingly utilised in the delivery of mental health services, reflecting a growing recognition of the value of experiential knowledge. Despite this recognition, there is a dearth of literature on the lived experience of counsellors and psychotherapists, and as such, insight into how counsellors and psychotherapists understand and experience their dual patient‐therapist identity is limited. This study explores the role of practitioner‐lived experience in counselling and psychotherapy. Semi‐structured interviews were conducted with two counsellors and one psychotherapist, and transcripts were analysed using interpretative phenomenological analysis. Four themes were identified: (a) identity as a practitioner; (b) self‐disclosure as enhancing therapeutic relationships; (c) importance of supervision; and (d) healing and recovery. This study adds to a growing body of research on the value of experiential knowledge in the production of mental health services, providing insight into how lived‐experience practitioners experience their dual identity within their practice, and how they can be supported in exploring and valuing their experience.

Persistent Left Superior Vena Cava Significance in Prenatal Diagnosis-Case Series.

The persistent left superior vena cava (PLSVC) is a congenital heart anomaly reported in 0.3–0.5% of the general population and can be associated with congenital heart diseases in up to 8% of cases. Prenatal identification of PLSVC is important to prompt an extended cardiac and extracardiac fetal examination. We retrospectively reevaluated anomaly scans performed in our unit in a 2-year interval according to the national guidelines to evaluate the incidence of PLSVC and its association with prenatal morbidity. In our population, the incidence of PLSVC was 0.31%, and we found a low association with cardiac and extracardiac anomalies. The standard sections (three-vessel and trachea view, four-chamber view and outflow tract’s view) are insufficient to exclude cardiac anomalies whenever PLSVC is found. In our case series, only one newborn required postnatal surgery for total pulmonary vein anomaly, and at 2 years of life all babies had a normal evolution. Prenatal diagnosis of PLSVC can raise counseling issues; therefore, awareness of its good outcome when isolated and need for an extended examination to rule out other anomalies is very important.

Linguistic Features of Clients and Counselors for Early Detection of Mental Health Issues in Online Text-based Counseling.

Online counseling is essential for overcoming mobility restrictions, schedule limitations, and mental health stigma. However, government counseling offices are being inun-dated with consultations for which non-mental health supports are targeted. Therefore, we aim to create a classification model that classifies whether the clients have mental health issues or other issues. We expect to support counselors by presenting the classification results. We conducted the first automatic detection of clients who might be suffering from mental health issues and used almost 1000 actual counseling sessions for our machine learning framework. We achieved an F1-score of 0.646 by classifying dialogue sessions using features such as frequency-inverse, document frequency, document embedding of a large-scale language model, linguistic inquiry and word count, topic modeling, and statistics of dialogue sentences. In addition, we performed dimensionality reduction with principal component analysis. We also conducted evaluation experiments using dialogue sentences from the beginning to the middle of sessions as input and clarified the relationship between the number of messages in the dialogues and the transition in the classification performance. We also identified the words that contribute to detecting mental health issues for each client and counselor. Clinical relevance-This study makes it possible to detect the trends identified in a client's anxieties during counseling. Our findings are critical for designing systems that assist counselors.

Preservation of Cerebellar Afferent Pathway May Be Related to Good Hand Function in Patients with Stroke.

Many chronic stroke patients suffer from worsened hand function, and functional recovery of the hand does not occur well after six months of stroke. Therefore, predicting final hand function after stroke through acute phase imaging would be an important issue in counseling with the patients or their family. Thus, we investigated the remaining white matter integrity in the corticospinal tract (CST) and cortico-ponto-cerebellar tract (CPCT) at the acute stage of stroke and chronic hand function after stroke, and present the cut-off value of fiber number (FN) and fractional anisotropy (FA) of CST and CPCT at the acute stage for predicting final hand function after the recovery period. This retrospective case-control study included 18 stroke patients who were classified into two groups: poor hand function with stroke (n = 11) and good hand function with stroke (n = 7). DTI was done within two months ± 15 days after onset, and the Jebson’s Hand Function test was conducted 6–12 months after onset. The investigation of white matter was focused on the values of FN and FA for CST and CPCT, which were measured separately. The normalized (affected/non-affected) FA and FN values in the CPCT in the good hand function group were higher than those in the poor hand function group. The normalized FN and FA values in the CST were not significantly different between the poor hand function group and the good hand function group. The normalized cut-off value that distinguished the good hand function group from the poor hand function group was 0.8889 for FA in the CPCT. The integrity of the CPCT in the acute stage was associated with hand function in the chronic stage after a stroke. Ultimately, the integrity of the CPCT in the early stage after onset can be used to predict chronic hand function. Based on these results, cerebellar afferent fiber measurements may be a useful addition to predict hand function and plan specific rehabilitation strategies in stroke patients.

A Young Bangladeshi Boy with Primary Ciliary Dyskinesia (Kartagener’s Syndrome): A Rare Case

Kartagener’s syndrome, an autosomal recessive inherited disorder, is a subgroup of primary ciliary dyskinesias (PCD). This genetic disorder manifests from early life which distinguishes it from acquired mucociliary disorders. Kartagener’s syndrome presents as a classical triad of situs inversus, sinusitis and bronchiectasis occurring majorly due to impaired ciliary motility. A 16 year-old boy from Fulbaria, Mymensingh with left sided consolidation for 1 month and recurrent episodes of nasal congestion and lower respiratory tract infection (LRTI) since his childhood. Clinical and imaging findings revealed left sided consolidation, chronic sinusitis, bronchiectasis, dextrocardia, and situs inversus. He was treated with orally administered antibiotics, bronchodilators, mucolytics, and chest physiotherapy. He was symptomatically better with the above therapy, and started on a long-term low-dose prophylactic antibiotic. As there is no easy, reliable non-invasive diagnostic test for Kartagener’s syndrome and the correct diagnosis is often delayed by years, it may cause chronic respiratory problems with reduced quality of life. Genetic counseling and fertility issues should be addressed once Kartagener’s syndrome is diagnosed.
 CBMJ 2022 January: vol. 11 no. 01 P: 56-60

Prenatal diagnosis of diphallia in association with bladder exstrophy: a case report

BackgroundPenile duplication or diphallia is a rare congenital anomaly with unclear pathophysiological cause. Most cases of diphallia are reported postnatally; however, today with the use of a high-resolution ultrasound device, in-uterine diagnosis of many congenital anomalies is possible.Case presentationHerein we report a multiparous mother at 25 weeks of gestation who referred due to an abnormal cystic structure protruding from a large abdominal wall defect located below the umbilicus that was noted during a routine exam. Target scan revealed two penile-like protrusions with an empty scrotal sac and double bladder in an otherwise normal fetus, which was confirmed postnatally. Neonatal microarray study and karyotype were normal.ConclusionDiphallia could be detected prenatally as an isolated anomaly, associated with caudal duplication syndrome, or as an exstrophy-epispadias complex. As this is a rare congenital anomaly, all sonographers should be familiar with prenatal ultrasound features and associated anomalies, an important issue in prenatal counseling with parents, delivery planning, psychological support of the family, and postnatal management.

Are We Ready for Newborn Genetic Screening? A Cross-Sectional Survey of Healthcare Professionals in Southeast China.

ObjectivesTo understand the knowledge, attitude, willingness, and ability of healthcare professionals working in newborn screening (NBS) centers regarding newborn genetic screening (nGS).MethodsThe questionnaire consisted of four sections with 27 questions and the data were collected by the WJX platform. All participants accessed the questionnaire by scanning a specific QR code with their mobile phones. Two researchers independently completed the summary and analysis.ResultsA total of 258 valid questionnaires were collected from 43 NBS centers in six provinces of southeast China. In total, 209 (81.01%) participants were interested in nGS, and almost all participants (97.67%) thought that nGS was necessary in China. About 89.53% of participants thought that it could be used to effectively expand the diseases that could be screened, but 72.87% also worried about the inability to provide genetic counseling. About 55.34% suggested that nGS and tandem mass spectrometry (TMS) screening could be applied in a unite screening mode. The higher the institution and personal education levels, the higher the interest healthcare professionals displayed toward nGS. However, they also showed greater concern about the inability to provide genetic counseling and ethical issues. If a center had engaged in TMS screening, its staff would have been more likely to believe that nGS had great advantages. In addition, most participants had ethical concerns, such as “the psychological burden caused by carrying information regarding adult morbidity risk.”ConclusionMost participants were interested and considered nGS necessary. The inability to provide genetic counseling may be the primary impediment to clinical practice. Three important influencing factors were level of education, institution level, and engagement in TMS screening.

Опыт врачебной профессиональной консультации школьников в условиях детской поликлиники

The article reviews the issues of career counseling for adolescents with health problems. Goal. Show the possibilities and share the experience of providing career advice with focus on health to adolescents with health problems in the settings of primary health care establishments. Patients and methods. Nine hundred forty schoolchildren were counseled in the career advice room. The participants were divided into 3 groups: group 1 — participants with disabilities since early childhood, group 2 — children with chronic diseases, group 3 — children at risk of developing chronic diseases. The inclusion criteria were: status of a schoolchild, signed and submitted informed consent form, lack of exposure to occupational hazards. The conducted study does not endanger the participants and complies with the biomedical ethics requirements. Statistica 10.0 software was used for statistical processing of the data collected. Based on the results of this work and review of the relevant publications, authors of the study suggest a structure of the health- centric career advice service. Conclusions Career advice that factors in health aspects is an important link in medical and psychological rehabilitation aimed at helping the teenager to adapt to current socio-e conomic conditions and realize his/her physical and intellectual capabilities.