Counseling Team Research Articles

Genetic counseling development and milestone in Oman

Genetic counseling as an emerging profession has seen an expansion around the world. In the Sultanate of Oman, the profession has developed with the establishment of clinical and biochemical genetic services in 2010 and genetic counseling services in 2011. Currently, three main genetic counseling teams serve the country through qualified genetic counselors who completed internationally-recognized MSc program. The genetic counselors are working in governmental clinical genetic units and play vital roles in enhancing the quality of genetic services dealing with pediatric and adult-onset disorders. The impact of the service is reflected in the escalated demand for preventative measures such as alternative reproductive options, premarital genetic counseling and testing as well as predictive counseling and testing. Despite the limited resources and absence of a licensing body, the genetic counseling profession in Oman is progressing. This special report describes the development of genetic counseling in Oman and the milestones reached. It details the areas of service, scope of practice, and the unique social and cultural nuances inherent to genetic counseling in Oman.

A nutrition-focused review of the interventions in US-living Latino communities with type II diabetes.

Type 2 diabetes (T2D) is a chronic, debilitating disease that disproportionally affects the Hispanic/Latino community residing in the United States. Optimal nutrition therapy is fundamental to the proper management of T2D and must be culturally adapted to facilitate permanent behavior change in this population. This review selected and assessed the nutrition components of interventions aimed to improve T2D outcomes in US-based Latinos/Hispanics, published from 2002 to 2023. An overview of the participant characteristics, nutrition intervention, and dietary assessment and outcomes is included. Nutrition interventions in this community benefit from the inclusion of bicultural registered dietitian nutritionist (RDNs) to assure the counseling team promotes culturally tailored nutrition recommendations based on current dietary guidelines. Nutrition assessment and outcomes should be captured with the use of validated dietary assessment tools and dietary quality indices appropriate to their target population. Standardizing these practices will facilitate intervention comparability and replicability and ultimately better target the needs of this community.

Molecular tumor board: Real-world experience in a tertiary cancer centre in Singapore.

107 Background: Genomic profiling is increasingly employed to support diagnosis and treatment of cancer. Our Molecular tumor boards (MTBs) serves as a collaborative platform for a multi-disciplinary team of oncologists, pathologists, scientists, bioinformaticians, genetic counsellors and research coordinators to discuss and match patients to the most relevant therapies and/or clinical trials. We report here the evaluation of our MTBs for year 2023 with the aim of identifying challenges and opportunities for successful implementation of precision oncology. Methods: Regular monthly MTBs were conducted to discuss molecular profiles from predominantly advanced-stage patients enrolled to the IMPACT study (Individualized Molecular Profiling for Allocation to Clinical Trials NCT02806388). Next-generation sequencing was performed either in-house using Oncomine or commercial FoundationOne panels. Additional tests such as whole transcriptome sequencing (WTS), immunohistochemistry (IHC) and fluorescent in-situ hybridization (FISH) were also performed where indicated. MTB recommendations were documented for follow-up and analysis. Results: A total of 102 out of 611 profiled patients were discussed in MTBs in 2023, with an average of 8.6 patients per month. Top 3 cancer types were gastrointestinal (32%), breast (18%) and lung (18%). 65/102 (63.7%) cases had MTB recommendations, of which 21 (20.6%) had multiple recommendations. Overall uptake rate for recommendations was 23.8% (29/122). Conclusions: MTB plays an important role in identifying therapeutic opportunities by factoring in patient variables, available data and physician experience while at the same time provides an avenue for further investigation to gather cumulative evidence. Frequent reasons encountered for not adopting the recommendations include: (1) insufficient sample to proceed with further investigations, (2) limited access to off-label treatments, and (3) additional considerations to participate in clinical trials. To fully realize the value of MTB, we will focus on (1) defining the molecular tests for efficient profiling, (2) crafting a route for special access to treatments and (3) increasing awareness and understanding of clinical trials. [Table: see text]

Cross-Sectional Analysis of Exome Sequencing Diagnosis in Patients With Neurologic Phenotypes Facing Barriers to Clinical Testing.

Exome sequencing (ES) demonstrates a 20-50 percent diagnostic yield for patients with a suspected monogenic neurologic disease. Despite the proven efficacy in achieving a diagnosis for such patients, multiple barriers for obtaining exome sequencing remain. This study set out to assess the efficacy of ES in patients with primary neurologic phenotypes who were appropriate candidates for testing but had been unable to pursue clinical testing. A total of 297 patients were identified from the UCLA Clinical Neurogenomics Research Center Biobank, and ES was performed, including bioinformatic assessment of copy number variation and repeat expansions. Information regarding demographics, clinical indication for ES, and reason for not pursuing ES clinically were recorded. To assess diagnostic efficacy, variants were interpreted by a multidisciplinary team of clinicians, bioinformaticians, and genetic counselors in accordance with the American College of Medical Genetics and Genomics variant classification guidelines. We next examined the specific barriers to testing for these patients, including how frequently insurance-related barriers such as coverage denials and inadequate coverage of cost were obstacles to pursuing exome sequencing. The cohort primarily consisted of patients with sporadic conditions (n = 126, 42.4%) of adult-onset (n = 239, 80.5%). Cerebellar ataxia (n = 225, 75.8%) was the most common presenting neurologic phenotype. Our study found that in this population of mostly adult patients with primary neurologic phenotypes that were unable to pursue exome sequencing clinically, 47 (15.8%) had diagnostic results while an additional 24 patients (8.1%) had uncertain results. Of the 297 patients, 206 were initially recommended for clinical exome but 88 (42.7%) could not pursue ES because of insurance barriers, of whom 14 (15.9%) had diagnostic findings, representing 29.8% of all patients with diagnostic findings. In addition, the incorporation of bioinformatic repeat expansion testing was valuable, identifying a total of 8 pathogenic repeat expansions (17.0% of all diagnostic findings) including 3 of the common spinocerebellar ataxias and 2 patients with Huntington disease. These findings underscore the importance and value of clinical ES as a diagnostic tool for neurogenetic disease and highlight key barriers that prevent patients from receiving important clinical information with potential treatment and psychosocial implications for patients and family members.

An early economic evaluation of Kooth, a web-based mental health platform for children and young people with emerging mental health needs

Background“Kooth” is a web-based mental health platform commissioned by the National Health Service (NHS), local authorities, charities, and businesses in the UK. The platform gives children and young people (CYP) access to an online community of peers and a team of counsellors. This study reports an early economic evaluation of the potential benefits of Kooth in the UK. MethodsAn early evidence cost calculator was built to estimate the potential costs and savings of implementing Kooth from a UK NHS and crime sector perspective. A decision tree structure was used to track the progress of CYP with emerging mental health needs (EMHN), comparing CYP with access to Kooth to CYP without access to Kooth. The model implemented a 12-month time horizon and followed a typical Kooth contract in relation to costing, engagement, and CYP demographics. ResultsThe base case results followed a cohort of 2160 CYP. The results of the cost calculator estimated that engagement with Kooth is associated with a cost saving of £469,237 to the NHS across a 12-month time horizon, or £236.15 per CYP with an EMHN. From a combined NHS and UK crime sector perspective, the cost savings increased to £489,897, or £246.54 per CYP with an EMHN. The largest cost savings were provided by an estimated reduction of 5346 GP appointments and 298 antidepressant prescriptions. For this cohort, the model predicted that engagement with Kooth averted 6 hospitalisations due to suicidal ideation and 13 hospitalisations due to self-harm. Furthermore, the number of smokers and binge drinkers was reduced by 20 and 24, respectively. When a crime sector perspective was taken, 3 crimes were averted. DiscussionThis early model demonstrates that Kooth has the potential to be a cost-saving intervention from both an NHS and a combined NHS and UK crime sector perspective. Cost savings were provided through aversion in clinical and social outcomes. The model used a conservative approach to balance the uncertainty around assumptions of the intermediate outcomes (GP and medication use). However, it is limited by a paucity of costing data and published evidence relating to the impact of digital mental health platforms.

Abstract PO1-08-07: Utilization Management: The Impact of Laboratory Genetic Counseling Oversight on BRCA1 and BRCA2 Targeted Analysis Orders

Abstract INTRODUCTION: While multigene hereditary cancer testing has become a common order for individuals with personal and/or family histories of cancer, targeted genetic testing (TGT) remains a cost-effective test option for cascade testing of individuals with a known gene mutation in the family. In order to proceed with TGT, the genetic testing laboratory must receive documentation of the specific variant. Intervention of a genetic counseling team (GCT), which includes laboratory genetic counselors and genetic counseling assistants, can play a major role in utilization management for genetic testing companies, including obtaining and reviewing mutation reports and offering clinically appropriate and cost-effective test options. Given previously reported low rates of cascade testing for family members of mutation carriers and the potential barriers of ordering TGT testing, we sought to review the success of providers ordering BRCA1 and BRCA2 TGT testing and the GCT role in management of these orders. METHODS: Per standard operating procedure at Labcorp, the GCT reviews all hereditary cancer genetic test orders before they begin processing through prior authorization and laboratory analysis. When societal guidelines dictate, GCT intervention may occur to request genetic testing reports and offer to update testing appropriately. A retrospective review of GCT notes on TGT orders was conducted, with review of all BRCA1 and BRCA2 TGT orders accessioned between January 1 and February 28, 2023. Orders that were updated or cancelled before GCT review were excluded from analysis. All other TGT orders were coded into one of seven categories: (1) ordered for TGT, mutation report provided, proceed without GCT intervention; (2) ordered for TGT, mutation report obtained after GCT intervention, proceed with TGT; (3) ordered for TGT, no report obtained, updated to BRCA1 and BRCA2 comprehensive sequencing and deletion/duplication analysis with or without other hereditary cancer genes (COMP) with authorization from ordering provider via GCT intervention; (4) ordered for TGT, report obtained, updated to COMP via GCT intervention; (5) ordered for TGT, no report or authorization to update testing obtained during GCT intervention, testing cancelled; (6) ordered for TGT and COMP, no report, TGT cancelled; and (7) ordered for COMP, mutation report obtained, updated to TGT with authorization from ordering provider after GCT intervention. Time between accessioning and initial GCT resolution was also collected. RESULTS: A total of 198 TGT orders and associated GCT notes were reviewed. 24 orders (12.1%) proceeded with TGT without GCT intervention (category 1) with an average turn-around-time of 1 day. GCT intervention was required for 158 (79.8%) of TGT orders with an average turn-around-time of 5 days. After GCT review and/or intervention, 60 (30.3%) orders proceeded with TGT analysis (categories 1, 2, and 7); 23 (11.6%) of these were originally ordered for COMP, then updated when a mutation report was obtained (category 7). Testing was updated from TGT to COMP because no mutation report was obtained in 78 (39.3%) cases (category 3). In 7 (3.5%) TGT orders, testing was updated to COMP even though a mutation report was obtained (category 4). CONCLUSION: TGT analysis is beneficial for cascade testing, but access to a mutation report as a requirement to proceed can be a barrier. More strategies are needed to provide education for ordering providers and patients on the benefit of sharing familial mutation reports for cascade testing. Efficiency of testing increases when patients and providers have access to records and provide this information to laboratories up-front. Laboratory GCTs are invaluable resources in reviewing nuanced genetic test orders, educating providers in the strengths and limitations of different genetic test options, and working to ensure patients receive clinically appropriate and cost-effective testing. Citation Format: Rebecca Vanderwall, Dagny Noeth, Angelica Goulbourne, Katherine Goode, Teresa Ruegg, Melissa Hayden, W. Christine Spence. Utilization Management: The Impact of Laboratory Genetic Counseling Oversight on BRCA1 and BRCA2 Targeted Analysis Orders [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-08-07.

Analysis of the Positive Interaction Development between Mental Health Counseling and Student Management

Objectives: Mental health counseling and student management are separate entities but closely related ones. Student management is an important part of the work of colleges and universities and plays a critical role in promoting students' all-round growth. Moreover, mental health counseling is an important contributor to student management. Methods: An analysis of basic theories and principles of mental health education and student management was undertaken. Results: Successful mitigation of common psychological problems of students is possible through a combination of approaches. Conclusions: Optimization strategies include cultivating a professional team of health counselors and counseling teachers, coordinating the development of mental health education and student management engineering, and offering psychological education courses, aimed at providing some theoretical reference for promoting the positive interaction between mental health counseling and student management.

A Qualitative Analysis of Cancer Patients' Perceptions of an Interprofessional Counseling Service on Complementary and Integrative Healthcare.

Medical guidelines recommend actively addressing patients' information needs regarding complementary and integrative healthcare (CIH). Within the CCC-Integrativ study, an interprofessional counseling program on CIH was developed and implemented at four comprehensive cancer centers (CCCs) in Germany. As part of the process evaluation, this study examines cancer patients' experiences with interprofessional CIH counseling sessions conducted by a physician and a nurse. Forty problem-centered interviews were conducted using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim, and analyzed using deductive-inductive content analysis based on Kuckartz and Rädiker's approach. Findings revealed that most participants had prior experience with CIH approaches and were burdened by physiological and psychological symptoms. Counseling sessions focused on cancer- and treatment-related symptoms and appropriate CIH recommendations (e.g., herbal poultice against anxieties and acupressure against nausea). Participants appreciated the mutual exchange and integration of perspectives from different healthcare professions within the interprofessional approach. They noted that the counseling team comprehensively addressed their healthcare and CIH information needs. Suggestions for improvement included the specificity of the CIH recommendations. As the participants only received counseling and no CIH treatments, information about reputable CIH providers was particularly important to many seeking advice. Patients with cancer receiving tailored CIH counseling from two healthcare professionals experienced benefits in CIH counseling for symptom management. The interprofessional teams offered a comprehensive perspective on patients' needs, proposing personalized recommendations for symptom control. These insights may foster collaboration between healthcare professionals interested in CIH counseling, enabling them to expand and consolidate their counseling services.

Patient Experience of Head and Neck Surgery With Free Flap Reconstruction

Major head and neck surgery with microvascular free tissue transfer reconstruction is complex, with considerable risk of morbidity. Little is known about patients' experiences, including decision-making prior to, and regret following, free flap surgery. To characterize patient experiences and decision regret of patients undergoing head and neck reconstructive free flap surgery. This mixed-methods cohort study comprising semistructured interviews was conducted June to August 2021 at a single tertiary academic cancer center. Participants underwent head and neck reconstructive surgery with microvascular free tissue transfer (flap) more than 3 months before recruitment (range, 3 months to 4 years). Interview transcripts were qualitatively analyzed for themes. Participants also completed a Decision Regret Scale questionnaire. Microvascular free flap surgery for head and neck reconstruction. Thematic analysis of interviews, decision regret score. Seventeen participants were interviewed. Median (IQR) age was 61 (52-70) years. Overall, 7 participants were women (49%), and 10 of 17 were men (59%). The most common free flap was fibula (8/17, 47%). Three major themes with 9 subthemes were identified: theme 1 was the tremendous effect of preoperative counseling on surgical decision-making and satisfaction, with subthemes including (1) importance of clinical care team counseling on decision to have surgery; (2) emotional context colors preoperative understanding and retention of information; (3) expectation-setting affects satisfaction with preoperative counseling; and (4) desire for diversified delivery of preoperative information. Theme 2 was coexisting and often conflicting priorities, including (1) desire to survive above all else, and (2) desire for quality of life. Theme 3 was perception of surgery as momentous and distressing, including (1) surgery as a traumatic event; (2) centrality of mental health, emotional resolve, and gratitude to enduring surgery and recovery; and (3) sense of accomplishment in recovery. On the Decision Regret Scale, most participants had no regret (n = 8, 47%) or mild regret (n = 5, 29%); 4 had moderate-to-severe regret (24%). In this mixed-methods cohort study, patient experiences surrounding major head and neck reconstructive free flap surgery were described. Opportunities to improve support for this complex and vulnerable population, and to mitigate decision regret, were identified.

Peningkatan Kinerja Guru Melalui Supervisi Pendidikan Terhadap Guru MA Negeri 2 Serang Provinsi Banten

This research is motivated by the decline in teacher performance in the process of implementing teaching and learning. One of the indicators of decreased teacher performance in learning is the decreased learning achievement of students in the MA Nederi 2 Serang Banten Province. The purpose of this research is to improve teacher performance through individual supervision of teachers at MA Negeri 2 Serang Banten. The research method used is qualitative. Data collection techniques using interviews, observation and documentation studies. Based on the results of the research shows that; First, the implementation of student counseling services is carried out through the creation of a student counseling program and the formation of a student counseling team. Second, implementation of academic supervision through approaches and techniques; class visits, observe teacher performance, observe material management, lead group discussions. Third, monitor the results of teacher academic leadership by discussing learning methods, use and assessment techniques, use of learning environments, and use of study time.

Development of a flipped learning course to deliver and scale molecular variant evaluation education: A quality improvement initiative.

Over the past several decades, molecular genetic testing volumes have grown and testing has expanded from single-gene assays to multigene panels, exome sequencing, and genome sequencing. The number of molecular genetic variants that require manual interpretation has grown simultaneously, resulting in an increased demand for education on molecular variant evaluation (MVE). To meet this growing need, a team of genetic counselors and educational experts undertook a quality improvement (QI) initiative with the objectives of assessing, standardizing, and scaling access to MVE education, without increasing instructor time to deliver the education. Using the Six Sigma define-measure-analyze-improve-control (DMAIC) framework, a flipped learning course with a series of standardized online modules was developed to deliver MVE education in an enduring and accessible format for a diverse group of learners. Outcome measures included the number of online modules developed, the number of individual learners and unique learner groups accessing MVE education, and direct instruction time required to deliver MVE education. Countermeasures to ensure maintenance of educational quality included post-course learner satisfaction scores and performance on competency assessments. Both the total number of learners and the number of unique learner groups accessing MVE education increased, while instructor time required to deliver content per learner decreased. Learner satisfaction scores remained constant and performance on competency assessments improved. The QI initiative successfully scaled MVE education to a diverse group of learners without decreasing learner outcomes or satisfaction. The flipped learning format provides a scalable and flexible educational model for instructors and learners in a rapidly changing environment that often includes remote work and education.

A unique collaborative model providing supportive and self-advocacy tools to the rare disease community

The National Ehlers-Danlos Syndromes (EDS) service is a highly specialised NHS commissioned service for diagnosing and supporting people with a rare, monogenic type of EDS. The service consists of a team of medical specialists and genetic counsellors. The EDS service has strong ties with national and international EDS charities, and together they participate in working and strategy groups alongside patients and carers. Acquired funding for research means that the service contributes to international knowledge regarding diagnosis and management of rare, monogenic EDS types. As a result of being a highly specialised service, there are multiple points of contact with patients, providing frequent opportunities for feedback. Patient data, surveys and collaborative working have enabled the development not only of extensive information resources and self-advocacy tools for patients, but also guidelines for health care professionals on the best ways to support their rare disease patients. The main challenges faced by patients affected by rare disease and the importance of self-advocacy are discussed, with the highly specialised National EDS service and the patients seen in this service as an example. The recommendations from this unique collaborative model include eight specific domains of self-advocacy: increasing knowledge of rare disease, taking care of mental well-being, taking care of physical well-being including routine care, the development of good working relationships between patients and health care professionals, information accessibility, emergency preparedness, taking part in education and outreach, and involvement in research and feedback opportunities. The service aims to be an example of patient-centred innovation and progress, providing a patient-focused supportive model that can be adapted by the rare disease community and other health care professionals.

A Study On College Counselors' Professional Well-Being Based On Tao Te Ching

College counselors play a vital role in the growth and success of college students as well as in supporting the teaching staff. The happiness of college counselors directly impacts their effectiveness and the stability of the counseling team, which in turn has a significant influence on achieving the moral education goals of the college. However, the increasing work pressure faced by college counselors in the rapidly developing higher education system in China has not been accompanied by a corresponding increase in their happiness level. To address this issue, this study takes a different perspective by examining the Tao Te Ching, a traditional philosophical text in China.The Tao Te Ching provides insight into the genuine significance of happiness. According to the authors of the Tao Te Ching, true happiness can be attained through cultivating peaceful thoughts, self-awareness, and self-reflection. It involves living a simple and authentic life, and approaching work with fluidity and an open mind. The aim of this study is to enhance the professional happiness of college counselors by examining and applying the principles of happiness found in the Tao Te Ching.

Sosialisasi Kesehatan Reproduksi Pada Remaja SMP Muhammadiyah 61 Tanjung Selamet

Adolescence is an important period that requires proper knowledge about reproductive health to avoid risks such as unwanted pregnancy, risky sexual behavior, and the spread of HIV/AIDS. This study aims to increase understanding and awareness of adolescent reproductive health at SMP Muhammadiyah 61 Tanjung Selamat through community service activities. Through counseling approaches and interactive discussions, students are provided with information about physical changes, reproductive health, and the impact of unhealthy behaviors. The results of this activity show the high enthusiasm of students in discussions and questions related to reproductive health, indicating the success of the program. This counseling provides a positive first step in equipping students with essential knowledge to make smart decisions related to reproductive health. For the continuation of the program, it is recommended to conduct periodic evaluations, form a team of trained adolescent counselors, and conduct monitoring by accompanying teachers to ensure the application of reproductive health information in students' daily lives. With support from educators and medical personnel, it is hoped that students can develop a better understanding of reproductive health and build a positive attitude towards self-care.

SCHOOL CONSULTATION MODEL IN VIETNAM

The school consultation model in Vietnam currently being implemented according to Circular No. 31/2017/TT-BGDDT effective from February 2, 2018, is the “Part-time teacher” model. The purpose of this exploratory study is to test the awareness of officials and teachers about the effectiveness of elements in the “part-time teacher” school consultation model in high schools in Ho Chi Minh City, Vietnam. The research sample was randomly selected from 4 high school heads and from teacher pedagogical training courses and management training classes, with 538 participants, of which teachers (69.0%), and managers (31.0%); in the study sample, there were (36.2%) participating in the school’s psychology team. Research subjects (28.6%) were trained in psychological consultation capacity by topic; (8.9%) training in psychological counseling capacity and granting training certificates; (5.4%) training for bachelor of psychology and master of psychology; (57.1%) had not studied through the psychological counseling competency program. The instrument’s validity and reliability were verified through the evaluation of Cronbach alpha analysis, and exploratory factor analysis (EFA). When analyzing the EFA factor, the results of the factors in the model have a positive correlation of 76.2% (R2 = 1.00), in the factors of personnel conducting consultations, policies for personnel participating in consultations, and policies for consulting personnel. Joining the school counseling team, the consultation process and the consultation room have not been paying attention.

The GC Immersive: Patching the pipeline with genetic counseling experiences for all.

Genetic counseling graduate programs largely recommend that prospective applicants shadow or gain exposure to genetic counselors (GC) as a means of developing insight into the profession. However, prospective students have cited this need to shadow genetic counselors as harder to access in comparison to other prerequisites. The GC Immersive (GCI) at Color was created as a no-cost, remote, self-paced professional exploration program designed to provide resources and live interaction with a team of genetic counselors to increase accessibility to GC exposure and enhance the competitiveness of underrepresented GC candidates. The program design and curriculum were developed by a team of certified genetic counselors and a GC student in 2021 and is marketed to those who have one or more identities underrepresented in the GC field. In total, 287 individuals enrolled in the program in the first and second cycles, with 115 providing demographic information. The majority of enrollees identified as an underrepresented minority in GC in one or more identities, with individuals who are ethnic and/or racial minority (70%), first-generation college student (44%), lesbian, gay, transgender, queer, intersex, and/or asexual (LGBTQIA+) (27%), and disabled community (16%) reported as the most common identities. Most participants had never shadowed a GC (55%) prior to this course. Twenty-two percent of enrollees resided outside of the United States, representing 15 different countries. Of the 287 enrolled participants, 21 (7%) have completed the program, with the remaining participants having between 5 and 11 months to complete. All individuals who completed the program reported they felt better prepared to apply for a GC program. The general structure of this program can be replicated by any institution, as the program consists primarily of recorded content. Ongoing effort by genetic counselors is minimal and has the ability to provide GC experience to prospective applicants at great scale.

Research on the Construction of College Counselor Team from the Perspective of Competency—Based on the Improvement of Learning Resilience

Based on the construction status of the college counselor team, this article analyzes the problems that exist in the team construction. Based on the basic characteristics of the competency perspective and with the aim of improving the learning resilience of medical students, this study aims to conduct research on the construction of the team of college student counselors. The aim is to demonstrate the mission and responsibility of counselors in college student management through the improvement of the team construction plan and the improvement of counselors’ comprehensive literacy, and to promote the steady development of college teaching management work.In the context of the reform of the education system in universities, college counselors, as grassroots forces in university management, can construct ideological and political education management work tailored to the characteristics of students, laying the foundation for the growth of college students. However, due to the heavy learning curriculum and high employment pressure of medical students, they prioritize postgraduate entrance exams over employment. Faced with conflicts between postgraduate entrance exams and clinical internships, there are psychological conflicts among students. The lack of autonomy and poor learning resilience in learning and daily life have an impact on the healthy growth of medical students. By continuously improving the team of college counselors, the characteristics, functions, influencing factors, methods, and carriers of enhancing the academic resilience of medical students and the construction of the counselor team have been clarified. The counselor’s service and education function has been fully utilized, combining practical problem-solving with ideological problem-solving. Focusing on the impact of academic resilience on students’ mental health, teachers and parents are encouraged to form a good learning psychology for students, Ensuring the healthy growth of college students plays a crucial role. Therefore, college student counselors should recognize the development status of the times, adhere to innovative ideas, build a counselor team training model based on the improvement of college students’ learning resilience, combine the characteristics of the competency model, and ensure the efficiency of various work execution through the cultivation of their own comprehensive abilities and the strengthening of work competence, to improve the overall level of counselor team construction, in order to meet the high level, distinctive, and The talent needs of international research universities.

The Role of the Neonatologist in Fetuses Diagnosed with Congenital Heart Disease.

Prenatal diagnosis of congenital heart disease (CHD) can decrease preoperative morbidity and mortality. Delivery room planning can improve cardiac hemodynamics and time to critical catheter and surgical interventions. Care algorithms have defined lesion-specific level-of-care assignments and delivery room action plans that can facilitate team-based approaches to safe deliveries. Neonatologists play critical roles in the care of fetuses diagnosed with CHD, from the time of diagnosis through the postnatal intensive care unit (ICU) stays. Prenatally, neonatologists are members of the multidisciplinary counseling teams, with expertise to counsel expectant parents about what to expect during the ICU stay, which is especially valuable in CHD associated with extracardiac or genetic anomalies. Neonatologists' role in delivery planning includes identification of the optimal delivery location and allocation of appropriate personnel and resources. After delivery, postnatal care considerations include hemodynamic stability, optimization of end-organ function, genetics consultation, developmentally appropriate care practices to encourage caregiver bonding, and optimization of care to improve neurodevelopmental outcomes of neonates with CHD.

Optimizing care of patients undergoing cardiac surgery using a digital platform and a multidisciplinary team approach

ObjectiveRestrictions to care access during the pandemic along with the increasing complexity of patients awaiting cardiac surgery provides unique challenges for care delivery. The University of Ottawa Heart Institute has developed a novel multidisciplinary digital platform, the Prehab Automated Follow-Up (AFU) Program, which delivers patient/caregiver teaching regarding risk factor mitigation, tracks patient symptoms, and screens for optimization using best practice guidelines. This study was conducted to quantify patient outcomes following initiation of the AFU Program. MethodsPatients awaiting elective cardiac surgery are enrolled and screened via automated telephone conversation, according to best practice guidelines, and a Short Form-12 preoperative assessment. Following this screen, patients are referred for an in-person assessment by an appropriate multidisciplinary team member; namely, a diabetes specialist, physiotherapist, dietitian, smoking cessation counselor, social worker, vocational counselor, and/or psychologist. ResultsSince initiation in February 2021, the AFU Program has enrolled more than 1237 patients with 508 multidisciplinary team referrals prompted by the AFU screening platform. Before program initiation, there were no multidisciplinary team referrals for preoperative optimization. Compared with patients treated between February 2020 and February 2021, there was a 2.5% decrease in hospital readmission rate within 30 days of surgery, a 0.6-day shorter hospital stay, and a 2.5% decrease in surgical site infection. ConclusionsOur cardiac surgery AFU Program reduced adverse health outcomes for patients by identifying and optimizing risk factors that increased quality of patient care. The AFU Program provides patient/caregiver engagement through educational support and multidisciplinary team counseling.

Analysis on the Problems and Countermeasures of the Professional Development of College Counselors

The team of college counselors is an important component of the framework of China's higher education system. In order to enhance the professional identity of college counselors, overcome the dilemma of unclear career positioning and future development, and explore a better path to achieve their professional development, the management team should do a good job in checking the selection and employment of counselors, optimize their onboarding training mode, clarify the boundaries of job responsibilities, and strengthen professional psychological identity. At the same time, counselors should also improve their professional abilities and knowledge level, and better engage in moral education work. This article proposes countermeasures and suggestions for the professional development of counselors, in order to provide reference for their professional development.