Family Counseling Research Articles

Global perspective of psychosocial care of patients with differences of sex development from low-income countries.

Management of Differences of Sex Development (DSD) is complex and in resource limited settings the psychosexual and psychosocial aspects of DSD care have received limited attention. This review aims to explore recent literature on psychosocial care of DSD in low and upper middle-income countries (L/UMIC). Scientific databases were searched and papers on management of DSD were reviewed according to predefined inclusion criteria. Papers published between January 2010 and July 2024 were screened for eligibility. Seventy studies specifically focusing on psychosexual and psychosocial aspects were identified. In these papers, the following aspects were studied in detail: gender identity, sexual behaviour, quality of life, perception of parents and society, communication and family counselling and socio-cultural and religious aspects. The geographical distribution and volume of studies on the psychosexual and psychosocial aspects of DSD in L/UMIC are mostly originating from East-and South-Asia and South & Central America. The findings underscore the need for integrated and culturally sensitive interventions to support the psychosocial well-being of patients and their families affected by DSD within resource-limited contexts. We highly recommend providing specific guidelines recognising the socio-cultural milieu and resource restricted settings. International collaboration providing education and training should be encouraged.

Media Use of Young Children: The Perceptions of Public Health Nurses Working in Child Health Clinics.

To describe the perceptions of public health nurses (PHNs) working in child health clinics on media use of young children and to investigate what are the perceptions of PHNs on adults' role in young children's media use. An electronic cross-sectional survey with Likert-scaled and open-ended questions. The total of 183 PHNs working in Finnish child health clinics. Statistical descriptive analysis for Likert-scaled questions and thematic analysis for open-ended questions were used. Most (96.7%) PHNs agreed that media use was very common among young children. According to PHNs, the negative impacts of media use of young children included social, physical, and psychological impacts. The positive impacts included learning, communication, and access to information. PHNs stated that parents were most responsible for intervening in media use of young children, but PHNs have an important role in counseling families on it. Most PHNs (80.9%) stated that parents did not control media use of their children effectively. PHNs are aware of impacts of media use and its prevalence among young children. They agree to have an important role in counseling families in it. More work in research is needed to improve PHNs' expertise and resources for them to be able to guide families in young children's media use. A wider perspective from other health care professionals working with families should be studied to constitute multi-professional understanding.

Simple Coaching Clinic to Improve Nurse's Knowledge of Genetic Counseling among Thalassemia Patients of Genetic Counseling among Thalassemia Patients

Introduction: The coaching clinic is one of the strategies designed to increase nurses' knowledge in conducting genetic counseling for patients and families of thalassemia patients. Nurses will not only be given information, but they will also be taught how to communicate and how to use genetic counseling to make sure the coaching clinic's goals are met. Objective: This study aims to describes the effect of a simple coaching clinic on nurses' knowledge of genetic counseling implementation in thalassemia care. Methods: This research used a quantitative approach and was conducted on August 20th–21st , 2022. The design of this study was quasi-experimental without a control group. This study obtained a total sample of 29 nurses using a proportional sampling technique and inclusion criteria. The inclusion criteria in this study were nurses with a diploma degree, an undergraduate education background, and registered nurses. The data collection instrument was a 30-questions genetic counseling questionnaire. IBM SPSS version 25.0 was used to analyze the data using the Wilcoxon test. Results: Simple coaching clinic proved to have a significant effect in improving the knowledge level of nurses in general with p-value = 0.004. Knowledge level improvement can be seen from Mean (+SD) 53.67 (+13.64) to 69.67 (+8.26). Likewise with nurses' knowledge about thalassemia, genetic counseling and bio-informatics, the majority of respondents experienced positive changes. In contrast to the genetic topic, the majority of respondents did not experience a change in their level of knowledge so that a p-value >0.05 was obtained. Conclusions: Changes in level of knowledge indicated that the coaching clinic's effects on level of knowledge are significant and have an impact on health services across a variety of health institutions, including clinics and hospitals. As a result, it is critical to have a health strategy that promotes the accessibility of genetic counseling services for patients with thalassemia and other genetic illnesses.

Genomics-informed neuropsychiatric care for neurodevelopmental disorders: Results from a multidisciplinary clinic.

Patients with neurodevelopmental disorders (NDDs) have high rates of neuropsychiatric comorbidities. Genomic medicine may help guide care because pathogenic variants are identified in up to 50% of patients with NDDs. We evaluate the impact of a genomics-informed, multidisciplinary, neuropsychiatric specialty clinic on the diagnosis and management of patients with NDDs. We performed a retrospective study of 316 patients from the University of California, Los Angeles Care and Research in Neurogenetics Clinic, a genomics-informed multidisciplinary clinic. Among the 246 patients who underwent genetic testing, 41.8% had a pathogenic or likely pathogenic variant. Patients had 62 different genetic diagnoses, with 12 diagnoses shared by 2 or more patients, whereas 50 diagnoses were found in only single patients. Genetic diagnosis resulted in direct changes to clinical management in all patients with a pathogenic or likely pathogenic variant, including cascade testing (30.6%), family counseling (22.2%), medication changes (13.9%), clinical trial referral (2.8%), medical surveillance (30.6%), and specialty referrals (69.4%). A genomics-informed model can provide significant clinical benefits to patients with NDDs, directly affecting management across multiple domains for most diagnosed patients. As precision treatments advance, establishing a genetic diagnosis will be critical for proper management. With the growing number of rare neurogenetic disorders, clinician training should emphasize core principles of genomic medicine over individual syndromes.

Family Relations of Muslims in the Post-Soviet Space: Main Features and Approaches to Psychological Counseling

The family relations of Muslims under present-day conditions are undergoing a signifi cant transformation. The increase in the number of divorces makes it necessary to look for the ways to resolve family confl icts and to harmonize marital relations. In this regard, the requirements for the qualifi cation of family psychologists consulting Muslim couples and families are increasing. It is not enough to master one or another method of family counseling for working with Muslim families. The most important role is played by the formation of the specialist's intercultural competence, as well as by mastering the knowledge and understanding the ethnic, religious and regional specifi cs of the clients. The culture of Muslim ethnic groups is collectivistic, which aff ects the relationships both within a married couple and within an extended family, whose role in Muslim communities is still important. In the article, this thesis is illustrated by the analysis of the author's practical case of family counseling. The author, based on the consideration of ethnic and religious values underlying Muslim family relations, examines the most eff ective psychotherapeutic approaches in working with Muslim families and couples.

Third-Line Therapeutic Interventions for Non-Neurogenic Bladder Dysfunction in Children.

The aim of this article is to review considerations and efficacy of third-line treatments for pediatric non-neurogenic bladder dysfunction, including Botulinum toxin A (BoTNA), Posterior Tibial Nerve Stimulation (PTNS), and Sacral Neuromodulation (SNM). Federal Drug Administration approval for use of beta-3-agonists in overactive detrusor activity in pediatric patients may provide an additional step prior to third-line therapies. New long-term data on pediatric SNM efficacy, complications, and revision rates will provide valuable information for counseling families. BoTNA offers a safe and efficacious treatment to decrease detrusor contractility and improve bladder capacity but is limited by the half-life of BoNTA agent. Percutaneous or transcutaneous PTNS offers improved voided volumes or cure in some patients but is time-intensive. SNM can be utilized in a variety of LUTD pathology with high success rate and cure but should consider cumulative anesthetic and fluoroscopic exposures for battery replacements and re-positioning for patient growth.

A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility. Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Demographic, preoperative physical examination, and radiographic data were collected from a multicenter national prospective cohort of patients with OCD of the knee. Inclusion criteria included patients <19 years of age and patients with arthroscopically confirmed mobility status based on the Research on Osteochondritis Dissecans of the Knee arthroscopy classification. Multivariable logistic regression analysis using stepwise model selection was used to determine factors associated with the likelihood of a mobile versus an immobile lesion. A 75% partition of the data was used for model training, and 25% was used as a validation cohort. Quantitative model fit statistics were computed using the holdout data, including sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC), along with the corresponding 95% CI. Results: A total of 407 patients in the prospective cohort met inclusion criteria, and 62% were male. The mean ± SD age was 13.7 ± 2.2 years, height 161.8 ± 5.3 cm, and weight 59.2 ± 42.2 kg. Arthroscopic evaluation yielded 235 immobile and 172 mobile lesions. Multivariable analysis determined that the best model to predict lesion mobility included chronologic age ≥14 years (P < .001), effusion on physical examination (P < .001), and any loss of range of motion on physical examination (P = .07), while controlling for male sex (P = .38) and weight >54.4 kg (P = .12). In the 25% holdout validation sample (n = 102), a sensitivity of 83%, a specificity of 82%, and an AUC of 0.89 (95% CI, 0.82-0.95) were achieved with these predictive factors. Conclusion: Age, effusion, and loss of motion can predict knee OCD lesion mobility at the time of arthroscopy. Education about lesion mobility can help with surgical planning and patient and family counseling.

Identification of mutation of MYOC (c.1099G&gt;A), a pedigree pathogenic gene of juvenile open angle glaucoma (JOAG): A case report

Rationale: The MYOC gene is associated with juvenile open-angle glaucoma (JOAG). This study aims to provide genetic counseling for a Chinese JOAG family by detecting MYOC mutations to identify high-risk individuals for early JOAG intervention. It also supplements the clinical characteristics of glaucoma patients with MYOC gene mutations. Patient concerns: A 43-year-old presented sought medical attention in a local hospital due to a 6-month decline in binocular vision. He was diagnosed as JOAG and underwent glaucoma surgery. The patient also had 11 family members with a history of JOAG. Diagnoses: After sequencing the polymerase chain reaction products of the patient, MYOC c.1099 G &gt; A (p.G367R) mutation was observed. That is consistent with a diagnosis of JOAG. Intervention: Polymerase chain reaction analyses of 9 patients and 42 healthy family members were performed to explore potential mutations associated with familial JOAG. Outcomes: JOAG assisted in diagnosing the III-5 proband. Genetic detection indicated that III-5 was exposed to a novel heterozygous missense mutation of MYOC (c.1099 G &gt; A [p.G367R]). The co-segregation of this gene with the trait observed in the pedigree was verified. All 10 participants exhibiting this mutation had JOAG phenotypes, whereas other participants did not show this mutation. In terms of MYOC mutation c.1099 G &gt; A (p.G367R), this mutation occurred when the 1099th nucleotide in the encoding zone of MYOC changed from G to A. Moreover, the 367th amino acid coded by this base got mutated from glycine to arginine. DNAMAN sequence homology results showed that the G residues of MYOC: 367 were significantly conserved among different species. In addition, 3D protein conformation predicted that these mutations could decrease protein stability. Lessons: MYOC c.1099 G &gt; A was identified as a pathogenic gene of JOAG in this pedigree. The addition of the MYOC mutant spectrum to JOAG in the Chinese population facilitates a complete understanding of the molecular pathogenesis and clinical diagnosis of MYOC.

Multiple Keratoacanthomas Associated with Genetic Syndromes: Narrative Review and Proposal of a Diagnostic Algorithm.

Keratoacanthoma (KA) is a relatively common, fast-growing epithelial tumour, with characteristic behaviour and clinical variability. Although it appears as a solitary lesion in a majority of cases, multiple KAs do occur, secondary to skin exposure to ultraviolet radiation, chemical carcinogens or certain medications, but may also be associated with various genetic syndromes. Thus, multiple KAs may serve as an early clinical alarm sign. Prompt diagnosis of the underlying cause and identification of the mechanism of development are critical for the secondary prevention of associated organ disorders or neoplasias, the improvement of patient quality of life and familial counselling. Although researchin this field has seen important progress in the last few years, there are still many pathogenic processes that have not been elucidated. Additionally, the literature on this topic is limited to individual case reports and small case series, making it difficult for clinicians to parse available data and select the essential information. Therefore, this work aims to review current knowledge, summarizing existing studies, with focus on multiple KAs associated with genetic syndromes, and proposes a diagnostic algorithm for these rare cases to help guide clinicians in their practice. Lastly, we aim to highlight the main gaps in understanding the underlying mechanisms and suggest further research avenues.

A family-based approach to cascade genetic testing in a pediatric cancer genetics clinic.

Hereditary cancer predisposition disorders account for up to 10% of all pediatric cancers. Genetic counseling for families of the proband includes risk assessment and recommendations for cascade genetic testing for parents and siblings, but there is no standardized method for cascade testing in place resulting in variability in how clinics approach cascade genetic testing. We explored the uptake and outcomes associated with a family-based approach to cascade testing, for non-syndromic cancer predisposition disorders, at a pediatric cancer genetics clinic serving an ethnically diverse patient population. A retrospective chart review was conducted to evaluate test uptake in the parents and siblings of 106 pediatric probands. The study included 99 mothers, 97 fathers, 116 full siblings, and 53 half siblings who were recommended testing due to genetic risk. Of these relatives, 156 (43%) had documentation of completed cascade testing within twenty-four months after the proband's result disclosure. Completion of cascade testing varied by the type of family member and degree of relatedness. 41% of mothers (41/99) were tested in comparison to 26% of fathers (26/97) and 70.6% of full siblings (82/116) were tested compared to 13.2% of half siblings (7/53). Statistical analysis using chi-squared tests revealed that siblings were more likely to have completed testing than parents (p < 0.001). Furthermore, amongst parents, mothers were more likely to complete testing than fathers (p = 0.03) and amongst siblings, full siblings were more likely to complete testing than half siblings (< 0.001). The proband's age (p = 0.008), parents' preferred language (p = 0.002), and interpreter use during visit (p = 0.004) were the factors associated with differences in test uptake amongst siblings, whereas the proband's race/ethnicity (p = 0.019) was the only factor associated with differences in test uptake amongst parents. The most common barriers noted in charts for lack of test completion included country of residence, lack of insurance, and loss to follow-up. In conclusion, we found that test uptake differed significantly among relatives of a proband with siblings being more likely to test than parents. We also found differences in the demographic and clinical factors associated with test uptake in parents and siblings. Future studies need to validate these differences and further explore the underlying cause of variation in test uptake among relatives.

Thoracolumbar Fracture

Background: Fractures of the thoracic and lumbar spine are increasingly common. Although it is known that such fractures may elevate the risk of near-term morbidity, the natural history of patients who sustain such injuries remains poorly described. We sought to characterize the natural history of patients treated for thoracolumbar fractures and to understand clinical and sociodemographic factors associated with survival. Methods: Patients treated for acute thoracic or lumbar spine fractures within a large academic health-care network between 2015 and 2021 were identified. Clinical, radiographic, and mortality data were obtained from medical records and administrative charts. Survival was assessed using Kaplan-Meier curves. We used multivariable logistic regression to evaluate factors associated with survival, while adjusting for confounders. Results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Results: The study included 717 patients (median age, 66 years; 59.8% male; 69% non-Hispanic White). The mortality rate was 7.0% (n = 50), 16.2% (n = 116), and 20.4% (n = 146) at 3, 12, and 24 months following injury, respectively. In adjusted analysis, patients who died within the first year following injury were more likely to be older (OR = 1.03; 95% CI = 1.01 to 1.05) and male (OR = 1.67; 95% CI = 1.05 to 2.69). A higher Injury Severity Score, lower Glasgow Coma Scale score, and higher Charlson Comorbidity Index at presentation were also influential factors. The final model explained 81% (95% CI = 81% to 83%) of the variation in survival. Conclusions: We identified a previously underappreciated fact: thoracolumbar fractures are associated with a mortality risk comparable with that of hip fractures. The risk of mortality is greatest in elderly patients and those with multiple comorbidities. The results of our model can be used in patient and family counseling, informed decision-making, and resource allocation to mitigate the potential risk of near-term mortality in high-risk individuals. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

FAMILY EDUCATION STYLES AND THEIR INFLUENCE ON THE FORMATION OF A CHILD’S PERSONALITY

The relevance of the study is due to the fact that it is now becoming important to consider the availability of the necessary factors for the successful development of the child. These include the psycho-emotional characteristics of the student, which are inextricably linked with the family system. The period of childhood is, on the one hand, the period of formation of individual abilities, and on the other, the time when the child is not emotionally separated from his family. The family system has the maximum impact on the psycho-emotional state, as well as on the disclosure of creative abilities. According with the opinion of L.S. Vygotsky that primary school age is a special period in a person’s life, we investigated children of this particular age group. Purpose of the study is to investigate the infl uence of parenting style on child development, as well as the relationship between parenting styles in families and the level of creativity in primary school children. The study sample included primary school students aged  to  years and their parents. Research methods included the technique for identifying the styles of family education by S. Stepanov, techniques for identifying the educational position (measures of care) of parents to a child by I.M. Markovskaya, Kettell’s multifactorial personality questionnaire for children from  to  years old (boys, girls), methods for identifying creative thinking - Torrens’ diagnosis of creativity. Study results. Relationships between parenting styles in families and the level of creativity in primary school children, as well as features of parenting styles, were identifi ed and described. A meaningful analysis of theoretical and empirical material was carried out, during which ideas about the relationship between the styles of upbringing in families and the level of creativity in primary school children were expanded. During primary school age, the upbringing style is an important factor that determines the psycho-emotional state of the child and the disclosure of the potential of creative abilities, as well as the development of such signs of giftedness as social courage and verbal intelligence. The results obtained can be used in the practice of family and child counseling, in the curriculum of training courses on family psychology and child-parent relations, school education programmes, etc.

Psychometric Features of the Emotional Climate Scale for Couples in Divorce Applicants

Background: In Iranian courts, counseling centers, and research institutes, the Family Emotional Atmosphere Questionnaire (FEAQ) by Navardgahfard in 1994 is widely used to assess the status of marital relationships. However, the FEAQ's contents are outdated, containing irrelevant questions, and lacking valid psychometric properties. Therefore, the aim of the present study is to revise and validate the psychometric properties of the Emotional Climate Scale for Couples (ECSC). Methods: This study was descriptive-correlational in nature and had practical implications. It was conducted from January 17th to July 30th, 2023. All divorce applicants referred by the courts to family counseling centers were included in the study population. Initially, the FEAQ was extracted from the website and modified to consist of 21 questions related to emotional climate between couples. Results: Subsequently, the face validity of ECSC was confirmed by experts, and exploratory factor analysis (N=307) demonstrated two subscales of lack of feelings and cooperation, and forced with limitations, explaining 63.26% of the variance in the 21 ECSC items. Confirmatory factor analysis (N=205) also indicated an acceptable fit for the ECSC model and showed good construct validity. The test-retest reliability (N=35, with a three-week interval) was 0.83 for the total scale, 0.82 and 0.81 for the two subscales, respectively, while Cronbach's alpha coefficients for the two factors were 0.93 to 0.94 and 0.96 for the total scale. Conclusion: Therefore, ECSC is a reliable and valid tool for assessing the emotional climate between couples and has wide applicability.

The Recurrent E-Cadherin (CDH1) Mutation c.760G>A Causes Orofacial Clefts but Does Not Predispose to Hereditary Cancer.

Objective: Congenital, non-syndromic orofacial clefts (CL/P) are infrequently monogenic in etiology. However, heterozygous pathogenic CDH1 germline variants were reported in a few non-syndromic CL/P families, as well as in one syndromic form of CL/P: the blepharocheilodontic syndrome. CDH1 encodes epithelial cadherin (E-cadherin), and close to 300 different pathogenic CDH1 variants are listed in the ClinVar mutation database. The majority of CDH1 germline variants are implicated in hereditary diffuse gastric cancer (HDGC) susceptibility. The purpose of this study was to classify the CDH1 c.760G>A (p.Asp254Asn) mutation with respect to its resulting phenotype. Methods: Exome sequencing and targeted Sanger sequencing were performed in a family segregating CL/P. A review of pathogenic CDH1 variants in ClinVar and those identified in a PubMed/MEDLINE search was performed. Results: We identified a family with six individuals, who were 35-77 years old (mean 56 years) at their last examination, uniformly affected with bilateral CL/P. The CDH1 c.760G>A variant segregated with CL/P. This variant had been reported in 21 individuals, most often children and young adults, from six families. We determined a significant sex preponderance for this variant regarding CL/P: all 16 male and 5 of 11 female heterozygotes presented with CL/P. Furthermore, none of the heterozygous individuals in seven families reported any gastrointestinal tumors. Conclusions: The recurrent CDH1 c.760G>A mutation confers a high risk for CL/P, with strong male preponderance. This review of 27 mutation carriers, including 3 who were 68, 70, and 77 years of age, indicates that c.760G>A does not confer an increased risk for HDGC. The relevance of differentiating craniofacial from cancer phenotypes in mutation carriers is substantial for precision medicine and for counseling families.

Clinical impact of genetic testing in a large cohort of pediatric cardiomyopathies

BackgroundThere are limited data that can explain the earlier penetrance and the different expressivity of pediatric cardiomyopathy (pCM) compared to adult-onset cardiomyopathy (aCM). In addition, the relationship between genotype and pCM results is poorly described. ObjectiveWe compared the genotypes between a cohort of aCM and a cohort of pCM to propose hypotheses on the earlier penetrance and expressivity of pCM. Finally, we report how genetic testing was used to guide genetic counseling in pCM. Methods253 pCM (<18 years old) and 1466 aCM patients were sequenced on a panel of 67 cardiomyopathy genes. Risk factors for death and heart transplantation were analyzed. ResultsIn pCM, the variant of interest (VOI) yield was 53.7 % including 24.2 % carrying two VOI. De novo variants represented 11 % of VOI in pCM and 50 % in restrictive pCM. An age at diagnosis younger than 1 year (HR = 2.07, p = 0.029), restrictive phenotype (HR = 2.87, p = 0.03) and the presence of two VOI (HR = 2.97, p = 0.001) were independent risk factors for death or heart transplantation.In comparison with aCM, pCM patients harbored more frequently two VOI (p = 0.02), or de novo variants (p = 4.10−13). In addition, the distribution of VOI was different in aCM and pCM. Genotyping of pCM improved genetic counseling in families and led to ten prenatal-diagnosis.Conclusions: Genetic testing provides clues for earlier penetrance of pCM. The presence of two VOI in children with CM is a risk factor for severe and early cardiac events.

Identification and transfer to stepped care of depressed and psychosocially stressed parents during peri- and postpartum—UPlusE: study protocol for cluster randomized trial of a screening intervention

BackgroundPerinatal depression affects 10–15% of mothers and approximately 5% of fathers. However, only a small number of affected individuals seek treatment. If left unrecognized and untreated, it can have negative long-term consequences for the family’s health, leading to subsequent high costs. Early treatment is crucial, yet there is a notable underdiagnosis and undertreatment. Affected individuals are often seen during this time, e.g. in paediatric practices, but not by specialists in mental health. Consequently, this study aims to increase detection and treatment rates of affected individuals by implementing a screening for depression and psychosocial stress in perinatal and postpartum parents within routine obstetric and paediatric care with subsequent advice and—if necessary—further referral to a mental health specialist.MethodsUPlusE is a prospective, cluster-randomized controlled trial conducted in an outpatient setting. Obstetric and paediatric practices will be randomized into an intervention and control group (1:1 ratio). Practices and enrolling patients will be required to use specific smartphone apps (practice apps) for interaction. The screening will occur with the apps at each paediatric checkup up to the child’s age of 12 months, using the Edinburgh Postnatal Depression Scale (EPDS), KID-PROTEKT questionnaire, and the scale 1 (impaired bonding) of the Postpartum Bonding Questionnaire (PBQ-1). The goal is to screen 10,000 patients across Germany. Gynaecologists and paediatricians will receive certified training on peripartum depression. Participants in the intervention group with scores above cut-offs (EPDS ≥ 10, KID-PROTEKT ≥ 1, PBQ-1 ≥ 12) will receive counselling through their treating gynaecologists/paediatricians and will be provided with regional addresses for psychiatrists, psychotherapists, and “Frühe Hilfen” (early prevention) as well as family counselling centres, depending on symptom severity. At each screening, participants will be asked whether they sought support, where, and with whom (utilization). Utilization is the primary outcome.DiscussionThe screening is designed to reduce underdiagnosis to enable suitable support at an early stage (especially for those often overlooked, such as individuals with “high-functioning depression”) and hence to avoid manifestation of mental health problems in the whole family, especially infants who are exceptionally dependent on their parents and their well-being will benefit from this program.Trial registrationGerman Clinical Trials Register, DRKS00033385. Registered on 15 January 2024.

The Impact of Social Networking Sites on the Family Cohesion of Algerian Society: Risks and Pros

Objective: Therefore, the aim of this study is to assess the impact of SNS on family closeness in the Algerian culture while looking at the benefits in addition to the drawbacks of using the technology. Theoretical Framework: Applying Social Capital Theory, Family Systems Theory, and Uses and Gratifications Theory allows the research to explain the connection between SNS and family cohesion and give a coherent concept of how the media affects family bonds. Method: A cross-sectional survey and qualitative interviews were used as main data collection tools from the families of different SES in Algeria; social networking usage patterns were also quantitatively measured by coded questionnaires and a qualitative approach was employed to explore the family dynamics and modes of communication. Results &amp; Discussion: This study revealed bi-directional relationship between SNS and family connectedness ; and, the following are the majority observation : Nevertheless, some families had lesser amounts of direct confrontation and roadside fights. The findings are elaborated in regard to theoretical frameworks. Research Implications: This research emphasizes on family therapy, counseling and education, and use of internet by families. It prescribes SNS usage as a means for a healthy functioning of families. Originality/Value: This work aims at giving a cultural angle to the effects of social networking sites (SNS) on family integration in Algeria while serving to substantiate the prior research on digitisation counterpoint in the area of relationship communication.

Retrospective Comparative Study of Lefort I Osteotomies With External or Internal Maxillary Distraction Devices

Introduction: This investigation aims to evaluate outcomes of LeFort I distraction osteogenesis (DO) using external distraction (ED) versus internal distraction (ID), focusing on acute complication rates and relapse/malocclusion necessitating a secondary LeFort I osteotomy. Factors associated with a higher likelihood of complication and secondary surgery are also described. Methods: A retrospective review of 467 electronic medical records was conducted for patients who underwent at least one maxillary or mandibular orthognathic procedure between 2003 and 2023. Results: Among these patients, 17% (79/467) underwent LeFort I with maxillary distraction and had at least 30 days of follow-up for acute complications. Eleven percent (50/467) underwent LeFort I with maxillary distraction and had at least 2 years of follow-up for the likelihood of a secondary LeFort I procedure. A statistically significant difference was seen in the number of acute complications for patients who used ED versus ID devices after LeFort I osteotomy with distraction. The need for secondary LeFort I osteotomy was not significantly different between patients using ED and ID devices. Conclusion: The complication and reoperation rates reported here may help counsel patients and families about potential outcomes and expectations for LeFort I advancement using ED and ID devices, as well as provide a point of comparison for future investigations.

Study of the Experiences of the Family Counselors of the Judiciary System to Identify the Effective Features of the Family Counseling in Reducing Family Disputes and Strengthening the Family

Aim: The aim of this study was to investigate the experiences of the family counselors of the judiciary system to identify the effective features of the family counseling in reducing family disputes and strengthening the family. Methods: This was a phenomenonological type of qualitative research. The participants in the research included 20 people (13 women and 7 men) whoe were family counselors at the judiciary system in several Iranian cities during 1399-1400 Persian calendar. Participants were selected using the purposeful sampling method according the entry criteria. Sampling continued until saturation was reached. In order to analyze the data, first, the data were recorded and coded, then analyzed using Van Menen's interpretive phenomenological analysis method. Results: The findings of the research included 6 main themes and 33 sub-themes of counselors' experiences as effective therapeutic features. The main themes obtained include: goals pursued to reduce family disputes and strengthening the family, characteristics of counselors, facilitating and promoting measures of counseling alongside the court proceeding, failure of resistance in clients beside the court, interventions to achieve change in order to reduce family disputes and strengthen the family and the characteristics of the counseling location in order to increase the effectiveness of the counseling near the court. Conclusion: The results of this study indicated that the counselors of the judiciary system who have a lower divorce rate at the end of the counseling sessions and are more successful in solving family problems than their other colleagues, have personal characteristics and principles governing their meetings as such that it provides safe and favorable conditions for this group of clients and paves the way for raising issues, listening to them, and ultimately resolving their concerns.

Recommendations for the training and practice of fetal cardiology from the Association of European Paediatric Cardiology.

Prenatal detection of cardiac abnormalities has increased significantly over the past few decades, such that fetal cardiology has developed into a sub-specialty of paediatric and congenital cardiology. As this speciality develops further and extends across Europe and more globally, it is important to standardize the requirements for training and subsequent practice, to optimize prenatal diagnosis and perinatal care. In addition to the knowledge and technical skills required to make a correct diagnosis, the counseling of families after diagnosis and the planning of appropriate perinatal management is equally important. The aim of these recommendations is to provide a framework for both basic and advanced training for paediatric cardiologists wishing to practice as fetal cardiologists, as well as highlighting requisites for a fetal cardiology service. All aspects regarding training in fetal cardiology and service provision are addressed including diagnosis, counseling and management.