Need For Counseling Research Articles

Standardizing Nutritional Care for Cancer Patients: Implementation and Evaluation of a Malnutrition Risk Screening.

Introduction Cancer-related malnutrition is a highly prevalent, yet often overlooked concern in clinical practice. Although cancer-related management guidelines recommend standardized nutritional care, its implementation is scarce. The aim of this study was to investigate the prevalence of malnutrition and the medical need for nutrition counseling in cancer patients employing a novel standardized nutritional management program (containing malnutrition risk screening, nutritional assessment and counseling). Furthermore, differences of malnutrition parameters in different cancer patient cohorts were examined. Methods Cancer patients were screened for malnutrition using the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) on the first day of their inpatient admission to the internal oncology or hematology wards. PG-SGA total score and classification into the three PG-SGA nutrition stages (A, B, C) were used to determine nutritional status. In case of a positive screening, nutritional assessment and individualized counseling by a nutritionist followed. For group comparisons, patients were divided into different groups (e.g., age, gender, tumor entity) and were evaluated accordingly. Results A total of 1,100 inpatients were included. 56.8 % of the patients had suspected or already existing malnutrition. The most common nutrition impact symptom was loss of appetite (26.7 %), followed by fatigue (16.5 %) and pain (16.0 %). Female (p < 0.001), elderly (p < 0.001) and patients with upper gastrointestinal tract tumors (p < 0.001) showed an unfavorable nutritional status and higher need for counseling. Despite suffering from malnutrition, patients had Body Mass Indices within the upper end of the normal range. Conclusion This study shows a high prevalence of malnutrition in hospitalized cancer patients and highlights the need for a standardized nutritional management in the clinical setting. Therefore, it is recommended to provide a malnutrition risk screening for all cancer patients and a following adequate assessment and personalized nutritional care if needed.

Ultra-processed food consumption and risk of coronary heart diseases: UK Whitehall II cohort study

Abstract In recent decades, ultra-processed foods (UPFs) intake has increased drastically, sparking concerns about their potential impact on cardiometabolic diseases. However, large-scale cohort studies tracking UPF consumption at multiple time points remain limited. This study explores the prospective association between repeated measures of UPF intake and the risk of coronary heart disease (CHD), along with its secondary endpoints, within the UK Whitehall II study. The analytical sample tracked 7,138 midlife British participants without CHD from baseline. UPF consumption was measured using validated food frequency questionnaire (127 items) and classified by the NOVA system during three phases: 1991/1994 (phase 3), 1997/1999 (phase 5), and 2002/2003 (phase 7). This study assessed the onset of CHD and its secondary endpoints, including CHD and all-cause mortality, through medical exams and hospital records up to 2016 and 2021, respectively. Cox proportional hazards regression models adjusted for socio-demographics, lifestyle factors and total energy intake were used to explore the prospective association between cumulative average UPF intake (in quintiles) and CHD outcomes. During a median follow-up of 13 and 19 years, 589 cases and 1,314 deaths were documented. In multivariable adjusted cox models, the highest UPF consumption quintile versus the lowest quintile was associated with higher CHD incidence [HR:1.26; 95% Confidence Interval (CI): 1.02-1.55; p = 0.03]. Additional adjustment of total energy intake increased the CHD risk by 28% [HR:1.28; 95% CI: 1.03-1.58; p = 0.02]. No significant relationships were found between cumulative average UPF intake and CHD or all-cause mortality. In UK midlife adults, higher UPF intake is prospective associated with increased CHD risk. Although additional research is warranted, these findings emphasize the importance of public awareness and food policy interventions to reduce UPF intake for alleviating the population burden of CVD. Key messages • Our study suggests the need for increased efforts to implement population wide strategies on regulating food processing, such as taxation and front of package warning labelling of UPF. • Our study emphasizes UPF’s role in cardiovascular prevention, highlighting the need for nutrition counseling on UPF consumption for those at risk of CVD.

A survey to analyze the need of genetic counseling among doctors in Lahore, Pakistan.

Pakistan with a population of approximately 200 million people faces a significant burden of genetic disorders. Higher preference for consanguinity (73%) is one of the significant reasons. Despite being a hub for rare genetic disorders, the country lacks professionally trained genetic counselors due to the absence of postgraduate degree programs or diplomas in genetic counseling. This shortage of specialized personnel results in inadequate and limited genetic counseling practices nationwide. This study aimed to highlight the urgent need for genetic counseling in Pakistan, focusing on the gaps within both society and the healthcare infrastructure. A survey-based study involving n = 101 participants was conducted to assess the demand for genetic counseling among medical professionals in Lahore, Pakistan. The study targeted five categories of medical specialists-gynecologists, oncologists, psychiatrists, pediatricians, and ultrasonologists-working in both private and public healthcare settings in Lahore. The survey included a questionnaire covering demographic information, 10 general questions, and a case study with follow-up questions. The survey was conducted both online and through in-person visits. Our findings reveal a significant lack of awareness among healthcare providers, with 91.1% of respondents unaware of any genetic counseling services or genetic counselors in Lahore. The research underscores the crucial role of genetic counselors, with the vast majority (99%) of specialists expressing an urgent need for their presence in Pakistan's healthcare system. This study highlights that only qualified genetic counselors can effectively address genetic issues. Furthermore, it advocates for the introduction of specialized professional training programs to address this pressing need in the country.

Impact of Small Group Counseling and Family Support on Increasing Complete Basic Immunization (CBI) Coverage at Siak Health Center

Complete Basic Immunization (CBI) is a crucial public health goal at the Siak Health Center. In recent years, the coverage has decreased from 48% in 2022 to 45.9% in 2023, necessitating effective interventions. This study assesses the impact of small group counseling and family support on increasing CBI coverage. The methodology involves direct small-group sessions and ongoing family visits in informal settings. Counseling materials were supported with visual aids to improve knowledge among mothers about the importance of immunization. Results indicate a positive response from participants, highlighting increased understanding and motivation. This study underscores the need for continuous counseling and monitoring to ensure higher immunization rates.

Case Report on Griscelli Syndrome with Hemophagocytic Lymphohistiocytosis

Objective: This case report was written with the intention of educating pediatric caregivers regarding the early detection and management of Griscelli Syndrome type 2 (GS2), thereby preventing fatal consequences, and to draw light on the necessity for premarital genetic counselling and education in public. Case Report: A two months and 7 days old male baby presented with tachycardia, fever, abdominal distension, cough, loose stools, and vomiting. Head to toe examination showed hypo-pigmented hair with silvery grey eyebrows and eyelashes. Bone marrow aspiration showed increased histiocytes exhibiting haemophagocytosis. Suspecting Griscelli Syndrome, genetic test was done which indicated RAB27A gene mutations, thereby confirming the GS2 diagnosis. The child was treated with 2 litres of oxygen with nasal prong, meropenem, fluconazole, dexamethasone and packed red blood cell transfusion. In view of worsening sepsis baby was given with vancomycin, tigecycline and cyclosporine and later intubated. Conclusion: Consanguineous marriages are common in India and are one of the major reason for autosomal recessive disorders like GS2 in newborns. This highlights the need of both premarital genetic counseling and education among public. Keywords: Hypopigmented hair, haemophagocytosis, abdominal distension, RAB27A mutation

Clinical and molecular cytogenetic findings of cat eye syndrome and a 2-year-old patient with congenital aural atresia and hearing loss

BackgroundCat eye syndrome (CES) is a rare congenital disease frequently caused by a partial tetrasomy of the proximal long (q) arm of chromosome 22, due to a small supernumerary marker chromosome (sSMC). CES patients show remarkable phenotypic variability. Despite the progress of molecular cytogenetic technology, the cause of phenotypic variability and the genotype–phenotype correlations remain unknown.MethodsWe analyzed clinical and genetic data of a new patient with CES together with 27 previously reported ones with a confirmed genomic gain in the PubMed database between 2012 and 2023.ResultsWe reported a boy with CES carrying a 22q11.1-q11.21 duplication of 1.76 Mb tetrasomy (16888900_18644241, hg19) who presented currently rare or unreported clinical findings such as congenital aural atresia, hearing loss, PLSVC, and IVC. The results of the whole exome sequencing (WES) showed a heterozygous mutation of the GJB2 gene (NM_004004.6: exon2: c.109G > A). In addition, the results of our literature review showed that the presence of a classical sSMC was the most frequent cytogenetic abnormality in CES (82%). 63% of cases were in a homogenous state and 37% of cases were in a mosaic state. 72% of cases had a 1–2 Mb duplication. In the majority of CES patients the breakpoints in chromosome 22 are localized to a 50 kb region (18610000_18660000 bp). The CES critical region (CESCR) may be further delimited to a 0.3 Mb region (17799398_18111588 bp). Within this region CECR2, SLC25A18, ATP6V1E1, and BCL2L13 are strong candidate genes for causing the main CES phenotype. The ear anomalies are the most frequent features in CES patients (89%) and hearing loss was present in 36% of CES patients.ConclusionsThe phenotypic features in CES are highly variable. Our findings expand the symptom spectrum of CES and lay the foundation for better delineating the clinical phenotype, molecular cytogenetic features associated with CES and genotype–phenotype correlations. We recommend performing WES to rule out the involvement of other genetic factors in the patient’s phenotype. In addition, our findings also highlight the need for genetic counseling and recurrence risk assessment.

A virtual assistant for primary care's food and nutrition surveillance system: Development and validation study in Brazil

ObjectiveThe study aimed to develop and validate a conversational agent (chatbot) designed to support Food and Nutrition Surveillance (FNS) practices in primary health care settings. MethodsThis mixed-methods research was conducted in three stages. Initially, the study identified barriers and challenges in FNS practices through a literature review and feedback from 655 health professionals and FNS experts across Brazil. Following this, a participatory design approach was employed to develop and validate the chatbot's content. The final stage involved evaluating the chatbot's user experience with FNS experts. ResultsThe chatbot could accurately understand and respond to 60 different intents or keywords related to FNS. Themes such as training, guidance, and access emerged as crucial for guiding FNS initiatives and addressing implementation challenges, primarily related to human resources. The chatbot achieved a Global Content Validation Index of 0.88. ConclusionThe developed chatbot represents a significant advancement in supporting FNS practices within primary health care. Practice implicationBy providing an innovative, interactive, educational tool that is both accessible and reliable, this digital assistant has the potential to facilitate the operationalization of FNS practices, addressing the critical need for effective training and counseling in developing countries.

9185 Pembrolizumab-Induced New-Onset Type 1 Diabetes Mellitus: A Case Report

Abstract Disclosure: D. Teng: None. T.L. Connelly: None. M. Ahmad: None. R. Saeed: None. Introduction: Immune checkpoint inhibitors are becoming essential in the treatment of various cancers. Pembrolizumab is a monoclonal antibody that binds PD-1 receptors, thereby enabling an anti-tumor response by preventing T-cell suppression. Common side effects associated with pembrolizumab include thyroid disorders, hepatitis, pneumonitis, and acute kidney injury, among others. We describe an interesting case of a woman presenting with diabetic ketoacidosis (DKA) in the setting of pembrolizumab-associated new-onset type 1 diabetes mellitus, which was reported at 0.1% during initial clinical trials but is now being increasingly recognized as a complication of immune checkpoint therapy. Case Description: The patient is a 70-year-old female with past medical history notable for stage IIIA vulvar squamous cell carcinoma initially diagnosed and treated in 2017, with recurrence in 2022 and in 2023, at which point pembrolizumab therapy was initiated. Approximately one month after her first dose, the patient presented to the emergency department with palpitations, nausea, non-bloody vomiting, polydipsia, and non-bloody diarrhea. On arrival, the patient’s vital signs were as follows: 97.2 °F, BP 128/74 mmHg, heart rate 80 bpm, respiratory rate 18 per minute, and SpO2 100% on room air. No acute findings were noted on physical exam. Initial blood work was notable for: pH 7.146, lactate 2.4 mmol/L, bicarbonate 8 mmol/L, anion gap 37 mmol/L, creatinine 1.59 mg/dL, glucose 563 mg/dL, C-peptide 0.16 ng/mL, HbA1c 6.9%, and WBC 18.8 B/L with neutrophilic predominance. Urinalysis was notable for 4+ glucose and 4+ ketones. The patient was admitted to the progressive care unit and DKA protocol was initiated including the administration of IV fluids, insulin infusion, and electrolyte replacement. Additional blood work was unrevealing, including insulin autoantibodies &amp;lt;0.4 U/mL, negative islet cell IgG cytoplasmic autoantibodies, and negative anti-GAD65 antibodies. The patient was eventually discharged with outpatient Endocrinology follow-up. Discussion: Immunotherapy is quickly redefining the standard of care in the treatment of several types of malignancies through the leveraging of the body’s immune defense apparatus. Pembrolizumab prevents the deactivation of T-cells via the PD-1/PD-L1 pathway. Unfortunately, this also predisposes non-cancerous cells to autoimmune destruction by these T-cells. It is proposed that such is the mechanism by which pancreatic beta islet cells are destroyed in the setting of pembrolizumab use, thereby resulting in a rapid reduction in insulin production capability. New-onset type 1 diabetes complicated by DKA is potentially life-threatening, and so we believe this case highlights the need for both pre-treatment counseling as well as follow-up screening following initiation of pembrolizumab therapy. Presentation: 6/2/2024

8676 Hereditary Fructose Intolerance Unmasked: Report of a Pediatric Case Exploring Differential Diagnosis of Hypoglycemia and Genetic Insights

Abstract Disclosure: N. Solano: None. D. Baboun: None. A. Granados: None. A. Carrillo-Iregui: None. Introduction: Hereditary fructose intolerance (HFI) is an uncommon autosomal recessive metabolic disorder characterized by a deficiency of aldolase B, a crucial enzyme involved in fructose metabolism. This deficiency causes an accumulation of fructose-1-phosphate, which triggers a cascade of metabolic disturbances including hypoglycemia, lactic acidosis, and hepatic dysfunction. If left untreated, HFI can lead to severe complications, including liver failure and even death. Diagnosing HFI can be challenging due to its nonspecific clinical presentation and the absence of routine screening tests. Case presentation: A 4-year-old girl was referred from an outside hospital for hypoglycemia requiring intravenous dextrose infusion. The patient became lethargic 30 minutes after consuming a honey-based cough syrup. Upon presentation to the emergency department, her blood glucose level was 41 mg/dL. Her past medical history revealed an episode of lethargy and persistent vomiting at age 21 months, coinciding with an intussusception. A finger blood glucose test at the time was undetectable, and further evaluation revealed metabolic acidosis, elevated liver enzymes, and a normal ammonia level. Plasma amino acid, acylcarnitine, carnitine, urine acylglycine, carnitine, and urine organic acid levels were all within normal limits. Fatty acid oxidation and glycogen storage disease panels were also negative. On inquiry into her dietary habits, her parents recalled she would spit fruits out whenever tasting them, suggesting an innate aversion to fructose-rich foods. Initial comprehensive inpatient workup, including a critical sample, yielded no definitive results. She underwent a strict 24-hour inpatient fast and remained asymptomatic, with blood glucose levels above 65 mg/dL, ruling out hyperinsulinism. A broader next-generation sequencing (NGS) hypoglycemia panel was ordered, which identified a heterozygous pathogenic variant, c.178C&amp;gt;T (p.Arg60*) maternally inherited, and a likely pathogenic variant, c.379+1G&amp;gt;T (Splice donor) paternally inherited, in the aldolase B gene. Both confirmed the diagnosis of hereditary fructose intolerance (HFI). The family received comprehensive dietary and genetic counseling. Conclusion: HFI is an uncommon but potentially life-threatening inborn error of metabolism. Maintaining a high index of suspicion, considering a broad differential diagnosis, and obtaining a detailed dietary history, including fruit consumption, are crucial for identifying and managing HFI in infants and children with unexplained hypoglycemia. This case highlights the importance of early diagnosis and dietary intervention to prevent severe complications in patients with HFI. Additionally, it emphasizes the need for comprehensive dietary counseling and education for patients' families to ensure lifelong adherence to a fructose-restricted diet. Presentation: 6/2/2024

Emphasizing the need for preconceptional, prenatal genetic counseling and comprehensive genetic testing in consanguinity: challenges and experience.

Preconception and prenatal genetic counseling is a well-established means of risk assessment in many parts of the world, and in recent years, an emerging concept in India. Likelihood of an offspring having autosomal recessive disorder increases based on the degree of consanguinity. Hence, genetic testing of the couple for the identification of carrier status for disease-causing variants is crucial. The purpose of this study is to understand the frequency of genetic abnormalities in consanguineous marriages by using a comprehensive genetic testing algorithm where in karyotyping, FISH, exome sequencing and microarray are used sequentially to determine the genetic etiology based on the clinical presentation and to evaluate the need and benefits of preconceptional and prenatal genetic counseling. This retrospective study includes 66 couples having consanguinity referred for genetic counseling and testing. Of the 66 couples, 58 underwent comprehensive genetic testing which included Karyotyping, Fluorescence in Situ Hybridization (FISH), Microarray and Exome sequencing based on their clinical presentation. The analyses revealed a genetic abnormality in approximately 31% and chromosomal polymorphic variations & variants of uncertain significance in 17% of the couples. Counseling in these couples helped in identifying the carrier status and enabled them to take an informed decision in subsequent pregnancies. These findings reiterate the acute need for preconception and prenatal genetic counseling services in India.

Counselling needs of secondary school students during the post-COVID-19 period

This study investigates the counselling needs of secondary school students as they face challenges in the post-pandemic era. It examines six domains of counselling needs: personal development, academic, family, emotional, peer relationships, and career development. A sample of 400 students from four secondary schools was selected using a cluster sampling technique. The study, which employed the quantitative research method, utilised the Secondary School Students' Counselling Needs Assessment Instrument to gather data from the respondents. The analysis revealed a significant gap between students' desired and current needs across all six counselling domains, with personal development emerging as the most required by the students, followed by academic, emotional, career development, peer relationships, and family needs. The study also investigated gender differences in counselling needs, showing that while both male and female students share similar patterns of counselling needs, female students have shown larger gap scores, which indicate gender-specific counselling needs that school counsellors must recognise and address in their intervention strategies. The research findings emphasise the need for school counsellors to develop tailored intervention programmes that specifically address the highlighted needs, providing students with necessary support as they navigate the evolving educational landscape of the post-pandemic era. The study highlights the vital role of responsive counselling services in promoting students' well-being and academic success, ensuring they are equipped to adapt to the new educational and social challenges they face.

Parallel Mediating Effects of Sleep Quality, Psychological Distress, and Self-Stigma in the Associations Between Long COVID Symptoms and Quality of Life Among Taiwanese Individuals With Mental Health Illness.

Long COVID symptoms (i.e., experiencing symptoms of COVID-19 for 3 months post-COVID-19) affect individuals' health and their quality of life (QoL). However, the pathways through which it does so are not fully known. The present study examined the mediating roles of sleep quality, psychological distress, and self-stigma in the associations between long COVID symptoms and QoL among individuals with mental illness. Individuals with mental illness (n = 333) were recruited from a psychiatric center in southern Taiwan to participate in the study. Data were collected regarding sleep quality, psychological distress, self-stigma, and QoL. Independent t-tests, Pearson correlations, and regression with Hayes' Process Macro were used to compare groups, examine relationships, and parallel mediation models, respectively. Participants with long COVID symptoms had significantly worse sleep quality, psychological distress, physical QoL, and psychological QoL compared to those without symptoms. There were significant relationships between sleep quality, psychological distress, self-stigma, and QoL. Sleep quality significantly mediated the associations between long COVID symptoms and physical and social QoL. Psychological distress significantly mediated the associations between long COVID symptoms and all domains of QoL, but not self-stigma. There are alternative pathways (e.g., sleep quality and psychological distress) through which long COVID symptoms may affect the QoL of individuals with mental illness. The findings suggest that individuals with long COVID symptoms have a higher chance of having poor QoL. Therefore, there may be the need for counseling and possible therapy for those who contract COVID-19, especially among individuals who already have mental illness.

An Evaluation of the Precision of Ocular Trauma Score and Factors for Poor Visual Outcomes in Open Globe Injury: A Retrospective Analysis of Resourcelimited Hospital Settings

Objective: To evaluate the accuracy and validity of ocular trauma scores (OTS) among patients with open globe injury (OGI) in rural hospital settings and to identify the determinants predicting poor visual outcomes. Materials and Methods: A single-center retrospective cohort study was conducted through a chart review of OGI patients between July 2018 and June 2023 at Bueng Kan Hospital. Demographic and preoperative factors affecting the final visual outcome were evaluated. OTS score for each patient was calculated and categorized. Final VA after 6 months was compared to the predicted VA from OTS study. Poor visual outcome was defined as legal blindness after 6 months of treatment. Results: Thirty-nine eyes from patients with a mean age of 44.05 years were evaluated. Most subjects were male (94.87%), and workplace injuries were the most common (78.38%). Compared to the OTS study, patients in OTS category 2 achieved a significantly higher percentage of better final VA, while categories 3 and 4 showed similar outcomes. OTS category 1 patients had a lower proportion of no light perception (NLP) outcomes, though the difference was not significant. Poor visual outcomes were predicted by initial VA (OR=4.64), wound extension ≥10 mm (OR=20.66), and lens injury (OR=7.44). Conclusion: OTS is beneficial for predicting final vision in patients with OGI, particularly with less severe trauma. Severe cases often lead to better visual outcomes, emphasizing the need for cautious management and counseling by ophthalmologists. Factors that estimate poor visual outcomes involve poor initial VA, wound extension  10 mm, and lens damage.

Complete Pentalogy Of Cantrell: Case Report And Review Of Literature

Introduction: Pentalogy of Cantrell (POC) is a rare congenital anomaly with two sub-categories: complete or partial. Complete has all five defects (anterior diaphragmatic defect, ventral abdominal wall defect, pericardial defect, intracardiac anomalies, and lower sternal defect). The first documented case was described by Cantrell et al. in 1958. Both sporadic and genetic causes have been proposed for POC, with a reported incidence of 5 - 10 cases per one million live births and various clinical presentations. The prognosis of POC depends on the severity of the defects and the associated cardiac anomalies. This case report seeks to increase awareness of this condition, emphasize the need for appropriate counselling in our environment, and review the literature on previous reported cases’ outcomes. Case Presentation: A 5-hour-old term female neonate was referred to our Children Emergency Center with multiple defects (ectopia cordis, sternal cleft, omphalocele, and limb abnormalities) with dysmorphic facies. A diagnosis of POC was made, and multidisciplinary management was instituted. The eviscerated heart and epigastric omphalocele were dressed and evaluated for palliative surgical care. However, she developed complications with sepsis and electrolyte derangements and died from multi-organ failure before any surgical intervention could be carried out. Conclusion: Though rare, the Pentalogy of Cantrell in its classical form does occur in our environment. The presence of extracardiac and limb deformities worsens the outcome. Based on poor outcomes, there is a need to emphasize appropriate antenatal and postnatal assessments to provide effective counselling on termination, neonatal palliative care, and surgical repairs as appropriate.

Characteristics and nutritional counseling needs among HIV outpatients in Ho Chi Minh city

Introduction: Nutrition plays a crucial role in overall health and can influence treatment effectiveness as well as disease progression, particularly in HIV patients. Methods: A cross-sectional study was conducted on 383 outpatients receiving antiretroviral therapy (ART). A consecutive sampling method was employed to select all eligible HIV patients during the study period. Patients were then face-to-face interviewed using a structured questionnaire, and relevant data were also extracted from their medical records. The questionnaire included information on demographic characteristics, nutritional characteristics, and nutritional counseling needs. Results: The percentage of patients who reported receiving nutritional assessment and counseling at the initiation of ART was 34.5% and 27.7%, respectively. During ART, 76.0% of patients reported having been assessed for nutritional status, and 33.9% reported receiving nutritional counseling. A total of 55.4% of patients expressed a need for nutritional counseling, and this rate did not differ based on gender, age, or duration of ART. Conclusion: The findings underscore the importance of integrating nutritional counseling into routine HIV care to improve treatment outcomes and quality of life for patients. Given the high demand for nutritional support across all patient groups, healthcare facilities should prioritize this aspect in their ongoing efforts to effectively manage HIV. Keywords: Nutrition, nutritional status, nutritional counseling, HIV, ARV

Forgotten Victims of War: A Rapid Review of Counseling Needs and a Proposed Intervention Model for Civilian Survivors

The counseling needs of civilian war victims, particularly those not classified as refugees, have been largely neglected in academic counseling research. This study addresses this gap by conducting a rapid literature review to evaluate the current state of counseling services available to these individuals. Using Google Scholar and Web of Science, we identified and reviewed studies on counseling services for war veterans, refugees, and civilians in conflict zones. This review revealed a significant lack of structured counseling support for non-refugee civilian war victims, despite their high vulnerability. Findings indicate that while substantial efforts have been made to support refugees and veterans, the mental health needs of civilians who remain in conflict areas are often unmet, with existing services being sparse and inadequately documented. To address this issue, we propose a preliminary model that includes culturally sensitive counseling programs, training for local counselors, and international collaboration to provide sustainable support. This study highlights the urgent need for focused research and practical interventions to develop comprehensive counseling programs for these overlooked victims of war, and encourages researchers to address this critical gap in mental health services.

Viral load non-suppression among adolescents and youth living with HIV in South Africa.

Despite the increased initiation and uptake of antiretroviral therapy (ART) in South Africa, some people living with HIV (PLHIV) who are on ART still have non-suppressed viral load (VL). This study aimed to determine the prevalence of VL non-suppression among adolescents and youth (aged 12 years - 24 years) living with HIV and on ART in South Africa, as well as the factors associated with it. Data from the 2017 South African national HIV prevalence, incidence, behaviour, and communication survey were analysed. The survey used a multistage-stratified cluster sampling design. A backward stepwise multivariable generalised linear model was used to identify factors associated with VL non-suppression. The study included 340 participants aged 12 years - 24 years, with a median age of 21 (interquartile range [IQR]: 18-23). The proportion of adolescents and youth living with HIV and on ART with non-suppressed VL was 19.2% (95% confidence interval [CI]: 14.4-25.3). Approximately 60% of the participants were not on ART. The odds of VL non-suppression were significantly higher among youth aged 15 years - 19 years (adjusted odds ratio [AOR] = 1.63 [95% CI: 1.24-2.13], p = 0.001) and aged 20 years - 24 years (AOR = 1.22 [95% CI: 1.06-1.41], p = 0.005) compared to adolescents aged 12 years - 14 years. The odds were significantly lower among individuals of other races (AOR = 0.80 [95% CI: 0.69-0.92], p = 0.003) compared to black African people. Findings suggest a need for ART education and counselling as part of treatment support. In addition, the promotion of HIV awareness as part of strengthening the HIV treatment and prevention cascade. The article showed the prevalence of VL non-suppression and associated factors among adolescents and youth.

Nutrient Intakes in Prostate Cancer Survivors in the United States: A Nationally Representative Study

There are currently more than 3.3 million prostate cancer (PC) survivors in the United States. Conformance with national dietary guidelines and a good diet quality may lower the risk for Gleason grade progression in PC patients. Assessing the nutritional status of PC survivors is thus of paramount importance from a public health nutrition perspective. We used 24-h dietary recall data from the National Health and Nutrition Examination Surveys (NHANES) to systematically estimate nutrient intakes in n = 360 PC survivors (which may be extrapolated to represent n = 1,841,030 PC survivors) aged 70.69 years on average, and contrasted the results to the daily nutritional goals (DNG) in the 2020–2025 Dietary Guidelines for Americans (DGA). Diet quality in PC survivors was found to be generally poor, and the DNG as specified in the DGA were not met for many micronutrients, including calcium, magnesium and potassium. PC survivors had an insufficient intake of many vitamins (including vitamins A, C, D and E), and did not meet the intake recommendations for dietary fiber. Racial disparities in PC were reflected in the lower overall DQ in Non-Hispanic Black participants. Our results reiterate the need for nutritional assessment and counseling to improve DQ in PC patients.

Comparative motility assessment of sperm retrieved from micro-testicular sperm extraction: A single-centre study comparing fresh and frozen-thawed sperm.

Microsurgical testicular sperm extraction (microTESE) is crucial for treating non-obstructive azoospermia (NOA), offering both 'fresh' and 'frozen' options. This study evaluates the impact of fresh versus frozen microTESE on the progression to intra-cytoplasmic sperm injection (ICSI) cycles, focusing on sperm motility. We conducted a retrospective analysis of microTESE procedures at a major medical centre from 2007 to 2021, excluding cases of obstructive azoospermia and cryptozoospermia. Patients were divided into two groups: fresh microTESE (Group FR) and frozen microTESE (Group FZ). Sperm motility was assessed, and ICSI outcomes were compared between groups. Out of 128 microTESE procedures on 113 NOA patients, 31 were fresh and 97 were frozen. Sperm was found in 67.7% of fresh cases and 45.3% of frozen cases. In fresh cases, 85.7% had motile sperm for ICSI, whereas in frozen cases, 81.8% had motile sperm initially, but only 52.7% retained motility post-thaw. Our findings indicate a significant drop in motile sperm availability for ICSI in frozen microTESE cases compared to fresh ones. This suggests a potential advantage of fresh microTESE for certain couples, despite the logistical challenges, highlighting the need for careful patient selection and counselling.

Career agency of immigrants participating in employment interventions in Norway

ABSTRACT In this study, we apply a theoretical framework that combines the life-course perspective and the concept of temporality to explore the career agency of immigrants participating in employment interventions in Norway. Findings suggest that immigrants’ career agency is influenced by several factors, including the management of family duties and temporal asynchronies; career history and temporal liminality; and coping with past traumas and temporal suspension. Immigrants might overlook job opportunities due to family obligations or opt for low-skilled professions, seeking an exit from temporal liminality. The endured traumas, followed by temporal suspension, prompt the pursuit of the employment opportunities that are less mentally taxing. Our study highlights the need for employment counselling that acknowledges the effects of disrupted life courses and temporality on immigrants’ career agency. By comprehending clients’ experiences of temporal challenges, counsellors can create tailored strategies and advice that resonate with clients’ lived experiences and current social context.