Professional Guidance Research Articles

Self-diagnosis and help-seeking behaviours: the impact of self-diagnosis in seeking counselling

ABSTRACT Objective This study explores the impact of self-diagnosis via social media on help-seeking attitudes and counselling service utilization among college students. With increasing numbers of young adults using social media to self-diagnose mental health concerns, it is essential to understand whether this behaviour translates into seeking professional help. Method A cluster sampling method was employed to survey participants from 30 community colleges across 15 states within the United States of America. The sample included 777 college students, and data were analysed using chi-square and ANOVA tests to assess the relationship between self-diagnosis through social media and help-seeking behaviours. Results The findings indicate that self-diagnosis via social media does not significantly predict seeking mental health services. Despite the high prevalence of self-diagnosis, only 47% of participants with mental health concerns pursued counselling, while 53% relied on self-diagnosis without professional guidance. Discussion These results highlight the complexity of mental health decision-making processes and suggest that self-diagnosis does not necessarily lead to professional help-seeking. This study underscores the need for mental health professionals to address the role of social media in clients’ self-diagnosis and outreach efforts. Future research should examine the long-term effects of social media-driven self-diagnosis and its impact on diverse demographics to guide targeted mental health interventions.

Delving into the world of webCHAT - an e-mental health support service for distressed youths in Singapore.

Young people face high rates of mental health issues, yet many do not seek professional help. In 2017, CHAT launched webCHAT - a free, anonymous, one-on-one synchronous web-based text service managed by case managers (CMs) to support young people aged 16 to 30 who may be hesitant about engaging in face-to-face mental health services. This study aimed to explore the perspectives and experiences of users who accessed webCHAT for mental health support in Singapore. A qualitative thematic analysis was conducted using transcripts of webCHAT sessions to identify main themes. Many users accessed webCHAT to seek support with emotional and behavioural concerns, valuing its immediacy and anonymity over traditional appointment-based services. A desire to 'get better' and self-realisation emerged as important motivators for seeking help, with webCHAT offering a supportive space for reflection. Key barriers to seeking additional support included fear of stigma, concerns about leaving a 'medical record', potential hospitalisation, and treatment costs. webCHAT appears to be a viable early intervention and preventive approach, providing young people with a pathway towards in-person support services. Professional guidance from CMs is essential in encouraging users to pursue further support, emphasising the importance of human expertise in digital mental health platforms. By fostering early help-seeking and self-realisation, webCHAT has the potential to reduce the long-term impact of mental health challenges. Future research could explore webCHAT's long-term effects and identify improvements to facilitate users' transitions to in-person support.

A comprehensive image dataset for the identification of lemon leaf diseases and computer vision applications.

A comprehensive dataset on lemon leaf disease can surely bring a lot of potentials into the development of agricultural research and the improvement of disease management strategies. This dataset was developed from 1354 raw images taken with professional agricultural specialist guidance from July to September 2024 in Charpolisha, Jamalpur, and further enhanced with augmented techniques, adding 9000 images. The augmentation process involves a set of techniques-flipping, rotation, zooming, shifting, adding noise, shearing, and brightening-to increase variety for different lemon leaf condition representations. Each of these images was standardized to 800 × 800 pixels resolution, so that consistency may be maintained among the dataset. All images were labelled in the nine prefixed categories: anthracnose, bacterial blight, citrus canker, curl virus, deficiency leaf, dry leaf, healthy leaf, sooty mould, and spider mites. In the present study, a DenseNet-121 architecture was used, where 20 % of the dataset was kept for validation and the remaining 80 % for training. A trained model with a batch size of 32 was trained for 30 epochs, achieving an accuracy of 98.56 % with augmentation, and 96.19 % without it. The dataset will not only act as a benchmark in developing accurate machine learning models for early disease detection, but it will also contribute to the cause of sustainable lemon cultivation practices by facilitating timely and effective disease management interventions.

BreathCarer: Informal carers of patients with chronic breathlessness: a mixed-methods systematic review of burden, needs, coping, and support interventions

BackgroundBreathlessness is a common symptom in chronic and advanced diseases, and it poses a significant burden to patients and to their informal carers. They play a crucial role in sustainable care for patients living with breathlessness, but their challenges and needs are often neglected.ObjectiveTo provide a systematic overview of the literature on the burden, needs, coping and use of healthcare and social services by carers of patients suffering from chronic breathlessness due to any life-limiting disease.DesignA mixed-methods systematic review (PROSPERO CRD42022312989).Data sourcesMedline, CENTRAL, PsycINFO, and CINAHL were searched and complemented with forward and backward searches and expert consultation.Review methodsThe mixed-methods review included any study on burden, needs and coping among carers of patients with breathlessness published from the inception of the databases until July 2023. A narrative analysis of the quantitative results and a pragmatic meta-aggregation of the qualitative findings were performed, followed by a mixed-methods convergent segregated approach.FindingsA total of 53 studies with 4,849 carers were included. Breathlessness is highly burdensome for carers who live with and care for patients or for those who do not live with the patients and care for them. Breathlessness is a significant risk factor for high carers’ burden, contributing to deteriorating physical and mental health among carers and creating an urgent need for external support. A major challenge is the sense of being trapped in a state of constant alertness and anxiety, centred around managing the patient's breathlessness. Carers bear substantial emotional burden due to uncertainty, sleep disturbances, and social isolation, which leads to severe psychological distress. Their unmet needs for professional guidance, self-management strategies, and social interaction are high. While supportive interventions, such as specialized services and multidisciplinary approaches, can alleviate some of the burden, there remains a lack of targeted interventions specifically designed for carers.ConclusionsThis review highlights the substantial burden associated with caring for patients with chronic breathlessness, the unmet needs of carers and the lack of supportive care structures, leaving them with little option but to accept the situation.

Parental Experiences of Administering Pediatric Tuina for Sleep and Appetite in Early School-Aged Children With Attention-Deficit/Hyperactivity Disorder: Qualitative Study in Hong Kong.

Previous research suggested that parent-administered pediatric tuina could improve symptoms of attention-deficit/hyperactivity disorder (ADHD), such as sleep quality and appetite. This study aimed to explore the experiences and perceptions of parents administering pediatric tuina to school-aged children with ADHD in Hong Kong. This qualitative study was embedded in a pilot randomized controlled trial on parent-administered pediatric tuina for improving sleep and appetite in school-aged children diagnosed with ADHD. Purposive sampling was used to invite 12 parents who attended a pediatric tuina training program and delivered the intervention to their children at home for at least 8 weeks. Data were collected through semistructured focus group interviews and individual interviews, which were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Two main themes emerged: (1) effects of parent-administered pediatric tuina and (2) parents' experience of administering pediatric tuina. Parents reported significant improvements in children's sleep quality, appetite, behavior, mental state, and academic performance. Facilitators provided professional guidance and applied a user-friendly course design. Challenges included difficulties in mastering techniques, locating acupuncture points, and time management. Participants suggested the need for more traditional Chinese medicine pattern diagnostic sessions, real-time supervision methods, and extended follow-up to better observe long-term effects. Parent-administered pediatric tuina was perceived to improve children's sleep quality and appetite significantly, along with other aspects of well-being. Professional guidance and a structured training program facilitated implementation, and challenges highlighted the need for more frequent diagnostic sessions, real-time supervision, and extended follow-up.

Shipping Containers as Temporary Shelters in Post-Disaster Scenarios: Flying Factories

After the recent earthquakes in Turkey, there has been a significant demand for temporary shelter. Issues such as the availability of emergency shelters, designated emergency assembly areas, and the lack of social networks have come to the forefront. Due to the construction industry's inability to produce the necessary quantity of prefabricated temporary housing, the Ministry of Trade imposed a three-month ban on the export of prefabricated structures in 2023. The limited availability of emergency assembly areas renders low-density temporary settlements unfeasible. For disaster victims, leaving their homes does not provide a solution to overcoming the trauma they have experienced; in fact, it can exacerbate other economic, social, and security issues. Reusable shipping containers can partially address the problem of temporary shelter by utilizing the concept of flying factories. This research proposes a model that encompasses both technical and social phases, including the creation of technical documentation prior to a disaster and aiming for a participatory production model in the aftermath. The establishment of temporary logistics and production facilities is crucial and should be driven by volunteer participation under the guidance of professionals. Additionally, this model includes training and coordination activities before a disaster as part of the execution plan. Through this study, which incorporates both physical and social dimensions, an integrated solution is proposed based on the identification of challenges faced after recent disasters.

Navigating Hope and Complexity: Turkish Parents' Experiences with Savior Siblings.

Preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing represents a significant advancement in treating inherited hematological disorders, particularly thalassemia major. This technology enables the birth of healthy children who can serve as compatible stem cell donors for their affected siblings. Turkey is a world leader in both PGD+HLA typing technology and hematopoietic stem cell transplantation from savior siblings born through PGD+HLA typing. This study investigated the experiences of Turkish parents who underwent successful savior sibling procedures using preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing and then successful hematopoietic stem cell transplantation, from this savior sibling, for the treatment of their thalassemia major child. The research aimed to understand the medical, psychological, and socio-cultural dimensions of this complex process within the Turkish healthcare context. A qualitative study using descriptive phenomenological approach was conducted. In-depth interviews were performed with 16 parents, who successfully completed PGD+HLA matching and subsequent successful stem cell transplantation process from this savior sibling to their thalassemia child. Data were analyzed using Colaizzi's seven-step method and MAXQDA 20.0 software. Analysis revealed six main themes: Disease Stage, Treatment, Recovery Process, Social Family, Support Systems, and Recommendations. Parents reported significant emotional challenges but demonstrated unexpected resilience. Religious and cultural factors played nuanced roles, with most parents viewing the process as compatible with their beliefs. Economic burden, prolonged hospitalizations, and geographical access to treatment centers emerged as key challenges. Extended family support and healthcare professional guidance were identified as crucial support mechanisms. The study highlights the complex interplay between advanced medical technologies and traditional values in Turkish society. Findings emphasize the need for comprehensive, culturally sensitive support systems and long-term follow-up for families. Results suggest implementing multidisciplinary care teams and developing specialized support programs for families undergoing savior sibling procedures.

Acceptability of self-administered acupressure for knee osteoarthritis in middle-aged and older adults: A mixed-method secondary analysis.

To evaluate the acceptability of self-administered acupressure for Knee osteoarthritis (KOA) among middle-aged and older adults. This is a mixed-method acceptability evaluation was embedded in a randomized controlled trial on self-administered acupressure for KOA. Participants received two 2-h training sessions on self-administered acupressure and were instructed to practice twice daily for 12 weeks. Quantitative data were collected using an acceptability questionnaire (n = 153) and acupressure logbooks (n = 157). Qualitative data were obtained through semi-structured interviews, including post-training (n = 13) and post-intervention focus groups (n = 13), and individual interviews with participants who dropped out (n = 5). Data were analysed using descriptive statistics and framework analysis based on the Theoretical Framework of Acceptability. The intervention had 91.7 % completion rate. Participants rated willingness to attend future sessions at 9.5/10 (SD=0.85). 57.8 % found technique education "very helpful" and 81.5 % followed the prescribed routine. Participants reported high overall acceptability of the self-administered acupressure training program, citing its practicality and potential benefits on knee pain, thigh strength, inflammation, and swelling. The minimal time and financial investment required were also appreciated. However, challenges related to personal efforts, time management, pressure from research monitoring, possible adverse events, and uncertainties with acupressure techniques were noted, leading to adherence issues. Participants expressed a need for continuous professional guidance. Self-administered acupressure is highly acceptable to middle-aged and older adults with KOA due to its potential benefits and merits of minimal time and cost. Future research should focus on optimizing intervention implementation by providing professional support and efficient monitoring to address identified challenges.

Understanding the Needs of Young and Middle-Aged Chinese People Who Have Experienced a Stroke Who Have Not Successfully Returned to Work: A Qualitative Study.

The study aims to understand the return to work (RTW) needs of young and middle-aged people who have experienced a stroke and to contribute to the development of supportive RTW services. A qualitative study employing the phenomenological method. Eleven young and middle-aged people who have experienced a stroke participated in the study. Semi-structured in-depth interviews were conducted and analysed using Colaizzi's 7-step method to identify and categorize the RTW needs of participants. The analysis delineated four overarching thematic categories of RTW needs among the participants: self-management needs, emphasizing the regulation of symptoms, health maintenance and recovery planning; social support needs, highlighting the significance of workplace accommodations, professional medical guidance, and emotional encouragement from companions and family; the need for information related to returning to work, which includes accessing resources on rehabilitation opportunities, labour rights and professional consultation services; and personal development needs, focusing on fostering self-worth, identifying growth opportunities and acquiring new skills to adapt to changing professional demands. The diverse and comprehensive needs of young and middle-aged people who have experienced a stroke underscore the importance of multifaceted support from healthcare professionals. This support should encompass medical, psychological, informational and skill-development aspects and should involve enhanced communication and collaboration with relevant stakeholders to facilitate a successful RTW. This study was designed without direct involvement from patients or the public in the development of the research question, the design of the study, or the conduct of the research. This decision was informed by the specific focus on qualitative experiences and perceptions of stroke survivors regarding their RTW journey, which relied heavily on personal narratives and subjective accounts collected through individual interviews. However, the insights gained from these narratives have been crucial in shaping the research outcomes, emphasizing the patient-centred approach to understanding RTW barriers and facilitators. This study followed the SRQR checklist for qualitative studies as its reporting method.

The Whakapiri framework in higher education: nurturing relational teaching

A growing body of research suggests that utilising Indigenous frameworks grounded in relational connection and multi-modal knowledge acquisition has numerous benefits for both Indigenous and non-Indigenous communities. This article focuses on the Whakapiri framework, and its application at Te Kunenga ki Pūrehuroa Massey University, Aotearoa New Zealand, within a new undergraduate mental health and addiction programme. This programme aims to equip graduates in the field, providing them with the foundational knowledge and engagement competencies necessary for working with both Māori (Indigenous people of New Zealand) and non-Māori. The Whakapiri framework enhances student engagement, fosters relational teaching practices, and designs effective online learning curricula. The framework also informs the design of online learning curricula, acknowledging the unique challenges and opportunities of digital education environments. Through its emphasis on engaging, enlightening, and empowering, the Whakapiri framework offers professional guidance and enriches student engagement, teaching methodologies, and the development of online learning curricula.

Navigating Media Complexities: Israeli Arab Parents' Perspectives on Media Challenges and Mediation

Background: Children's exposure to digital media presents both opportunities and significant challenges, particularly for parents balancing traditional values with modern influences. This study aims to examine Arab parents' perceptions, strategies, and challenges in managing their children’s media exposure, shedding light on an increasingly critical aspect of parenting. Method: This is a qualitative phenomenological study employed semi-structured interviews with 12 Arabic-speaking parents of children aged 5–12. The interviews were analyzed using thematic analysis. Findings: Parents voiced concerns about inappropriate media content and shared a mix of reactive and proactive mediation strategies. They reported feelings of helplessness due to technological gaps but emphasized the importance of professional guidance and community support. Conclusions: The findings highlight the necessity of culturally sensitive interventions that integrate traditional values with modern parenting practices, equipping families to navigate the complexities of digital media use effectively.

Peer Social Support and Career Decision-Making in Adolescents from Broken Homes: A Career Counseling Perspective

This study investigates the relationship between peer social support and career decision-making difficulties among adolescents from broken homes. Adolescents from broken homes often face emotional, social, and academic challenges, particularly in career planning, due to the absence of parental guidance. This research aims to explore how peer support may act as a protective factor in mitigating these difficulties. The study used a quantitative correlational design with 176 participants aged 15-18 years, who experienced parental divorce during adolescence and are in their final year of high school in Indonesia. Participants completed the Peer Social Support Scale and the Career Decision-Making Difficulty Scale. The results indicated a significant negative correlation (r = -0.365, p < 0.01) between peer social support and career decision-making difficulties, suggesting that higher levels of peer support are associated with reduced difficulties in making career decisions. Most participants reported receiving high levels of peer support and low levels of career decision-making difficulties, demonstrating the critical role that peer networks play in providing both emotional and informational support. The findings suggest that peer support can compensate for the absence of parental guidance in adolescents from broken homes. However, over-reliance on peers who lack sufficient knowledge may lead to suboptimal decisions. The study concludes that peer support is a valuable resource in reducing career decision-making difficulties among adolescents from broken homes, but professional guidance is necessary to ensure well-rounded career planning. Future research should expand to include other forms of family instability for a more comprehensive understanding of this population's challenges.

“They are your sub-group”: The experience of siblinghood in out-of-home placements as conveyed by adults who aged out of family group homes in Israel

BackgroundSibling bonds play a crucial role in the development, well-being, and resilience of individuals, particularly during challenging life circumstances. However, there is limited research on siblinghood within the context of out-of-home placements. ObjectiveThis study aims to investigate the experiences of siblinghood among adults who aged out of family group homes in Israel. The primary objective is to amplify their voices and convey their key messages to professionals and academics working in the field. Participants and settingsThe participants included 71 adults who aged out of family group homes, comprising 49 women and 22 men, mostly under the age of 30. MethodsData was collected through an online survey, which was analyzed using descriptive statistics and qualitative analysis. ResultsThe fundamental experience of being a sibling in a family group home was mainly positive. The sibling bond in their current life stage was also reported as positive, which was especially evident among participants who stayed in joint placements. The participants mostly preferred joint placements and highlighted the importance of professional support and guidance to nurture and sustain sibling relationships. However, most participants reported a lack of systemic support for sibling bonds. ConclusionsThe findings underscore the significance of recognizing sibling bonds as a valuable resource for children in out-of-home placements, which needs to be actualized by professionals and acknowledged by policymakers and researchers.

Rho(D) immune globulin shortage and fetal Rh(D) screening with cell-free DNA.

Despite the availability of Rh(D) immune globulin (RhIg) to prevent alloimmunization in Rh(D)-negative pregnant patients, anti-Rh(D) alloimmunization remains a prevalent cause of hemolytic disease of the fetus and newborn (HDFN). Recent RhIg shortages have caused clinicians and professional societies to identify methods to prioritize RhIg administration. New cell-free DNA (cfDNA) tests to predict fetal red blood cell antigen genotypes have been proposed as an option to prioritize the administration of RhIg to Rh(D)-negative pregnant people. Commercial laboratories offer fetal Rh(D) genotype testing as part of cfDNA screening for fetal aneuploidy. Studies indicate that these tests have a high sensitivity and specificity for the detection of fetal Rh(D) status. Considering the current RhIg shortage, the American College of Obstetricians & Gynecologists (ACOG) suggests that utilizing cfDNA tests to determine fetal Rh(D) status is a reasonable approach to prioritize RhIg administration when supply is limited. cfDNA screening for fetal Rh(D) status is a reasonable approach to triage the administration of RhIg in the setting of the current RhIg shortage. Utilization of cfDNA screening for fetal Rh(D) and other red blood cell antigen status is likely to increase in routine care. Research, professional society guidance, and education are necessary to ensure well tolerated and equitable utilization.

Investigating the effects of home-based rehabilitation after intensive inpatient rehabilitation on motor function, activities of daily living, and caregiver burden.

Home-based rehabilitation involves professional rehabilitation care and guidance offered by physical, occupational, and speech therapists to patients in their homes to help them recuperate in a familiar living environment. The effects on the patient's motor function and activities of daily living (ADLs), and caregiver burden for community-dwelling patients are well-documented; however, little is known about the immediate benefits in patients discharged from the hospital. Therefore, we examined the effects of continuous home-based rehabilitation immediately after discharge to patients who received intensive rehabilitation during hospitalization. We retrospectively reviewed 150 patients [mean (standard deviation, SD) = 81 (9) years] discharged from the convalescent rehabilitation and community-based integrated care wards undergoing tailored home-based rehabilitation for 6 months (provided by physical or occupational therapists: 1-2 sessions of 40-60 min each per week). The outcome measures at baseline and after 3 and 6 months were compared. The participants included in this study had orthopedic (n = 76), cerebrovascular (n = 50), neuromuscular (n = 11), cardiovascular (n = 5), respiratory (n = 3), cancer (n = 3) and other diseases (n = 2). The mean (SD) time from discharge to the start of rehabilitation was 4 (4) days. One-way analysis of variance and post-hoc comparisons showed significant improvements at 3 months from baseline in grip strength (p = 0.002), 5-repetition sit-to-stand test (p < 0.001), Standing test for Imbalance and Disequilibrium test (p = 0.025), Functional Independence Measure (p < 0.001), modified Frenchay Activities Index (p < 0.001). Additionally, a statistically significant improvement was observed in the Japanese Zarit Caregiver Burden Interview score at 6 months from baseline (p < 0.001). Home-based rehabilitation improves motor function, ADLs, and instrumental ADLs even after intensive inpatient rehabilitation and decreases the burden of the caregiver in the long term. Hence, tailored home-based rehabilitation should be continuously implemented after the completion of intensive inpatient rehabilitation.

How I met my mother: Kinning and new beginnings between unaccompanied Afghan minors and voluntary Danish guardians

Abstract A relatively large part of the asylum seekers that came to Denmark during ‘the long summer of migration’ in 2015 were under the age of eighteen and travelled without adult relatives. The number of unaccompanied minors from Afghanistan was 844 in 2015 and 527 in 2016. As minors, they receive professional help, care and guidance in the asylum process and are placed in special centres for minors. When they are finally granted temporary residency as refugees, they receive a legal guardian, a volunteer Danish citizen who agrees to help the young refugees establish a new life in the municipality they have been assigned to. Inspired by Signe Howell’s work on transnational adoption in Norwegian families, this article discusses the dynamics of kinning processes where unaccompanied minors and their legal guardians over time develop strong emotional ties. The bumbling transformation of the ‘order of law’ into the ‘order of nature’ not only constitutes a new beginning in family relationships but may also promote a future model for sustainable inclusion of refugees in Denmark.

Through their eyes: A retrospective mixed-methods study on the experiences and support needs of children growing up with a parent with Huntington’s disease

Background Growing up with a parent with Huntington's disease (HD) profoundly impacts children. However, this impact and children's needs are often misunderstood, even by professional services. Even when resources are available, children often feel that their needs are unmet, raising concerns about the adequacy of available guidance and support. Objective This study aims to offer an in-depth understanding of the multifaceted impact of growing up with a parent with HD, examining the needs for professional guidance on emotional and social aspects, and identifying specific areas where support can be improved to better aid them. Methods This retrospective study utilized an exploratory sequential mixed methods design, combining qualitative focus groups ( n = 13) and a quantitative survey ( n = 23). Qualitative data were analyzed using an inductive thematic analysis with a descriptive phenomenological approach. Quantitative data were analyzed using descriptive statistics. Results The impact of HD on children extends across various domains, affecting self-development, social interactions, and family dynamics. Support received at home varied, with limited access to professional help. Support needs primarily revolved around emotional support and access to comprehensive information. Key support providers, such as parents, peers, mentors, healthcare providers and coaches with expertise in HD, play crucial roles in addressing these needs. Conclusions The study underscores challenges faced by children in HD families. By centering our efforts on the emotional well-being of these children, offering tailored information, involving their social network, providing community-based support, and strengthening parental support systems, we can improve the support required by children in these families.

The effectiveness of digital technology interventions for cognitive function in older adults: a systematic review and meta-analysis of randomized controlled trials.

Digital technology interventions (DTIs) are seen as promising interventions to prevent or delay cognitive decline in older adults, yet evidence from reviews is not conclusive. The aim of this study is to explore the effectiveness of DTIs in improving older adults' cognitive function while taking study design and intervention characteristics as moderators. We searched the PubMed, Embase, CINAHL, PsycINFO, and Scopus databases up to May 26, 2023. Only randomized controlled trials examined the effects of DTIs on cognitive function were included in our study. Standardized mean difference (SMD) and 95% confidence interval for outcomes were applied in meta-analyses and subgroup analyses. A risk of bias assessment was also conducted. Overall, 23 eligible studies with a total sample size of 1454 participants were included. We found that DTIs significantly improved global cognitive function (SMD = 0.479), attention and processing speed (SMD = 0.488), executive function (SMD = 0.287), immediate recall (SMD = 0.266), and working memory (SMD = 0.307). Our subgroup analyses revealed that DTIs were more effective for cognitively impaired subjects, and DTIs with specific intervention characteristics, such as the inclusion of cognitive standard tasks, virtual reality-based interventions, specialized settings, professional guidance, low/medium-density training, > 24 sessions, and sessions lasting > 30 min, were more effective for different cognitive domains. This study supported the effectiveness of DTIs in improving cognitive function in older adults aged 60 years old and over, which may be influenced by study design and intervention characteristics. These findings have important implications for clinical dementia prevention and treatment strategies targeted at specific cognitive domains.

Effects of a symptom-titrated exercise program on fatigue and quality of life in people with post-COVID condition – a randomized controlled trial

Fatigue is the most prevalent symptom within the post-COVID condition (PCC). Furthermore, many patients suffer from decreased physical performance capacity and post-exertional malaise. Although exercise has been proposed as an effective therapeutic strategy for PCC, there is limited evidence on individualised and symptom-titrated exercise interventions in patients with fatigue and PEM. Therefore, we conducted a multi-centre randomised controlled trial to investigate the effectiveness of an individualised and symptom-titrated exercise program. We measured fatigue, health-related quality of life, hand-grip strength, endurance capacity and PEM before and after the 10-week intervention. A total of 118 individuals with PCC were included in the final intention-to-treat analysis. All tests and training sessions took place in commercial fitness and health facilities. We found significant effects on fatigue severity, health-related quality of life and physical performance capacity. Adjusting the individual exercise load to daily fatigue has proven to be an effective and safe strategy in PCC patients with fatigue. Under the guidance of qualified professionals and by utilising symptom-titrated training recommendations, commercial fitness and health facilities present an appropriate setting for outpatient exercise rehabilitation in PCC.

Effects of Systematic Oral Hygiene Guidance on Plaque Control Among Periodontal Patients.

To evaluate the efficacy of systematic oral hygiene instruction in improving oral hygiene knowledge and to practice and control oral plaque, among periodontal patients. A total of 407 patients were recruited, with 205 in the experimental group and 202 in the control group. Participants in the experimental group received professional dental examination, cleaning tools and instruction of oral hygiene practices. The patients in the control group received conventional educational guidance. Two follow-ups with 7-10-day intervals were conducted after the baseline examination. Compared to those in control group, the plaque index of participants in the experimental group was significantly improved after the intervention. Moreover, participants' behaviours, including brushing twice or more a day, brushing more than 2 min, skill in using dental floss and brushing before going to bed, significantly improved after receiving professional systematic oral hygiene guidance (p < 0.001). Significant improvement was achieved in patients' oral hygiene knowledge, attitudes and practices (p < 0.001). Overall, 26.8% of the participants reached standard oral plaque control (plaque index ≤ 20%) in experimental group. Multivariable analysis showed that participants' old age and severity of illness had significant effects on plaque control. Professional educational guidance is effective in maintaining good oral hygiene practices following periodontal management compare with conventional education. Oral health promotion interventions should be adjusted by age, severity of disease and the distal portion of the oral cavity.