Health Counseling Services Research Articles

Self-reported Health Service Utilization and Barriers to Care Among US Adults with a History of Post COVID-19 Condition.

Millions of US adults continue to experience symptoms of post COVID-19 condition (PCC). More data on health service utilization patterns and barriers to care in this population are needed to understand how to care for people with PCC. To evaluate health service utilization and barriers to medical care among individuals with a history of PCC compared with other US adults. Data were analyzed from the 2022 National Health Interview Survey (NHIS), a nationally representative, cross-sectional survey of the US population. US adults. Health service utilization and the presence of financial and nonfinancial barriers to care in the preceding 12 months. There were 24,905 individuals included in the analysis, representing approximately 230 million US adults. The weighted prevalence of those with a history of PCC was 6.9% (95%CI, 6.5-7.3). Compared to other US adults, participants with a history of PCC were more likely to have had an urgent care visit (adjusted odds ratio (aOR) 1.52 [95%CI, 1.34-1.72]), emergency room visit (aOR 1.94 [95%CI 1.71-2.21]), hospitalization (aOR 1.48 [95%CI, 1.24-1.77]), rehabilitation services (aOR 1.35 [95%CI, 1.14-1.60]), home care (aOR 1.55 [95%CI, 1.66-2.26]), mental health counseling (aOR 1.39 [95%CI, 1.17-1.65]), and complementary and integrative medicine services (aOR 1.29 [95%CI, 1.13-1.49]). Furthermore, respondents with a history of PCC were more likely to report at least one financial barrier to care (aOR 1.71 [95%CI, 1.48-1.97]) and at least one nonfinancial barrier (aOR 1.77 [95%CI, 1.56-2.00]). A greater proportion of participants with a history of PCC reported a financial barrier and nonfinancial barrier than adults with most other chronic conditions captured by NHIS. Individuals with a history of PCC were more likely to use a variety of health services and report barriers to medical care. Health systems should consider developing accessible, multidisciplinary care pathways for this population.

The impact and application of artificial intelligence technology on mental health counseling services for college students

With the intensification of social pressure and the enhancement of mental health awareness, the mental health issues of college students have become increasingly prominent, attracting social attention. Mental health counseling services, as an important way to alleviate students’ psychological stress, are facing the dual challenges of a shortage of professionals and growing service demands. In recent years, the application of artificial intelligence (AI) technology in the field of mental health has gradually risen, and its advantages in data analysis, pattern recognition, and natural language processing provide new solutions for mental health counseling services. However, existing research still faces problems such as insufficient understanding and limited emotional interaction capabilities in practical applications. This paper delves into the application of AI technology in mental health counseling services for college students and innovates and improves upon the deficiencies in existing research. The study focuses on two main areas: First, word vector generation technologies based on statistics and language models are used according to different application scenarios, and their effectiveness in the analysis of mental health counseling texts is compared. Second, an improved Seq2Seq model is proposed to enhance the emotional understanding and interaction capabilities of emotional dialogue generation algorithms in mental health counseling. This study not only provides technological support for college mental health counseling services but also opens new research directions and perspectives for the application of AI in the field of mental health.

Hidden in plain sight: New partners for forensic nursing education

BackgroundBreaking disciplinary silos and increasing understanding for students has the potential to transform the future of healthcare, yet it can be challenging to develop interdisciplinary simulations. MethodsWhile integrating the AACN Essentials into a new course about forensics in the healthcare setting, innovative simulation design helped undergraduate nursing and pre-health track science students demonstrate specific sub-competencies. ResultsThe simulations resulted in self-reported increased student learning. ConclusionWith simulation-based experiences in both healthcare and chemistry lab settings, nursing faculty and students, science faculty and students interested in health sciences, public safety, and counseling services are ubiquitous to institutions of higher learning that house nursing programs and are all great partners in designing simulations in the interdisciplinary forensic science field.

Insurance acceptance and cash pay rates for psychotherapy in the US.

Cost and insurance coverage remain important barriers to mental health care, including psychotherapy and mental health counseling services ("psychotherapy"). While data are scant, psychotherapy services are often delivered in private practice settings, where providers frequently do not take insurance and instead rely on direct pay. In this cross-sectional analysis, we use a large national online directory of 175 083 psychotherapy providers to describe characteristics of private practice psychotherapy providers who accept and do not accept insurance, and assess self-reported private pay rates. Overall, about one-third of private practice psychotherapists did not accept insurance, with insurance acceptance varying substantially across states. We also found significant session rate differentials, with Medicaid rates being on average 40% lower than reported cash pay rates, which averaged $143.26 a session. Taken together, low insurance acceptance across a broad swath of mental health provider types means that access to care is disproportionately reliant on patients' ability to afford out-of-pocket payments-even when covered by insurance. While our findings are descriptive and may not be representative of all US psychotherapists, they add to scant existing knowledge about the cash pay market for an important mental health service that has experienced increased use and demand over time.

Depression symptoms among Afghan TB patients: A multi-center study

BackgroundDepression in TB patients carries a heightened risk of treatment failure and a lower quality of life. However, no study to date has documented depression prevalence among TB patients in Afghanistan. ObjectivesWe aimed to assess depression prevalence in TB patients in Southern Afghanistan. MethodsBetween February 2023 and May 2024, a sample of 1,003 TB patients aged 18 years and above were randomly sampled in Southern Afghanistan. The questionnaire gathered patients’ sociodemographic information, clinical characteristics, social support level, and the PHQ-9 (Patient Health Questionnaire). We fitted a binary logistic regression model to identify correlates of depression symptoms among TB patients. ResultsOut of 1,003 patients, 69.6% (95% CI: 66.6%-72.4) had depression symptoms. We found that patients with no formal education [AOR = 3.18, 95%CI (2.35–4.30)], those with severe disease [1.84 (1.30–2.59)], patients with medical comorbidity [1.88 (1.29–2.74)], and those with low social support [1.69 (1.22–2.33)] were more likely to have depression symptoms. ConclusionTB patients in Afghanistan have high levels of depressive symptoms. Therefore, this study advocates for dedicated mental health screening and counseling services for TB patients in Afghanistan.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective: The study aimed to assess medication management compliance and mental health in elderly patients with hypertension. Method: The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling. Data was collected using the Morisky Medication Compliance Questionnaire, Hospital Anxiety and Depression Scale, and a checklist. Ethical practices were strictly observed. Results: A study of 100 elderly hypertensive patients found poor drug management compliance, with female patients showing worse compliance. Female patients were more vulnerable to anxiety and depression. The study also found no significant association between gender, age, education level, marital status, living standards, and medication compliance. Barriers to medication management included food and daily necessities, lack of awareness about the importance of drug treatment, and basic family needs. The lowest-ranked barriers were lack of support from government health clinics, low income, and lack of family support. Conclusion: Based on the results, the study proposes an educational plan for elderly hypertensive patients and their families, to be evaluated and implemented by the hospital and township community service center. The plan aims to improve medication management and lifestyle modification compliance, encourage active participation, and provide access to medical and mental health clinics, support groups, and counseling services.

Implementasi Manajemen Konseling Kesehatan Mental bagi Mahasiswa Institut Teknologi dan Kesehatan Muhammadiyah Kalimantan Barat

Undergraduate students are individuals who experience a transition period that focuses on searching for self-identity. During this transition period, students will experience changes in their behavior, emotions and cognition. This change will affect the mental health status of students. Mental health problems in students are a serious problem to be handled because students' mental health problems are invisible but can have bad consequences if not treated immediately. Negative stigma towards mental health has an impact on students' awareness and initiative to resolve their mental health problems. Students feel embarrassed and think that this mental health problem can heal by itself. In fact, mental health problems will get worse if they are not handled well. The importance of mental health counseling services for students as a medium for early detection of mental health problems. Mental health screening can detect several mental health problems so that existing problems can be prevented and students' mental health status can improve. The role of the academic community is very important to support the existence of mental health counseling services. Moreover, policies and service standards do not yet exist at ITEKES Muhammadiyah West Kalimantan. Thus, this underlies strategic planning activities for mental health services that can be beneficial for students and have an impact on student welfare in maintaining their mental status.

Evaluation of female university students’ knowledge, attitudes, and practices toward human papillomavirus infection and vaccination. Multicenter cross-sectional study

IntroductionHaving good knowledge and a favorable attitude toward human papillomavirus (HPV) and HPV vaccinations is the cornerstone for increasing the use of HPV vaccinations and preventing cervical cancer. The objective of this study was to evaluate the level of knowledge, attitudes, and practices regarding HPV and HPV vaccinations, as well as to identify associated factors among female undergraduate health science students at both the University of Gondar (UoG) and Bahir Dar University (BDU), Amhara, Ethiopia.MethodsInstitutional-based multicenter descriptive cross-sectional study was conducted from June 1, 2023, to July 30, 2023. A multistage sampling technique was used to select 633 female undergraduate health science students, and data were collected using a structured, self-administered questionnaire. The data were coded, entered in Epi-data, and exported to SPSS for analysis. Variables with a P-value < 0.25 in the bivariate analysis were inserted in a multivariate logistic regression model, and those with a P-value of < 0.05 in the multivariate binary logistic regression were considered statistically significant factors for knowledge, attitude, and practice regarding HPV and vaccine against it.ResultsThe study included 600 participants with a mean age of 20.8 ± 0.75 years. Using Bloom’s cutoff points for the KAP study, among the participants, 436 (72.7%) had good knowledge about HPV, whereas 315 (52.5%) had good knowledge about HPV vaccinations. More than half of the participants, 359 (59.8%) heard about HPV vaccinations in Ethiopia. More than half of the participants, 342 (57%) had favorable attitudes toward HPV vaccinations. Only 261 (43.5%) participants believed the HPV vaccine was safe and effective. All participants had never been tested for HPV, and 471 (78.5%) refused to have their samples for regular HPV testing. The factors like ages between 21 and 23 years (AOR, 2.12, 95% CI: 1.22–3.09) and favorable attitudes toward HPV vaccinations (AOR: 1.88; 95%, CI: 1.15–3.41) were associated with the participant’s knowledge about HPV vaccinations. Having good knowledge about the virus (AOR: 1.92; 95%, CI: 1.11–5.88) and its vaccine (AOR:1.60; 95%CI: 1.07–2.47) were factors associated with the attitude of the participants about HPV vaccinations. Additionally, HPV vaccination practice was significantly associated with the attitude of the participants toward HPV vaccinations (AOR: 1.85; 95%CI: 1.15–3.45), knowledge about HPV (AOR: 1.18; 95%CI: 0.55–5.50), and HPV vaccinations (AOR: 1.85; 95%CI: 1.08–2.44).ConclusionThis study revealed that half of the students had good knowledge and a favorable attitude toward HPV vaccinations, but there was poor HPV vaccination practice. There is still a need for continued health education, training, and counseling services for students to strengthen HPV vaccination practices, improve students’ attitudes and knowledge about the benefits of vaccination, and improve counseling abilities against HPV-induced cancer.

UNMC Quick Checks: An “Opt-Out” Model for Health Profession Student Appointments with Mental Health Counseling Services

UNMC Quick Checks: An “Opt-Out” Model for Health Profession Student Appointments with Mental Health Counseling Services

The Hidden Epidemic: Burnout and Mental Health Amongst Medical Students

In the noble pursuit of healing others,medical students often find themselvesgrappling with their own silent battles:burnout and mental health issues. Despitethe aura of prestige surrounding themedical profession, the harsh reality is thatthose training to become doctors facetremendous pressure, leading to alarmingrates of burnout and mental healthchallenges. In the UK, this issue has beengaining significant attention, shedding lighton the need for systemic changes to supportthe well-being of future physicians.The Burnout Epidemic:According to a recent study published in theBritish Medical Journal (BMJ), burnoutamongst medical students in the UK isalarmingly high; with nearly two-thirdsexperiencing symptoms at some pointduring their training. Burnout,characterised by emotional exhaustion,depersonalisation, and reduced personalaccomplishment, not only affects themental health of medical students but alsocompromises patient care and contributesto high dropout rates within the professionThe Perils of Perfectionism:One contributing factor to the prevalence ofburnout among medical students is theculture of perfectionism ingrained inmedical education. From the rigorousacademic demands to the relentless pursuitof clinical excellence, students often findthemselves striving for unattainablestandards, leading to chronic stress andpsychological strain.Research conducted by the Royal Collegeof Psychiatrists indicates that the fear offailure and the pressure to excelacademically contribute significantly to themental health challenges faced by medicalstudents. The stigma surrounding mentalhealth within the medical communityfurther exacerbates the problem, leadingmany students to suffer in silence ratherthan seeking the support they desperatelyneed.The Impact on Mental Health:Beyond burnout, mental health issues suchas anxiety, depression, and suicidal ideationare prevalent among medical students. Asurvey conducted by the Medical SchoolsCouncil revealed that nearly one in fivemedical students in the UK experiencedepression or anxiety severe enough torequire treatment.The demanding nature of medical training,coupled with long hours, sleep deprivation,and exposure to distressing clinicalscenarios, takes a toll on the psychologicalwell-being of students. Without adequatesupport systems in place, many studentsfind themselves overwhelmed, strugglingto cope with the demands of their studieswhile battling their inner demons Addressing the Crisis:Recognising the urgent need to addressburnout and mental health issues amongmedical students, universities andhealthcare institutions are beginning toimplement proactive measures to supportstudent well-being. From mental healthcounseling services to peer supportnetworks and wellness initiatives, effortsare underway to create a more nurturingand supportive learning environment forfuture physicians.Additionally, initiatives such as the#MentalMovement within the medicalcommunity are working to reduce thestigma surrounding mental health andencourage open conversations about thechallenges faced by medical students andprofessionals alike. By fostering a culture ofcompassion and understanding, theseinitiatives aim to break down barriers toseeking help and promote a healthierapproach to medical education and practice.The prevalence of burnout and mentalhealth issues among medical students in theUK is a pressing concern that demandsimmediate attention. As future guardians ofpublic health, it is imperative that weprioritize the well-being of those entrustedwith the responsibility of caring for others.By addressing the root causes of burnout,challenging the culture of perfectionism,and fostering a supportive learningenvironment, we can create a brighter andhealthier future for medical students andthe patients they serve.Now we want YOUR opinions on this.burnout and mental health are subjectswhich are hard to talk about as medicalstudent so we would love to hear about yourthoughts and opinions. If you have 5 minutesto fill in the google form below it would begreatly appreciated.

Zero-shot learning to extract assessment criteria and medical services from the preventive healthcare guidelines using large language models.

The integration of these preventive guidelines with Electronic Health Records (EHRs) systems, coupled with the generation of personalized preventive care recommendations, holds significant potential for improving healthcare outcomes. Our study investigates the feasibility of using Large Language Models (LLMs) to automate the assessment criteria and risk factors from the guidelines for future analysis against medical records in EHR. We annotated the criteria, risk factors, and preventive medical services described in the adult guidelines published by United States Preventive Services Taskforce and evaluated 3 state-of-the-art LLMs on extracting information in these categories from the guidelines automatically. We included 24 guidelines in this study. The LLMs can automate the extraction of all criteria, risk factors, and medical services from 9 guidelines. All 3 LLMs perform well on extracting information regarding the demographic criteria or risk factors. Some LLMs perform better on extracting the social determinants of health, family history, and preventive counseling services than the others. While LLMs demonstrate the capability to handle lengthy preventive care guidelines, several challenges persist, including constraints related to the maximum length of input tokens and the tendency to generate content rather than adhering strictly to the original input. Moreover, the utilization of LLMs in real-world clinical settings necessitates careful ethical consideration. It is imperative that healthcare professionals meticulously validate the extracted information to mitigate biases, ensure completeness, and maintain accuracy. We developed a data structure to store the annotated preventive guidelines and make it publicly available. Employing state-of-the-art LLMs to extract preventive care criteria, risk factors, and preventive care services paves the way for the future integration of these guidelines into the EHR.

An Exploration of Satisfaction with Mental Health Counseling Services in Western Australia Among Sexuality and Gender Diverse Youth

ABSTRACT Clinically significant psychological distress affects approximately 29.3% of Australian adolescents and 80.6% of sexuality and/or gender diverse youth (SGD-Y). Often, SGD-Y experience inadequate access and lower satisfaction with mental health services, stemming from age- and sexuality and/or gender diversity-status. Accordingly, exploration of factors affecting SGD-Y’s access to, and satisfaction with, mental health services is critical. Using a social constructionist lens, we explored factors supporting SGD-Y’s satisfaction with mental health services, and how these needs are or could be met. Seven LGBTQA+ youth aged 15 to 21 who received counseling in Western Australia in the last year, recruited via a university student participant pool and community organizations, participated in semi-structured interviews via video-conference, phone call, or SMS. Reflexive thematic analysis was inductively applied to participants’ verbatim accounts. Satisfaction was tied to participants’ sense of control over their healthcare-system experiences, shaped by four themes: person-centered support during the service-access process, resources to guide the search for services, confidence in therapists, and healthcare-system organization. Practices and policies supporting SGD-Y’s self-determination during their service access may allow for empowering and personally meaningful therapeutic experiences. Developers of policies and initiatives may need to adopt a systems approach to foster SGD-Y’s self-determination as they access services.

Study protocol for a randomized controlled trial of supportive parents – coping kids (SPARCK)—a transdiagnostic and personalized parent training intervention to prevent childhood mental health problems

BackgroundTo meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents – coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent–child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group).MethodsWe describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up.DiscussionThe current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology.Trial registrationClinicalTrials.gov ID: NTCT05800522

Advancing Educational accessibility and experiences: A sophisticated Chatbot integration approach

The integration of chatbots into the educational sector has ushered in a new era of learning and administrative support. This review paper explores the dynamic landscape of chatbots within educational institutes, focusing on their evolution and the emergence of innovative trends. From their early days as basic information providers to their current roles as personalized learning companions, chatbots have undergone significant transformations. The study identifies key milestones in the evolution of chatbots in education, highlighting their transition from rule-based systems to intelligent learning assistants. Moreover, this review delves into the latest trends shaping the chatbot ecosystem in education. It underscores the growing emphasis on Al-powered personalization, multimodal interfaces, and integration with Learning Management Systems (LMS) to streamline administrative tasks. Chatbots are no longer confined to text-based interactions; they now support voice and video, making education more accessible and inclusive. Additionally, they are contributing to mental health support and counseling services, addressing the well-being of students. The paper will argue that chatbots have the potential to revolutionize education by providing students with personalized learning experiences, supporting students with special needs, and promoting student engagement. However, it is important to address the ethical implications of using chatbots in education, such as privacy and bias. The paper will be of interest to educators, researchers, and policymakers who are interested in learning more about the potential of chatbots to transform education. Keywords— Deep Learning, Machine learning, NLP, Voice Assistant, Linux, Artificial Intelligence, Speech Recognition, LLMs.

Prevalence of stress and types of coping strategies among adolescents (14–18 years) in collectivist communities

Background: Stress is highly prevalent among adolescents and might lead to maladaptive coping. Methods: This cross-sectional study assessed the prevalence of stress and determined the types of coping strategies used by adolescents; and identified the predictors of stress levels among this cohort. The study recruited 1344 participants, aged 14 to 18 years, in schools. The study used the DASS-42 and the Brief COPE Inventory Scale for data collection. The findings of this study showed that more than two-thirds of adolescents suffer from stress, and moderate, severe, and extremely severe were 22.8%, 43.0%, and 16.8%, respectively. The most used coping behaviors among these adolescents were religious factors, with a Mean ± SD of (Mean 6.28 ± 1.16), followed by instrumental support (Mean 6.17 ± 1.18). The stress level has a significant negative correlation at (p < 0.001) with active coping (r = −0.183**), self-distraction (r = −0.190**), acceptance (r = −0.140**) and religion (r = −0.097**; P < 0.001). Binary logistic regression analyses revealed that the whole model had R2 (0.232); p < 0.005 and shows that those aged 15 had an odd of 0.272 to develop stress more than those at 18. Fathers' and mothers' education levels strongly influenced adolescents' stress levels. Those with an income between <500 and 500–750 Jordanian Dinars had an odds ratio of 5.241 and 3.514 of developing stress, respectively, compared to their counterparts. Application to practice: This study highlights the significance of developing health intervention programs and counseling services for managing adolescents' psychological well-being and provides valuable insights for policymakers on addressing mental health issues.

Composition of buprenorphine prescribing networks in Medicaid and association with quality of care

IntroductionDespite Medicaid's outsized role in delivering and financing medications for opioid use disorder (MOUD), little is known about the extent to which buprenorphine prescriber networks vary across Medicaid health plans, and whether network characteristics affect quality of treatment received. In this observational cross-sectional study, we used 2018–2019 Medicaid claims in Oregon to assess network variation in the numbers and types of buprenorphine prescribers, as well as the association of prescriber and network characteristics with quality of care. MethodsWe describe prescribers (MD/DOs and advanced practice providers) of OUD-approved buprenorphine formulations to patients with an OUD diagnosis, across networks. For each patient who initiated buprenorphine treatment during 2018, we assigned a “usual prescriber” and assessed four measures of quality in the 180d following initiation: 1) continuous receipt of buprenorphine; 2) receipt of any behavioral health counseling services; 3) receipt of any urine drug screen; and 4) receipt of any prescription for a benzodiazepine. We used multivariable linear regressions to examine the association of prescriber and network characteristics with quality of buprenorphine care following initiation. ResultsWe identified 645 providers who prescribed buprenorphine to 20,739 eligible Medicaid enrollees with an OUD diagnosis. The composition of buprenorphine prescriber networks varied in terms of licensing type, specialty, and panel size, with the majority of prescribers providing buprenorphine to small panels of patients. In the 180 days following initiation, a third of patients were maintained on buprenorphine; 69.9 % received behavioral health counseling; 88.4 % had a urine drug screen; and 11.3 % received a benzodiazepine prescription. In regression analyses, while no single network characteristic was associated with higher quality across all examined measures, each one unit increase in prescriber-to-enrollee ratio was associated with a 1.18 p.p. increase in the probability of continuous buprenorphine maintenance during the 180 days following initiation (95 % confidence interval = [0.21, 2.15], p = 0.017). ConclusionsMedicaid plans may be able to leverage their networks to provide higher quality care. Our findings, which should be interpreted as descriptive only, suggest that higher prescriber-to-enrollee ratio is associated with increased buprenorphine maintenance. Future research should focus on isolating the causal relationships between MOUD prescribing network design and patient outcomes.

Evaluation of activities and instrumental activities of daily living and correlated factors of traumatic brain injury patients in Vietnam

Traumatic brain injury (TBI) is among the leading causes of death in Vietnam. Survivors of TBI suffer from functional and cognitive deficits. Understanding that Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are crucial in measuring the treatment and health-related quality of life among patients with TBI. This study aims to evaluate ADLs and IADLs among the TBI population in Vietnam and determine the correlated factors to these two indices. A cross-sectional study was conducted on 212 patients with TBI in Vietnam from February to September 2020. ADLs and IADLs scales were applied. Depression, quality of sleep, and social support scales were used. Multivariate Tobit regression was adopted to identify factors associated with ADLs and IADLs. Patients who received first aid had higher ADLs scores than those who had not, by a statistical difference with a p value = 0.04. The mean ADLs score was 5.4 (SD = 1.4). The mean score of IADLs was 7.3 (SD = 1.7). Female patients (Mean = 7.6, SD = 1.1) performed better in IADLs than male patients (Mean = 7.1, SD = 1.9). Both ADLs and IADLs were affected strongly by depression and Injury Severity scores (p < 0.01), whereas IADLs were significantly correlated to caregiver types and quality of sleep (p < 0.01). Family support was observed as a negatively correlated factor to IADLs. Findings from the study provided evidence for authorities to adjust the health strategies among patients with TBI. Proper prehospital care, a basic low-cost hospital care model, and mental health counseling services should be considered when developing health interventions in Vietnam.

Acquaintance of Cervical Cancer Screening and Prevention Practices among Women’s Self-help Groups in Puducherry – A Community-based Cross-sectional Study

Abstract Context: Cervical cancer is a global public health problem with particularly high burden in many low- and middle-income countries. Aims: This study aimed to assess the knowledge regarding cervical cancer screening and adherence to preventive practices among self-help group women in Puducherry. Settings and Design: This was a community-based cross-sectional study among women belonging to self-help groups in the field practice areas of our tertiary care hospital. Subjects and Methods: The study was conducted for a period of 3 months from July to September 2023. The study population consists of women belonging to various self-help groups in the field practice areas of our tertiary care hospital based on the inclusion and exclusion criteria. A multistage random sampling method was used with an estimated sample size of 245. Statistical Analysis Used: Continuous variables were presented in the form of frequency and proportion. The Chi-square test was used for determining the association. Results: Out of 245, 39.6% had good knowledge regarding cervical cancer and 60.4% had poor knowledge. Majority of the rural women (140) had poor knowledge compared to urban areas. A significant association between employment and awareness (P = 0.000) regarding cervical cancer screening and prevention was observed. Conclusions: Health promotion and counseling services should be increased, and an efficient tracking of screening and assessment system should be intensified as part of the National Programme for Prevention and Control of Noncommunicable Diseases to accelerate its elimination.

Discipline, caregiving, and identity work of frontline professionals: Talking about the acts of compliance and resistance in the everyday practices of social workers

Abstract This article investigates how the identities of frontline professionals are (re)constructed in their talk about their everyday work activities. Based on a study of a mental health and addiction counselling service organization in Ontario, we illustrate that when talking about acting in accordance with their organizational policies, the social workers’ identities are disciplined by and appropriated from addressing the practices of documentation and regular meetings with their supervisors that constitute the routine processes of organizing. However, when discussing instances where they override the organizationally sanctioned rules, their identities are disciplined by the aspiration of fabricating a client-centred caregiver identity adopted from the dominant discourse in their profession. We, therefore, counterbalance the understanding that professionals’ identity work related to their deliberate micro-emancipation acts are merely an expression of agency and argue that their preferred resistant identities pertaining to their self-declared apparent deviation from the organizational order are also made within frameworks of disciplinary power. By delineating that both discursive conformity and resistance cut across the boundaries between acting in alignment with and against organizational guidelines, we unveil an underexplored complexity of conducting professional identity work associated with the interrelationships between practices of talk and action that has largely been overlooked in prior scholarship. We, therefore, offer an action-related analysis of discursive identity work that extends beyond the context of this study and informs future research.

Acute malnutrition relapse and associated factors among 6-59 months old children treated in the community-based management of acute malnutrition in Dessie, Kombolcha, and Haik towns, Northeast Ethiopia.

Undernutrition is a major health concern in many developing countries, and is one of the main health problems affecting children in Ethiopia. Although many children experience multiple relapses following the management of severe acute malnutrition, it is scarcely studied in Ethiopia. A community-based cross-sectional study was conducted in Dessie, Kombolcha, and Haik towns among 6-59-month-old children enrolled and discharged from community-based acute malnutrition management (CMAM). The total sample size was 318 children, and data were collected from April 15, 2021, to May 14, 2021. The data were entered into EPI data version 4.4.1 before being exported and analyzed with SPSS version 25 software. A multivariate logistic regression analysis was performed, and a 95% confidence interval and p-value <0.05 were used to identify significantly associated variables. Additionally, the weight-for-height z-score (WHZ) was generated using the WHO Anthro 3.2.2 software. The overall acute malnutrition relapse after discharge from CMAM was 35.2% (6.6% relapsed to severe acute malnutrition and 28.6% relapsed to moderate acute malnutrition). The following variables were significantly associated with the relapse of acute malnutrition: child age (AOR: 3.08, 95% CI; 1.76, 5.39), diarrhea after discharge (AOR: 2.93, 95%CI; 1.51, 5.69), have not immunized (AOR: 3.05, 95% CI; 1.14, 8.23), MUAC at discharge (AOR: 3.16, 95% CI; 1.56, 6.40), and poorest and poor wealth index (AOR: 3.65, 95% CI; 1.45, 9.18) and (AOR: 2.73, 95% CI; 1.13, 6.59), respectively. Over one-third of children treated with the CMAM program reverted to SAM or MAM. The age of the child, diarrhea after discharge, lack of immunization, MUAC at discharge (<13 cm), and poor and poorest wealth index were significantly associated with acute malnutrition relapse. Therefore, adequate health education and counseling services are essential for mothers to improve child immunization coverage and maintain adequate hygiene to prevent diarrhea. In addition, further experimental research is needed to investigate the effect of MUAC at discharge on the risk of acute malnutrition relapse.