National Counseling Research Articles

Capacity building trauma-specific school counseling in occupied Palestine: A narrative review (2009–2024)

ABSTRACT The narrative review explores 15 years of research and development in culturally attuned trauma-specific programs for school counseling in occupied Palestine. The review examines the long-standing collaborative partnership between two educational psychologists, one in Palestine, the other in Scotland. The review begins with the context of violent military occupation, a description of our mission, the issues addressed in cross-cultural decision-making, the implementation of culturally sensitive programing, and our praxis of sustainability through a national school counseling network. The review then shifts focus to explore our trajectory of research methodology and the outcomes of our studies. The latter involves the re-conceptualization of trauma exposure and resultant symptomology in occupied Palestine and provides evidence for the efficacy of culturally attuned trauma-specific programs. Finally, the review identifies key lessons learned to continue building a trauma-specific school counseling system in occupied Palestine. Recommendations are made for future practice and research within and beyond Palestine.

Germline mutations of breast cancer susceptibility genes through expanded genetic analysis in unselected Colombian patients

BackgroundIn Colombia and worldwide, breast cancer (BC) is the most frequently diagnosed neoplasia and the leading cause of death from cancer among women. Studies predominantly involve hereditary and familial cases, demonstrating a gap in the literature regarding the identification of germline mutations in unselected patients from Latin-America. Identification of pathogenic/likely pathogenic (P/LP) variants is important for shaping national genetic analysis policies, genetic counseling, and early detection strategies. The present study included 400 women with unselected breast cancer (BC), in whom we analyzed ten genes, using Whole Exome Sequencing (WES), know to confer risk for BC, with the aim of determining the genomic profile of previously unreported P/LP variants in the affected population. Additionally, Multiplex Ligation-dependent Probe Amplification (MLPA) was performed to identify Large Genomic Rearrangements (LGRs) in the BRCA1/2 genes. To ascertain the functional impact of a recurrent intronic variant (ATM c.5496 + 2_5496 + 5delTAAG), a minigene assay was conducted. ResultsWe ascertained the frequency of P/LP germline variants in BRCA2 (2.5%), ATM (1.25%), BRCA1 (0.75%), PALB2 (0.50%), CHEK2 (0.50%), BARD1 (0.25%), and RAD51D (0.25%) genes in the population of study. P/LP variants account for 6% of the total population analyzed. No LGRs were detected in our study. We identified 1.75% of recurrent variants in BRCA2 and ATM genes. One of them corresponds to the ATM c.5496 + 2_5496 + 5delTAAG. Functional validation of this variant demonstrated a splicing alteration probably modifying the Pincer domain and subsequent protein structure. ConclusionThis study described for the first time the genomic profile of ten risk genes in Colombian women with unselected BC. Our findings underscore the significance of population-based research, advocating the consideration of molecular testing in all women with cancer.

Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster

In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.

Perceived barriers, recommendations, and resources for multistate licensure in the United States: A mixed-methods study of laboratory genetic counselors.

With genetic counselor licensure now available in 32 states, the number of laboratory genetic counselors (LGCs) who are required to be licensed in multiple states has risen substantially. Although previous studies have documented the complexity of the multistate licensing (MSL) process, there has been little research on the experiences of LGCs applying for and maintaining licensure. The purpose of this study was to identify perceived barriers, recommendations, and resources for LGCs pursuing MSL. A 15-item mixed-methods, anonymous questionnaire was used to survey genetic counselors currently or formerly employed by genetic testing laboratories. Responses were analyzed with a combination of descriptive statistics and inductive thematic analysis. Of the 150 eligible participants who completed the survey, the majority worked at a commercial, non-academic laboratory (84%, n = 126), had 1-4 years of laboratory genetic counseling experience (54%, n = 81), held non-patient-facing roles (65%, n = 97), and were required by their employer to hold licensure in at least one state (73%, n = 110). Most participants (86%, n = 129) felt there were barriers to MSL for LGCs, with three emergent themes: (1) resource burden, (2) complexity, and (3) legislative ambiguity. Participants described the current MSL process as tedious, cumbersome, confusing, overwhelming, and redundant. Several shared that the current licensing system undermines the intent to improve the status of the profession and actually negatively impacts patient care. Recommendations to improve MSL included overall process enhancements, like transitioning to online systems and a single central information repository for licensees, increased professional advocacy, and investing in collaborative pathways to licensure such as interstate compacts. Participants found national genetic counseling organizations, state-based genetic counseling organizations, and genetic counseling colleagues to be the most helpful resources for understanding licensure law and where to apply for licensure.

Assessing HIV Care Services in Nigeria: A Comparative Study of the North-East and South-South regions of Nigeria

This study conducted a comparative case study analysis of the HIV program in Nigeria’s South-South and North-East regions of Nigeria to determine the access and quality of HIV care and treatment services. Service delivery is an essential component of the WHO Health systems framework. Data were collected from 385 respondents using structured questionnaires and analysed using descriptive and inferential statistics. The study found that the North-East region of Nigeria had significantly lower numbers of primary healthcare facilities and inpatient beds per 10,000 population compared to the South-South region. The North-East region had an average of 0.02 inpatient beds per 1,000 population, significantly below the WHO standard, while the South-South region had an average of 0.18 inpatient beds per 1,000 population, relatively closer to the WHO standard. The general service readiness score for delivering HIV program services was at least 94% in all health facilities in both the North-East and South-South regions. The HIV service readiness index for the North-East region was higher than that of the South-South region, with some disparities in the availability of national ART guidelines, national HIV counselling and testing guidelines, staff training, and availability of HIV prevention services. HIV testing and counselling services were described as readily available and accessible in both regions, with some communities taking ownership of promoting the availability of these services. However, both regions had a relatively high service readiness score for delivering HIV program services, with some disparities in the availability of national guidelines and training of staff. These findings demonstrate extensive investment of government and donor agencies in delivering quality HIV services with areas to improve to ensure alignment with WHO system strengthening framework. Keywords: Health systems, HIV, North-East, Service delivery, South-South, WHO.

Assessment of Depression and Death Anxiety among Adolescents and Husbands of Palestinian Women with Cancer

Assessment of Depression and Death Anxiety among Adolescents and Husbands of Palestinian Women with Cancer This study aimed to assess the prevalence of death anxiety and depression among adolescent children and husbands of women with cancer in Palestine. The study involved 285 participants, including 200 adolescents aged 12 to 20 years and 85 husbands of women with cancer who were treated at two major cancer centers in Palestine. The participants completed a self-reported questionnaire to assess death anxiety using the Templer Death Anxiety Scale (DAS) and depression using the Beck Depression Inventory (BDI). The results showed that depression and death anxiety were prevalent among family members of women with cancer, with a significantly higher mean depression score in adolescents than in husbands. The worst depression and highest anxiety mean scores were observed in daughters. In total, up to 20% of the sample had scores indicating clinical depression. The anxiety analysis revealed that 39.9% of all participants had concerns or serious concerns about death, with daughters having the highest percentage. The study found that coping and work were significant predictors of depression among sons of women with cancer while coping, mothers’ education, residence, and monthly income of the family significantly predicted sons’ death anxiety. Age, coping, type and duration of treatment, and care provider were significant predictors of depression among daughters, while age, care provider, monthly income, and mothers’ stage of cancer significantly predicted daughters’ death anxiety. Coping was also a significant predictor for depression and death anxiety in husbands, in addition to work. The study highlights the need for national policy initiation and counseling programs implementation for families with cancer patients, especially for adolescent daughters, and to assess mental disorders, such as depression and death anxiety, among those families.

A field experiment on subgoal framing to boost volunteering: The trade-off between goal granularity and flexibility.

Research suggests that breaking overarching goals into more granular subgoals is beneficial for goal progress. However, making goals more granular often involves reducing the flexibility provided to complete them, and recent work shows that flexibility can also be beneficial for goal pursuit. We examine this trade-off between granularity and flexibility in subgoals in a preregistered, large-scale field experiment (N = 9,108) conducted over several months with volunteers at a national crisis counseling organization. A preregistered vignette pilot study (N = 900) suggests that the subgoal framing tested in the field could benefit goal seekers by bolstering their self-efficacy and goal commitment, and by discouraging procrastination. Our field experiment finds that reframing an overarching goal of 200 hr of volunteering into more granular subgoals (either 4 hr of volunteering every week or 8 hr every 2 weeks) increased hours volunteered by 8% over a 12-week period. Further, increasing subgoal flexibility by breaking an annual 200-hr volunteering goal into a subgoal of volunteering 8 hr every 2 weeks, rather than 4 hr every week, led to more durable benefits. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

دراسة حول الافكار الانتحارية ومحاولة الانتحار بين مرضى فيروس نقص المناعة البشرية في مركز امدرمان القومي للارشاد النفسي والفحص التطوعي ولاية الخرطوم - السودان (2021-2022)

Background: Suicidal ideation and attempt are more frequent in HIV patients than general population Objective: The aim of this study was to assess the suicidal ideation and attempt among HIV patients in Omdurman National Voluntary Counseling and Testing Center, Khartoum state, Sudan. Methods: Descriptive cross-sectional institutional based study was conducted among HIV patients attending Omdurman national voluntary counseling and testing Center. Systematic random sampling technique was used to select 235 participants from March to May 2021, data was collected by using a questionnaire consisted of sociodemographic and clinical characteristics and validated tool (Mini international neuropsychiatric interview for suicidality- the Arabic version), data was analyzed using SPSS 26 edition and Chi squire test, the t test and Multivariate test were used for the associations between variables Results: Suicidal ideation in the last month was (14.5%), suicidal attempt in the last month was (0.4%) and lifetime suicidal attempt was (4.3%). Suicide risk were high in (2.5%), moderate in (10.6%) and low in (12.7%). Marital status, occupation, duration of diagnosis, WHO stages and opportunistic infections were significantly associated with suicidal ideation, whereas opportunistic infections and marital status were significantly associated with suicidal attempt. Conclusion: The suicidal ideation and attempt in the HIV patients in the last month were 14.5% and 0.4% respectively, and the lifetime suicidal attempt was 4.3%. There is significant association between suicidal ideation and attempt and some sociodemographic and clinical characteristics of the patients.

Using tailored eHealth programmes to stimulate primary health care professionals’ lifestyle counselling guideline adherence - Lessons learned from the STAR project

BackgroundAlthough individually tailored eHealth programmes have shown to be effective in changing patient and citizen health behaviours, they have so far not been applied to lifestyle counselling guideline adherence in primary health care professionals beyond our STAR project. The programme aimed to support general practice nurses adhering to national smoking cessation counselling guidelines and showed encouraging positive impacts on both nurse and patient level. ObjectiveTo identify lessons learned from our successful application of a tailored eHealth programme in primary health care. MethodsTriangulation of information from different sources collected throughout the project run time (e.g., project meetings, discussions with experts in the fields of computer tailoring, smoking cessation and professional education and interactions with general practice nurses). ResultsWe identify four lessons learned which developers and testers of tailored eHealth programmes in primary health care should consider, relating to 1) Choosing outcome measures, 2) Measuring outcomes, 3) Practical feedback application & Programme accessibility, and 4) Programme interaction. Practice implicationsWe share this information in the hope that we will see more applications of this promising intervention strategy – that can build on our work – in the future.

Genotype Hemophilia Screening Program Identified 2 Novel Variants Including a Novel Variant (c.5816-2A > G) Causing a Pathogenic Variant of the Factor 8 Gene.

Establishing a national screening program for hemophilia patients is highly encouraged by the World Health Organization and the World Federation of Hemophilia. Hence, this study aimed to analyze the variant spectrum of F8 and F9 genes in Arab hemophilia patients. Molecular genetic and sequencing studies were performed on a cohort of 135 Saudi hemophilia patients. Out of all screened hemophilia patients (97 hemophilia A and 39 hemophilia B), 15 (11.1%) were positive for inversion 22 and 4 (3%) for inversion 1. Out of a total of 32 (23.7%) substitution/deletion mutations, 2 novel variants were identified: a novel splice acceptor site missense mutation (c.5816-2A > G) causing a pathogenic variant of the F8 gene and another splicing site point mutation in intron/exon 23 (g.164496G > A). The frequent F8 variants were (c.409A > C, p.T137P) in exon 4, (c.760A > G) in exon 6, and (c.1835G > C, p.R612P) in exon 12, while the frequent F9 variants were (c.580A > G) in exon 6 and (c.880C > T) in exon 8. These study data will enrich the spectrum of the genetic databases in the Arab population that could be applied in the future for national genetic counseling.

Oncofertility and Reproductive Counseling in Patients with Breast Cancer: A Retrospective Study.

Introduction. Improving the prognosis of breast cancer patients is of utmost importance in terms of increasing survival rates. Modern medicine has therefore prioritized better quality of life for patients, even after the disease, through a better management of the potential long-term side effects induced by anticancer treatments. Fertility preservation and family planning are therefore crucial issues to be addressed in all cancer patients of reproductive age. Along those lines, a new branch of medicine with distinct multidisciplinary characteristics has developed over the years: oncofertility. Although both national and international guidelines value reproductive counseling as an essential aspect of the diagnostic-therapeutic pathway, part and parcel of the informed consent process, it is not included within the protocols adopted by the operating units for the care and management of neoplastic diseases. Objective. This study aimed to evaluate the activity of the Breast Unit of the Policlinico Umberto I Hospital, Rome, Italy, and the degree of compliance with guidelines. By knowing the strengths and weaknesses of such approaches, the standards of care offered to breast cancer patients can be improved. Materials and methods. A retrospective study based on a review of medical records was conducted between 2014 and 2021. Patients under 40 years of age diagnosed with non-metastatic malignancies were included who received chemotherapy treatment, namely neoadjuvant, adjuvant or adjuvant hormone therapy. Results. The data were extracted from the medical records of 51 patients who met the inclusion criteria, 41% of whom received reproductive counseling, and of these, 43% decided to undertake a path of fertility preservation. Factors such as the absence of children and young age reportedly favored both the interest in counseling proposals by the medical staff and the decision to undertake a path of fertility preservation. Conclusions. The study shows that there has been growing interest in the topic of oncofertility, especially in light of law 219/2017. Therefore, since 2018, multiple proposals for reproductive counseling have been set forth, but there was not an equally growing demand for fertility preservation practices, which can be explained by the invasive nature of such practices, the patients’ concern about their own state of health, and poor or inadequate information. Such impediments highlight the importance of standardized counseling and the need for a multidisciplinary medical team to support the patient in the decision-making process. The study also revealed a drop in the number of patients receiving counseling due to the COVID-19 pandemic, contrary to the positive trend that was recorded prior to the pandemic.

Regional and rural clients’ presenting concerns and experiences of care when engaging with an online substance use counseling service

Introduction People are increasingly turning to online services for help with substance use concerns. There has, however, been limited research on the use of online substance use services by regional and rural populations. This study explored: (1) the experiences of care of regional and rural clients of an Australian national online text-based substance use counseling service, Counselling Online; (2) their reasons for accessing the service; and (3) their interaction with the counselor. Design and methods We thematically analyzed transcripts of 31 online counseling sessions involving regional and rural clients seeking help for their alcohol, cannabis or amphetamine use. Results Regional and rural clients commonly experienced difficulties accessing local services, were often in distress, and were navigating rurally-influenced social challenges. Counselling Online provided support, education and helped clients explore their substance use. Clients generally found Counselling Online beneficial, however some counselors were unaware of the unique issues affecting regional and rural clients, such as transportation barriers and geographical isolation. Discussion and conclusions Online substance use services provide useful support to regional and rural clients, however we identified several opportunities for improving the service experience for regional and rural clients. These include training online counselors on the unique experiences of regional and rural clients, adapting referrals to match client preferences, and encouraging counselors to ask about the physical location in which clients are using the service.

Effect of COVID-19 Pandemic on Career Choice among Medical Postgraduate Aspirants in Chennai: A Cross-sectional Study

Introduction: Many frontline workers including doctors and nurses have succumbed to the Coronavirus Disease-19 (COVID19) pandemic. In the COVID-19 pandemic, medical postgraduate (PG) aspirants had to deal with a variety of problems, including an increased workload, delay in National Eligibility cum Entrance Test (NEET) PG test and counselling. Aim: To assess the effect of COVID-19 pandemic and various factors influencing career choice among medical PG aspirants in Chennai. Materials and Methods: The present cross-sectional questionnaire-based study was conducted in the Department of Community Medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India from August 2021 to September 2021 among 272 medical Postgraduate (PG) aspirants. A Google form questionnaire was sent to students who were in an internship in the past six months or had completed their internship in the past one year. There were 28 multiple choice questions comprising of socio-demographic details (with exception of age) and various factors related to career choice. Five questions were scored yes/no, and 15 questions were scored using 5-point Likert scale. Results: The mean age of the participants was 24.41±1.81 years and there were 129 males and 143 females in total among the study participants. Change in career choice was observed in 39.33% of the participants. The top two choices prior to and during the COVID-19 pandemic was General Surgery and General Medicine. Among the participants who had a change in career choice, the mean score of four questions in COVID-19 pandemic domain was higher when compared with participants who had no change. Conclusion: Most of the participants believed that the COVID-19 pandemic limited the learning opportunities for postgraduates and the violence against doctors had an impact on their decision to pursue a particular career. Due to the present pandemic, participants interest in community medicine and infectious diseases has increased.

Whiteness Scholarship in the Counseling Profession: A 35-Year Content Analysis

We conducted a content analysis of counseling scholarship related to Whiteness for articles published in national peer-reviewed counseling journals within the 35-year time frame (1984–2019) following the publication of Janet Helms’s seminal work on White racial identity. We identified articles within eight counseling journals for a final sample of 63 articles—eight qualitative (12.7%), 38 quantitative (60.3%), and 17 theoretical (27.0%). Our findings outline publication characteristics and trends and present themes for key findings in this area of scholarship. They reveal patterns such as type of research methodology, sampling, correlations between White racial identity and other constructs, and limitations of White racial identity assessment. Based on this overview of extant research on Whiteness, our recommendations include future research that focuses on behavioral and clinical manifestations, anti-racism training within counselor education, and developing a better overall understanding of how White attitudes and behaviors function for self-protection.

Improving caregivers’ infant and young child-feeding practices using a three-group food guide: A randomized intervention study in central Uganda

Despite improvements in food production and healthcare services, the burden of malnutrition in Uganda has for the last 30yearsremained unacceptably high with rates of stunting (chronic undernutrition) and anemia (proxy for micronutrient deficiency) currently estimated at 29% and 53%,respectively among young children aged 6-59 months. Considering that both undernutrition and over nutrition are greatly attributed to monotonous diets characterized by limited dietary diversity and overdependence on starchy refined grains or roots as staples,there is need to improve the population’s awareness of appropriate dietary practices. To improve nutrition education, the Infant and Young Child-feeding national counseling cards for community volunteers (IYCF cards)that were developed by United Nations Children’s Fund (UNICEF), are currently the standard package used in Uganda’s health sector to educate caregivers on appropriate child-feeding practices. In this study, the effectiveness of a three-group food guide was evaluated against IYCF cards.A randomized, controlled intervention trial engaged three randomly selected distant groups of child-caregiver pairs (n=40) concurrently in one of three treatments namely: (i) nutrition education using a three-foodgroup guide (FG), (ii) nutrition education using age-appropriate IYCF cards, and (iii) negative control group that engaged in hair-plaiting sessions. At baseline, all groups had randomly selected caregivers of children aged 6-14 months and were met once a week for five consecutive weeks during the intervention. Caregivers were interviewed at baseline and 2 months after the interventions to determine changes in child-feeding practices while their children were concurrently measured to determine changes in their nutritional status.At baseline, caregivers in the three treatment arms exhibited inappropriate child-feeding practices indicated by low child-feeding index (CFI) scores,which were also related to poor nutritional status of their children. After the interventions, children in FG group were given more varied animal-source foods than those in IYCF cards group (p =0.02). Compared to controls, caregivers in FG group gave their children significantly more snacks (p = 0.01), their child-feeding practices indicated by CFI scores significantly improved (p = 0.001) and their children exhibited better growth patterns indicated by weight-for-age (p = 0.02) and MUAC-for-age (p = 0.03) Z-scores.These findings,therefore,indicate that the three-group food guide is more likely to improve child-feeding practices and growth patterns than IYCF cards.Hence, there is need to integrate the food guide into IYCF materials to foster child-feeding practices and growth.

One-year Outcomes of Congenital Duodenal Obstruction: A Population-based Study.

Congenital duodenal obstruction (CDO) occurs in 1.2 per 10,000 live births and is frequently associated with other anomalies, most commonly cardiac. The aim of this study was to report important outcomes to 1 year following surgical repair. This was a prospective population-based study using the British Association of Paediatric Surgeons Congenital Anomaly Surveillance System. Cases were identified at specialist pediatric surgical centres in the United Kingdom during a 12-month period starting in March 2016. Outcomes were recorded at 1 year following surgical repair. There were 100 infants with possible follow-up at 1 year and follow-up was achieved in 80 of these (80%) of whom 76 were alive at 1 year. The remainder had been discharged home, although one remained on parenteral nutrition. Five (6.1%) infants underwent repeat surgery for reasons related to CDO and overall 23 (23%) experienced at least 1 central venous catheter-related complication within 1 year. Overall mortality either before repair or within 1 year following surgical repair was 8.4% (95% CI 2.5%-14.4%), no deaths were related to CDO. One year outcomes for CDO are generally very good with poor outcomes typically related to comorbidities. These data are useful for national benchmarking and parental counselling.

COVID-19 pandemic in India: through psycho-social lens.

COVID-19 pandemic is an unprecedented crisis that simultaneously affected different countries and communities across the globe. The large-scale psychosocial impact of the pandemic and the subsequent lockdown, is an experiential reality for many, in India. Despite this impact, a closer look at India’s response to the pandemic shows that the two strands of health and relief measures, continue to occupy centre-stage. The psycho-social aspects of the pandemic unfortunately largely remain undocumented and unaddressed. Using experiences of iCALL, National national level psycho-social counseling counselling service and a field action project of the Tata Institute of Social Sciences, the paper throws light on the much-neglected experiential psycho-social dimensions of COVID-19 pandemic and the subsequent lockdown in India. It describes the stressors experienced by users who approached iCALL and the consequent impact; especially among those who belonged to the vulnerable sections of the society. The nature of stressors as well as the impact reported by iCALL users, clearly points out to a complex interplay among several factors at individual, interpersonal, community and structural levels. The paper then, critically looks at the merits and limitations of the mental health framework that predominated the mental health response during the pandemic with its bio-medical and individualistic undertones; and suggests an alternative framing using a ‘psycho-social’ paradigm that views distress as an interaction between the psychological and social worlds. The paper asserts reciprocal linkages between development and psycho-social distress; highlighting the need to consciously integrate mental health issues into the development response. In the end, it makes an appeal for an inter sectoral dialogue, integrated response and advocacy for investing in mental health and psycho-social infrastructure to effectively respond to the pandemic.

The Relationship Between Housing Status and Substance Use and Sexual Risk Behaviors Among People Currently Seeking or Receiving Services in Substance Use Disorder Treatment Programs.

Although HIV risk behaviors such as substance use and condomless sex are prevalent among people currently seeking or receiving services at substance use disorder (SUD) treatment programs, associations with housing status in this population have not been well studied. We examined the associations between housing status, substance use and HIV-related sexualriskbehaviors among 1281 participants from 12 US community-based SUD programs. In addition, substance use was examined as a potential mediator of the relationship between housing status and sexual risk behaviors. We conducted Chi-square, univariate and multivariate logistic regression models on data from the National Drug Abuse Treatment Clinical Trials Network HIV Rapid Testing and Counseling study. Path analysis was used to test the mediation and indirect effects. Unstable housing was significantly associated with having multiple concurrent condomless sex partners, condomless sex with non-primary partners, and partners of unknown HIV serostatus. Homelessness was significantly associated with condomless vaginal sex and condomless sex with any substance use. The path between unstable housing and sexual risk behaviors was mediated by problematic drug use, particularly by cocaine, opioids, and marijuana use. Because housing status impacts HIV risk behaviors for individuals in SUD treatment programs, both housing status and substance use behaviors should be assessed upon program entry in order to identify and mitigate risk behaviors.

Impact of a Smoking Cessation Quitline in Vietnam: Evidence Base and Future Directions.

Smoking is considered the most critical modifiable factor with regard to lung cancer and remains a public health concern in many countries, including Vietnam, which is among those countries with the highest tobacco consumption rates in the world. This study has examined the impact of national telephone counselling for smoking cessation and has identified the factors associated with the impact of the quitline among male callers in Vietnam. A randomized cross-sectional survey of 469 smokers who sought smoking cessation services via the national quitline was performed from September 2015 to May 2016. The primary outcomes were measured by a self-reported quit rate at the time of assessment, 7 day point prevalence abstinence (PA), 6 month prolonged PA, service satisfaction, and level of motivation. Among the participants, 31.6% were abstinent, and 5.1% of participants successfully stopped smoking and did not need to seek quitline support. Most of the clients were satisfied with the quality of service (88.5%), felt more confident about quitting (74.3%), and took early action via their first quit attempt (81.7%); 18.3% reported a more than 7 day abstinence period at the time of survey. The primary reasons for smoking relapse were surrounding smoking environments (51.6%) and craving symptoms (44.1%). Future smoking cessation efforts should focus on improving the quality of quitline services, client satisfaction, and developing a tailored program and counseling targeting smokers with specific characteristics, especially ones experiencing chronic diseases.

The Role of Guidance and Counselling in Performance of Post-Primary Education in Nigeria: Regulatory and Theoretical Perspectives

The issue of role of guidance and counselling in the performance of post-primary education is highly debated in Nigeria and the world over. This paper advances our understanding of regulatory and theoretical frameworks of guidance and counselling towards this contentious issue using qualitative approach to explain the phenomenon. Based on the selected theories, model and available regulatory provisions in Nigeria, it was deducted that the theories, model and national regulations gave credence to the role guidance and counselling performs in achieving the national education goal. The study shows broad support of the theories, model and regulations for prioritizing guidance and counselling role in post-primary education. This is contrary to what some exponents suggest. The paper therefore finds no evidence of polarization in opinions that theories and regulations in guidance and counselling are not adequately sufficient to explain the roles of guidance and counselling at post-primary education level. From the study, it was safe to conclude that regulatory, theoretical frameworks and model of guidance and counselling do explain the role it plays in the performance of post-primary education in Nigeria. From the study, it was safe to conclude that regulatory, theoretical frameworks and model of guidance and counselling do explain the role it plays in the performance of post-primary education in Nigeria. Among others, the study recommended for designing a national guidance and counselling model for all levels of education in Nigeria as well as urged for more regulatory provisions for guidance and counselling programmes in Nigeria. It further suggested that this study should be extended to empirical approach, among others.