Professional Guidance Research Articles

Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study.

Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.

Aided Evaluation of Motion Action Based on Attitude Recognition

For athletes who are eager for success, it is difficult to obtain their own movement data due to field equipment, artificial errors, and other factors, which means that they cannot get professional movement guidance and posture correction from sports coaches, which is a disastrous problem. To solve this big problem, combined with the latest research results of deep learning in the field of computer technology, based on the related technology of human posture recognition, this paper uses convolution neural network and video processing technology to create an auxiliary evaluation system of sports movements, which can obtain accurate data and help people interact with each other, so as to help athletes better understand their body posture and movement data. The research results show that: (1) using OpenPose open-source library for pose recognition, joint angle data can be obtained through joint coordinates, and the key points of video human posture can be identified and calculated for easy analysis. (2) The movements of the human body in the video are evaluated. In this way, it is judged whether the action amplitude of the detected target conforms to the standard action data. (3) According to the standard motion database created in this paper, a formal motion auxiliary evaluation system is established; compared with the standard action, the smaller the Euclidean distance is, the more standard it is. The action with an Euclidean distance of 4.79583 is the best action of the tested person. (4) The efficiency of traditional methods is very low, and the correct recognition rate of the method based on BP neural network can be as high as 96.4%; the correct recognition rate of the attitude recognition method based on this paper can be as high as 98.7%, which is 2.3% higher than the previous method. Therefore, the method in this paper has great advantages. The research results of the sports action assistant evaluation system in this paper are good, which effectively solves the difficult problems that plague athletes and can be considered to have achieved certain success; the follow-up system test and operation work need further optimization and research by researchers.

Analysis of Factors Influencing Middle-aged and Elderly People’s Decisions of Investment and Financial Management

In this paper,we took middle-aged and elderly people as the research objects and collected the influence degree data of factors affecting the investment and financial decision-making through questionnaire,then applied statistical methods and the analytic hierarchy process to determine the primary and secondary ranking of the influence degree of these influencing factors.This study may provide reference for middle-aged and elderly people doing investment and financial management, financial institution constructing platform and developing product,government supervision,etc.We found that the most important factor affecting the investment and financial decisions of middle-aged and elderly people is the system stability in the platform factors,followed by the professional guidance in the personal characteristics and the operation difficulty in the platform factors.

Procuring and Implementing Management Systems for Electronic Records

Many organisations in the East and Southern African Regional Branch of the International Council of Archives region are facing serious records management challenges and are developing and implementing strategies to ensure compliance with approved standards. These strategies include policies and procedures for proper record management. Technology and the growth of computerised systems that generate electronic records have further created pressure for implementing electronic systems to manage documents and records as part of the broader records management programme. Several organisations in the East and Southern African Regional Branch of the International Council of Archives region are undertaking initiatives aimed at procuring such systems. Most of these organisations seem to lack guidance on steps to follow, from building a business case to tendering and final implementation. The problem has been worsened by a mushrooming of vendors marketing their products as records management solutions, creating confusion in organisations that have no professional guidance. The data were collected using a questionnaire in the region and confirmed that there is a lack of professional guidance. A framework to guide the procurement of these systems in organisations must be developed to ensure consistency and standardisation in the approach. The article will contribute by developing a framework or standardised strategy that will be used by national archival institutions and other public organisations in countries in the East and Southern African Regional Branch of the International Council of Archives region when procuring and implementing such systems.

Variability of Glycemic Outcomes and Insulin Requirements Throughout the Menstrual Cycle: A Qualitative Study on Women With Type 1 Diabetes Using an Open-Source Automated Insulin Delivery System.

The impact of hormone dynamics throughout the menstrual cycle on insulin sensitivity represents a currently under-researched area. Despite therapeutic and technological advances, self-managing insulin therapy remains challenging for women with type 1 diabetes (T1D). To investigate perceived changes in glycemic levels and insulin requirements throughout the menstrual cycle and different phases of life, we performed semi-structured interviews with 12 women with T1D who are using personalized open-source automated insulin delivery (AID) systems. Transcripts were analyzed using thematic analysis with an inductive, hypothesis-generating approach. Participants reported significant differences between the follicular phase, ovulation, and luteal phase of the menstrual cycle and also during puberty, pregnancy, and menopause. All participants reported increased comfort and safety since using AID, but were still required to manually adjust their therapy according to their cycle. A lack of information and awareness and limited guidance by health care providers were frequently mentioned. Although individual adjustment strategies exist, achieving optimum outcomes was still perceived as challenging. This study highlights that scientific evidence, therapeutic options, and professional guidance on female health-related aspects in T1D are insufficient to date. Further efforts are required to better inform people with T1D, as well as for health care professionals, researchers, medical device manufacturers, and regulatory bodies to better address female health needs in therapeutic advances.

Editorial Policy

Editorial Policy

Self-medication in patients over 18 years of age in health centers in Honduras

Context: Inappropriate self-medication is seen as a global public health concern. Without appropriate professional healthcare guidance, a variety of issues can arise with potentially serious consequences to one’s personal health. Aims: To describe self-medication in outpatients aged 18 years or over who attended public health care centers in Honduras. Methods: A sample of 4573 people was chosen using a cluster sampling technique. A structured questionnaire was applied. Study variables included: sociodemographic factors, frequency and reasons for self-medicating, kind of medicine and sources of acquisition. Results: With a minimum age of 18 years and a maximum age of 94 years, women predominated with 3340 (73.0%), originated from the department of Francisco Morazán with 1186 (25.9%) persons, primary complete in 1042 (22.8%) persons, and with a monthly household income of less than $171.41 in 1462 (32.0%) persons, 3035 (66.4%) people reported knowing what self-medication is, but 2365 (51.7%) of them were unaware of the consequences of self-medication and 2385 (52.2%) people used medications in the last three months without a prescription. Conclusions: The frequency of self-medication in the studied population shows the need to implement national prevention and promotion initiatives in the rational use of medicines, emphasizing the consequences of self-medication, as well as the creation of stricter surveillance and regulation policies in the sale of medicines.

Medical mentorship deconstructed: an analysis and structural recommendation for high value mentorship

Background: Mentorship is a necessary component for young students to pursue a career in medicine. In medically underserved areas, mentorship can be sparse due to the lack of access to healthcare professionals. The purpose of this project was to gain an understanding of the mentorship received by practicing medical students. Methods: The authors conducted structured, one-on-one interviews with 10 current medical students about their perceptions and experiences with mentorship. Interviews were transcribed, coded, and analyzed for themes and subthemes. Results: Our findings revolve around three time periods of mentorship: 1) Before Obtaining a Mentor; 2) During the Mentorship; and 3) After the Mentorship. In our findings we describe key characteristics such as professional development, personal qualities of the mentor, and professional and personal guidance as important components in guiding the mentee starting from the undergraduate level and continuing to their current level of education. Conclusion: Interviewees’ experiences with and perspectives on the mentorship they received were generally positive, though it was evident there are some aspects of the mentee-mentor relationship that can be improved upon and universally changed. Building on the results obtained, setting expectations, providing mentor training, and pairing mentors/mentees from similar backgrounds are what we propose to create fulfilling and meaningful relationships between a mentee and mentor.

Confidentiality and public interest disclosure: A framework to evaluate UK healthcare professional regulatory guidance

Confidentiality and disclosure of information in the public interest present difficult dilemmas for healthcare practitioners and call for clear legal and regulatory guidance. The common law duty of confidence, and established exceptions to it, are shaped by medical practice and detailed guidance produced by the General Medical Council. Guidance issued by other healthcare regulators in a highly fragmented environment is at best unclear and at worst inaccurate. This article assembles and justifies a framework of evaluation against which regulators’ guidance can be assessed, focussing on the specific issue of when the duty of confidentiality can be set aside in the public interest. Comparison of statutory regulators’ guidance reveals wide variation which creates uncertainty for practitioners confused by inconsistency between guidance documents. The results of this analysis raise questions about the relationship between common law and regulatory guidance, in particular, whether it is appropriate to recognise different standards for different healthcare professions. This article argues that there is an opportunity to correct this anomaly and ensure appropriate consistency as part of a wider review of healthcare professional regulation.

Analysis of the Psychological Characteristics and Entrepreneurial Intentions among University Students

Today’s technological development and rapid advancements are increasing day by day, simultaneously the rate of unemployment is also rising, especially in developing economies. In the view of long-term perspective, the global economic cycle has also been affected and is leading towards economic crises. Hence, with the dearth of employment opportunities, the youth in developing economies are inclined towards entrepreneurship and startups. Startup ventures provide them with specific sources of income as well as self-independence and self-sufficiency. Hence, the researcher in this paper attempts to explore the entrepreneurial intentions among university students. It has been observed that the reason behind this inclination is the outstanding potential the university students possess and their ambition to try new things and risk-taking tendencies. Furthermore, the new generation has the ability to develop various variations in businesses. The work is conducted on a Pakistani youth segment from the Quaid-i-Azam University Islamabad, which has a diverse pool of students belonging to various regions of Pakistan. Data analysis and findings demonstrate that the students of Quaid-i-Azam University, Islamabad, not only possess a positive attitude toward entrepreneurial intention, but they also face ambiguities and difficulties in taking initiatives. Business assistance is required by them, in the form of financial and moral support, as well as professional guidance for understanding the business background. The study provides some useful insights on the subject and presents future study recommendations and practical implications.

Protein Supplement Perceptions, Use, and Associated Performance in Young Lebanese Resistance-Training Athletes.

The aims of this study were first to evaluate the nutritional knowledge, perception, and source of nutrition information among resistance-trained individuals consuming protein supplements (PS), to determine whether a correlation exists between nutrition-related knowledge and the use of PS, and finally to compare the impact of PS use among participants classified as nonprotein supplement users (NPSUs) and protein supplement users (PSUs). A cross-sectional study was conducted among a highly selected group of resistance-specialized trainees (RSTs). Among the 100 RST participants recruited, the Internet and coaches were the most common source of nutritional information. About one-third of participants believed that there were no health risks after consuming PS. Both NPSU and PSU exhibit performance improvement that was significantly lessened in PSU compared to NPSU. This study demonstrated that RST may have misconceptions regarding the benefits of PS usage to increase strength. Our data also suggest a shortage of knowledge about PS and confirm that PSUs lack proper professional guidance. These findings highlight the need for proper monitoring to ensure adequate perception, awareness, and safety in the Lebanese sports sector.

Re-imagining ‘the patient’: Linked lives and lessons from genomic medicine

How ‘the patient’ is imagined has implications for ethical decision-making in clinical practice. Patients are predominantly conceived in an individualised manner as autonomous and independent decision-makers. Fields such as genomic medicine highlight the inadequacies of this conceptualisation as patients are likely to have family members who may be directly affected by the outcome of tests in others. Indeed, professional guidance has increasingly taken a view that genetic information should, at times, be regarded as of relevance to families, rather than individuals. What remains absent from discussions is an understanding of how those living through/with genomic testing articulate, construct, and represent patienthood, and what such understandings might mean for practice, particularly ethical decision-making.Employing the notion of ‘linked lives’ from lifecourse theory, this article presents findings from a UK-based qualitative longitudinal study following the experiences of those affected by the process and outcomes of genomic testing. The article argues that there is a discord between lived experiences and individualised notions of ‘the patient’ common in conventional bioethics, with participants predominantly locating their own decision-making within the matrix of linked lives in which they are embedded. In the quest to gain ‘answers’, many took an intra or intergenerational view, connecting their own experiences to those of past generations through familial narratives around probable explanations, and/or hopes and expectations for the health of imagined future generations. The article argues that a re-imagining of ‘the patient’, that reflects the complex and shifting nature of patienthood, will be imperative as genomic medicine is mainstreamed.

Cognitive Behavioral Therapy Versus the Low FODMAP Diet for Irritable Bowel Syndrome: A Non-Inferiority Comparison of Two Self-Help Books

Background: IBS is a highly prevalent, chronic gastrointestinal (GI) disorder of gut-brain interaction that can lead to considerable distress and disability. Although IBS does not respond particularly well to standard medical care, empirically supported treatments exist, including CBT and the low FODMAP diet. Many patients with IBS seek self-help and adjunctive treatments to supplement traditional medical care. Therefore, it is important to rigorously test some of those publicly available options to see if they provide measurable benefit to consumers. Aims: This study compared the efficacy of 2 self-help books (one cognitive-behavioral therapy or CBT book and one low FODMAP diet book) for irritable bowel syndrome (IBS). Method: This study was a randomized, controlled, optional cross-over, single-blind, non-inferiority trial of 2 popular self-help books with 3 months of longitudinal follow-up. The books were Reclaim Your Life from IBS and The Complete Low FODMAP Diet Book. Result: Immediately post-treatment, participants in both conditions showed significant improvement in health-related quality of life (HRQL), GI symptom severity, catastrophizing, anxiety about visceral sensations, and depressive symptoms. There were no significant between-group differences at post-treatment in HRQL; although, the low FODMAP group did show greater declines in GI symptom severity. By 3-month follow-up, both groups continued to show significant improvement over baseline in HRQL, and there were no significant between group-differences on any measure. Conclusion: Reading either book with no professional guidance resulted in substantial improvement in patients with self-reported IBS.

The meaning of life according to patients with advanced lung cancer: a qualitative study

ABSTRACT Purpose This qualitative study explores the meaning of life and end-of-life coping strategies among patients in China with advanced lung cancer. Methods We conducted in-depth interviews with 21 hospitalized patients with advanced lung cancer and analysed the data using the 7-step Colaizzi method. Results The analysis revealed themes in patients’ experiences and feelings about living with a terminal illness. These include: 1) The core of the meaning of life is “self-iteration,” which includes self-recognition and cherishing life; 2) The existence form of the meaning of life is “yu-wei,” including self-reliance and altruism; 3) The meaning of life is embodied in three levels: the past, present, and future. The past includes gratitude, guilt and remorse, and avoidance; the present includes using the support system, positive response, independence, and integrity; the future includes accompanying relatives, preparing for death, living a high quality of life, and worrying. Conclusion Meaning of life is a multidimensional and diverse concept among patients with advanced lung cancer. Medical care providers and family members can provide targeted professional guidance and psychological support according to patients’ characteristics to help them discover their meaning of life, improve their quality of life, and achieve a positive end-of-life perspective.

Clarifying responsibility: professional digital health in the doctor-patient relationship, recommendations for physicians based on a multi-stakeholder dialogue in the Netherlands

BackgroundImplementation of digital health (eHealth) generally involves adapting pre-established and carefully considered processes or routines, and still raises multiple ethical and legal dilemmas. This study aimed to identify challenges regarding responsibility and liability when prescribing digital health in clinical practice. This was part of an overarching project aiming to explore the most pressing ethical and legal obstacles regarding the implementation and adoption of digital health in the Netherlands, and to propose actionable solutions.MethodsA series of multidisciplinary focus groups with stakeholders who have relevant digital health expertise were analysed through thematic analysis.ResultsThe emerging general theme was ‘uncertainty regarding responsibilities’ when adopting digital health. Key dilemmas take place in clinical settings and within the doctor-patient relationship (‘professional digital health’). This context is particularly challenging because different stakeholders interact. In the absence of appropriate legal frameworks and codes of conduct tailored to digital health, physicians’ responsibility is to be found in their general duty of care. In other words: to do what is best for patients (not causing harm and doing good). Professional organisations could take a leading role to provide more clarity with respect to physicians’ responsibility, by developing guidance describing physicians’ duty of care in the context of digital health, and to address the resulting responsibilities.ConclusionsAlthough legal frameworks governing medical practice describe core ethical principles, rights and obligations of physicians, they do not suffice to clarify their responsibilities in the setting of professional digital health. Here we present a series of recommendations to provide more clarity in this respect, offering the opportunity to improve quality of care and patients’ health. The recommendations can be used as a starting point to develop professional guidance and have the potential to be adapted to other healthcare professionals and systems.

Using stakeholder insights to enhance engagement in PhD professional development.

There is increasing awareness of the need for pre- and post-doctoral professional development and career guidance, however many academic institutions are only beginning to build out these functional roles. As a graduate career educator, accessing vast silos and resources at a university and with industry-partners can be daunting, yet collaboration and network development are crucial to the success of any career and professional development office. To better inform and direct these efforts, forty-five stakeholders external and internal to academic institutions were identified and interviewed to gather perspectives on topics critical to career development offices. Using a stakeholder engagement visualization tool developed by the authors, strengths and weaknesses can be assessed. General themes from interviews with internal and external stakeholders are discussed to provide various stakeholder subgroup perspectives to help prepare for successful interactions. Benefits include increased engagement and opportunities to collaborate, and to build or expand graduate career development offices.

Evaluation of the first Accelerated Bachelor of Science in Nursing program as a second career in Japan

BackgroundThe first Accelerated Bachelor of Science in Nursing (ABSN) program with a two-year educational period in Japan was developed in a nursing university in Tokyo in 2017 (i.e., 2017-ABSN two-year program or designated as program 1) for individuals aiming to pursue nursing as a second career. It replaced program 2, the second-year bachelor's degree transfer program which is a three-year program implemented from 1997 to 2016. The original and currently on-going four-year undergraduate Bachelor of Science in Nursing (BSN) is designated as program 3. ObjectiveTo evaluate the 2017-ABSN two-year program from learners' perspective. MethodsWe used a case-control study design. As cases, the subjects were third-year bachelor's degree transfer students of program 1 at the nursing university in Tokyo. As controls, second-year bachelor's degree transfer students of program 2 and four-year undergraduate students of program 3 in the same university were given a questionnaire when they graduated. The survey items were grouped into five scales: (1) The education you are receiving, (2) Studying nursing, (3) Stress level, (4) The highest score on the national nursing examination practice test, and (5) The vocational commitment. The mean score of each item was calculated and comparisons were conducted using the Mann Whitney test. ResultsResponses from 77 students (program 1), 23 students (program 2), and 133 students (program 3) were analyzed. The program 1 students had a significantly lower mean score on (1) The education you are receiving item “There is time for preparation and review” (p = 0.01). The program 1 students had a significantly lower score on (2) The studying nursing item “I can get the job (role) I want” (p = 0.01). The program 1 students had a significantly higher score on (4) The best score in the national nursing examination practice test (p = 0.01). ConclusionShortening the academic period to two years in program 1 had no effect on the knowledge base of the students. However, the program 1 students had a significantly lower score in their identity as a nurse. It is often difficult to acquire a new nursing culture in a short period from a previous culture that has already been mastered. Educators need to fully understand the characteristics of learners and provide them with individualized and professional guidance to further improve their skills.

Family Approach of Older People with Major Neurocognitive Disorder: Experiences and Perceptions from the Psychogerontological Clinical Practice

The approach to older adults with major neurocognitive disorder constitutes a challenge for families, this due to the lack of information to carry out this type of specialized care, and the scarcity of health professionals trained to facilitate an approach and Professional guidance on mental health in old age. In this sense, psychogerontological clinical practice is established today as an interdisciplinary field of study, due to the exhaustive knowledge about the sciences of aging and clinical psychology, for the evaluation, detection, rehabilitation, orientation and promotion of mental health with older people, family members and caregivers. Objective: To understand the experiences and perceptions of family members who care for older adults diagnosed with major neurocognitive disorder. In such a way, it allows to explore, understand and interpret about the knowledge about the appropriate approach, the risks of patient care and decision-making for coping. Materials and methods: a phenomenological-oriented qualitative study was carried out in an integral medicine unit, through the design and application of semi-structured interviews and observations of ten caregivers who attended the Psychogerontology service. Results: The informants stated that they did not have the necessary information to carry out adequate care for their relatives. However, the need for more professionals and social institutions to receive information is necessary. In this sense, they perceive their quality of life as poor, since they present the signs and symptoms of caregiver syndrome. Conclusions: Psychogerontological clinical care favors effective intervention in the approach to major neurocognitive disorder.

Older patients’ perspectives on participating in multimodal rehabilitation including anabolic steroids following hip fracture: a qualitative study embedded within a pilot RCT

Purpose To explore patient perspectives of participating in a pilot RCT evaluating feasibility and effect of anabolic steroid, physiotherapy and nutritional supplement following hip fracture. Methods Semi-structured telephone-based interviews of 16 women and three men (average age 73 years) were conducted at baseline and after a 12-week intervention. Qualitative content analysis was performed. Results Two main categories were identified: (1) Trust and hope for a positive change with three sub-categories; reflections on anabolic steroids, anticipation of extra attention, lack of energy. (2) Curiosity, care, and commitment with four sub-categories; a sense of anabolic steroids, feeling of exclusivity and privileges, challenges and sense of obligation, and perspectives on personal gain. Conclusions Findings suggest high acceptability of the intervention. Participants motivated their participation on a trust that the intervention would “do more good than harm”. They found the randomization and possibility of receiving anabolic steroids intriguing, and especially valued trial participation because of their experience of getting extra care and “deluxe” rehabilitation including close contact and support by health professionals. Our findings may help inform future research recruiting older patients and generally considered relevant for health professionals in rehabilitation, emphasizing the impact of professional guidance and social support to encourage self-efficacy. Implications for rehabilitation With muscle enhancing medicine being suggested as a supplement in rehabilitation following hip fracture, exploring patients’ perspectives is warranted and may help inform future trials in this area. Factors reported as important by older adults for engaging in rehabilitation trials are: simple but thorough information, friendly and trustful relation with study staff and opportunities of extra care and attention. Older patients with hip fracture highly valued professional guidance and support by health professionals during the rehabilitation intervention. High acceptability was identified for the supervised outpatient rehabilitation, where especially the individually structured progressive strength training was highlighted as the “active ingredient” accelerating recovery and potentially promoted self-efficacy.

Influence of Peers and Parental Lifestyles on Alcohol Use and Abuse among Students of Tertiary Institutions in Northern Nigeria

The use and abuse of alcohol in Nigeria have been on the increase among youths and old people alike. The prevalence of peer pressure or influence can become overwhelming, especially to students who have subjected themselves to sources of alcohol that results in degradation of school careers. Hence, the purpose of this study was to investigate the influence of peer pressure and parental lifestyle on alcohol use and abuse among students of tertiary institutions in Northern Nigeria. To achieve this purpose, A total of 660 respondents from colleges of Education, Polytechnics and Universities in the region were used. The instrument for data collection was the Tertiary Institution Students’ Alcohol Use and Abuse Questionnaire (TISAUAQ). Data collected was analyzed using descriptive statistics of frequency, percentage, mean, standard deviation, and inferential statistics of Chi-square test at 0.05 level of significance. Based on the findings from the study, it was revealed that peer influences alcohol use among students of tertiary institutions as male students were better coordinated under the influence of moderate alcohol than female students; male students were influenced more to drink alcohol regularly than female students. It was discovered that parental lifestyles influence on alcohol use and abuse; as alcohol is shared during festivities while parents also drink in the presence of their children. There is strong statistical evidence on the influence of peer group on alcohol use and abuse among students of different tertiary institutions in Northern Nigeria. Also there is strong significant statistical evidence on the influence of parental lifestyle on alcohol use and abuse among students of different tertiary institution in Northern Nigeria. Based on the findings of the study, it was recommended that parents should desist from drinking alcohol in the presence of their children as this lifestyle could greatly influence their children’s level of alcohol use and abuse. This study also infers that all tertiary institutions in Northern Nigeria should have a functional Guidance and Counselling Centre with professional Guidance and Counsellors that would handle student’s developmental and societal challenges. Health Educators should make provisions for information and skills that are relevant to the youth and students on alcohol use and abuse.