Psychological Support Research Articles

Resource-rational contractualism: A triple theory of moral cognition.

It is widely agreed upon that morality guides people with conflicting interests towards agreements of mutual benefit. We therefore might expect numerous proposals for organizing human moral cognition around the logic of bargaining, negotiation, and agreement. Yet, while "contractualist" ideas play an important role in moral philosophy, they are starkly underrepresented in the field of moral psychology. From a contractualist perspective, ideal moral judgments are those that would be agreed to by rational bargaining agents-an idea with wide-spread support in philosophy, psychology, economics, biology, and cultural evolution. As a practical matter, however, investing time and effort in negotiating every interpersonal interaction is unfeasible. Instead, we propose, people use abstractions and heuristics to efficiently identify mutually beneficial arrangements. We argue that many well-studied elements of our moral minds, such as reasoning about others' utilities ("consequentialist" reasoning) or evaluating intrinsic ethical properties of certain actions ("deontological" reasoning), can be naturally understood as resource-rational approximations of a contractualist ideal. Moreover, this view explains the flexibility of our moral minds-how our moral rules and standards get created, updated and overridden and how we deal with novel cases we have never seen before. Thus, the apparently fragmentary nature of our moral psychology-commonly described in terms of systems in conflict-can be largely unified around the principle of finding mutually beneficial agreements under resource constraint. Our resulting "triple theory" of moral cognition naturally integrates contractualist, consequentialist and deontological concerns.

Nursing care for HIV/AIDS patients according to the Virginia Henderson model

Introduction: the nursing professional plays the role of providing or assisting with care and needs. There are several theories or models that govern nursing care. Virginia Henderson introduces a holistic humanistic model that can be applied to special groups such as patients with HIV/AIDS. The objective of the research was to characterize nursing care for HIV/AIDS patients according to the Virginia Henderson model.Methods: a literature review was conducted, where 25 articles in Spanish and English were selected, published in the last five years on the subject, in databases such as: Scopus, Pbmed, Springer.Results: assuming the care of people with HIV/AIDS is opting for the care of an incurable and life-limiting condition. Nurses must assist the person in procedures or in their treatment and create a bond of therapeutic help; guaranteeing professional confidentiality of the diagnosis, focusing on addressing the pathology and opportunistic infections, providing the means that contribute to achieving patient independence; as well as preventing stigma and social rejection of the patient.Conclusions: care for patients with HIV/AIDS requires professionals prepared to guarantee the necessary care for this specialized group. The required psychological, physical and emotional support must be provided, avoiding rejection or overprotection of the position, seeking solutions by providing patients with humane treatment; preventing social stigma, rejection and demoralization

“Do not forget about us.” A systematic review of needs and unmet needs in dementia care in Europe

Abstract Background In Europe, the prevalence and costs of dementia, including Alzheimer’s disease, are rising due to demographic changes. The care provided does not adequately address the needs of stakeholders involved. This systematic review aims to identify the needs, and unmet needs in European dementia care, thus providing a comprehensive framework to improve dementia care services. Methods Our inclusion criteria, adhering to PRISMA guidelines, include studies published from 2013 to 2023, and addressing needs and unmet needs of persons living with dementia, caregivers, and dementia care professionals. Risk of bias was evaluated using the Mixed Methods Appraisal Tool. Results From an initial pool of 3738 articles, 48 studies meet inclusion criteria. Caregivers express need for support, notably in psychological and logistical assistance, in managing daily errands and healthcare tasks, and to navigate healthcare system, exacerbated by the stress and isolation during the COVID-19 pandemic. Persons living with dementia face challenges in social inclusion due to the lack of public understanding and community-based care. Dementia care professionals emphasise need for more training and resources to manage dementia effectively, with a recent shift towards the necessity for telehealth competencies. Furthermore, caregivers from ethnic minorities highlight the importance of culturally sensitive healthcare access to overcome cultural and language barriers. Conclusions Educational resources, broaden community support, clear information about available care services, and public understanding of dementia were the most commonly expressed unmet needs. Addressing these needs within the dementia care network is crucial for better service integration and improving the quality of life for all stakeholders involved. Future research should focus on developing strategies to address the unmet needs, ensuring robust support for the increasing number of individuals affected by dementia. Key messages • Care dementia effectively needs more resources, training, and a culturally sensitive healthcare access to ethnic minorities. • People living with dementia and caregivers need psychological and community-based support, social inclusion, clear information about available care services, and public understanding of dementia.

VIDA UNIVERSITÁRIA E SAÚDE MENTAL: FORMAS DE ATENÇÃO E PROMOÇÃO À SAÚDE MENTAL DOS ESTUDANTES DE MEDICINA NO AMBIENTE ACADÊMICO

The transition period that young people face when they enter higher education is extremely important, as the start of academic life is marked by major challenges that involve changes, often extreme in the student’s life, such as leaving home, distance from family and the great demands that higher education imposes. This level of pressure can be a contributing factor to the development of mental disorders such as anxiety, depression and even suicidal ideation. It is important to emphasize that the university plays an important role in this transition, in welcoming and guiding these young people, both to prevent these conditions and to promote the mental health and well-being of medical students who are facing any of these disorders. This study showed that the implementation of promotion programs such as psychological and psycho-pedagogical support, the development of stress coping skills and mental health conversation circles are promising initiatives for improving these conditions and facilitating self-knowledge and self-care during the university journey.

Depressive symptoms among medical students

Abstract Background Adolescence is a period of psychological development which is associated with an increased risk of developing mental health disorders. Medical students have a higher prevalence of depression compared to the general population, but they are given low priority in the healthcare system. The aim of this study was to examine the prevalence of clinically significant scores on the Patient Health Questionnaire 9 (PHQ-9), and factors associated with clinically significant scores. Methods The research was conducted through a cross-sectional study among fifth-year medical students, using a 95-item questionnaire anonymously filled out. The questionnaire examined: socio-demographic and socio-economic characteristics of the students; students’ lifestyles (including alcohol consumption, binge drinking, smoking cigarettes, electronic cigarettes, use any of other tobacco products); Patient Health Questionnaire (PHQ-9); International Physical Activity Questionnaire (IPAQ); Zung’s Anxiety Scale; and Problematic Internet Use Scale. Based on the score on PHQ-9, the participants were classified in two groups: with clinically significant scores (score ≥10) and without clinically significant scores (score <10). Results The study included 461 medical students who completed the PHQ-9. Average score on PHQ-9 scale was 5.25±4.53 and total of 66 students (14.3%) had the PHQ-9 indicative of clinically significant depressive symptoms (PHQ-9 ≥10). The clinically significant depression was associated with smoking of any tobacco product (OR:3.02, 95% CI: 1.37-6.63), score on social support scale (0.94, 95% CI: 0.90-0.98), age (OR: 1.42, 95% CI: 1.06-1.90) and score on Zung anxiety scale (OR: 1.15, 95% CI: 1.16-1.34). Conclusions Considering that medical students, are at higher risk of developing clinically significant symptoms of depression, it is crucial to form psychological and social support programs. Key messages • Monitoring the mental health of young individuals holds significant importance. • It is crucial to detect risk factors in time and develop prevention programs.

Self-esteem and illness perception in multiple sclerosis: Unveiling key factors for self-management

Abstract Background Multiple sclerosis (MS) is characterized by demyelination and variable symptomatology, and typically appears during young adulthood, making it a condition of considerable public health concern. Given its chronic nature, understanding of the illness perception plays a crucial role in long-term disease management. Our research aims to examine the factors affecting illness perception among people with MS. Methods The study sample consisted of 166 patients with MS (75.3% women; mean age: 40.9±11.3 years; mean disease duration: 11.6±7.1 years). People with MS underwent medical examination to assess their functional disability measured by Expanded Disability Status Scale (EDSS), and structured interview, during which data on age, sex, education, employment status, income and disease duration were obtained. Finally, they were asked to fill in the Brief Illness Perception Questionnaire (BIPQ), and the Rosenberg Self-esteem Scale (RSE). Data were analysed with multiple linear regression analysis. Results Our results showed an association between functional disability and illness perception (β = 0.22; p < 0.05). However, this association lost its significance upon adding self-esteem into the model (β=-0.53; p < 0.001), with overall explained variance in illness perception rising from 2.7% to 27.5%. No statistically significant contribution of other socio-demographic or clinical variables was observed. Conclusions Higher self-esteem in people with MS appears to be intricately connected to their illness perception. Given that the management of chronic conditions heavily relies on patients’ personal resources, healthcare providers could play a crucial role in fostering self-esteem. By encouraging the development of self-esteem, patients may come to view their illness as more manageable and less daunting, potentially leading to mitigation of negative consequences of functional disability. [Grant support: VEGA 1/0608/23] Key messages • Self-esteem may be stronger predictor of illness perception than functional disability in people with MS. • MS patients may benefit from psychological support aimed at promoting self-esteem.

Flooding and Mental Health interventions for vulnerable groups

Abstract Issue/Problem The UK is increasingly vulnerable to flooding due to climate change, which significantly affects mental health. Vulnerable populations are disproportionately impacted, experiencing stress, anxiety, and other severe mental health issues, requiring effective intervention strategies. Description of the problem The UK’s third Climate Change Risk Assessment (CCRA) highlights flooding as a key challenge, with mental health impacts representing a major health burden. Effective interventions are crucial for these communities. Results UKHSA’s flooding and mental health guidance is incorporated into flooding and health advice documents for the public and frontline responders. It includes assessment and support strategies for health and social care staff, emergency responders, and local authorities. It focuses on those most at risk and promotes a phased approach to care-from immediate safety and shelter to long-term psychological support. This strategy accommodates the prolonged nature of mental health recovery, requiring adaptable and sustained interventions. Lessons Addressing the mental health impacts of flooding demands a comprehensive, multi-phase strategy that adapts to the evolving needs of affected populations. Early intervention and long-term support are vital to mitigate the extensive psychosocial damage. Key messages • Flooding severely affects mental health, necessitating structured, long-term interventions. • Flexible support strategies that evolve over time are crucial for effective recovery, ensuring that interventions meet the changing needs of those impacted by flooding.

A Framework for Bariatric Surgery Patient Care: Patient and Professional Perceptions

Abstract Introduction A multidisciplinary health team for perioperative care of the bariatric patient, sustained in a viable framework to support a long-term follow-up service, may decrease rates of complications, help the recognition of the complexity of this chronic disease, and provide a comprehensive bariatric surgery process analysis. This study aimed to analyze patients’ and professionals’ experiences with the perioperative care process and identify their perceptions of the bariatric surgery process to support the long-term management of obesity surgical treatment. Methods This qualitative study was conducted in a bariatric surgery center in south Portugal. Seven health professionals participated in one focus group, and sixteen patients participated in one of the three focus groups. Patients’ focus group script had eleven open main questions with follow-up questions to probe for more information, addressing motivations, experiences with the pre-surgery and post-surgery process, and perceptions of lifestyle changes. Results Participants reported the need for a reference professional in the hospital to contact, the importance of psychological support to help patients deal with the ‘ups and downs’ of post-surgery life, and the financial support for physical activity programs. Conclusions This research helped identify a need for a framework for long-term follow-up and showed priorities to tailor health services for managing bariatric surgery patients. New bariatric surgery programs should incorporate a diverse health team, focusing on patient support in the long-term follow-up. This team should be led by a dedicated case manager and include physical activity specialists. Key messages • The positive effects of bariatric surgery go beyond weight loss, reinforcing the importance of developing a new conceptual framework based on a patient-centered care model. • A case manager specialist on the bariatric surgery process may be the key to improving the long-term benefits of bariatric surgery.

Study tours as strategy in building multi-level public health system transformation in Ukraine (UA)

Abstract With 14 million Ukrainians in need of psychological aid (UNDP) and a strained health system, UA urgently requires mental health and psychological support services (MHPSS). As a TA partner on the USAID funded Public Health System Recovery and Resilience project in UA, the Philadelphia (PHL) team supports capacity building for population-based MHPSS at the community level with a study tour strategy. Such approaches apply to other countries interested in remodeling public health systems. The strategy aims to advance community based MHPSS through in person tours in PHL with remote follow up to stimulate vision, exchange ideas and accelerate action among governmental, community, and academic partners. The study tours presented overviews on health policy, system development, program services delivered to children and adults, community interventions, and workforce development of professionals and paraprofessionals. All included the foundational principles of trauma-informed practice. The June 2023 tour hosted 11 decision makers and regional officials who embraced the vision for system development and endorsed further engagement. The December 2023 tour hosted 13 practitioners and coordinators of health and social services to observe community programs. Results include development of PHL NGOs and UA social service hub partnerships to implement train the trainer programs for peers/people with lived experience and for mural arts programs to promote community engagement and empowerment. The September 2024 tour involves university partners from nursing, social work and psychology and PHL counterparts to strengthen curricula to include mental health competencies, support faculty development with potential for collaborative research and student exchange, and design post-graduate continuing education courses for upskilling the incumbent workforce. Study tours and direct exchange are an effective strategy for capacity building for MHPSS in Ukraine to address population health needs. Key messages • The sequenced study tour strategy affects distinct levels of change makers in UA. The results are governmental buy-in, partnerships for programmatic development, and academic advancement. • The study tour model promotes systematic change and offers solutions to MHPSS workforce shortages through information exchange, relationship building, and capacity development.

Barriers and enablers towards integrated care for sexual violence victims in humanitarian settings

Abstract Background Sexual violence (SV) is a complex public health issue that necessitates a coordinated multisectoral response. Ideally, this response should be provided through an integrated care package to strengthen timely access and comprehensive care for victims. However, in humanitarian settings with high levels of SV, care is often offered through fragmented silos, exacerbating the burden on the health workforce and victims. Methods Using the Valentijn framework, a qualitative, real-time Delphi study was conducted with 17 SV care experts representing 7 geographical subregions to gain informed opinions on key contextual and health system barriers and enablers for integrated care for SV victims in humanitarian settings. Results Challenges and enablers reported across the diversity of the participants’ contexts showed consistency. Contextual challenges included volatile contexts, collapsed health systems, and poor infrastructure. Professional challenges included a lack of expertise among healthcare providers (HCPs), high staff attrition, and compassion fatigue among HCPs. Health systems challenges included poor referral and coordination mechanisms, insufficient resources, misaligned donor-programme priorities and low prioritisation of SV comprehensive care. Key enablers reported were effective networking, community engagement, capacity building, co-locating services, participatory management, promoting staff’s sense of ownership, digitalised information systems, and joint patient files. Conclusions The sustainability of integrated care for SV victims can be strengthened by ensuring HCPs access regular psychological support and training and are incentivised to provide quality care. Regular coordination among actors, including donors, can support integrating care that responds to patients’ holistic needs. Further research is needed to assess HCPs’ and SV victims’ experiences of current service delivery and how to optimise integrated care in humanitarian settings. Key messages • Addressing care providers challenges in humanitarian settings, such as high attrition, lack of training, psychosocial support, and burnout, can ensure proper integration of sexual violence care. • Integration of sexual violence care demands systemic changes, including aligning donor-programme goals, building accountability mechanisms and the buy-in of political and community leaders.

SOCIAL AND PSYCHOLOGICAL SUPPORT IN VETERAN DEVELOPMENT CENTERS: PRACTICAL EXPERIENCE

Institutions of higher education actively participate in the implementation of the state veteran policy. The article characterizes the practical experience of the Center for Veteran Development in providing first-level psychological assistance. Research methods applied: analysis of the activities of the Center for Veteran Development of Pavlo Tychyna Uman State Pedagogical University, generalization of the main forms of social and psychological support for veterans and their family members; study of the official website of the institution of higher education. The main form of socio-psychological support for veterans and veterans is Veteran Development Centers. The article`s purpose is to characterize the practical experience of the Center for Veteran Development in providing first-level psychological assistance. Research methods: analysis of the activities of the Center for Veteran Development of Pavlo Tychyna Uman State Pedagogical University, generalization of the main forms of social and psychological support for veterans and their family members; study of the official website of the institution of higher education. Since 2023, such a center has been created based on Pavlo Tychyna Uman State Pedagogical University. The university staff is working on creating a barrier-free space and accessible services. Among the forms of work of the center: individual psychological counseling is provided; group therapeutic classes, psychoeducation, and information sessions are practiced; rehabilitation programs are being developed; measures to support families are in demand; relaxation techniques and therapies are effective; individual work on social and psychological adaptation is carried out; training work is popular. Volunteer activities are systematically carried out by specialists and volunteers of the Center. It is possible to study for veterans at the university, as well as to study a foreign language.

The psychological burden of bereavement in the general population of UK and Ireland

This study examined the experiences of loss among bereaved adults, and the association between loss-related factors and mental health outcomes. Participants were 2023 bereaved adults from the United Kingdom and Ireland who completed measures of their bereavement experiences and symptoms of depression, anxiety, and somatization. The highest proportion of participants and those at greatest risk of meeting criteria for all disorders were those with less time since loss, who were in contact with the deceased every day or not at all in the year prior to their death, experienced sudden unnatural death, and those who lost a partner/spouse or a child. Age of the deceased was negatively correlated with meeting criteria for depression, anxiety, and somatization. Overall, depression, anxiety, and somatization were common in the bereaved population. Identifying key loss-related variables—such as time since bereavement and nature of death—will help target those needing urgent psychological support.

The assessment of the perceived stress and the quality of life in the patients with myasthenia gravis: The mediating role of the psychological capital and social support

Background: Stress has been known as a risk factor for the onset and modification of autoimmune disorders such as myasthenia gravis (MG). However, the patients can control their stress and improve their quality of life (QOL) using some factors such as psychological and social support. Psychological capital and social support play a key role in decreasing stress and improving QOL in the patients with MG. Therefore, the present study aimed to assess the mediator role of the psychological capital and social support in perceived stress and QOL of the patients with MG. Methods: In the present cross-sectional study, 203 patients with MG, including 138 women and 65 men, were selected from Iran Myasthenia Gravis Association and Shariati Hospital, Tehran City, Iran, using available sampling. The selected patients completed the Myasthenia Gravis Quality of Life questionnaire (MG-QOL), Luthans Psychological Capital Questionnaire (PCQ), Multidimensional Scale of Perceived Social Support (MSPSS), and Cohen Perceived Stress Scale (PSS-14). To assess the mediator role of the psychological capital and the perceived social support in the relationshipwith the perceived stress and QOL of the patients with MG, structural equation modeling (SEM) was used. Results: There was a significant negative relationship between the perceived stress and the variables of psychological capital (including hope, resilience, optimism, and self-efficacy), perceived social support dimensions (including support from important people, support from family, and support from friends), and QOL dimensions (including social activity and mental health) (P < 0.01). The results also showed that the perceived social support dimensions (including support from important people, support from family, and support from friends) and the variables of psychological capital (including hope, resilience, optimism, and self-efficacy) had a significant positive relationship with the QOL in patients with MG (P < 0.01). The indirect effect of perceived stress on the QOL through social support and psychological capital was 0.16 and 0.15, respectively, which was statistically significant (P < 0.05). Conclusion: The present study results show that a part of the shared variance between the conceptual circles of the perceived stress and QOL in patients with MG results from variability in the psychological capital and social support.

Exploring the Stressors and Coping Mechanisms of Chinese University Instructors Amidst the COVID-19 Pandemic

This study explores the pressures and challenges Chinese university instructors face during the rapid shift to online teaching due to the COVID-19 pandemic. Using a quantitative research methodology, the study employed a questionnaire distributed via the Qualtrics platform to gather data from instructors at over 20 top-tier Chinese universities. The results of the correlation analysis of the data show that personal factors significantly influence instructors’ stress levels and coping strategies. The study underscores the need for enhanced technical training, psychological support, and improved online teaching resources. These insights inform educational reforms and support measures to enhance instructors’ well-being and teaching quality in an evolving educational landscape.

Smart Home Technologies for Enhancing Independence of Living and Reducing Care Dependence in Older Adults: A Systematic Review.

To systematically review the potential of smart home technology to enhance the independence of older adults and reduce their dependence on care. Additionally, it sought to examine the positive impacts of such technology on their golden years. A systematic review based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The search was conducted on 8 April 2024. Peer-reviewed studies in PubMed, Embase, Web of Science, IEEE Xplore, Scopus, The Cochrane Library, CINAHL, CNKI, WANFANG DATA and VIP from 1 January 2000 to 8 April 2024 were searched. The methodological quality assessment used the Mixed Methods Appraisal Tool (MMAT). Positive findings relevant to this study were extracted from the literature and analysed using thematic synthesis. After meticulously examining 3404 studies, we identified 21 relevant sources for in-depth analysis, including qualitative studies (n = 10), experimental studies (n = 9) and mixed method studies (n = 2). These sources were grouped into five core themes based on the pivotal role of smart home technologies in enabling ageing in place: daily monitoring, assisted living activities, life reminders, functional improvement and emotional companionship. The study found that smart home technology offers numerous benefits to the lives of older adults, including increased independence, psychological support, improved cognitive functioning, enhanced self-management, increased mobility, support for caregivers, promoted social engagement and enhanced quality of life. Smart home technology can enhance the independence of older adults' lives, reduce their dependence on care, alleviate the burden on caregivers and promote home-based elderly care. This systematic review contributes to understanding the capability of smart home technology to promote elderly care at home and help better utilise smart home technology to benefit older adults. Older adults and their caregivers should be encouraged to adopt this technology to improve older adults' quality of life. No patient or public contribution.

Bezoar in Pediatrics: Case Series and Literature Review

Introduction: Bezoars are accumulations of indigestible material within the gastrointestinal tract, which, although rare, can lead to significant intestinal obstruction, especially in pediatric patients. This condition often necessitates not only surgical intervention to remove the obstruction but also a multidisciplinary approach to address underlying psychological issues due to the high recurrence risk associated with compulsive disorders. This study presents a series of cases involving children under 14 years old who experienced intestinal obstruction from bezoars and were treated at a tertiary care public hospital, complemented by a literature review to enhance understanding of this condition. Case Series: This descriptive case series study reviews three pediatric patients who underwent surgical treatment for intestinal obstruction caused by bezoars over the past two years. Results: The study identified three patients, all under 14 years of age, who required surgical intervention for bezoar-related intestinal obstruction. Among them, two were male and one was female. Two patients had trichobezoars (66.7%), located one in the stomach and one in the jejunum, while the remaining patient had a phytobezoar (33.3%) in the jejunum. Surgical treatment involved conventional laparotomy with exploration and two-layer enterorrhaphy in all cases. Discussion: Bezoars are categorized into four types: phytobezoars (plant material), pharmacobezoars (medications), lactobezoars (milk products), and trichobezoars (hair). Trichobezoars are most common in the studied cases, contrasting with existing literature that suggests a higher frequency of other types. Bezoars typically present with gastric symptoms but may also cause small intestine obstruction in about 10% of cases. The management of bezoars usually requires endoscopic or surgical removal, with psychological follow-up recommended due to high recurrence rates. The study emphasizes the importance of thorough surgical exploration for concurrent bezoars and integrating psychological care into treatment plans. Conclusion: Bezoars, although rare, are a serious concern in the pediatric population due to their potential to cause significant gastrointestinal obstruction. Effective management requires not only the surgical removal of the bezoar but also consideration of psychological factors to prevent recurrence. This case series highlights the need for a comprehensive approach, including psychological support and detailed surgical exploration, to optimize patient outcomes.

How COVID-19 pandemic and Ukrainian crisis shaped mental health services for medical students in Poland?

The mental health of medical students is a crucial concern in contemporary medical education. This manuscript reports the availability and shape of psychological support for medical students in Poland in the backdrop of the COVID-19 pandemic and the Ukrainian crisis. A survey comprising 10 questions was distributed to 22 medical schools in Poland, with a 59% response rate. The findings reveal that psychological support programs are predominantly managed by internal university units. Funding sources vary, with some universities utilizing internal budgets and others leveraging European funds or external projects. The support modalities are primarily hybrid, catering to student preferences. Limitations exist in the number of consultations, although some universities provide extended support based on student needs. Assistance is offered in multiple languages, with additional programs like stress-reduction workshops and mindfulness training being available in several universities. A notable increase in demand for psychological support post-COVID-19 was reported, with some universities establishing their programs during or after the pandemic. The commentary highlights the rising need for mental health services among medical students and underscores the importance of flexible, inclusive, and well-funded support. The effective functioning of these programs aligns with the broader objective of fostering a resilient and emotionally balanced healthcare workforce.

Expanding the primary care workforce by integrating genetic counselors in multidisciplinary care teams.

Collectively, rare diseases are common, affecting approximately 8% of the population in Canada and the USA. Therefore, the majority of primary care (PC) clinicians will care for patients who are affected or at risk for a genetic disease. Considering the increasing ways in which genetics is being implemented into all areas of healthcare, one way to address these needs and expand the capacity of the PC workforce is through the integration of genetic counselors (GCs) into PC multidisciplinary teams. GCs are Masters-educated allied health professionals with specialized training in molecular genetics, communication, and short-term psychotherapeutic counseling. The current models of GCs in PC mimic other multidisciplinary models. Complex tasks related to genetics, such as pre- and post-test counseling, genetic test selection, and results interpretation, are conducted by GCs, which, in turn, allows physicians, nurse practitioners, and other PC providers to work at the top of their scope of practice. Quality genetics services provided by GCs improve clinical outcomes for patients and their families; the simultaneous provision of genetic education and psychological support by a GC is associated with an increase in patient knowledge, perceived personal control, decrease in distress, and can lead to positive health behavior changes, all of which are aligned with the goals of primary healthcare. With their extensive training in clinical care, medical communication, and psychotherapeutic counseling, integrating GCs into PC care teams will improve the care patients receive and allow PC clinicians to ensure their patients are at the forefront of the personalized medicine revolution.

Community case study for surveillance and early case-detection of SARS-CoV-2 infections across high-risk key populations: the Sentinella programme.

At the beginning of the COVID-19 pandemic, an ad hoc organisational framework was established between academic, local government and community partners to implement the "Sentinella - Identify, Trace and Prevent" screening programme in Verona, north-east Italy. Between September 2020 and May 2021, key populations not covered by any screening policies at the local and national level were screened for SARS-CoV-2. Target populations were: older adult residents (males >65 years and females >75 years), bus and taxi drivers, social workers, supermarket employees, hospital cleaning and catering staff, researchers working in the local hospitals, students, and people experiencing homelessness (PEH). Five dedicated swab clinics, home testing facilities, and one mobile clinic were activated to collect nasopharyngeal swabs. Molecular analysis was performed for all the subjects; an antigen-rapid diagnostic test (Ag-RDT) was also implemented as a point-of-care test for PEH. Medical follow-up, psychological support, and quarantine facilities were organised for subjects who tested positive for SARS-CoV-2. Overall, 2075 subjects participated in the surveillance programme. Amongst these, 1,572 were residents/workers, whilst 503 were PEH. A total of 127 (6.2%) participants tested positive for SARS-CoV-2. Sixty-nine were residents, 58 PEH. The incidence rate was 4 per 10.000 person/day (95% CI 3.1-5.0). The highest prevalence and incidence rates were found amongst supermarket employees (9.7% and 8.5 per 10.000 person/day, 95% CI 3.81-18.86, respectively), followed by hospital cleaning staff (8.1%, 7.6 per 10.000 person/day, CI 95% 4.9-11.7). Regarding PEH, the prevalence of SARS-CoV-2 was 11.5%. All PEH identified as positive were isolated in dedicated shelter facilities. Amongst the 69 residents/workers who were quarantined, 53 were reached for initial psychological support for assessing the presence of any psychological distress or psychiatric pathology. Amongst the subjects evaluated, 10 (18.9%) presented clinically significant psychological discomfort and accessed the stepped-care psychological intervention. The community partnerships played a pivotal role in optimising early case detection. Promotion of testing helped to prevent and contain more efficiently potential clusters through strategic planning, especially for PEH. Insights from the study highlight the importance of community partnerships in public health emergencies, particularly in the context of highly transmissible diseases pathways.

The Association between Emotional Responses to Climate Change, Antenatal Anxiety and Maternal-Fetal Attachment in Primigravida Women.

To investigate the association between emotional responses to climate change, antenatal anxiety, and maternal-fetal attachment in primigravida women. A multi-site cross-sectional research design study. This study was conducted at four primary health care (PHC) facilities in Damanhur district, El-Behera, from February 2024 to April 2024. Two hundred eighty-five women completed a comprehensive questionnaire that included a Woman's Social and Reproductive Form, The inventory of climate emotions (ICE) scale, The Stirling Antenatal Anxiety Scale (SAAS) and the Maternal-Fetal Attachment Scale (MFAS-HU-20). The study revealed that emotional responses to climate change show strong positive correlations with each other, ranging from 0.689 to 0.840, all significant at p < 0.001 level. Additionally, antenatal anxiety demonstrates substantial positive correlations with emotional responses to climate change, albeit with associations ranging from 0.239 to 0.287, all significant at p < 0.001 level. Moreover, maternal-fetal attachment displays substantial negative correlations with emotional responses to climate change, indicating that as emotional responses to climate change increase, maternal-fetal attachment tends to decrease. The correlations range from -0.263 to -0.426, all significant at p < 0.001. The emotional impact of climate change can adversely affect the bonding process between mother and fetus. Healthcare professionals, including obstetricians, midwives, and mental health counsellors, should integrate climate-related emotional distress into their assessments and interventions. Providing targeted psychological support for expectant mothers. The study's findings highlight the need for nursing to integrate climate-related emotional distress screening into prenatal care and for research to explore long-term effects and intervention effectiveness. In practice, healthcare providers should adopt holistic approaches that combine environmental and psychological support, developing comprehensive guidelines and community-based programs to support pregnant women. The research adhered to that is STROBE. Public contributions by women in community health centers.