Specific Counseling Research Articles

Breastfeeding interventions and programs conducted in the Islamic Republic of Iran: a scoping review.

The purpose of this review was to identify interventions promoting breastfeeding (BF), BF practices and their outcomes in Iran. Using the PRISMA-ScR Guidelines, we searched across 14 databases for publications published between 2010 and February 2024 to identify studies published in English or Farsi language in peer-reviewed journals, using search terms 'breastfeeding', 'lactation', 'education', 'promotion', 'intervention' and 'program'. Inclusion criteria included intervention-based studies with quantitative outcomes of pregnant women/mothers receiving education, training or other intervention that promoted BF or exclusive BF. Excluded studies were protocols, those examining Iranian communities outside of Iran publications in other languages, brief communications, gray literature and qualitative studies. After screening for relevance, identified articles that met the inclusion criteria were summarized and tabulated using Rayyan QCRI software. Of the 45 identified studies, 37 used randomized-control trial designs, 20 applied theoretical frameworks or specific counseling techniques. Samples included women pregnant for the first time, mothers of babies born prematurely or with low-birth weight, adolescents, mothers who had very young children at home. Only three studies included family members. BF self-efficacy was the most popular variable to assess, which was examined in 32 studies. Almost all studies showed positive results as a result of intervention. Majority of studies were focused at the individual level. No studies were identified that assessed strategies to change routine care or policies that might facilitate BF. Identifying barriers to moving intervention content into standard of care is an important next step in the development of BF research in Iran.

GENOTYPE PHENOTYPE CORRELATION IN LIPOID PROTEINOSIS: 15 cases from Turkey

Introduction: Lipoid proteinosis (LP), a rare autosomal recessive disorder typified by generalized thickening of the skin, mucosae, and certain viscera, is primarily associated with pathogenic ECM1 variants. Skin lesions like beaded eyelid papules, acneiform scars, wavy, yellow papules, and nodules, typically appear in early childhood. Some patients may exhibit neurological abnormalities like temporal lobe or hippocampi-amygdala complex calcification, epilepsy, and neuropsychiatric abnormalities. Methods: We included 15 individuals with LP from 10 unrelated families. The study includes clinical evaluations of family history, radiological findings, histopathological examination of the skin, and genetic investigations. Results: All affected individuals exhibited skin and mucosal lesions. Among the 15 cases, five showed neurological (33%), four presented neuropsychiatric findings (26%), and three had diabetes mellitus (20%). We observed characteristic intracranial calcifications in all patients with epileptic seizures. Four out of the five cases with epilepsy and intracranial calcifications also had neuropsychiatric findings. All patients with neurological and neuropsychiatric findings had a frame-shift variant, but the same frame-shift variant was not associated with these findings in other individuals. In our study, no patient with variants other than frame-shift variants exhibited neurological or neuropsychiatric findings. Adrenal calcification, which was observed in one patient, was not previously linked to LP. Conclusion: Our study observed diverse variations in LP cases among the Turkish population, with varying clinical presentation even among individuals with identical variations within the same family. In our series, the lack of correlation between genotype and phenotype makes providing specific genetic counseling to families challenging.

Pengaruh Kemampuan Menghadapi Konflik dan Kritik Terhadap Hubungan Sosial

Social relationship abilities can be improved by the ability to deal with conflict and criticism. The aim of the research is to reveal the influence of the ability to deal with conflict (X1) with the ability to deal with criticism (X2), using a quantitative associative strategy method. The research location was SMP Negeri 2 Gido, the research population was all class VIII students and the sample was taken purposively as many as 60 people. The data collection instrument was a closed questionnaire which was distributed to a number of respondents. Data were analyzed using multiple linear regression analysis to answer research questions according to the proposed hypothesis. The research results concluded that the ability to deal with conflict (X1) partially had a significant effect on improving social relations (Y). The regression coefficient value for the variable ability to deal with conflict is negative, namely 0.071 and every 1.00% increase in ability will be followed by an increase in social relations of 0.071%. The ability to face criticism (X2) partially has a significant effect on increasing social relationship abilities (Y). The regression coefficient value for the ability to face criticism is positive, namely 1.102 and for every 1.00% increase in the ability to face criticism, it will be followed by an increase in social ability of 1.102%. Variables X1 and X2 together have a significant effect on variable Y and every increase in X1 and the contribution of the influence of variables X1 and it is recommended for school counselors to provide special guidance and counseling services to handle, develop and improve students' social abilities.

A qualitative study on the field experience of genetic counseling in Korea.

In Korea, genetic counseling services began with the opening of genetic clinics in the early 1990s; in recent years, demand for these services has increased. However, genetic counseling is not an officially recognized healthcare service under the Korean national health insurance system; further, its certification is not recognized as a medical qualification. To clarify the role and significance of genetic counselors, this study examined their field experiences. To this end, we conducted focus group interviews with 11 certified genetic counselors, six advanced practice nurses, and four regular nurses. The interviews were transcribed verbatim and examined using thematic analysis. We found that even though Korea did not recognize their roles, the participants met their responsibilities and primary duties. In addition, they faced challenges during counseling due to a lack of formal education in genetics and genomics. Moreover, they encountered dilemmas related to the legal and ethical aspects of decision support for family testing or prenatal diagnosis due to the complexity of rare genetic disorders. However, they attempted to acquire the specialized knowledge needed to support patients with rare genetic disorders and their families, gradually developing practical experience and specialized knowledge. Therefore, it is necessary to develop manuals, establish systems, and improve working environments to provide high-quality and specialized genetic counseling. Additionally, there is a need for national support, such as establishing set wages for genetic counselors, developing a national qualification certification system, and securing dedicated personnel.

Inherited PURA Pathogenic Variant Associated With a Mild Neurodevelopmental Disorder.

Purine-rich element-binding protein alpha (PURA) regulates gene expression and is ubiquitously expressed with an enrichment in neural tissues. Pathogenic variants in PURA cause the neurodevelopmental disorder PURA syndrome that has a variable phenotype but typically comprises moderate-to-severe global developmental delay, intellectual disability, early-onset hypotonia and hypothermia, epilepsy, feeding difficulties, movement disorders, and subtle facial dysmorphism. Speech is reportedly absent in most, but the specific linguistic phenotype is not well described. We used genome sequencing to identify a pathogenic gene variant as part of a study of children ascertained for severe primary speech disorder in the absence of moderate or severe ID. The novel PURA c.296G>T (p.Arg99Leu) pathogenic missense variant segregated in the female proband and her affected mother. The proband had dysarthria; phonological disorder; and severe receptive and expressive language impairment, borderline intellect, attention difficulties, oropharyngeal dysmotility, and dysmorphic facial features. Her mother had dysarthria, moderate receptive language impairment, and borderline intellect. Both the proband and her mother completed mainstream schooling with classroom support. This is the first inherited PURA pathogenic germline variant in over 600 unrelated families documented on ClinVar or reported in the literature. PURA testing should be considered in families with primary speech disorder and borderline intellectual disability, given the specific genetic counseling implications.

Smoking cessation assistance among pneumologists and thoracic surgeons in Switzerland: a national survey.

Smoking, with a prevalence of about 25%-30% in Switzerland, is proven to cause major systemic, avoidable diseases including lung cancer, increasing societies morbidity and mortality. Diverse strong quitting smoking recommendations have been made available providing advice facilitating smoking cessation globally. In other European countries like Germany, clinical practice guidelines for smoking cessation services have been implemented. However, in Switzerland, there is still no national consensus on a comprehensive smoking cessation program for lung cancer patients nor on the adequate provider. Our primary aim was to assess the current status of smoking cessation practice among specialists, mainly involved in lung cancer care, in Switzerland in order to uncover potential shortcomings. A self-designed 14-items questionnaire, which was reviewed and approved by our working group consisting of pneumologists and thoracic surgeons, on demographics of the participants, the status of smoking cessation in Switzerland and specialists' opinion on smoking cessation was sent to thoracic surgeons and pneumologists between January 2024 and March 2024 via the commercially available platform www.surveymonkey.com. Data was collected and analysed with descriptive statistics. Survey response rate was 22.25%. Smoking cessation was felt to positively affect long term survival and perioperative outcome in lung cancer surgery. While 33 (37.08%) physicians were offering smoking cessation themselves usually and always (35.96%), only 12 (13.48%) were always referring their patients for smoking cessation. Patient willingness was clearly identified as main factor for failure of cessation programs by 63 respondents (70.79%). Pneumologists were deemed to be the most adequate specialist to offer smoking cessation (49.44%) in a combination of specialist counselling combined with pharmaceutic support (80.90%). The development of Swiss national guidelines for smoking cessation and the implementation of cessation counselling in standardized lung cancer care pathways is warranted in Switzerland to improve long-term survival and perioperative outcome of lung cancer patients.

Trauma-informed counseling for individuals who have an intellectual developmental disorder: Considerations for mental health counselors.

Individuals with an intellectual developmental disorder are four times more likely to have a co-occurring mental health diagnosis, as compared to the general population, and 60%-80% of individuals with IDDs have experienced at least one form of abuse. However, counselors receive little training to adequately help this population. In this article, counseling considerations related to individuals who have intellectual development disorder are discussed, with a particular focus on the presence of trauma in this population. Trauma-focused treatment, potential mental health issues, counseling considerations, general issues related to counseling this population, and common associated mental health experiences among this population are addressed. Specific evidence-based counseling approaches, modifications to counseling, and best practices that can be helpful when counseling this population are presented. Due to the unique challenges that individuals with IDDs face, it is essential that counselors address the counseling and mental health needs of this population.

Pelaksanaan Layanan Informasi dalam Meningkatkan Self Management Siswa dalam Belajar di SMP Budi Agung Medan

A guidance and counseling teacher or supervisor is responsible for his students at the school, especially regarding students' lack of discipline towards school regulations, the guidance and counseling teacher must provide services to students who often make mistakes against themselves, therefore the aim of the guidance and counseling teacher there is to provide information services in improving Self Management of students there, not just for students who discipline, guidance and counseling teachers provide information services to all students at school to form behavior that is in accordance with what has been arranged to achieve something good and expected at Budi Agung Middle School Medan. The type of research that researchers use is qualitative research or field research. In this research, researchers conducted interviews with guidance and counseling teachers as key informants. And 8 students who experienced disciplinary problems as data triangulation, as well as the head of student affairs, and the student's homeroom teacher. The results of the research found that the basic consideration for guidance and counseling teachers in providing information services is to develop students' disciplinary behavior because there are still students who have less disciplined behavior such as often coming late, skipping classes, not doing assignments, often going out during class hours and not dressing neatly. The time used by guidance and counseling teachers is during special guidance and counseling lessons every week and can be used during free hours or when other subject teachers are not available. And the duration of time used by the guidance and counseling teachers themselves is approximately 30 minutes to carry out information services. The places where it is implemented are in the classroom, outside the classroom, in the hall and in applications such as Google Met and Zoom. Information service materials to develop student discipline behavior include self-discipline, clean and healthy lifestyle, and leadership spirit. At the time of implementation, students who had received information services were very active in paying attention to what was conveyed and enthusiastic in giving their opinions and understanding what was conveyed by the guidance and counseling teacher regarding the services delivered after being given the information service. If there were still students who had not changed, then the guidance and counseling teacher would individual counseling services to the student. After providing individual services, if the student has not changed, the guidance and counseling teacher will hand the student over to the head of student affairs for further follow-up.

Airway consequences of alendronic acid aspiration.

Bisphosphonates are commonly prescribed medications to prevent and treat osteoporosis. Although possessing low side effect profiles, the potential for severe topical effects is rare but important. Irritation of the upper gastrointestinal tract is well documented; however, the risk and effects of accidental aspiration are rarely reported.Attention is drawn to a case recently managed at a tertiary head and neck centre where a patient in their 70s was admitted in respiratory distress 3 days after aspirating alendronic acid. This case highlights the potential risk of topical chemical injury posed to the airway by bisphosphonates.Bisphosphonates should be prescribed with detailed and specific counselling regarding this risk. Pharmacological product literature should be updated to reflect the risk. Clinical teams should be aware of and vigilant for the delayed presentation and prolonged symptom course of such injuries. Prompt airway intervention and techniques to minimise further mucosal trauma ensure optimal outcomes.

Associations of mental health with vaccination readiness in informal caregivers and the vaccination status of their care recipients during the Covid-19 pandemic – A cross sectional analysis

IntroductionVaccinations are important for informal caregivers and their care recipients. Mental health problems are common among care givers. The aim of this study was to investigate vaccination readiness in informal caregivers and associations with mental health issues. Associations between vaccination readiness in informal caregivers and the vaccination status of their aged care recipients were examined. MethodsWithin the multicenter prospective registry study ‘Bavarian ambulatory Covid-19 Monitor (BaCoM) ‘, informal caregivers were asked for symptoms of depression (PHQ-9), burden of caretaking (BSFC-s), psychological antecedents of vaccination readiness (5C model) and previous Covid-19 infections of their care recipients. The vaccination status against Covid-19, seasonal influenza and pneumococcal disease was determined via vaccination certificates. Data analysis was performed using ordinal regressions and Mann-Whitney-U tests. ResultsData of n = 91 informal caregivers, associated with n = 84 care recipients were collected. Symptoms of depression were associated with reduced vaccination readiness (Calculation: p = 0.026, OR = 1.18), as well as the perceived burden of caretaking (Confidence: p = 0.006, OR = 0.88). A previous Covid-19 infection of the care recipients was associated with decreased vaccination readiness of informal caregivers (Median (Q1–Q3) Confidence: 5.0 (4.5–6.0) vs. 4.0 (3.0–5.0); Calculation: 5.0 (3.0–6.0) vs. 4.0 (1.0–5.0)). The vaccination status of the care recipients interrelated significantly with vaccination readiness of their informal caregivers (Confidence: p < 0.001; Complacency: p < 0.01; Constraints p < 0.05). No significant interrelations between vaccination readiness and the vaccination status against seasonal influenza or pneumococcal disease occurred. ConclusionMental health issues of informal caregivers seem to be associated with the actual vaccination status against Covid-19 in their care recipients. Target group specific counselling as well as an active involvement of informal caregivers in shared decision-making processes can be of relevance, but even more attention should be paid to the protection of mental health for informal caregivers.Trial registration number: German Register of Clinical Studies DRKS 26039.

EFFECT OF SPIRITUAL INTERVENTION ON STRESS MANAGEMENT AMONG STUDENT MOTHERS IN KENYAN PUBLIC SECONDARY SCHOOLS IN KENYA: A CASE OF BUNGOMA COUNTY, KENYA

Internationally, teenage pregnancy has been recognized as a major pertinent issue. Lack of adequate family support affects the emotional well-being of the pregnant student mother as well as the unborn and/or the newborn baby. Furthermore, student motherhood hinders the chance of the student mother from completing her studies. In Kenya, teenage pregnancy thwarts achievements in the education of the girl child. The objective of this study was to establish the effect of spiritual intervention on stress management among student mothers in public secondary schools in Kimilili Sub-County, Bungoma County, Kenya. This study was guided by William Glasser’s Psychological Reality Theory on Maladaptive Behaviour. The study employed a cross-sectional research design. The target population was 5,069 Form three and Form four girls from public secondary schools in Kimilili Sub-County, Bungoma County, Kenya. The study also targeted 23 school Guidance and Counselling teachers as well as 23 school Chaplains. The sample size table proposed by Krejcie &amp;amp; Morgan, 1970 was used to obtain 381 female students from girls’ schools as well as mixed schools, 19 Guidance and Counselling teachers and 19 School Chaplains. Questionnaires and interview schedules were used to gather qualitative and quantitative data. The instruments used to collect data were piloted with the intention of establishing their validity and reliability using a Cronbach alpha value greater than 0.7, which is an indication of higher reliability. SPSS package version 23 was used to analyse both descriptive and inferential statistics. Presentations were done in frequencies and percentage tables. Descriptive data were analyzed using means, percentages, and standard deviations. Inferential data were analyzed using Pearson’s product-moment correlation coefficient (r). Spiritual counselling had a positive and significant effect on stress management (r=0.836, p&amp;lt;0.000). The study concluded that spiritual intervention has a significant effect on stress management among student mothers in public secondary schools in Kimilili sub-county, Bungoma County, Kenya. Consequently, this study recommends that schools should prioritize and enhance consistent pastoral support for student mothers. Also, there is a need for comprehensive sex education from parents, guidance and counselling teachers, school and religious leaders. Further, the study recommends that future studies be conducted on specific counselling approaches that prove most effective in managing stress among student mothers. Also, there is a need to consider further studies on factors contributing to teenage pregnancies among students in the region.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0890/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Promoting multicultural and social justice counselling competency of international counselling students

AbstractThe enrolment of international students in US counselling programmes has been increasing steadily over the past decade. These international counselling students, as an emerging international workforce, can contribute to the decolonisation of counselling practice through the development of their multicultural and social justice counselling competency (MSJCC)—an essential counselling competency to improve counselling outcomes across culturally diverse clients. However, current US counsellor training programmes often fail to adequately address the unique challenges faced by international counselling students, which can impede their progress in enhancing MSJCC. This article explores specific challenges international counselling students encounter in developing MSJCC, underscoring the importance of culturally sensitive pedagogies. By focusing on the intersectional identities of international counselling students, this article proposes targeted pedagogical strategies that align US counsellor education with the lived experiences and challenges faced by these students. Case studies are provided to illustrate the application of these pedagogies. Promoting international counselling students' MSJCC can help prepare an international workforce capable of effectively working with a diverse global population and contribute to the decolonisation of counselling practices.

Prehabilitation Consultation on Self-Care and Physical Exercise in Patients Diagnosed with Abdominopelvic Cancer: Protocol of the Study.

Introduction: Prehabilitation in the field of oncology has been defined as "the process in the continuum of care that occurs between diagnosis and the start of treatment involving physical and psychological measures that determine the patient's baseline functional status." To determine the effectiveness of a Prehabilitation consultation on self-care and targeted physical exercise for patients diagnosed with abdominopelvic cancer. An observational study that will evaluate the pre-post efficacy of an ad-hoc designed Prehabilitation intervention. The study population consists of patients diagnosed with colon or gynecological cancer with a surgical indication as part of their therapeutic plan from the General Surgery Services. It is configured around four key interventions: (a) health education and self-care, (b) specific nutritional counseling, (c) initial psychological assessment, and (d) directed physical exercise intervention. Health education, self-care interventions, and physical exercise will be carried out weekly from diagnosis to the scheduled surgery day. Aspects such as self-care capacity or agency, perioperative anxiety, aerobic capacity, strength and flexibility, postoperative complications, and recovery time to adjuvant treatment will be measured using tools such as Appraisal of self-care agency scale (ASA), State Trait Anxiety Inventory (STAI), walking test, sit and Reach, Hand Grip or Squad Jump. Utilizing validated tools for analyzing selected variables will contribute to refining and expanding care guidelines, ultimately enhancing support for both patients and their caregivers.

Navigating Diverse Career Paths: Students’ Perception on Career Counseling Need in Islamic Universities

This research aims to explore the needs of career counseling services for students in different majors in Islamic universities, and identify how these services can be tailored to meet their unique needs. A mixed-methods approach was used to collect and analyze data from undergraduate students in diverse majors at an Islamic university in Kendari. The study found that students in certain majors require more specific counseling, such as information on job market trends and technical skills development. Additionally, the study suggests that career counseling services can be tailored to meet the specific needs of students in diverse majors by providing specialized workshops and networking events, as well as spiritual counseling and guidance. Providing a combination of in-person and online resources can also be highly beneficial for students' career development. The findings of this study can inform the development of more effective and tailored career counseling services for students in Islamic universities, and help ensure that graduates are well-prepared for the job market and can make meaningful contributions to society.

Hidden Burdens: Creative Techniques for Understanding and Addressing Clients’ Transgenerational Trauma

ABSTRACT This article provides an overview of considerations related to counseling transgenerational trauma survivors. Creative counseling interventions are discussed as an effective way to support those navigating generational trauma issues. Specific creative counseling techniques are presented along with detailed directions for applying these techniques. A case study application and considerations for future research are also provided.

상담실습 수업을 통한 석사생들의 상담 전문성 발달 경험 연구

Objectives This study is a qualitative study to explore the experience of developing counseling competencies in counseling practice classes conducted in the classroom of master counseling students. Methods The participants were 10 enrolled and graduates who had taken counseling practice classes within the master's curriculum, and the counseling practice class is a class where students can experience counseling practice in the form of counseling skills practice and mock counseling within the class. The interview was conducted via Zoom, and two researchers participated in pairs. The collected data were analyzed using Colaizzi's phenomenological research method. Results As a result of the data analysis, 3 theme groups, 6 topics, and 24 compositions were derived. The 3 theme groups appeared as ‘desperate for practice classes’, ‘the practice course of overcoming fear and cyclical experience’, and ‘qualitative maturity as counseling experts’. The 6 topics are in the following: ‘want to fill in insufficient counseling skills’, ‘want to have counseling expertise’, ‘practice classes that are anxious and afraid that insufficient counseling capabilities will be revealed’, ‘community learning process that deepens through repetitive cyclical experiences’, ‘qualitative change in counseling techniques through embodiment’ and ‘internal growth of counseling attitudes’. In particular, through feedback and interactions that occurred in the practice class process, the participants experienced repetitive and cyclical counseling practice with colleagues, deepened their insight into their inner selves, and learned and embodied counseling techniques, and applied them back to counseling, and they experienced learning and improved counseling expertise. Conclusions This study is significant in that it sheds light on the experience of developing specific professional counseling competencies and providing basic data in the process aspect of improving the quality of counseling practice classes by revealing the in-depth reality that counseling majors actually experience in counseling practice classes.

Extended postpartum outcomes with systematic treatment of and management of postpartum hypertension program

ObjectiveThe purpose of this study was to examine the long-term effect of a quality improvement initiative at one-year post delivery. Study DesignThis was a retrospective study of 1480 patients who delivered between October 2018 and June 2020 at the study institution and were enrolled in the Systematic Treatment and Management of PostPartum Hypertension Program (STAMPP). Patients received standardized cuffs, education, and follow-up. At the six-week postpartum follow-up, patients were again given instructions to establish follow-up. Main Outcome MeasuresThe primary outcome was a visit with a primary care physician (PCP) or cardiologist between 6 weeks and 1 year postpartum. ResultsA total of 939 (63 %) patients had some follow-up within twelve months. Of these, 113 (12 %) and 175 (19 %) had follow-up with cardiology and primary care providers, respectively. Patients with no follow-up were more likely to have public aid (73.9 % vs 60.3 %; p < 0.001). 77 % identified as Black, with only 12 % of this cohort following up with cardiology and 13 % with a PCP. ConclusionsDespite specific counseling about long term follow-up, a minority of patients completed one year follow-up, notably amongst Black patients and those with public insurance. Further work is needed to optimize long-term follow-up after HDP to reduce the prevalence of cardiovascular disease, especially amongst high-risk patients.

Tocophobia: Risk Factors, Consequences and Management - A Systematic Review of the Literature.

As far as childbirth is concerned, it is well known that it constitutes a major life process for every woman. Many women experience negative emotions during pregnancy because of the normal hormonal changes. However, if fear becomes severe, it gives rise to a specific pathology termed tocophobia. Especially, tocophobia adversely affects women's pregnancy and childbirth, including increased caesarean sections. Consequently, midwives need to detect women with tocophobia in order to support them. The aim of the present systematic review was to analyze the risk factors for tocophobia, the impact of this health condition on caesarean sections and the midwife's role. The present systematic review comprised 32 full-text cross-sectional, qualitative, experimental studies and cohort studies published in English between 2017 and 2022, that were obtained from PubMed and Google Scholar databases, and it was conducted according to the PRISMA guideline. The present analysis found that sociodemographic, obstetric and psychological factors were associated with tocophobia. Moreover, women with severe fear had increased obstetric interventions, particularly caesarean sections. Studies have also shown that psycho-education, preparation classes and specific counselling by trained midwives are effective methods in reducing tocophobia. Midwives should be aware of the risk factors for tocophobia in order to detect women with fears and support them in the attempt to avoid non-urgent obstetric interventions. Antenatal and intrapartum care should be offered to women with tocophobia to reduce their fear as well as the prevalence of caesarean section and to promote vaginal birth with a positive experience.

대학생의 내면화된 수치심과 전위공격성의 관계에서 방어기제유형의 매개효과

Objectives The purpose of this study was to examine the mediating effect of defense mechanism style on the relationship beꠓtween internalized shame and displaced aggression. Methods A self-report questionnaire was distributed in order to measure internalized shame, displaced ag-gression and defense mechanism style, targeting university students enrolled in 3 different universities in Seoul during the period from March to April 2019. A total of 300 questionnaires were distributed and all of them were retrieved. As a total, 287 samples excluding 7 non-Korean participants (international students) and 6 participants who responded incompletely were analyzed using the SPSS 22.0 program. For statistical analysis, a regression analysis and a three-stage multiple regression analysis were performed in order to establish the correlation among internalized shame, displaced aggression, and defense mechanism style. Finally, we conducted a Baron and Kenny’s three-stage multiple regression analysis (1986) to verify the mediating effect of the defense mechanism style. Results First, significant correlations have been identified among university students' internalized shame, dis-placed aggression, and defense mechanism style. Second, There were both a complete mediating effect of im-mature defense mechanism style and a partial mediating effect of self-regulation defense mechanism style on the relationship between university students’ internalized shame and displaced aggression. Conclusions In conclusion, the results of this study show that in students who display displaced aggression, the manner in which they used this psychological mechanism to handle internal conflicts in daily life significantly influ-enced their internal displaced aggression variably. Therefore, this study concludes that examining and under-standing the defense mechanism of counselees must precede specific counseling in order to mitigate university students’ displaced aggression.

Prevalence, Clustering, and Current Management of Cardiovascular Risk Factors Upon First Referral to Hypertension Specialists: the APPROACH Study.

Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022-2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies.