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Background: Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and Nottingham) aiming to co-produce a community delivered CVD risk assessment and coaching intervention to support community members to reduce their risk of CVD.The overall aim of the project is to implement a tailored-to-context community engagement (CE) intervention on awareness of CVD risks in vulnerable populations in high, middle and low-income countries. The specific objectives of the study are to enhance stakeholder' engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks., Methods: This study uses both qualitative and quantitative methods in three phases of evaluation, including pre-, per- and post-implementation. To ensure contextual appropriateness the 'Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research' (SPICES) project will organize a multi-component community-engagement intervention. For the qualitative component, the pre-implementation phase will involve a contextual assessment and stakeholder mapping, exploring potentials for CVD risk profiling strategies and led by trained Community Health Volunteers (CHV) to identify accessibility and acceptability. The per-implementation phase will involve healthy lifestyle counselling provided by CHVs and evaluation of the outcome to identify fidelity and scalability. The post-implementation phase will involve developing sustainable community-based strategies for CVD risk reduction. All three components will include a process evaluation. A stepped wedge cluster randomised trial of the roll out will focus on implementation outcomes including uptake and engagement and changes in risk profiles. The quantitative component includes pre and post-intervention surveys. The theory of the socio-ecological framework will be applied to analyse the community engagement approach., Discussion: Based on the results ultimately a sustainable community engagement-based strategy for the primary prevention of CVD risk will be developed to enhance the performance of NHS health care in the UK. The Trial Registration number is ISRCTN68334579., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Although the use of theories and evidence is often stressed in the development of health promotion interventions, this does not guarantee the success of an intervention. Thus, we need to reflect on intervention development processes that use different types of theories and evidence. In this paper, we provide a reflective discussion on how we identified evidence-based behavior change techniques and counseling themes for a health promotion intervention. In addition, we discuss the challenges that we encountered and what we learned during the process: a) a lack of previous research and meta-analyses, b) inconsistencies in evidence, c) integrating evidence and theories that have different starting points, and d) collaborating with researchers who represent different evidence and theories. During the process, we benefitted from having the clear goal of conducting evidence- and theory-based work. We solved the challenges by, for example, utilizing different types of evidence and being reflective about the reasons behind any inconsistencies in the evidence. In retrospect, we would have benefitted from closer collaboration between the teams that worked separately with different evidence. These kinds of reflective descriptions of development processes and the challenges encountered during them may help other researchers and professionals avoid encountering the same challenges., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This position paper summarises the current knowledge on the epidemiology, diagnosis and management of women of childbearing age with rheumatic heart disease (RHD) in Africa, as well as the available data on their use of reproductive health services. The aim is to provide guidance to health professionals on aspects of sexual and reproductive health in women with RHD. It reviews the diagnosis, management and counselling of women with RHD throughout their reproductive life. Additionally, this publication discusses potential ways of integrating obstetric and cardiovascular care at peripheral levels of the health systems, as a way of improving outcomes and reducing maternal mortality rates related to cardiovascular disease in Africa. Finally, the article proposes responses to fulfil the actual needs for better reproductive health services and improvement in care for women with RHD.

The growing number of autistic adults challenges the limited adult service system. While data on service use and barriers are available, there is limited information from the individual's perspective on which services are most helpful in adulthood and how service use is connected to community participation outcomes. Forty autistic adults participated in a study combining global positioning system community participation measures with survey and interview data on service use, including which services are most helpful in adulthood, barriers to services, and service needs. Participation outcomes were analyzed relative to demographics, number and types of services received in the past 2 years, and current mental health service use. Participants received an average of two services in the past 2 years, most frequently mental health and employment services. Individuals currently seeing a mental health counselor were more likely to be working full-time and visit more community locations compared to those who were not seeing a counselor. Participants reported mental health services as the most helpful service received in adulthood followed by employment services. While an emphasis is often placed on employment services in the transition to adulthood, findings suggest a need for integrated mental health and employment services for autistic adults. [This paper was presented at the Conference on Rehabilitation Education (NCRE/CSAV/RSA) Annual Meeting, 16 September 2022.]

Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri‐ and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid‐life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri‐ and postmenopause, worldwide. Synopsis: The increase in life expectancy has made post‐reproductive health a global priority. Counseling on the benefits and risks of menopausal hormone therapy and lifestyle education is fundamental. [ABSTRACT FROM AUTHOR]

Asthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them, what are the rescue medication and the controller one, proper inhaler techniques, and how to monitor asthma control. Patient education accounts for 90% of success and this can be achieved by an active collaboration among health care providers. This is a prospective interventional study that aims at evaluating pharmacist counseling for asthmatic children. The study involved 105 participants whose consent was taken and underwent a face-to-face interview about asthma counseling and inhaler technique for those who use it. Ninety-two eligible participants remained. Their CACT was recorded at the first visit and then followed up weekly for one month either by phone or physical to assess asthma control. In the fourth week, a CACT was recorded and compared to the first one before intervention. There was a significant improvement in CACT after providing the counselling and weekly follow up.

Introduction: Cancer in adolescence raises unique challenges for all involved. In healthy populations, the transition from childhood to adulthood is seen as a normal phase of the human life course focused primarily on the process of identity formation. For young people diagnosed with cancer, there are specific, negative impacts to consider. In this paper, the impact on intimacy, body image, and sexuality are discussed and the need for innovative supportive solutions highlighted., Aim: Based on a presentation given at the ISSM conference in Washington, DC, the paper describes the challenges in providing effective supportive care in relation to sexuality in young people surviving cancer., Main Outcome Measures: Discussion of key issues involved when developing psychosexual interventions for this age group., Methods: A scan of available evidence was combined with examples of recent service and research developments., Results: The limited amount of available research belies the complexity of providing effective supportive care in relation to sexuality for young people both during and after cancer. As the number of long-term survivors of cancer during childhood and adolescence increases, there will be increasing demand for attention to be paid to the supportive care needs of this population; including issues of relationships and sexuality. Two examples of novel interventions are presented., Conclusions: Services provided for cancer survivors must consider the unique challenges facing different age groups. For young people diagnosed during adolescence and young adulthood there is a need to enhance the evidence base, and to apply this evidence in practice contexts. Locating the need for further developments within a Complex Intervention Framework may assist in the development of interventions that can be developed and tested in a logical, step-wise fashion., (© 2013 International Society for Sexual Medicine.)

Cardiac patients after an acute event and/or with chronic heart disease deserve special attention to restore their quality of life and to maintain or improve functional capacity. They require counselling to avoid recurrence through a combination of adherence to a medication plan and adoption of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling, exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise training as central components in all rehabilitation and preventive interventions. Many of the risk factor improvements occurring in CR can be mediated through exercise training programmes. This call-for-action paper presents the key components of a CR programme: physical activity counselling and exercise training. It summarizes current evidence-based best practice for the wide range of patient presentations of interest to the general cardiology community.

Unsafe and violent schools are a widespread problem in South Africa. This paper argues that Adverse Childhood Experiences (ACEs) contribute to this phenomenon. While various individual and community-level interventions to address ACEs have been reported on, the contribution of safe parks towards preventing school violence has not yet been explored. To support schools in dealing with violence, the Adopt-a-School Foundation introduced a pilot project at eight schools in Botshabelo in the Free State Province. The programme included psychosocial support services, establishing safe parks, and ensuring community involvement. The goal was to improve school communities by creating environments that are empowering, academically effective, gender sensitive and free from violence. Although there are safe parks in communities around South Africa, they are an uncommon sight at schools. This paper reports on the quantitative study conducted on safe parks' contribution to making schools safer and less violent. Results show that safe park activities improve community well-being, including reduced gangsterism, enhanced learner safety, and decreased disciplinary problems. It is recommended that safe parks continue to provide psychosocial services to children at schools and that their programmes be expanded to include more services.

The effect of nurses' confidence to counsel patients at risk of stroke in selected health promotion areas: smoking cessation, exercise and nutrition was examined. Bandura's (1986) self-efficacy and Knowles' adult learning theories provided the theoretical underpinnings for the study. This was a quasi-experimental design in which neuroscience nurses (N = 23) from a quaternary hospital completed questionnaires prior to, immediately after, and 2 months post completion of a self-directed learning manual (SDL). The researcher-designed manual was designed to enhance learning about the risk factors for stroke and the importance of stroke prevention. Along with reflective activities and pre-post test, strategies for counseling high-risk, stroke-prone individuals in the areas of smoking cessation, exercise, and nutrition were also integrated. The Health Promotion Counseling Self-Efficacy Scale (Tresolini, Saluja, and Stritter, 1995), consisting of 10 self-efficacy subscales relating to self-confidence in knowledge and ability to counsel in health promotion areas, was used to capture the nurses' self-report of self-efficacy. Using a 5-point Likert Scale, nurses also rated their amount of agreement or disagreement about health promotion counseling in practice. Overall, self-efficacy levels for both knowledge and counseling increased significantly (p < .01) from pre-to immediately post completion of the manual, and decreased slightly at two-month follow-up. This pattern was evident in all health promotion areas measured except for knowledge in exercise (p = .015). Nurses' attitudes about aspects of health promotion practices correlated significantly (p < 05) at two-month follow-up with all health promotion areas. Results of this study support the usefulness of a self-directed learning manual as a teaching strategy for health promotion counseling of individuals at risk of stroke.

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It is widely accepted that cancer patients have unmet psychosocial needs. There are as yet few guidelines on the appropriate role of a counsellor in centres for cancer treatment. In this study the activities of a radiographer counsellor were audited to try to identify the proportion of patients who would benefit from seeing a counsellor, to estimate the cost of such a service, and to obtain indications of how the effects of counselling could be evaluated. The study suggested that 44% of patients attending for routine radiotherapy have abnormally high levels of anxiety and might benefit from counselling. The Hospital Anxiety and Depression Scale (HADS) is proposed as an objective measure of benefit. Costing and resource allocation are discussed.

This paper poses the question 'What can we learn from the person-centred counselling literature which could be used by the action learning facilitator to help benefit the set?'. This question may be particularly important to facilitators seeking new ways to run their sets and to facilitators who would like to introduce a more humanistic and less mechanistic way of working with set members. Person-centred counselling is an approach to helping which aims to foster human growth and wellbeing. The person-centred approach was developed by Carl Rogers in the 1950s and has a number of similarities with Revan's original ideas. Although Revans was insistent that action learning was not counselling there are several facets of person-centred theory which align with Revans underlying ideas and philosophy. The paper concludes with suggestions of how to incorporate Rogerian ideas into facilitation, namely those of empathy, congruence and Unconditional Positive Regard.

In a sample of students (n=93), preference for country and western music was not associated with depression or suicidal preoccupation as has been suggested by Stack and Gundlach. However, preference for heavy metal music was associated with prior suicidal ideation. Stronger associations were found between music preferences and measures of psychoticism and extraversion. (Author)

Negative life events are unpleasant, stressful, and uncontrollable experiences found to be risk factors for increased psychological distress and decreased life satisfaction in college students. In addition, distress and life satisfaction are closely related to college students' quality of life and academic performance. Conversely, positive psychological states have been hypothesized to buffer the effects of negative life events. Data from 738 college students in the U.S. were analyzed to examine the moderating effects of three positive psychological variables on negative life events: optimism, hope, and gratitude. The results showed that negative life events positively predicted distress and negatively predicted life satisfaction. The results also revealed that optimism, hope, and gratitude moderated the effects of negative life events. The authors conclude that the evidence supports positive psychology interventions in college counseling to combat the effects of negative life events through the positive psychological states of optimism, hope, and gratitude. The specific clinical implications for practicing counselors and educational settings are suggested. [Paper presented by Eurasian Congress of Positive Psychology (2nd, Istanbul, Turkey, May 12-14, 2017).]

Background: In the United Kingdom, schools play an increasingly important role in supporting young peoples' mental health. While there is a growing evidence base to support the effectiveness of school-based interventions, less is known about how these provisions impact on local Child and Adolescent Mental Health Service (CAMHS) referral rates. There is a concern that an increase in school-based provision might lead to an increase in CAMHS referrals and overwhelm services. We aimed to examine the longitudinal association between Place2Be counselling provision in primary schools on CAMHS referral rates in South London., Method: This was a retrospective cohort study using linked data from the National Pupil Database (NPD) and CAMHS referrals to the South London and Maudsley's NHS Foundation Trust (SLaM) identified through the Clinical Record Interactive Search (CRIS) tool. The cohort included a total of 285 state-maintained primary schools in four London boroughs for the academic years of 2007-2012. During the study period, 23 of these schools received school-based mental health provision from Place2Be. The primary outcome was the incident rate ratio (IRR) of school-level accepted CAMHS referrals in 2012/13 in schools with, or without, Place2Be provision., Results: There was no significant association between elevated rates of CAMHS referral and Place2Be provision, even after comprehensive adjustment for school-level and pupil characteristics (IRR 0.91 (0.67-1.23)). School-level characteristics, including higher proportion of white-British pupils (IRR 1.009 (1.002-1.02)), medical staff ratio (IRR 6.49 (2.05-20.6)) and poorer Ofsted school inspection ratings (e.g. IRR 1.58 (1.06-2.34) for 'Requires Improvement' vs. 'Outstanding') were associated with increased CAMHS referral rates., Conclusions: Place2Be provision did not result in increased specialist mental health referrals; however, other school-level characteristics did. Future research should investigate pupils' Place2Be clinical outcomes, as well the outcomes of individuals referred to CAMHS to better understand which needs are being met by which services., (© 2021 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

The study investigated the perceived role of digital theological library and term paper counselling in undergraduate religious education students' academic success in the federal universities in southeast Nigeria. The study adopted a descriptive survey design. A structured questionnaire developed by the researchers was used for data collection. 166 undergraduate religious education students were chosen as respondents in this research. The results showed that items on the perceived role of digital theological library and term paper counselling were all accepted by the students as means of achieving academic success. There was a significant difference in the perceived role of the digital theological library in achieving academic success among religious education students by the university. There was a significant difference in the perceived role of term paper counselling in achieving academic success among religious education students based on university. There was also a significant difference in the perceived role of university librarians in achieving academic success among religious education students based on university. The researchers noted that these findings have implications for university librarians across the universities and it was recommended that the use of digital theological libraries for academic purposes and term paper counselling should be strengthened. [ABSTRACT FROM AUTHOR]

An editorial is presented discussing the challenges and complexities of applying nutrition evidence to individualized care, as highlighted in a recent Academy of Nutrition Sciences Position Paper. Topics include the importance of evidence-based dietary advice, the role of clinical practice guidelines, and recommendations for nutrition and dietetic professionals, researchers, and disseminators in navigating the abundance of conflicting information in the field.