Bhutanese Counselors\u27 Experiences with Western Counseling: A Qualitative Study

Following centuries of independence from the rest of the world, the remote and fast-developing Kingdom of Bhutan has recently opened its doors to outside influence. Bhutan has invited the profession of counseling to aid in responding to growing mental health problems, social and family issues, and school and career guidance needs. This study employed the methods of phenomenology to investigate the experiences of Bhutanese counselors with Western counseling in order to understand the intersection of the culture of Bhutan with the culture of counseling. Eleven participants were interviewed and four themes were identified: Conceptualization of counseling, Bhutanese culture, Bhutanese counseling, and the relationship between Western counseling and Bhutan. The worldview differences between collectivism and individualism are highlighted as well as the compatibility and integration of Buddhist principles with counseling. Elements of a potential model of Bhutanese counseling are suggested as well as recommendations for counselor training, ongoing Western contributions, and the further development of the profession

Building bridges? An evaluation of the costs and effectiveness of the separated parents information programme (PIP)

The Separated Parent Information Programme (PIP) is the first nationally available parent education programme for parents involved in litigation over contact and residence in England. The programme is a Contact Activity, introduced by the Children and Adoption Act 2006 as an additional tool for courts to facilitate contact. PIP is a four hour group programme for parents referred by the court. Both parties, i.e. the applicant and respondent, are required to attend the programme, but former couples attend separate groups. The groups are designed to include both men and women. The aim of the programme is to encourage parents to focus on children’s needs and perspectives. The programme is delivered by trained providers from mediation, counselling or contact services backgrounds

Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study.

ObjectivesTo explore trajectories of physical and psychosocial health, and their interrelationship, among women completing fistula repair in Uganda for 1 year post-surgery.MethodsWe recruited a 60-woman longitudinal cohort at surgical hospitalisation from Mulago Hospital in Kampala Uganda (Dec 2014-June 2015) and followed them for 1 year. We collected survey data on physical and psychosocial health at surgery and at 3, 6, 9 and 12 months via mobile phone. Fistula characteristics were abstracted from medical records. All participants provided written informed consent. We present univariate analysis and linear regression results.ResultsAcross post-surgical follow-up, most women reported improvements in physical and psychosocial health, largely within the first 6 months. By 12 months, urinary incontinence had declined from 98% to 33% and general weakness from 33% to 17%, while excellent to good general health rose from 0% to 60%. Reintegration, self-esteem and quality of life all increased through 6 months and remained stable thereafter. Reported stigma reduced, yet some negative self-perception remained at 12 months (mean 17.8). Psychosocial health was significantly impacted by the report of physical symptoms; at 12 months, physical symptoms were associated with a 21.9 lower mean reintegration score (95% CI -30.1, -12.4).ConclusionsOur longitudinal cohort experienced dramatic improvements in physical and psychosocial health after surgery. Continuing fistula-related symptoms and the substantial differences in psychosocial health by physical symptoms support additional intervention to support women's recovery or more targeted psychosocial support and reintegration services to ensure that those coping with physical or psychosocial challenges are appropriately supported

Building bridges? An evaluation of the costs and effectiveness of the Separated Parents Information Programme (PIP)

This study was conducted over a three month period from January to March 2011.The Separated Parent Information Programme (PIP) is the first nationally available parent education programme for parents involved in litigation over contact and residence in England. The programme is a Contact Activity, introduced by the Children and Adoption Act 2006 as an additional tool for courts to facilitate contact. PIP is a four hour group programme for parents referred by the court. Both parties, i.e. the applicant and respondent, are required to attend the programme, but former couples attend separate groups. The groups are designed to include both men and women. The aim of the programme is to encourage parents to focus on children’s needs and perspectives. The programme is delivered by trained providers from mediation, counselling or contact services backgrounds.Department of Educatio

Giving away used injection equipment: missed prevention message?

Abstract Background Our objective was to examine factors associated with distributive injection equipment sharing and how needle exchange programs (NEPs) can help reduce distributive sharing among injection drug users (IDUs). Methods 145 English speaking Canadian IDUs ages 16 years and over who had injected in the past 30 days were recruited for a cross-sectional survey. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, social support, drug treatment readiness, program satisfaction, health and social service use and NEP drug use. Bivariate statistics and logistic regression were used to characterize the population and examine correlates of sharing behaviour. Results More IDUs reported distributive sharing of cookers (45%) than needles (36%) or other types of equipment (water 36%; filters 29%; swabs 8%). Regression analyses revealed the following factors associated with distributing used cookers: a history of cocaine/crack injection, an Addiction Severity Index (ASI) score indicative of a mental health problem, and older than 30 years of age. Factors associated with giving away used water included: male, injected methadone, injected other stimulants and moved 3+ times in the past 6 months. Factors associated with giving away used filters included: injected cocaine/crack or stayed overnight on the street or other public place. Factors associated with giving away swabs included: an ASI mental health score indicative of a mental health problem, and HCV negative status. Conclusions Our findings show that more IDUs give away cookers than needles or other injection equipment. While the results showed that correlates of sharing differed by piece of equipment, each point to distributive sharing by the most marginalized IDUs. Targeting prevention efforts to reduce equipment sharing in general, and cookers in particular is warranted to reduce use of contaminated equipment and viral transmission

Delayed Therapy with Plasma Gelsolin Improves Survival in Murine Pneumococcal Pneumonia

Abstract Background: Innate immune responses contribute to successful resolution of bacterial pneumonia. Bolstering host defense with immunomodulators might be increasingly needed to improve outcomes in antibiotic-resistant infections. One candidate molecule is recombinant human plasma gelsolin (rhu-pGSN), an abundant normal blood protein whose levels fall proportionally with disease severity. Pretreatment with rhu-pGSN has beneficial effects in many pre-clinical models of inflammation and injury, including pneumonia. We evaluated the effects of delaying therapy with rhu-pGSN up to 48 hours after lethal intra-nasal pneumococcal challenge in a mouse model to more closely mimic realistic clinical circumstances. Methods: Adult Bl/6 mice were inoculated intra-nasally with S. pneumoniae serotype 3 on day 0, followed by subcutaneous rhu-pGSN 24 hours later for evaluation of bacterial clearance in lavage fluids. To assess effects on survival, rhu-pGSN was administered on days 2 and 3 after infection and effects monitored for 10 days. No antibiotics or other interventions were given. Results: Treatment with rhu-pGSN at 24 hours after infection improved bacterial clearance, seen as reduction of bacterial CFU in bronchoalveolar lavage fluid at 48 hours (% of initial inoculum, vehicle vs.. rhu-pGSN (dose range 0.5–2 mg): 30 ± 13 vs. 11 ± 7, n = 6 trials using inocula ranging 0.3–1.8 x 106 CFU, 3 mice/group/trial, P = .001). In 3 separate trials, pGSN (0.5 mg s.c.) reduced weight loss and mortality (% survival, vehicle vs. pGSN: 40 vs. 80, 0 vs. 25, 17 vs. 43; n ≥ 16/group, P =.02). Increasing the dose to 1 mg further improved survival from 17 to 71%. Conclusion: Rhu-pGSN can substantially improve survival in a murine model of fatal pneumococcal pneumonia, even when administered as single doses on days 2 and 3 after infection without antibiotics. The data support further evaluation of pGSN as adjunctive therapy for serious infections with diverse pathogens and in models of antibiotic-resistant pneumonia. Disclosures Z. Yang, BioAegis: Shared NIH grant to study plasma gelsolin, we receive plasma gelsolin for our lab studies; S. Levinson, BioAegis: BIoAegis shares a grant to investigate plasma gelsolin with HSPH, Employee and Shareholder, Salary; T. Stossel, BioAegis: Consultant and Shareholder, portion of royalties from Hospital IP licensed to BioAegis; M. DiNubile, BioAegis: Employee and Shareholder, Consulting fee; L. Kobzik, BioAegis: Collaborator and We share a NIH grant on pGSN with BioAegis, we receive plasma gelsolin for our lab studie

Activation of the Alternative NFκB Pathway Improves Disease Symptoms in a Model of Sjogren's Syndrome

The purpose of our study was to understand if Toll-like receptor 9 (TLR9) activation could contribute to the control of inflammation in Sjogren's syndrome. To this end, we manipulated TLR9 signaling in non-obese diabetic (NOD) and TLR9−/− mice using agonistic CpG oligonucleotide aptamers, TLR9 inhibitors, and the in-house oligonucleotide BL-7040. We then measured salivation, inflammatory response markers, and expression of proteins downstream to NF-κB activation pathways. Finally, we labeled proteins of interest in salivary gland biopsies from Sjogren's syndrome patients, compared to Sicca syndrome controls. We show that in NOD mice BL-7040 activates TLR9 to induce an alternative NF-κB activation mode resulting in increased salivation, elevated anti-inflammatory response in salivary glands, and reduced peripheral AChE activity. These effects were more prominent and also suppressible by TLR9 inhibitors in NOD mice, but TLR9−/− mice were resistant to the salivation-promoting effects of CpG oligonucleotides and BL-7040. Last, salivary glands from Sjogren's disease patients showed increased inflammatory and decreased anti-inflammatory biomarkers, in addition to decreased levels of alternative NF-κB pathway proteins. In summary, we have demonstrated that activation of TLR9 by BL-7040 leads to non-canonical activation of NF-κB, promoting salivary functioning and down-regulating inflammation. We propose that BL-7040 could be beneficial in treating Sjogren's syndrome and may be applicable to additional autoimmune syndromes