A Phenomenological Investigation of Counselors\u27 Perceived Degree of Preparedness When Working with Suicidal Clients

Little is known of counselor perspectives of their training and level of preparedness when working with suicidal clients. Although professional standards and guidelines regarding counselor competency in this area exists, training may not be occurring throughout a trainee\u27s program, or is occurring inconsistently. The purpose of this phenomenological inquiry was to understand the essence of counselors\u27 perceived degree of preparedness working with suicidal clients, and to provide clinical and training recommendations in this subject area. Using individual semi-structured interviews, 10 participants were recruited, using maximum variation and criterion sampling who had previous experience working with suicidal clients. The results of the study identified four structural themes and 15 textural themes were identified that answered the research questions. Findings highlighted participant insight training preparedness, components of preparedness, assessment and intervention knowledge, and training recommendations for suicide prevention and assessment. Master\u27s level training implications for counselor education programs and post-master\u27s training in the area of suicide prevention and assessment are presented, along with future research directions

Evaluation of Trends in Diabetes Care in a Patient-centered Medical Home

Background: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network. Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome measures were determined for selected diabetic core measures, based on the 2015 American Diabetes Association and Physician Quality Reporting System of the Centers for Medicaid and Medicare (CMS). These measures included glycated hemoglobin (HbA1c), blood pressure (BP), low-density lipoprotein cholesterol (LDL), urine microalbumin (Um), diabetic foot and eye exams, and influenza and pneumococcal vaccinations. These values were analyzed by the CochranArmitage test for trends over time to determine the proportions of patients at the recommended goals. Results: Over time, there were increasing trends for patients who were at the goals for frequencies of HbA1c, Um, LDL, pneumococcal vaccinations, and diabetic retinal exams. Conclusions: Since AUFMC achieved PCMH recognition status, efforts to improve the management of patients with diabetes have yielded positive outcomes and valuable lessons. Areas of strength include utilization of the diabetes registry, education by regular providers, tailored use of electronic health records for patient education and physician documentation, and appropriate utilization of all team members. Trend analysis indicated that targeted diabetic interventions contributed to improved outcomes in selected diabetic core measures

Prevalence and Risk Factors of Alcohol Abuse among University Students from Eastern Croatia: Questionnaire Study

The aim of the study was to examine the prevalence of alcohol abuse among university students in Osijek, Croatia and its possible interconnections with gender, year of study, repetition of year of study, faculty subject area, sources of financing and type of residence during study. A validated questionnaire was self-administered to cross-faculty representative student sample of »J. J. Strossmayer« University of Osijek in June 2006. General demographic data, as well as data on academic features and student socio-economical status were obtained. The Alcohol Use Disorders Identification Test (AUDIT) was used for assessing the extent of alcohol consumption, with cut off value of 8 indicating possible alcohol problems. The majority of study participants 90.9% (755/831) had tried alcohol at least once in their life. Among this group, 43.8% (331/755) had an AUDIT total score of 8 or more: 69.2% (229/331) were males and 30.8% (102/331) were females. Among the study participants who screened positive, 70.4% (233/331) responded positively to simple advice focused on the reduction of hazardous drinking (AUDIT 8–15), 14.5% (48/331) needed brief counseling and continued monitoring (AUDIT 16–19), and 15.1% (50/331) clearly warranted further diagnostic evaluation for alcohol dependence (AUDIT 20 and above). Significantly different statistical data was found within the following factors: gender, repetition of year of study, faculty subject area and type of residence (c2=76.232, p=0.0000; Fisher exact test=31.828, p=0.0000; c2=11.667, p= 0.0086 and c2=6.639, p=0.0362 respectively). Alcohol consumption resulting in risk behaviors is common among university students from eastern Croatia. These findings emphasize the need for comprehensive and effective preventative strategies directed towards student population

"Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students

BACKGROUND: Evidence is growing that sleep problems in adolescents are significant impediments to learning and negatively affect behaviour, attainment of social competence and quality of life. The objectives of the study were to determine the level of sleepiness among students in high school, to identify factors to explain it, and to determine the association between sleepiness and performance in both academic and extracurricular activities METHODS: A cross-sectional survey of 2201 high school students in the Hamilton Wentworth District School Board and the Near North District School Board in Ontario was conducted in 1998/9. A similar survey was done three years later involving 1034 students in the Grand Erie District School Board in the same Province. The Epworth Sleepiness Scale (ESS) was used to measure sleepiness and we also assessed the reliability of this tool for this population. Descriptive analysis of the cohort and information on various measures of performance and demographic data were included. Regression analysis, using the generalised estimating equation (GEE), was utilized to investigate factors associated with risk of sleepiness (ESS>10). RESULTS: Seventy per cent of the students had less than 8.5 hours weeknight sleep. Bedtime habits such as a consistent bedtime routine, staying up late or drinking caffeinated beverages before bed were statistically significantly associated with ESS, as were weeknight sleep quantity and gender. As ESS increased there was an increase in the proportion of students who felt their grades had dropped because of sleepiness, were late for school, were often extremely sleepy at school, and were involved in fewer extracurricular activities. These performance measures were statistically significantly associated with ESS. Twenty-three percent of the students felt their grades had dropped because of sleepiness. Most students (58–68%) reported that they were "really sleepy" between 8 and 10 A.M. CONCLUSION: Sleep deprivation and excessive daytime sleepiness were common in two samples of Ontario high school students and were associated with a decrease in academic achievement and extracurricular activity. There is a need to increase awareness of this problem in the education and health communities and to translate knowledge already available to strategies to address it