BACKGROUND: Lack of index case testing increased the risk of contracting HIV among the families of index clients, partners, and biological children. The aim of this study was to determine the prevalence of index case HIV testing uptake and its associated factors at Oromia, Ethiopia.
METHODS: An institutional-based cross-sectional study was conducted. A face-to-face interviewer administered structured questionnaire and chart review checklist were used to collect data. The data were analyzed using SPSS version 25. Logistic regressions were executed and statistical significance was declared at P < .05.
RESULTS: The prevalence of index case testing was 80.2%. Factors associated with index case HIV testing uptake included HIV status disclosure (AOR = 5.4, 95% CI: 2.1, 14.0), discussed about HIV with family (AOR = 3.1, 95% CI: 1.2, 7.5), counseling of the index case (AOR = 3.3, 95% CI: 1.7, 10.6), perceived benefit of the index case tested (AOR = 3.2, 95% CI: 1.5, 8.7), being on ART 12 months or more (AOR = 2.6, 95% CI: 1.1, 6.1), and maintained privacy (AOR = 3.1, 95% CI: 1.3, 7.1).
CONCLUSIONS: The uptake of index case HIV testing was moderately high. Additionally, factors such as HIV status disclosure, discussion of HIV with family, counseling of the index case, perception of the benefits of HIV testing for the index case, duration of clients on ART, and privacy maintenance during service delivery were significantly associated with index case HIV testing. To enhance index case testing, it is crucial to raise awareness and ensure client privacy during the initial HTC visit. Encouraging HIV status disclosure through discussion and promoting adherence to HIV medication is also recommended.

Mental health conditions research often relies on reductionist cultural assumptions about the population studied and instruments validated from majority populations. In exhaustively reviewing the limited body of Amish mental health conditions research, we find that studies are well-executed by methodological protocols but that findings are inconsistent or limited in generalizability, instrument validity remains contested, and study investigation into Amish cultural and religious dynamics is limited. A case study from a sizeable Amish community in Ohio illustrates how various ideologies-notably old Amish religious theology, the scientific-psychological, and the Evangelical Protestant-have generated population-internal controversies among the Amish over defining and treating mental health conditions, suggesting that mental health conditions research and diagnosis of ethnic religious adherents should better account for internal cultural-religious dynamics. In order to make some assertions about how Amish culture and religion impacts mental health conditions, future research should include pre-study investigations into the targeted population\'s cultural and religious dynamics, consist of more nuanced case reports from therapists and psychiatrists, and include replication studies at different times and places, with deliberate attention to contextual factors.

In this study, we pilot tested Therapeutic Assessment (TA) in a university counseling center using a replicated single-case design to generate hypotheses on the effectiveness and applicability for this setting and population. We aimed to see whether TA could be an effective brief intervention to address students\' presenting mental health concerns. Further, we explored whether different types of presenting concerns were associated with differential symptomatic improvement during the intervention. An independent clinician interviewed participants before the baseline period to develop individualized rating scales pertaining to their presenting concerns. Eight consecutive students accessing the counseling center enrolled in the study and rated their presenting problems across baseline, intervention, and follow-up periods. The intervention involved five TA sessions. The results suggested that TA is associated with statistically significant reductions in clients\' symptoms in the context of a university counseling center. Idiographic trajectory analysis of participant data who experienced significant and insignificant change was used to test whether changes were associated with the onset of TA. The findings suggest TA might be more effective for certain presenting concerns than for others. The implications for the implementation of TA in university counseling centers is discussed.

BACKGROUND: Uganda embraced Nutrition Assessment Counselling and Support (NACS) since 2009 as a health system strengthening approach to improve health and nutrition outcomes. However, scant evidence exists on NACS integration and drivers. This study therefore assessed the extent of NACS integration in the health system and identified key drivers and barriers.
METHODS: A mixed method design was employed. In a facilitated panel discussions at each of the 17 health facilities, 4-5 health staff participated, responding to a semi-structured questionnaire. Integration was assessed on a 5-point scoring scale of 1 for not done nor integrated, 2-4 for partial and 5 for fully integration. Data was captured, analysed in microsoft excel and presented using as bar and spider charts. Integration drivers were identified deductively from key informant and in-depth interviews using Atlas.ti 9 and thematic analysis.
RESULTS: The NACS integration across the health facility level was partial at a score of 2.9 indicating a weak integration into the health system. Integration across the health system building blocks was partial at; service delivery (3.8), health work force (3.7), health information (3.3), community support system (3.0), governance and leadership (3.0) signifying that NACS activities are provided by Ministry of Health but sub-optimal due to weak capacities. Health financing (2.2) and Health supplies (1.5) were the least integrated due to partner dependence. Under service delivery, deworming (5) was fully integrated and provided by Ministry of Health. The key drivers for integration were; good leadership, financing, competent staff, quality improvement approaches, nutrition talks, community dialogues, nutrition logistics and supplies.
CONCLUSIONS: The NACS integration in the health system was generally low and lacked adequate support. Governance, financing and community follow-up under service delivery require more government investment for enhanced integration.

Intensive adherence counseling (IAC) is the global standard of care for people living with human immunodeficiency virus (PLHIV) who have unsuppressed VL after ≥ 6 months of first-line anti-retroviral therapy (ART). We investigated whether the number of IAC sessions is associated with suppressed VL among PLHIV in Kampala, Uganda.
We conducted a nested case-control study among PLHIV with unsuppressed VL after ≥ 3 IAC sessions (cases) and a 2:1 random sample of PLHIV with suppressed VL after ≥ 3 IAC sessions (controls). Unsuppressed VL was defined as VL ≥ 1000 copies/ml. We performed multivariable logistic regression to identify factors that differed significantly between cases and controls.
Demographic and clinical characteristics were similar among the 16 cases and 32 controls including mean age, sex, baseline CD4 count, VL before IAC, and WHO clinical stage. Only the number of IAC sessions differed significantly between cases and controls in unadjusted (p = 0.012) and adjusted (p = 0.016) analyses. Each unit increase in IAC session was associated with unsuppressed VL (Adjusted odds ratio 5.09; 95% CI 1.35-19.10).
VL remained unsuppressed despite increasing IAC frequency. The fidelity to standardized IAC protocol besides drug resistance testing among PLHIV with unsuppressed VL before IAC commencement should be examined.

UNASSIGNED: Breast density notifications advise women to discuss breast density with their clinicians, yet little is known about such discussions.
UNASSIGNED: To examine the content of women\'s reports of breast density discussions with clinicians and identify variations by women\'s sociodemographic characteristics (age, income, state legislation status, race and ethnicity, and literacy level).
UNASSIGNED: This US nationwide, population-based, random-digit dial telephone survey study was conducted from July 1, 2019, to April 30, 2020, among 2306 women aged 40 to 76 years with no history of breast cancer who underwent mammography in the prior 2 years and had heard the term dense breasts or breast density. Results were analyzed from a subsample of 770 women reporting a conversation about breast density with their clinician after their last mammographic screening. Statistical analysis was conducted in April and July 2023.
UNASSIGNED: Survey questions inquired whether women\'s clinicians had asked about breast cancer risk or their worries or concerns about breast density, had discussed mammography results or other options for breast cancer screening or their future risk of breast cancer, as well as the extent to which the clinician answered questions about breast density.
UNASSIGNED: Of the 770 women (358 [47%] aged 50-64 years; 47 Asian [6%], 125 Hispanic [16%], 204 non-Hispanic Black [27%], 317 non-Hispanic White [41%], and 77 other race and ethnicity [10%]) whose results were analyzed, most reported that their clinicians asked questions about breast cancer risk (88% [670 of 766]), discussed mammography results (94% [724 of 768]), and answered patient questions about breast density (81% [614 of 761]); fewer women reported that clinicians had asked about worries or concerns about breast density (69% [524 of 764]), future risk of breast cancer (64% [489 of 764]), or other options for breast cancer screening (61% [459 of 756]). Women\'s reports of conversations varied significantly by race and ethnicity; non-Hispanic Black women reported being asked questions about breast cancer risk more often than non-Hispanic White women (odds ratio [OR], 2.08 [95% CI, 1.05-4.10]; P = .04). Asian women less often reported being asked about their worries or concerns (OR, 0.42 [95% CI, 0.20-0.86]; P = .02), and Hispanic and Asian women less often reported having their questions about breast density answered completely or mostly (Asian: OR, 0.28 [95% CI, 0.13-0.62]; P = .002; Hispanic: OR, 0.48 [95% CI, 0.27-0.87]; P = .02). Women with low literacy were less likely than women with high literacy to report being asked about worries or concerns about breast density (OR, 0.64 [95% CI, 0.43-0.96]; P = .03), that mammography results were discussed with them (OR, 0.32 [95% CI, 0.16-0.63]; P = .001), or that their questions about breast density were answered completely or mostly (OR, 0.51 [95% CI, 0.32-0.81]; P = .004).
UNASSIGNED: In this survey study, although most women reported that their clinicians counselled them about breast density, the unaddressed worries or concerns and unanswered questions, especially among Hispanic and Asian women and those with low literacy, highlighted areas where discussions could be improved.

Congenital urethral atresia is generally considered to be incompatible with life unless there is either a patent urachus or vesicoamniotic shunt. Here we present the case of a male neonate with anhydramnios detected at 28weeks gestation due to urethral atresia, who was born without evidence of either a patent urachus or vesicoamniotic shunt, who has survived and is not requiring respiratory support at age 5months. While this is a thought-provoking clinical case, it also highlights the importance of early and effective parental engagement in cases of complex congenital anomalies of the urinary tract.

Evidence-based obstetrics can employ statistical models to justify greater use of cesareans, sometimes excluding experiential elements from informed decision making. Over the past decade, prenatal providers adopted a vaginal birth after cesarean (VBAC) calculator designed to support patients in making informed decisions about their births by estimating their probability for a VBAC. Among other factors, the calculator used race and ethnicity to make its estimate, assigning lower probabilities for a successful VBAC to Black and Hispanic patients. I analyze how a diverse group of women and their providers engaged with the VBAC calculator. Some providers used low calculator scores to remove a shared decision-making model by prescriptively counseling Black and Hispanic women who desired a VBAC into undergoing repeat cesareans. Consequently, women racialized by the calculator as Black or Hispanic used experiential knowledge to challenge the calculator\'s assessment of their supposed lesser ability to give birth vaginally.

Although there is no lack of research on masculinity and help-seeking behavior, men continue to seek counseling less often than women. It is crucial we find effective therapeutic approaches to connect and meet men where they are, acknowledging the positive aspects of their masculinity while addressing their needs in the counseling setting. In this conceptual research article, we propose a new approach for counselors to utilize with men seeking counseling, the Relational Resilience Approach, which applies tenets of Relational-Cultural Theory, Positive Psychology, and Shame Resilience Theory.

University counseling centers have grappled with clinical supply and demand imbalance for decades. Chronic understaffing, increased scrutiny from the campus community, and concerns about overall student well-being have only exacerbated the challenges. Traditional models of service that rely on advanced scheduling with limited services aside from individual and group psychotherapy continue to flounder each academic semester. This agency revamped its service model by drawing from evidence-based service delivery models of stepped care, flexible care, and consultation and triage systems. This article provides a case example of this agency\'s urgency, preparation, implementation, and initial outcomes of its navigated care model. (PsycInfo Database Record (c) 2023 APA, all rights reserved).