Holistic Intervention Research Articles

A holistic lifestyle mobile health intervention for the prevention of type 2 diabetes and common mental disorders in Asian women with a history of gestational diabetes: a randomised control trial with 3-year follow-up protocol

BackgroundWomen with a history of gestational diabetes mellitus (GDM) are 12-fold more likely to develop type 2 diabetes (T2D) 4–6 years after delivery than women without GDM. Similarly, GDM is associated with the development of common mental disorders (CMDs) (e.g. anxiety and depression). Evidence shows that holistic lifestyle interventions focusing on physical activity (PA), dietary intake, sleep, and mental well-being strategies can prevent T2D and CMDs. This study aims to assess the effectiveness of a holistic lifestyle mobile health intervention (mHealth) with post-GDM women in preventing T2D and CMDs in a community setting in Singapore.MethodsThe study consists of a 1-year randomised controlled trial (RCT) with a 3-year follow-up period. Post-GDM women with no current diabetes diagnosis and not planning to become pregnant will be eligible for the study. In addition, participants will complete mental well-being questionnaires (e.g. depression, anxiety, sleep) and their child’s socio-emotional and cognitive development. The participants will be randomised to either Group 1 (Intervention) or Group 2 (comparison). The intervention group will receive the “LVL UP App”, a smartphone-based, conversational agent-delivered holistic lifestyle intervention focused on three pillars: Move More (PA), Eat Well (Diet), and Stress Less (mental wellbeing). The intervention consists of health literacy and psychoeducational coaching sessions, daily “Life Hacks” (healthy activity suggestions), slow-paced breathing exercises, a step tracker (including brisk steps), a low-burden food diary, and a journaling tool. Women from both groups will be provided with an Oura ring for tracking physical activity, sleep, and heart rate variability (a proxy for stress), and the “HAPPY App”, a mHealth app which provides health promotion information about PA, diet, sleep, and mental wellbeing, as well as display body mass index, blood pressure, and results from the oral glucose tolerance tests. Short-term aggregate effects will be assessed at 26/27 weeks (midpoint) and a 1-year visit, followed by a 2, 3, and 4-year follow-up period.DiscussionHigh rates of progression of T2D and CMDs in women with post-GDM suggest an urgent need to promote a healthy lifestyle, including diet, PA, sleep, and mental well-being. Preventive interventions through a holistic, healthy lifestyle may be the solution, considering the inextricable relationship between physical and psychological health. We expect that holistic lifestyle mHealth may effectively support behavioural changes among women with a history of GDM to prevent T2D and CMDs.Trial statusThe protocol study was approved by the National Healthcare Group in Singapore, Domain Specific Review Board (DSRB) [2023/00178]; June 2023. Recruitment began on October 18, 2023.Trial registrationClinicalTrials.gov NCT05949957. The first submission date is June 08, 2023.

Frailty Indices and Their Importance in Elderly Patients: A Perspective Review.

The aging demographic landscape of the United States highlights a concomitant rise in chronic conditions and infectious diseases. Older adults face a heightened susceptibility to infections, particularly pneumonia and urinary tract infections, and comorbidities such as cancer, cardiovascular disease, and dementia. Frailty, defined by a set of phenotypic criteria, emerges as a crucial predictor of adverse outcomes in infections, affecting hospitalization and post-care interventions. In the context of cancer, various frailty indices demonstrate their utility in predicting complications, mortality, and long-term outcomes. Cardiovascular diseases, including acute coronary syndrome and myocardial infarctions, exhibit varied associations with frailty, influencing both short-term and long-term prognosis. Frailty's impact extends to valvular heart disease, necessitating risk assessment and tailored care. In dementia patients, frailty is linked to cognitive decline, mortality, depression, and reduced daily living activities, emphasizing the need for holistic assessment and intervention. This review explores the role of frailty indices in predicting outcomes across diverse health conditions, with a focus on infections, cancer, cardiovascular disease, and dementia. Future interventions should address the role of frailty in predicting poor prognostic outcomes, including mortality, readmission rates, and complications across diverse health conditions.

Fluoroquinolones in Focus: Unraveling Prescription Trends among Clinician Specialties in Washington State

Background: An overall decrease of prescriptions for outpatient fluoroquinolones (FQs) following the FDA’s release of boxed warnings in 2016 was shown in a previous analysis1. An additional study found that this decline held true when further broken down by specialty 2. We sought to determine which different clinician specialties in Washington State (WA) continue to prescribe FQs and if these rates are congruent with previously conducted national analyses. Methods: We conducted a comprehensive analysis of Medicare Part D data from 2021. We identified specialty types contributing the highest proportions of FQ claims from the total volume of claims in 2021. Subsequently, we calculated the average FQ claims per 1,000 Medicare Part D beneficiaries for each specialty. The analysis excluded providers with missing beneficiary data. All dosage formulations were included (i.e. topical & oral). We repeated this process for each year from 2021 to 2013 to assess changes in the average FQ prescription rate for each specialty over time. Results: Our analysis encompassed 99,250 FQ prescriptions involving 976,209 Medicare Part D beneficiaries from January 1 to December 30, 2021. Among the specialties, urologists emerged as the highest prescribers of FQs to Medicare Part D beneficiaries, closely followed by ophthalmologists and family practitioners (Table 1). Notably, 72.4% of urologists prescribed FQs, while only 12.4% of family practitioners did so in 2021. Trend analysis indicated that the average FQ claims per 1,000 beneficiaries for urologists decreased from 251 claims per 1,000 beneficiaries (SD = 177.98) in 2013 to 130 claims per 1,000 beneficiaries (SD = 122.50) in 2021 (Figure 1A). In contrast, the only specialty types that had positive trends in average FQ claims per 1,000 beneficiaries from 2013 to 2021 included ophthalmologists, optometrists, and otolaryngologists (Figure 1A). Conclusion: Throughout the years leading up to 2021, most prescriber specialties contributing high volumes of FQ claims experienced a decline in FQ prescriptions. The positive trend noted amongst ophthalmologists, optometrists, and otolaryngologists could be due to the limited ability to differentiate between oral & topical FQ formulations within the dataset. These findings underscore the importance of understanding specialist prescribing behaviors and partnering with them to formulate tailored antibiotic stewardship guidance. By doing so, we can further promote patient safety and well-being in the context of FQ usage. Public health departments can promote more holistic antibiotic stewardship interventions and better patient safety outcomes with FQs. Ambulatory Fluoroquinolone Use in the United States 2015–2019 Outpatient Fluoroquinolone Prescription Fills.Disclosure: Erica Stohs: Contracted research - Merck; Contracted research – bioMerieux

TRAUMA, CRIME, AND JUSTICE: A CRITICAL EXAMINATION OF STRUCTURAL INEQUALITIES AND RECIDIVISM

This qualitative study critically examines the intricate interplay between trauma, structural inequalities, and recidivism within the criminal justice system. By synthesizing secondary data from seminal works, the research explores how Adverse Childhood Experiences (ACEs) influence criminal behavior and contribute to patterns of recidivism globally. The study highlights the often-overlooked gendered dimensions of trauma, emphasizing the unique challenges faced by female offenders and the role of reintegration support in mitigating recidivism. It delves into the systemic impacts of societal institutions, reflecting elements of human evolutionary history and how these perpetuate trauma and anger within Western criminal justice systems. Additionally, the research investigates the influence of personality traits on criminal behavior, shaped by both genetic and environmental factors. The transformative potential of restorative justice diversion is explored as a structural health intervention aimed at addressing trauma and reducing recidivism. The findings advocate for a comprehensive approach to justice reform that prioritizes healing, rehabilitation, and equity, challenging conventional punitive measures and promoting a more humane and effective response to crime. This study contributes to the broader discourse on crime and justice, offering insights that inform holistic interventions within the criminal justice system.

REVIEWING THE INFLUENCE OF MENTAL HEALTH AND COPING STRATEGIES ON ACADEMIC PERFORMANCE

This study investigates the impact of mental health on academic performance among university students in Malaysia through a systematic literature review. By synthesizing findings from various peer-reviewed studies, the research identifies key themes, including the significant negative correlation between mental health issues (such as depression, anxiety, and stress) and academic performance. Additionally, it highlights the influence of broader societal issues, gender disparities, and the importance of socioemotional skills and well-being in academic success. The methodology involves a comprehensive search of electronic databases, stringent inclusion and exclusion criteria, and robust meta-analytic procedures to ensure unbiased and reliable analysis. The findings underscore the critical need for holistic approaches and effective mental health interventions to support students' academic success and overall well-being. This study provides valuable insights and recommendations for university administrators, policymakers, and mental health professionals, aiming to enhance support systems for Malaysian university students. Future research directions include exploring cultural differences, longitudinal effects, and the efficacy of various interventions for coping strategies.

Assessment of the relation between depression, frailty, nutrition and quality of life among older adults: findings from a cross-sectional study in Greece.

Quality of life (QOL) among older adults is a crucial aspect of geriatric care, particularly in the context of global demographic shifts toward ageing societies. Understanding the determinants of QOL in older adults is essential for developing effective interventions to promote well-being in this population. This cross-sectional study conducted in Greece aimed to investigate the complex relationship between depression, frailty, nutritional status, and QOL on 90 older adults (aged ≤65). Assessment instruments including the World Health Organization Quality of Life (WHOQoL)-BREF questionnaire, Geriatric Depression Scale (GDS), Clinical Frailty Scale (CFS), and Mini Nutritional Assessment (MNA) were utilised to evaluate various dimensions of QOL, depressive symptoms, frailty, and nutritional status. The study revealed significant negative correlations between depression and frailty with all domains of QOL (P < 0.05), indicating that higher levels of depressive symptoms and frailty were associated with lower QOL across physical, psychological, social, and environmental dimensions. Conversely, positive correlations were found between nutritional status and all QOL domains (P < 0.05), suggesting that better nutritional status was linked to higher QOL. Multivariate logistic regression analysis further demonstrated associations between nutritional status and participant characteristics, with females being more likely to be malnourished (odds ratio (OR) = 6.56, P = 0.013), while better health status (OR = 0.34, P = 0.486) and marital status (OR = 0.02, P = 0.019) were protective against malnutrition. These findings underscore the interconnectedness of depression, frailty, and nutritional status in shaping QOL among individuals. Holistic interventions targeting mental health, physical vulnerability, and nutritional well-being are essential for promoting overall well-being and functional outcomes in this population.

The impact of narcolepsy symptoms and treatment on sex life - current evidence and reports

Introduction: Narcolepsy (NT) can manifest as excessive daytime sleepiness (EDS), cataplexy, hypnagogic (HHG) and hypnopompic (HHP) hallucinations, sleep paralysis, orgasmolepsy – all of which may affect patients' functioning. The aim of the study was to determine the impact of NT, specific sexual dysfunctions and drugs used in NT on sex life. Materials and methods: A narrative review was conducted, using keywords: narcolepsy, sexual dysfunctions, medications in narcolepsy from repository inception to March 17, 2024 searching PubMed/MEDLINE, Google Scholar, Crossref, Cochrane databases. The quality of the reviewed articles was assessed using the Scale for the Assessment of Narrative Review Articles (SANRA). Results: Sexual activity and satisfaction are reduced in up to 81.1% of patients. There are often multiple co-occurring autonomic dysregulations in patients, including the genitourinary system, causing sexual dysfunction (erectile dysfunction in 48% of men; vaginal lubrication in 81% of women). Orgasmolepsy negatively affects sexual and social relationships in more than 1⁄3 of respondents. Sleep paralysis can be accompanied by HHG, which often present the impression of sexual assault and harassment. They may cause anxiety, post-traumatic stress disorder (PTSD) features, depressed mood, in extreme cases leading to suicide attempts. Of the drugs used in NT, only methylphenidate can increase libido and reduce erectile dysfunction in NT. Conclusions: Orgasmolepsy, sexual and autonomic dysfunction in NT significantly reduce patients' quality of sex life. Sleep paralysis with sexual HHG can reduce psychological well-being. A holistic intervention approach, using behavioural interventions, cognitive-behavioural therapy, education of the patient and their loved ones, is crucial in the treatment of sexual difficulties. Keywords: narcolepsy, sexual dysfunctions, medications in narcolepsy

Acute response to the October 7th hostage release: rapid development and evaluation of the novel ReSPOND protocol implementation within a children’s hospital

BackgroundThe decision to allocate hospitals for the initial reception of hostages abducted on the October 7th Hamas attack introduced an array of unprecedented challenges. These challenges stemmed from a paucity of existing literature and protocols, lack of information regarding captivity conditions, and variability in hostage characteristics and circumstances.ObjectiveTo describe the rapid development, implementation and evaluation of the Hostage-ReSPOND protocol, a comprehensive trauma-informed procedure for the care of hostages, including young children, their caregivers and families, immediately following their release from prolonged captivity.MethodsA multidisciplinary expert focus group conducted a comprehensive literature review to develop the ReSPOND protocol, consisting of: Readiness of teams via multifaceted trainings, utilizing live simulations and video debriefings; Specialized professional teams experienced in providing holistic trauma-informed care; Personalized care tailored to individualized and developmentally-informed needs; Optimal safety rooted in creating a secure environment and trauma-informed response to young children, adolescents, caregivers and families; and Navigating Discharge, through coordination with community-based care systems.ResultsA designated facility at the Children’s hospital was carefully prepared for receiving 29 hostages, aged 3.9–80 years, 28% under the age of 18. Implementation of the ReSPOND protocol, which prioritized holistic psychosocial interventions above urgent medical care, proved feasible and effective in managing the diverse and complex needs of returnees as per provider report. Finally, systemic assessment of returnee’s immediate and long-term mental health needs proved highly challenging.ConclusionsThere is currently no literature addressing the response to released hostages, especially those involving infants, young children and families within a children’s hospital facility. This study has the potential to fill a crucial gap in knowledge by introducing a novel protocol which could offer valuable insights for public health organizations tasked with providing acute care to diverse individuals and families experiencing extreme, multi-layered mass traumatization.

The Trajectory of Holistic Interventions.

The Trajectory of Holistic Interventions.

Understanding Micronutrient Access through the Lens of the Social Ecological Model: Exploring the Influence of Socioeconomic Factors-A Qualitative Exploration.

Micronutrient deficiencies disproportionately affect various populations, influenced by a complex interplay of socioeconomic factors. This study delves into the intricate relationship between socioeconomic status and micronutrient access, emphasizing the perceptions of affordability, availability, and the impact of social support networks. A qualitative research design was employed, using purposive sampling to enlist a diverse cohort of participants from varied socioeconomic backgrounds. The methodology comprised semi-structured interviews and focus groups to gather detailed insights into the participants' experiences and views on micronutrient access. The analysis framework was based on the Social Ecological Model (SEM), enabling an in-depth examination of individual, interpersonal, community, and societal influences. With 30 participants, aged 20-70, representing a range of unique characteristics such as differing health conditions, cultural backgrounds, and economic statuses, the study uncovered five key themes: Individual-Level Factors, Interpersonal Relationships, Community Environment, Societal Factors, and Intersectionality. These themes illustrate how personal dietary habits, social networks, community resources, and broader socioeconomic policies converge to shape micronutrient access, emphasizing the complex interplay of overlapping social identities and structural barriers. The findings highlight the need for holistic nutrition interventions that account for the extensive spectrum of socioeconomic determinants. This study not only enriches the theoretical underpinnings of the SEM but also provides actionable insights for crafting targeted strategies to enhance micronutrient access and ameliorate dietary inequities. It advocates for comprehensive public health initiatives attuned to the nuanced needs and hurdles faced by diverse demographic sectors.

Sugary snack restriction enhances body composition improvement in overweight women engaging in non-face-to-face walking during COVID-19.

This study assesses the impact of dietary modification, specifically sugary snack restriction, in conjunction with a brisk walking program on overweight management in young overweight women, with a focus on changes in body composition and glucose metabolism. An 8-week randomized controlled trial was conducted amidst the COVID-19 pandemic, utilizing a remote intervention approach to comply with health guidelines and ensure participant safety. The study's remote nature highlights adaptability in health interventions during challenging periods, such as the COVID-19 pandemic. Twenty-one overweight Korean women aged 20-39, with an average BMI of 24.6, were selected for the study. They were divided into two groups: one engaging in brisk walking and the other combining this exercise with a sugary snack restriction, demonstrating the study's focus on comparative intervention efficacy. The exercise-only group showed notable reductions in glucose, insulin, HOMA-IR (p < 0.05), and total cholesterol levels (p < 0.01). In contrast, the group that combined exercise with dietary modification displayed more pronounced improvements in body weight, fat mass, and waist circumference (p < 0.05). This differential outcome emphasizes the added benefit of integrating dietary control with physical activity. The findings suggest that adding a dietary component, particularly a sugary snack restriction, to an exercise regimen can significantly enhance the effectiveness of overweight management in young women. This study underscores the importance of holistic lifestyle interventions that combine dietary and physical activity modifications for improved health outcomes.

Managing osteoporosis in COPD.

Chronic obstructive pulmonary disease (COPD) is a serious respiratory disease with high morbidity, disability and mortality worldwide. Every year, many people die from the disease or its comorbidities. Osteoporosis is a common complication of COPD, which can lead to increased fractures in COPD patients, aggravate the disease, and then bring great pain and burden to patients. The possible factors leading to osteoporosis in COPD patients include systemic inflammation, corticosteroid use, vitamin D deficiency, physical inactivity, tobacco exposure, lower bone mineral density, hypogonadism, hypoxia, and anemia. In clinical practice, the rate of diagnosis and treatment of osteoporosis in patients with COPD is low. Several studies demonstrated that treating osteoporosis with bisphosphonates could improve bone density, make breathing easier, and improve the quality of life of COPD patients. However, no studies have examined the effect of anti-osteoporosis therapy on fracture prevention in COPD patients. More research is needed to clarify how to implement holistic medical interventions in COPD patients with osteoporosis. We recommend that every COPD patient be screened for osteoporosis and treated with standard medications for primary osteoporosis.

What interventions have addressed the inverse care law in general practice in Scotland over the last 20 years? A systematic scoping review.

Recent evidence demonstrates persistence of the inverse care law (ICL), with fewer GPs and less funding in more deprived areas. To map out interventions that aimed to address the ICL and the rationale behind them, and to review the impact and sustainability of these interventions - what has worked, for whom, and why? The authors searched Embase, Web of Science, MEDLINE, CINAHL, Cochrane, and BASE from 2000 to 2022 for articles describing interventions or policies that aimed to address the ICL in general practice in Scotland. A systematic grey literature search of government, NHS, and third-sector websites was also performed. All articles were double screened for inclusion. Quantitative and qualitative studies were included. Other forms of primary care, such as dental or pharmacy, were not included. There were 77 included articles (35 from the database search and 42 from the grey literature) reporting on 20 interventions. Interventions were categorised as: 1) enhancing financial or social support; 2) targeting specific health conditions; 3) holistic interventions targeting specific populations; and 4) enhancing generalist care. Seven key interventions accounted for over 70% of all included articles. Evidence of impact and sustainability was variable. Key lessons were summarised for each intervention and grouped by category. To address the ICL, a key recommendation is for greater investment in general practice as part of the overall NHS spend, with graded additional resources for more deprived areas depending on local population need (a 'proportionate universalism' approach).

Intersecting Realities: Body Dysmorphic Disorder and Substance Abuse in Women – A Holistic Treatment Approach

The intersection of Body Dysmorphic Disorder (BDD) and substance abuse in women presents a clinical tableau rich with complexity and challenges. This review explores the intricate relationship between BDD—a disorder characterized by an obsessive preoccupation with perceived physical flaws—and substance abuse, where women may turn to drugs or alcohol as a maladaptive coping mechanism to alleviate the distress associated with BDD. A literature-focused methodology was employed in the study. In this context, databases such as PubMed, DergiPark, WoS, and ScienceDirect were utilized to explore the relevant literature. The analysis delves into the unique manifestation of BDD in women, influenced by societal, cultural, and psychological factors that often impose stringent beauty standards and exacerbate body image concerns. Patterns of substance abuse among women are discussed, highlighting the rapid progression from usage to dependency, known as telescoping, and the impact of societal stigma that compounds the struggles of women with addiction. Risk factors for both conditions are examined, with a focus on shared contributors such as trauma, mental health comorbidities, and societal pressures. Current treatment approaches are reviewed, advocating for an integrated model that combines psychotherapy, pharmacotherapy, and holistic or alternative interventions. The review emphasizes the importance of Cognitive Behavioral Therapy for BDD and Medication-Assisted Treatment for substance abuse, as well as the inclusion of mindfulness, meditation, and gender- The conclusion reinforces the imperative of a cohesive treatment strategy, underscoring the need for gender-specific, trauma-informed care that understands and addresses the complex interplay between BDD and substance abuse in women. This comprehensive approach promises more effective support and a hopeful pathway to recovery for women entangled in the web of these co-occurring disorders.

Spanning care and comfort: examining Pradhan Mantri Jan Arogya Yojana's role in enhancing well-being of individuals in South Gujarat

Purpose This study aims to delve into the impact of the Pradhan Mantri Jan Arogya Yojana (PMJAY) on the well-being and quality of life of beneficiaries in Surat City of India. Employing correlation and regression analyses, the study uncovers significant correlations between Awareness, Healthcare Utilisation, and Financial Burden Reduction with well-being outcomes. Design/methodology/approach The investigation employs a structured questionnaire to gather data from 250 beneficiaries, exploring the relationships between Awareness, Healthcare Utilisation, Financial Burden Reduction, Well-Being and quality of Life. The data was collected using a structured questionnaire using a survey method. Findings The results highlighted the crucial role of Awareness in empowering beneficiaries to make informed healthcare decisions, positively influencing their well-being. Furthermore, the study underscores how active engagement with PMJAY's healthcare services enhances well-being. The mitigation of financial burdens emerges as a pivotal factor, signifying the program's efficacy in improving beneficiaries' quality of life. Originality/value The comprehensive model presented in this study reveals that PMJAY's multifaceted approach is pivotal in promoting enhanced well-being and quality of life among beneficiaries. These findings affect public health policies seeking to create holistic interventions that holistically address vulnerable populations' healthcare access, financial burdens, and overall well-being.

Examining the Impact of Social Workers on Overcoming Rehabilitation Challenges for Individuals Undergoing Community Service Sentences in Butimba Central Prison, Tanzania

Globally, there is an increasing outcry on the congestion of prisoners on their welfare and human rights. To deal with such congestion, the government of Tanzania introduced the community service, intending to reduce the number of prisoners and, ultimately, the congestion of prisoners. This study aimed to examine the Impact of Social Workers on Overcoming Rehabilitation Challenges for Individuals Undergoing Community Service Sentences in Butimba Central Prison, Tanzania," The specific objectives were to investigate the specific rehabilitation challenges faced by individuals undergoing community service sentences in Butimba Central Prison, Tanzania, and to explore how social workers address these challenges. Social cognitive theory guides the study, and the study design is qualitative. Data was collected using interviews with 20 participants, observations, and document analysis. Findings highlighted pervasive stigma, discrimination, reintegration struggles, and employment difficulties among individuals in community service sentences. Social workers' interventions included counselling, family mediation, advocacy for societal acceptance, successful reintegration, reduced recidivism rates, and a more inclusive environment not adequately addressed. Social workers' challenges, including limited resources, community resistance, and legal barriers, hindered rehabilitation programs' effectiveness. The study recommended developing targeted training programs, enhancing stakeholder collaboration, and implementing evidence-based practices. The conclusion emphasised ongoing support, policy reforms, and holistic interventions in correctional settings for positive outcomes during the transition to community life

Analisis Model Pengambilan Keputusan Dalam Program Pemberian Suplemen Makanan Pada Anak-Anak Stunting Kota Surabaya

Stunting in children and toddlers is an urgent health issue in the city of Surabaya, Indonesia. This research aims to develop effective decision-making strategies in tackling stunting in the city. Through a risk factor analysis approach, evaluation of local needs, and cross-sector collaboration, a holistic and sustainable intervention strategy can be formulated. This study highlights the importance of active community involvement, including the role of mothers and families, as well as support from local governments and health institutions. Regular evaluation of program implementation and monitoring of its impact are also the main focus. Surabaya has allocated a special budget, formed a Stunting Reduction Acceleration Team, and designed an integrated recording system. Even though the food supplement program is supported by the pregnant women class, there are still obstacles such as managing a large population and low food availability. The Fishbone model is used to analyze children's nutritional needs and the factors that cause stunting. It is hoped that the results will provide practical guidance for decision makers and stakeholders in designing and implementing effective stunting prevention programs, with the ultimate aim of improving the health and welfare of children in the city of Surabaya.

Why Do More People Commit Suicide after the Economic Bubble

This paper examines the relationship between the economic recession and the high suicidal rates in Japan during the post-economic bubble in the late 1990s and early 2000s. The aim of the study is to explore the relationship between the economic recession, mental health, suicide prevalence and sociocultural dynamics. The literature review and empirical analysis show compelling evidence linking economic instability, financial distress, and unemployment to increased suicide rates. In addition, this paper explores the interplay of cultural factors for instance, stigma surrounding mental health and collective norms, in explaining the vulnerability experienced by individuals during economic recessions and hard times. Key findings emphasize the role of economic stability in increasing vulnerabilities as well as the effects of unemployment, familial relationships and self-esteem. The findings also show that the societal pressure to adhere to traditional roles, especially in times of economic uncertainty, is a key stressor affecting mental well-being. The study advocates for detailed research strategies such as interviews and surveys to further investigate causal relationships. This research provides key insights into the varying factors that contribute to suicide during economic crises, suggesting the need for holistic interventions that address both sociocultural and economic dimensions.

Impact of Deep Breathing, Murottal, and Hypertension Exercises on Headache Management in Hypertensive Individuals

Hypertension, characterized by an abnormal increase in blood pressure, often triggers headaches at the back of the head and neck due to vascular disturbances. This study explores the effectiveness of a holistic non-pharmacological intervention—comprising Deep Breathing Relaxation Technique, Qur'anic recitation (murottal), and Hypertension Exercise—to alleviate these headaches in hypertensive patients at Mekarjaya Community Health Center, Indonesia. Employing a quantitative approach, the research utilized a Quasi-Experimental Design with a Pretest and Posttest Control Group. The intervention group underwent IMAS therapy, an integrated approach combining the three techniques, while the control group continued only with routine medication. Conducted in December 2022 with 16 participants in each group, results from both Dependent and Independent T-tests (p &lt; 0.05) confirmed the significant effect of the interventions. This study not only underscores the potential of such integrative therapies in managing hypertension-related headaches but also contributes to broader health care practices by offering a viable alternative to conventional medication. The findings align with and extend existing research on relaxation therapies for hypertension, suggesting substantial benefits in patient well-being and symptom management.

Malaria Prevalence and Risk Factors in Outpatients at Teda Health Center, Northwest Ethiopia: A Cross-Sectional Study.

Despite extensive efforts and achievements made in prevention and control, malaria is still a public health problem in Ethiopia. Currently, the case number has been climbing, even changing the epidemiology to the previously low-burden reporting locations. Therefore, our study is aimed at assessing malaria prevalence and associated risk factors in outpatients, Northwest Ethiopia. A facility-based cross-sectional study was conducted among 318 malaria-suspected outpatients from October 22 to December 15, 2022, at Teda Health Center, Northwest Ethiopia. Sociodemographic characteristics and malaria risk factors were assessed by a face-to-face interview using a pretested questionnaire. Plasmodium parasites were detected by using microscopy on a blood film stained with 10% and 3% Giemsa stain. The data were analyzed using Statistical Package for Social Sciences software version 25, and statistical significance was reported at a p value < 0.05. Of the 318 study participants, 124 (39.0%; 95%CI = 33.6% - 44.6%) tested positive for Plasmodium infection. Plasmodium vivax, P. falciparum, and mixed infections were identified in 71 (57.3%), 47 (37.9%), and 6 (4.8%), respectively, among positive study participants. Individuals above the age of 15 (AOR = 2.704, 95% CI 1.370-5.336) were more likely to be infected with Plasmodium than under-five-year-old individuals. Rural residents (AOR = 2.56, 95% CI 1.281-5.098), those who sleep or work outside at night (AOR = 1.99, 95% CI 1.020-3.875), and individuals who did not use long-lasting insecticide-treated net (AOR = 3.26, 95% CI 1.633-6.499) and had a family member with a history of malaria (AOR = 2.902, 95%CI = 1.671 - 5.041) had higher odds of acquiring Plasmodium infection than their counterparts. In our study area, malaria was a major health problem, with P. vivax being the dominant species. Multiple environmental and behavioural factors were associated with the infection acquisition. Therefore, urgent holistic intervention is required.