Improvements In Psychological Health Research Articles

Impact of Alternating Exercise Intensity Interventions on the Physical and Mental Health of Middle-Aged and Young Men

Exercise interventions have been shown to improve health levels; however, the effects of different exercise intervention methods remain to be studied. This study designed seven types of exercise interventions, including high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), low-intensity steady-state training (LISS) and various alternating combinations. A 16-week follow-up investigation analyzed the impact of these different exercise interventions on participants’ physical and psychological health. The results indicate that exercise interventions are an effective health promotion method, significantly reducing BMI and body fat percentage, improving metabolic health, cardiovascular health, and cardiorespiratory function and enhancing quality of life and psychological state. Specifically, the HIIT-LISS combination performed best in reducing BMI, regulating blood lipids, and increasing VO2max. Furthermore, HIIT demonstrated the most significant improvement in body fat percentage and blood pressure, with body fat reduced by up to 5.65% and blood pressure decreasing by nearly 9 mmHg, whereas the MICT-LISS showed better effects on heart rate. Although the improvement in psychological health from different exercise interventions was not significant, it increased by over 10% compared to the control group. Overall, the combined effect of HIIT and MICT was found to be the most effective, with mixed exercise interventions showing more pronounced effects on physical health indicators.

Peer Support Interventions for People With CKD: A Scoping Review

Formalized peer support is a promising approach for addressing the emotional and practical needs of people living with chronic kidney disease (CKD). We aimed to systematically identify and summarize peer support interventions studied in individuals with CKD with or without kidney replacement therapy (KRT). We searched electronic databases and grey literature sources in March 2023. Studies of any design were eligible if they reported sufficient detail on peer support interventions and outcomes for adults with CKD with or without KRT and/or their caregivers. We extracted information on study and intervention characteristics and reported outcomes using established frameworks. We summarized quantitative data descriptively and qualitative data thematically. Our approach observed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. We included 77 studies describing 56 unique peer support interventions. Most reports were program evaluations (39%) or randomized controlled trials (27%) published after 2013. Two thirds of interventions focused on in-centre hemodialysis or mixed CKD populations, and three quarters were integrated within a kidney care clinic or program. Whereas most peer interactions centered on informational support, few programs offered focused support in areas such as transplant navigation or dialysis modality selection. Only one third of outcomes were assessed against a comparator group, with results suggesting improvements in psychological health with peer support. Heterogeneity of included studies; lack of rigorous program evaluation. This review suggests recent growth in peer support programming with a variety of formats and delivery methods to address the diverse needs of people living with kidney disease. Notable gaps in peer support availability for transplant and home dialysis recipients and the lack of rigorous evaluations present opportunities to expand the reach and impact of peer support in the kidney care context.

Relapse Prevention Group Therapy in Indonesia Involving Peers via Videoconferencing for Substance Use Disorder: Development and Feasibility Study.

Substance use disorder (SUD) is a major health issue in Indonesia, where several barriers to treatment exist, including inaccessibility to treatment services, stigma, and criminalization of drug issues. Peer involvement and the use of telemedicine to deliver psychotherapy are promising approaches to overcome these barriers. This study aims (1) to describe the development of a new group psychotherapy coprovided by a health care worker and a peer and (2) to evaluate the acceptability, practicality, and preliminary outcomes of the program delivered via videoconferencing in Indonesia. Building upon an established relapse prevention therapy in Japan, we developed a 3-month weekly group therapy module in the Indonesian language. Adjustments were made via focus group discussions with local stakeholders in terms of substance types, understandability, inclusive language, and cultural relevance. A pilot study was conducted to test the new module provided by a peer and a psychiatrist via videoconferencing, termed tele-Indonesia Drug Addiction Relapse Prevention Program (tele-Indo-DARPP), with a pre- and postcontrolled design. We analyzed data from semistructured feedback interviews and outcome measurements, including the number of days using substances and quality of life, and compared the intervention (tele-Indo-DARPP added to treatment as usual [TAU]) and control (TAU only) arms. In total, 8 people diagnosed with SUD participated in the pilot study with a mean age of 37 (SD 12.8) years. All were men, and 7 (88%) used sedatives as the primary substance. Collectively, they attended 44 of the 48 tele-Indo-DARPP sessions. A total of 3 out of 4 (75%) preferred telemedicine rather than in-person therapy. Positive acceptability and practicality were shown from qualitative feedback, in which the participants who joined the tele-Indo-DARPP reported that they liked the convenience of joining from home and that they were able to open up about personal matters, received helpful advice from peers, and received support from other participants. Providers reported that they feel the module was provider-friendly, and the session was convenient to join without diminishing rapport-building. Meanwhile, troubles with the internet connection and difficulty in comprehending some terminology in the workbook were reported. The intervention arm showed better improvements in psychological health and anxiety symptoms. Group psychotherapy via videoconferencing coprovided by health care workers and peers was acceptable and practical for participants with SUD and service providers in this study. A large-scale study is warranted to examine the effectiveness of the newly developed module in Indonesia.

Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions

Although there is substantial evidence to suggest the health benefits of acceptance and commitment therapy (ACT) among informal caregivers of people with chronic health conditions, the great variation in intervention designs among published studies limits its application. To identify intervention characteristics of ACT that are associated with improved psychological health and to assess the acceptability of ACT among informal caregivers. Seven English- and 3 Chinese-language databases without limits on publication dates, the reference lists of previous reviews, and gray literature were searched up to February 2023. Randomized clinical trials comparing the effect of ACT vs control groups on improving psychological health among informal caregivers. Two reviewers independently screened searched records and extracted data from eligible studies. Random-effects meta-analysis and mixed-effects metaregression were performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Psychological health outcomes (eg, depressive symptoms) measured by valid measurements and the acceptability of ACT based on identified parameters. A total of 29 studies with 2010 participants, published between 2015 and 2023, were identified. ACT showed moderate to large effect sizes for improving psychological health at postintervention assessments (Hedges g range, -0.55 [95% CI, -0.98 to -0.12] to -1.14 [95% CI, -1.83 to -0.45]) and at 1-to-3-month and 4-to-6-month follow-ups (Hedges g range, -0.47 [95% CI, -0.69 to -0.25] to -1.29 [95% CI, -2.33 to -0.24]). Multivariable metaregression analysis regarding intervention characteristics found that ACT delivered in a mixed individual- and group-based format, face-to-face, or through more intervention sessions was associated with greater improvements for experiential avoidance (face-to-face: β = -1.170 [95% CI, -2.020 to -0.319]; number of sessions: β = -0.242 [95% CI, -0.353 to -0.130]), depressive symptoms (mixed delivery format: β = -2.583 [95% CI, -4.845 to -0.321]; face-to-face: β = -1.555 [95% CI, -3.002 to -0.108]), or anxiety symptoms (face-to-face: β = -1.241 [95% CI, -2.337 to -0.146]). In general, ACT had low attrition rates (11%), and participants' adherence (51%-80%) and satisfactory ratings (72%-95%) lend support to its acceptability. This systematic review and meta-analysis found that ACT was consistently associated with improvements in psychological health, supporting its application to improve informal care for chronic disease management. This review provides specific details on the design parameters of ACT for achieving greater efficacy.

The effectiveness of the National Veterans Summer Sports Clinic for veterans with probable posttraumatic stress disorder.

Recreational and adaptive sports programs may be beneficial therapeutic interventions for improving psychological outcomes among veterans and service members with posttraumatic stress disorder (PTSD) because they provide opportunities for exercise, socialization, respite, and time outdoors. Although there are an increasing number of sports programs for veterans and service members with PTSD, data evaluating the outcomes of such programs are limited. The sample included 74 U.S. veterans who participated in the National Veterans Summer Sports Clinic (NVSSC), an annual, week-long adaptive sports program in San Diego, California. Participants were categorized into two subgroups: those who met criteria for probable PTSD using the PTSD Checklist for DSM-5 (n = 20) and those who did not (n = 54). Participants completed self-report assessments before and after each daily activity, before and after the program, and 3 months following program completion. Over the course of NVSSC program participation, the diagnostic subgroups (probable PTSD vs. no PTSD) did not significantly differ on changes in depression, positive affect, negative affect, or insomnia. Compared to those without PTSD, veterans with PTSD experienced greater reduction in generalized anxiety during the program (MD = -3.07, p = 0.034). Veterans with PTSD also experienced significant improvements in PTSD symptoms at postprogram (MD = -23.76, p < 0.001). For both groups, significant benefits were shown during the program but rebounded by the 3-month follow-up. Over the course of each daily activity, positive affect (MD = 2.71, p < 0.001) and depression/anxiety scores significantly decreased (MD = -0.75, p < 0.001), with no differences between PTSD diagnostic groups across time (ps = 0.714 and 0.961, respectively). Veterans with and without PTSD benefited from participation in the NVSSC. Participants with probable PTSD experienced greater improvements in generalized anxiety at postprogram only; there were no other significant differences between the two groups at postprogram or at 3-month follow-up. In line with prior research, benefits for those with PTSD were lost by 3-month follow-up, suggesting that regular engagement in recreational and adaptive sports may be necessary to sustain psychological health improvements.

Effects of Liraglutide 3.0 mg Injection on Weight Reduction and Metabolic Parameters for Patients Living with Obesity and Type 2 Diabetes Mellitus

Background: By 2025, it is projected that one billion adults will be classified as having obesity worldwide. Unfortunately, the disease of obesity remains vastly undertreated. As an example, in the United States, nearly half of the adults meet recommendations for anti-obesity pharmacotherapy (defined as having a BMI ≥ 30, or a BMI ≥ 27 with weight-related diseases).&#x0D; Owing to its impact on weight loss, remission of diabetes mellitus, and metabolic syndrome, treatment of obesity with medical therapy like Liraglutide 3.0 mg injection has offered hope for obese individuals. In recent years, obesity has increased in the UAE and the use of medical treatment for obesity has increased in-line with this trend. However, data regarding medical treatment for obesity outcomes in diabetic and non-diabetic Emirati people is scarce.&#x0D; Objectives: The primary objective of the study is to evaluate the effect of Liraglutide 3.0 mg injection for weight management in patients with diabetes mellitus. In addition, we evaluated the impact of weight reduction in improving the metabolic parameters (HbA1c and LDL-c for a patient living with type2 diabetes).&#x0D; Secondary objectives include improvement of infertility in females with PCOS and improvement of psychological well-being, functional capacity and quality of life. Also, we evaluated the response post-bariatric group who received Liraglutide 3.0 mg to treat their post-bariatric weight regain.&#x0D; Results: In terms of weight changes, the average weight at baseline was 100.98 kg and had decreased to 97.54 kg, 96.00 kg, and 96.37 kg at 3, 6, and 12 months, respectively. Males experienced a greater rate of weight reduction than females, while diabetic patients had a lower percentage of weight loss than non-diabetic patients. Additionally, patients with PCOS were able to conceive after reducing 10% of their body weight after using Liraglutide, while the remaining 15 patients who were married but unable to conceive had an improvement in their menstrual cycle and hirsutism.&#x0D; Conclusion: The results demonstrated that Liraglutide helps to induce and sustain weight loss in patients with obesity. It is an effective treatment for weight reduction and offers the unique benefit of improved glycaemic control. In addition, the study identified a correlation between weight reduction and improvements in psychological health, quality of life, and fertility in females with PCOS. Additional studies are needed to determine its long-term efficacy and safety profile.

Self-forgiveness, self-compassion and psychological health: A qualitative exploration of change during compassion focused therapy groups.

Little research exists into the relationships between self-forgiveness, self-compassion, affect and psychological health, and are only just beginning to be explored within the self-compassion and the Compassion-Focused Therapy (CFT) literature. This qualitative study (n= 31) utilised Thematic Analysis (TA) to understand participants' experiences of participating in a 12-week compassion-focused therapy group. Thematic analysis yielded two major themes: 'becoming self-compassionate and self-forgiving', and 'the CFT group was beneficial'. The first major theme reflected participants' growing familiarity, awareness and insight into their inhibitions to and the benefits of self-compassion and self-forgiveness, their capacities for self-condemnation, becoming appropriately responsible for their thoughts and actions, and the links between self-compassion and the process of self-forgiveness. The second major theme reflected participants' impressions that taking part in the CFT group and developing CFT skills had facilitated personal change through taking compassionate ownership for their thoughts and feelings about themselves and their mistakes, rather than condemning themselves and others. Participants reported that these changes helped to regulate their negative affect through the development of more compassionate and balanced thinking about their mistakes, leading to improvements in psychological health. The findings of this study provide explanations of the processes of change in CFT in relation to self-forgiveness, affect and psychological health and contribute to the theory and practice of CFT especially as practiced within a group format.

PSUN189 Psychological Treatment for Diabetes Distress is Associated with Reduction in HbA1c, Emergency Department Presentations and Improvement in Psychological Health.

Abstract Introduction Patients with diabetes distress (DD) experience poorer health outcomes than patients with diabetes mellitus (DM) who do not experience DD. However, few studies have examined whether treatment for DD delivered by a psychologist embedded in a multi-disciplinary team (MDT) improves not only psychological health, but glycaemic control and other physical health outcomes, especially in low socioeconomic populations. Method: This study examined the impact of intervention by a clinical psychologist, as part of an outpatient MDT at a tertiary referral hospital diabetes service, on glycaemic control, emergency presentations and hospital admissions, diabetes distress, depression, anxiety and stress symptoms. Inclusion criteria were high DD indicated by a Problem Areas in Diabetes (PAID) questionnaire score ≥ 40, together with either 1) recent diabetes-related hospitalisation, 2) HbA1c &amp;gt;8% or 3) conflict over diabetes management with family or healthcare professionals, such as difficulty aligning diabetes management goals. Measures at baseline and treatment completion were the PAID questionnaire, the 21-item Depression, Anxiety, Stress Scale (DASS21), HbA1c, and number of emergency department presentations and hospital admissions in the three months before and after treatment commencement. Participants were assessed and treated by a clinical psychologist in addition to existing treatment by the MDT (which could include a diabetes educator, endocrinologist and dietician). Psychological treatment was individually determined, based on participants’ needs, and included cognitive therapy for health beliefs, mindfulness, distress tolerance, behavioural activation, problem solving, interpersonal effectiveness, Cognitive Behaviour Therapy (CBT) for disordered eating, and blood glucose awareness training. CBT for depression or anxiety was used as an adjunct where clinically indicated. Length of treatment and frequency of sessions varied depending on individual needs. Results Participants were 67 outpatients with DM aged 16-82 years, (72% female) in an area with a high prevalence of socio-economic disadvantage. Forty five patients had Type 1DM, 21 had Type 2DM and 2 had other or undefined DM type. Mean HbA1c decreased from 9.25% pre-treatment to 8.27% in the three months post treatment (p&amp;lt;0.001). Emergency department presentations halved (p&amp;lt;0.05). All psychological variables showed significant improvement: DD measured by PAID decreased from 57.5 to 33.03 (p &amp;lt;0.0001); DASS21 depression scores reduced from 11.17 to 7.36, anxiety scores reduced from 9.4 to 6.03, and stress scores from 12.29 to 9.46 (p&amp;lt;0.0001 for all). Hospital admission numbers did not change post intervention. Controlling for diabetes type, duration and gender did not have a significant impact on any outcome variable. Conclusion This study provides evidence that treatment by a clinical psychologist can improve both physical and psychological health outcomes for people with diabetes distress and should be considered standard of care for people experiencing diabetes distress with high HbA1c, diabetes related hospitalisation or conflict with family or healthcare professionals around diabetes management. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Role of Yoga on Glycaemic Control and Other Health Parameters in Type 2 Diabetes Mellitus (T2DM) – A Review of Controlled Studies

It is reported that about 1 in 11 adults have diabetes mellitus (DM) globally. A total of 415 million people have DM and an estimated 193 million people have undiagnosed DM worldwide. Where, type 2 diabetes mellitus (T2DM) accounts for around 90% of patients with DM. Yoga interventions appeared to be more effective in T2DM as compared to physical exercise interventions which may be because of various aspects of yoga other than the physical one. The yoga intervention involves subtle components such as mindfulness, relaxation, breath regulation, and notional corrections. The mechanism through which yoga works may be the down-regulation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis which may lead to the improvement in psychological health, quality of sleep, autonomic balance, and reduction in insulin resistance. Lifestyle modification programs such as yoga interventions on a regular basis for long duration have potential to manage and cure T2DM. The government and the concerned bodies should pay attention to this area.

The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: A randomized controlled trial

Introduction The aim of this research was to investigate the effects of telerehabilitation-based remote supervised or unsupervised structured exercise therapy on pain, disability, and quality of life related to chronic nonspecific neck pain. Method The study was designed as a single-blinded randomized controlled trial. Sixty-six eligible chronic nonspecific neck pain patients were randomized across three groups: remote supervised group (RSG, n = 22), unsupervised group (UG, n = 22), and waitlist control group (CG, n = 22). Progressive structured exercise therapy program was delivered weekly to patients in remote supervised group and unsupervised group to perform four days a week for four weeks. Remote supervised group was supervised by videoconference and text message. Pain, disability, and quality of life of participants were assessed at baseline, week 2, and post-therapy. Results Post-therapy pain and disability total change scores were −3.64 (95% CI −4.85 to −2.42) and −7.27 (95% CI −11.05 to −3.50) for remote supervised group compared with a change of −2.44 (95% CI −3.46 to −1.43) and −5.77 (95% CI −8.54 to −3.01) for unsupervised group, respectively. Post-therapy, quality of life improvements were greater for remote supervised group than unsupervised group overall (general health; remote supervised group: 19.01 (95% CI 6.86 to 31.16), unsupervised group: 12.50 (95% CI 4.79 to 20.21), and physical health; remote supervised group: 18.35 (95% CI 10.35 to 26.35), unsupervised group: 7.31 (95% CI 0.01 to 14.60)). Significant improvements in psychological health and environment-telerehabilitation for remote supervised group were not seen for unsupervised group and outcomes differences did not reach significance for control group (p > 0.05) post-therapy, except environment-telerehabilitation. Discussion Structured exercise therapy can improve chronic nonspecific neck pain outcomes when remotely supervised or unsupervised. Structured exercise therapy content and frequent communication are important for remote chronic nonspecific neck pain management.

An Innovative Program Using Magic to Provide Early Clinical Experiences for Preclinical Medical Students: Goals, Experiences, and Results of the MagicAid Program.

ObjectiveEffectively training medical students in compassion, communication, and empathy is essential in fostering a holistic approach to patient care. We sought to address this by implementing an early clinical experience service learning program for medical students in the initial years of their medical education.MethodsMedical students at Stony Brook University initiated, designed, and facilitated the volunteer program, which provides students a framework to learn magic therapy and engage with pediatric patients. The program includes an introductory presentation, training course, and organized bedside sessions with patients. To evaluate the program, a sample of participants partook in a focus group, written questionnaire, and/or online survey.ResultsFrom 2015 to 2020, 130 students participated in magic therapy rounds, engaging 1391 patients. Nine themes of student benefit emerged from qualitative analysis, including acquisition of familiarity with the hospital and healthcare team, cultivation of communication skills, contribution to improvement of patient affect, development of empathic qualities and techniques, and improvement in psychological health. Students were very satisfied with their experiences and viewed the activity as helpful for patients, parents, staff, and themselves.ConclusionsThe program engaged students in compassionate patient care within a holistic approach to patient care early in training.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40670-021-01456-y.

Exploring the impact of a transdiagnostic cognitive behavioural therapy-based intervention on a group of Malaysian adolescents with problematic drug use and emotional problems

IntroductionAdolescents with problematic substance use frequently have anxiety and depression and tend to have “unhealthy” lifestyle such as having poor dietary patterns and physical inactivity. The overall aim of the present study was to explore the impact of a Transdiagnostic Cognitive Behavioral Therapy-based Intervention (“Super Skills for Life” – adolescent version; SSL-A) on emotional problems among adolescents with problematic substance use and to identify demographic factors which influence the intervention outcomes. MethodA total of 108 adolescents (M = 16.30 years, SD = 1.6) with problematic substance use who showed high levels of anxiety and depression participated in this study. They completed a set of questionnaires to measure substance use, mental health problems, cognitive emotion regulation strategies, loneliness, and lifestyle and habits at pre- and post-intervention. ResultsThe adolescents reported less emotional symptoms and more prosocial behavior after the intervention. These adolescents were also consumed less substance and used less maladaptive emotion regulation strategies after participating in SSL-A. Females compared to males showed more treatment gains (i.e., reduction in loneliness and improvement in psychological health and self-esteem) after the intervention. ConclusionThis study provides empirical evidence for the utility of the SSL-A in reducing emotional problems and substance use among adolescents with problematic substance use.

Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis.

PurposeThis study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor.MethodsThe following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality.ResultsTwenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges’ g=–0.67; 95% confidence interval [CI], –0.91 to –0.44), gestational diabetes (Hedges’ g=–0.38; 95% CI, –0.54 to –0.12), and preterm labor (Hedges’ g=–0.73; 95% CI, –1.00 to –0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias.ConclusionNonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.

E-Health as a tool to improve the quality of life of informal caregivers dealing with stroke patients: Systematic review with meta-analysis.

The objective of this review was to elucidate the evidence related to utilizing e-Health as a tool in improving the quality of life of informal caregivers of dependent patients due to cerebrovascular accident (CVA). This systematic review with meta-analysis includes 13studies. For these studies, seven databases were searched between 2009 and 2019. A random-effects model was adopted for overall estimation and to explain the heterogeneity. A random-effects model was adopted for overall estimation and to explain heterogeneity. The results did not demonstrate statistical significance (p<0.05) and low heterogeneity (I2 =0). There is a tendency toward improvement in psychological health, solving care-related problems, as well as better prevention of problems arising from the burden. Therefore, new studies with larger sample size and primarily to conduct them for more than 6months for the accuracy. This study reflects a trend toward improving psychological health, solving care-related problems, as well as improved the prevention of problems arising from the burden.

“Death groups” through the prism of the theory of routine actions

This article analyzes the emergence of the phenomenon of suicidal communities in the Russian cyberspace from the perspective of the widespread in modern criminology theory of routine actions. The relevance of the selected topic is substantiated by the fact that despite a variety of studies dedicated to &amp;ldquo;death groups&amp;rdquo;, the problems associated with encouraging or assisting suicide using the Internet platforms are not fully covered in the view of criminological science. At the same time, there is urgent need for criminological research of this phenomenon due to the qualitative transformation of criminality &amp;ndash; use of the Internet platforms for inflicting harm to human life and health without direct physical and psychological abuse is a distinguishing feature of the modern world. The subject of this research is the key concepts of the theory of routine actions (&amp;ldquo;motivated criminal&amp;rdquo;, &amp;ldquo;potential victim&amp;rdquo;, &amp;ldquo;no external control&amp;rdquo;) applicable to the problem under review. The author explores certain psychological and cultural aspects that characterize the modern younger generation (increased engagement in social media, more tolerant perception). It is concluded that criminalization of relationships developing between people in social media naturally increased criminality due to the emergence of new ways of communication in modern world. The author believes that the effective method to minimize the category of such type of crimes consists in promotion of the state policy aimed at improvement of psychological health of the population.

Therapeutic effects of traditional Thai herbal blood and wind tonic formulations for treatment of menopausal symptoms

IntroductionTraditional Thai herbal medicine formulations have been used as alternative therapies for menopausal symptoms due to concerns from adverse effects associated with hormone therapy. This study aimed to demonstrate the effects of traditional Thai herbal blood and wind tonic formulations used by a traditional Thai medicine doctor, Mr. Somporn Chanwanitsakul, in postmenopausal women. Materials and methodsA pilot clinical study was conducted on thirty-five postmenopausal women, referring to Tambon Thung Tam Sao Health Promotion Hospital, Hat Yai, Songkhla, from October 2019 to March 2020. The participants consumed combined Thai herbal formulations including blood tonic and wind tonic thrice daily for four weeks. Outcomes were assessed at baseline, end of treatment (4 weeks), and follow-up (8 weeks). Pre- and post-treatment measures included menopause rating scale, sleep quality, and quality of life questionnaire. All data were analyzed using SPSS software at the significance level of 0.05. ResultsTherapeutic effects of Thai herbal medicine formulations on menopausal symptoms intensity were assessed by modified Menopause Rating Scale (MRS). Severity of women's total menopausal symptoms decreased significantly (p < 0.05) at end of treatment and follow-up. Analysis of changes in specific symptoms indicated significantly less moderate headache, mild hot flashes, sweating, emotional instability, irritability, anxiety, sleep problem, lethargy, back pain, joint pain, muscular discomfort, dry skin, dryness of vagina, boring sex, and frequent urination (MRS score 0). In addition, subjective analysis of sleep quality using Pittsburgh Sleep Quality Index (PSQI) data revealed significant post-treatment improvements in subjective sleep quality and daytime dysfunction over the last month (PSQI score 0). Furthermore, subjective analysis of quality of life using World Health Organization Quality of Life Brief showed significant post-treatment improvement in psychological health (score 23). ConclusionThe findings demonstrate that Thai herbal medicine formulations used by a traditional Thai medicine doctor, Mr. Somporn Chanwanitsakul, are effective for treating menopausal symptoms and improve sleep quality and quality of life in postmenopausal women.

Proactive psychological programs designed to mitigate posttraumatic stress injuries among at-risk workers: a systematic review and meta-analysis

BackgroundPublic safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTE) and developing posttraumatic stress injuries (PTSI, e.g., depression, anxiety) by the nature of their work. PTSI are also linked to increased absenteeism, suicidality, and performance decrements, which compromise occupational and public health and safety in trauma-exposed workers. Evidence is lacking regarding the effectiveness of “prevention” programs designed to mitigate PTSI proactively. The purpose of this review is to measure the effectiveness of proactive PTSI mitigation programs among occupational groups exposed to PPTE on measures of PTSI symptoms, absenteeism, and psychological wellness.MethodsFive electronic databases were searched per PRISMA guidelines for English or French peer-reviewed studies from 2008 to 2019 evaluating PTSI and psychological wellness in adults exposed to occupational PPTE. The risk of bias was assessed using the Newcastle-Ottawa Scale.ResultsWe identified 42 studies evaluating 3182 public safety and frontline healthcare professionals, PPTE-exposed educational staff, and miners. Significant overlap was found across program themes that included mindfulness, psychoeducation, resilience promotion, and stress management strategies. Post-program effect sizes were small (SMD < 0.5) to moderate (SMD < 0.8) for reductions in PTSI symptoms and for promoting measures of well-being as indicated by a meta-analysis on 36 studies. There was no evidence for significant reductions in substance use, absenteeism, or biomarkers of distress except for heart rate. Subgroup analyses indicated that multimodal programs effectively improved general psychological health, while resilience programs improved measures of depression, burnout, coping, and resilience. Effect sizes for resilience, depression, and general psychological health improvements were greatest immediately or 1-month post-training, while improvements in PTSD symptoms and coping were larger at longer follow-up. Studies were of moderate quality and risk of bias.ConclusionsThe current results showcase modest evidence for time-limited reductions in PTSI following participation in holistic programs that promote resilience, stress, and emotion regulation among at-risk workers. Implications for organizational implementation of proactive PTSI mitigation programs and areas of future research are discussed.Systematic review registrationPROSPERO (CRD42019133534)

Efficacy of Cognitive Training When Translated From the Laboratory to the Real World.

Research shows that cognitive performance and emotional well-being can be significantly strengthened. A high-performance brain training protocol, Strategic Memory Advanced Reasoning Training (SMART), was developed by cognitive neuroscientists at The University of Texas at Dallas Center for BrainHealth based on 25-plus years of scientific study. Randomized controlled trials with various populations have shown that training and use of nine "SMART" strategies for processing information can improve cognitive performance and psychological health. However, the multi-week intensive training used in the laboratory is not practical for widespread use outside the laboratory. This article examines the efficacy of SMART when translated outside the laboratory to two populations (military/veterans and law enforcement) that received SMART in condensed time frames. In two translation studies with healthy military personnel and veterans, 425 participants received between 6 and 10 hours of SMART over 2 days. In a third translation study, 74 healthy police officers received 9 hours of SMART over 3 days. Training was conducted by clinicians who taught the nine "SMART" strategies related to three core areas-strategic attention, integrated reasoning, and innovation-to groups of up to 25 participants. In all three translation studies, cognitive performance and psychological health data were collected before and immediately following the training. In one of the military/veteran studies, psychological health data were also collected 1 and 4 months following the training. In both translations to military personnel and veterans, there were improvements in the complex cognitive domains of integrated reasoning (P < .0001) and innovation (P < .0001) immediately after undergoing SMART. In the translation to police officers, there were improvements in the cognitive domains of innovation (P = .02) and strategic attention (P = .005). Participants in all three translations saw statistically significant improvements in self-reported symptoms of psychological health. The improvements continued among a subset of participants who responded to the later requests for information. The results of translating to these two populations provide evidence supporting the efficacy of SMART delivered in an abbreviated time frame. The improvements in two major domains of cognitive function demonstrate that strategies can be taught and immediately applied by those receiving the training. The immediate psychological health improvements may be transient; however, the continued improvements in psychological health observed in a subset of the participants suggest that benefits may be sustainable even at later intervals.

Testing direct and indirect effects of green space availability on reproductive outcomes

Background/Aim:Adverse reproductive effects can lead to cognitive development problems, medical conditions, morbidity and mortality in future stages of lives. Surrounding residential greenness has a positive effect in reproductive health. Different studies have proposed that this effect could be both direct and indirect. Indirect effects of greenness may happen through the reduction of environmental exposure (air pollution, noise and temperature regulation), the promotion of physical activity and the improvement of psychological health. The aim of the study was to analyze the relationship between surrounding residential greenness and reproductive health, studying the possible role of said mediators.Methods:441 pregnant women (mean age 33.52, SD = 4.88) were recruited in Donostialdea, Basque Country, Spain, during the first ultrasound in the Basque Health Service. After signing the informed consent form, participants were given the study questionnaire and one accelerometer (ActiGraph GT3X-BT) which they used it for one week. In the second trimester of pregnancy they repeated the whole process again. Environmental exposures (NO2 and availability of &gt;5000 m2 green space in 300m) were assigned to all participants. Moderate to Vigorous Physical Activity (MVPA) was determined with the accelerometer. Psychological health was measured with the General Health Questionnaire (GHQ-12). Birth weight, preterm birth, small and large for gestational age (SGA &amp; LGA) were defined as outcome variables and newborn sex, season, deprivation index and parity as covariates. Natural effects models were used to analyze aforementioned direct and indirect effects.Results:Greenness availability had a negative effect on birth weight (-138g; p-value = 0.022). A marginal protective effect of greenness availability on LGA (OR = 0.54; p-value = 0.091) was detected in the model with GHQ as mediator.Conclusions:Greenness availability in 300m had limited effects on reproductive outcomes. Using other measures of greenness may help to understand this question better.

Quality of life after gender reassignment surgery in transwomen

Background: Gender dysphoria is a condition in which there is discrepancy between a person's gender identity and that person's sex assigned at birth. Gender reassignment surgery (GRS) has an important role in alleviating the distress caused by gender dysphoria and it is medically necessary. The literature on quality of life (QoL) of transgenders post-GRS is limited in India.Methods: This is a prospective study on transgender women who volunteered to undergo male to female (MtF) GRS from March 2015 to August 2017. The demographic details and the surgical complications were registered. The Quality of life using the WHOQOL-BREF questionnaire was measured both before and a year after the surgery. The data were compared and presented.Results: A total of 62 GRS were performed during the study period. In that, 43 patients are literate (69.35%) and only 31.93% are employed in a socially respectable position. Our study shows significant improvement in physical, psychological and social health domains after the Surgery. Highest improvement was observed in the psychological health domain. There were no major complications observed in our study group.Conclusions: The surgical management improved the QOL in the first three domains of WHOQOL-BREF instrument namely physical health, psychological health and social relationship. Among these three domains, there is a significant improvement in psychological health. Hence, GRS has an important role in relieving the psychological distress caused by gender dysphoria and significantly improves the quality of life postoperatively.