WHO-5 Well-being Index Research Articles

Assessment of lifestyle and health-related behaviors and correlates during the COVID-19 pandemic among Lebanese adults

IntroductionThe novel coronavirus disease 2019 (COVID-19) has quickly become a worldwide threat to human health and has significantly impacted people’s lives and changed their lifestyles and health behaviors. This study aims to assess lifestyle and health-related behaviors (LHBs) and associated factors among the general population in Lebanon during the COVID-19 pandemic.MethodsAn online cross-sectional study was conducted among 403 Lebanese adults. The study questionnaire was developed on Google Forms in English and Arabic. It included self-reported questions about sociodemographic characteristics, COVID-19, and perceived behavioral changes (smoking, alcohol consumption, sexual and hygiene behaviors, and intake of nutritional supplements and immunity-boosting foods). It also comprised three scales, i.e., the Lifestyle and Health Behaviors questionnaire (LHB-17), the WHO-5 Well-being Index, and the Fear of COVID-19 scale (FCV-19S).ResultsThe mean age of participants was 29.74 ± 10.81 years, with 51.2% females. Most participants reported that COVID-19 negatively affected their LHBs, mainly diet, sleep, and psychological well-being, while physical activity aspects remained unaffected. Female gender (Unstandardized Beta (ß) = − 2.336), living in Lebanon (ß = − 7.502), nargileh smoking (ß = − 3.433), high BMI (ß = − 0.263), and increased daily usage of electronic devices during the COVID-19 lockdown (ß = − 0.853) were significantly associated with lower LHB-17 scores, indicating worsened LHB. However, living in urban areas (ß = 2.464), employment status (ß = 1.920), good overall health (ß = 3.543), a higher quality of life (ß = 0.204), and unaffected physical (ß = 2.101) and mental (ß = 1.586) health during the COVID-19 lockdown were all significantly associated with higher LHB-17 scores, reflecting positive LHB.ConclusionLebanese adults reported several unfavorable lifestyle changes and psychological problems during the lockdown due to COVID-19, particularly affecting women, non-workers, waterpipe smokers, electronic device heavy users, people of lower socioeconomic status, and those with chronic diseases. Health promotion strategies are needed to assess negative changes both in physical and mental health and maintain as many positive health-related behaviors as possible among the Lebanese population.

A Randomized Controlled Trial of the Safety and Efficacy of Systemic Enzyme Supplementation on Symptoms and Quality of Life in Patients with Idiopathic Pulmonary Fibrosis.

Idiopathic pulmonary fibrosis (IPF) imposes a substantial symptom burden that adversely impacts patients' quality of life. Current anti-fibrotic treatments for IPF provide limited symptomatic relief, necessitating the implementation of complementary disease management strategies to enhance health-related quality of life (HRQOL). Serracor-NK® and Serra Rx260, systemic enzyme supplements, improved symptoms and HRQOL with favorable safety profiles in a proof-of-concept study in PF patients. This prospective, double-blind randomized placebo-controlled trial enrolled 100 IPF patients from six institutions. The supplement group (n = 50) received the oral systemic enzyme supplements Serracor-NK® and Serra Rx260 in addition to standard care for 6 months, while the placebo group (n = 50) received standard care alone. The primary objective was to evaluate the regimen's impact on symptoms, QOL, and well-being using the UCSD shortness of breath (UCSD-SOB) questionnaire, St. George's respiratory questionnaire (SGRQ), and WHO well-being index (WHO-5). Safety evaluation was a secondary objective. A significantly higher proportion of patients in the supplement group demonstrated meaningful improvement in symptoms as compared to the placebo group, as assessed by the UCSD-SOB (p < 0.05) and SGRQ questionnaires (p < 0.05). Additionally, a significantly greater proportion of patients in the supplement group showed improved QOL and well-being (p < 0.05) and reduced health impairment (p < 0.05), as assessed by SGRQ. Mental well-being (WHO-5) and physical activity (SGRQ activity domain) did not differ significantly between the groups. Safety assessments, including liver function tests and vital signs, indicated that the supplement regimen was well tolerated. To conclude, Serracor-NK® and Serra Rx260 alleviate symptoms and enhance HRQOL in IPF patients with a favorable safety profile (Clinical Trials Registry India registration number: CTRI/2020/05/025374).

Association Between Organizational Downsizing and Depressive Symptoms Among Korean Workers: A Cross-sectional Analysis

BackgroundOrganizational downsizing may be significantly linked to depressive symptoms, yet research on this impact in Asian contexts is limited. This study investigates the association between downsizing during the COVID-19 pandemic and depressive symptoms across diverse employment statuses. MethodsThis study used the data from 6th Korean Working Conditions Survey. Depressive symptoms were measured using WHO-5 well-being index with a cut-off of 50. Downsizing was defined as decrease in the number of employees during last three years. Multivariable logistic regression adjusted for socio-demographic and occupational factors was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (CI) for depressive symptoms associated with downsizing, including subgroup analyses. ResultsAmong 26,247 Korean workers (mean age: 43.4, men: 47.5%), the prevalence of depressive symptoms was 29.5% (n = 7,751), and the proportion of downsizing was 15.2% (n = 3,978). The prevalence of depressive symptoms was significantly higher among the downsizing group (36.7%, n = 1,460) than among the no-downsizing group (28.3%, n = 6,291). The result of logistic regression revealed a significant association between downsizing and depressive symptoms (adjusted OR [95% CI]: 1.39 [1.29–1.50]), particularly pronounced among high socioeconomic status workers. ConclusionThis study underscores the significant association between depressive symptoms and organizational downsizing, especially high vulnerability of socioeconomically advantaged and stable workers. These findings highlight the necessity for targeted mental health support and further longitudinal research to clarify the relationship between employment changes and mental health within the Korean workforce.

Subjective household poverty as a moderator for the association between employment precariousness and mental health across five european welfare state types

ObjectivesTo create better understanding of the mechanisms underlying the association between employment precariousness (EP) and mental health by considering household poverty as a moderator while stratifying for gender across welfare state types (WSTs): Scandinavian, South European, Central- and East European, Bismarckian and Anglo-Saxon. MethodsData from the sixth wave of the European Working Conditions Survey (N = 18,725) was used. The Employment Precariousness Scale was used to assess EP on a continuous scale. Mental health was measured using the WHO-5 Well-Being Index. A binary variable for subjective household poverty was created. We estimated gender-stratified, multi-level models with a random intercept at country-level for the association between EP and mental health, with an interaction term between EP and subjective household poverty, for each WST separately. Models were adjusted for age, education, having a partner and having children under age 18 in the household. ResultsIn all WSTs, among men as well as women, we found a negative relation between EP and mental health. Among women, this relation was not moderated by household poverty. Among men in the Anglo-Saxon WST, the negative relation between EP and mental health was stronger among employees that reported household poverty compared to those who did not report household poverty. ConclusionsEvidence of a moderating effect of household poverty on the association between EP and mental health was only found amongst men in the Anglo-Saxon WSTs and the combined full sample. Other factors that might affect the association between EP and mental health should be investigated.

Wellness and its correlation with vitamin D

Abstract Background: Wellness encompasses various interconnected physical, mental, and social dimensions beyond the traditional definition of health. Vitamin D deficiency is a widespread nutritional deficiency, with a prevalence of 80%–90% in India, and is often under-diagnosed and under-treated worldwide. While vitamin D is classically known for its role in bone health, it also has significant extra-skeletal effects, including maintaining muscle function, immunity, anti-inflammatory activity, and cell proliferation and differentiation. Recent studies have linked vitamin D deficiency to fatigue, myalgia, low-energy fractures, muscle weakness, anxiety, and depression. Furthermore, it is implicated in the development of type 1 and type 2 diabetes mellitus (DM) and hypertension. Vitamin D deficiency is also associated with recurrent exacerbations of bronchial asthma, autoimmune diseases, and malignancies. Addressing this deficiency can substantially enhance patient well-being, prevent serious health outcomes, and improve overall wellness. Aim: This study aims to investigate the relationship between wellness and vitamin D levels. Materials and Methods: This prospective nonrandomized therapeutic study was conducted at MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India, and included 246 participants from July 2021 to December 2022. The study included patients reporting generalized weakness, fatigue, myalgia, low mood, lack of motivation, and decreased interest in life by the inclusion and exclusion criteria. Their serum vitamin D levels were tested. Participants with vitamin D deficiency (&lt;30 ng/mL) completed a pre-structured well-being questionnaire and received vitamin D supplementation for 10 weeks. Wellness in these patients was evaluated using a pre-structured post-supplementation well-being questionnaire. Results: The results revealed that out of 324 patients included in the study, 253 (78.1%) were deficient in vitamin D. The highest deficiency rate was among those aged 18–35 years (85.5%). Vitamin D deficiency was more prevalent in females (79.5%, 167 out of 210 females) compared with males (75.4%, 86 out of 114 males). The paired t test results showed a significant increase in post-test vitamin D levels (t = -219.922, P &lt; 0.001) and a significant decrease in post-test Fatigue Assessment Scores (t = 31.328, P &lt; 0.001) and Fatigue Severity Scores (t = 33.066, P &lt; 0.001). Additionally, there was a significant improvement in post-test World Health Organization-Five Well-Being Index (WHO-5) scores (t = -28.495, P &lt; 0.001) and Warwick–Edinburgh Mental Well-being Scores (WEMWBS; t = -28.996, P &lt; 0.001). Karl Pearson’s correlation coefficient indicated that post-supplementation vitamin D levels were positively correlated with post-supplementation Fatigue Assessment Scores (r = 0.315) and Fatigue Severity Scores (r = 0.334). Conversely, they negatively correlated with the WHO-5 Well-being Index (r = -0.322) and the WEMWBS (r = -0.294). Conclusion: This study concludes that wellness is directly correlated with vitamin D levels. There is a significant improvement in the Fatigue Assessment Scale, Fatigue Severity Scale, WHO-5 Well-being Index, WEMWBS, and overall physical, mental, and social wellness following vitamin D supplementation in patients, both with and without comorbidities (hypertension and DM).

Development and validation of the 12-item video consultation self-efficacy scale

Background: Video consultations in healthcare are remote solutions for delivering assessments and treatments to patients. The acceptance and use of video consultations may depend on self-efficacy among healthcare practitioners. Measuring self-efficacy in providing video consultations may identify individuals with insufficient self-efficacy and enable targeted interventions and support. No valid and reliable scale was available for measuring self-efficacy in the Norwegian context. Therefore, our aim was to develop (Study 1) and validate (Study 2) a new research-based video consultation self-efficacy scale for Norwegian practitioners in specialized healthcare. Method: In Study 1, we developed preliminary scale items, based on results from a systematic review. These items were subjected to experts’ opinions in a modified Delphi method-based study. The experts also suggested additional items. These results were then used in developing an initial video consultation self-efficacy scale. In Study 2, this scale was validated in a questionnaire study. Reliability was examined by using item analysis and Cronbach’s alpha (internal consistency). Construct validity was examined by using exploratory factor analysis and Spearman’s correlation (convergent and divergent validity). Results: In Study 1, a total of 56 scale items were considered, and resulted in a preliminary 15-item scale. In Study 2, item analysis and exploratory factor analysis resulted in a unidimensional 12-item video consultation self-efficacy scale. Cronbach’s alpha (internal consistency) was (α) = .974. The Spearman’s correlations showed a moderate positive correlation between the 12-item scale and the Digital Competence Questionnaire, a weak positive correlation between the 12-item scale and the General Self-Efficacy Scale, and a weak positive correlation between the 12-item scale and the WHO-5 Well-Being Index. These results suggest that the scale is a reliable and valid measure for assessing practitioners’ self-efficacy in providing video consultations to patients in specialized healthcare. Implications: We recommend further, more comprehensive, validation of the scale in different contexts in Norwegian specialized healthcare, such as in different clinical specialties and with larger samples. Keywords: development and validation, self-efficacy scale, specialized healthcare, practitioners, video consultation

Effectiveness of meditation on wellness management among corporate employees in India: An interventional study.

Urban corporate sector relies heavily on workplace well-being, with meditation being a potent stress reduction method that significantly enhances the quality of life (QoL) and wellness. The study aims to assess the effectiveness of meditation on wellness management among corporate employees in India. The quasi-experimental controlled study design was employed from May to June 2021, which assessed stress, QoL, and wellness indices (satisfaction with life, well-being) with meditation practice as the intervention. The online questionnaire incorporates questions from the Depression, Anxiety, Stress Scale, World Health Organization (WHO) QoL Scale, Five-item Satisfaction with Life scaleand WHO-5 Well-being Index. A nonrandom sampling technique selected 146 and 74 subjects in the intervention and control groups, respectively, among the employees of Star health- and allied insurance company. The data was analyzed using SPSS V27 (©IBM SPSS Statistics). The Wilcoxon signed rank test for the dependent groups, and Mann-Whitney U test for the independent groups (between subjects) was performed. Among a total of 220 subjects who enrolled in the recruitment survey, 146 subjects underwent the intervention thus providing a response rate of 66.4%. For the intervention group, the difference (within group) in mean scores between baseline and endline assessment shows a reduction in stress (0.02) and significant improvement in QoL (0.21) and wellness indices (satisfaction with life: 0.21, well-being: 0.24). The difference (betweenthe experimental and control groups) in mean endline scores shows a decrease in stress (0.07), an increase in wellness indices (satisfaction with life: 0.12, well-being: 0.23), and a significant change in the QoL(0.17). Meditation intervention in corporate wellness programs enhances the QoL, wellness, and stress management, establishing the effectiveness of health profile-raising ingenuities at the workplace.

Caregiver strain among relatives of out-of-hospital cardiac arrest survivors; the DANCAS relative survey

BackgroundKnowledge about caregiver strain among relatives of out-of-hospital cardiac arrest (OHCA) survivors is limited. Thus, the objectives were to i) describe differences in self-reported mental well-being, mental health, and caregiver strain at different time points (1–5 years) post-OHCA and ii) investigate characteristics associated with caregiver strain. MethodsA national cross-sectional survey (DANCAS) from October 2020 to March 2021 with OHCA survivors and their closest relatives. The relative survey included the WHO-5 Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS) and the Modified Caregiver Strain Index (M−CSI). Differences in scores between time groups were explored using descriptive statistics. Associations between characteristics and caregiver strain were investigated with multivariable logistic regression models, presented as odds ratios (OR) with 95% confidence intervals (CI), adjusted for gender, age, education status, relative affiliation, and time after OHCA. ResultsOf 561 relatives, 24% (n = 137) experienced caregiver strain, with no significant differences in the relatives' mental well-being, mental health, or caregiver strain with time since OHCA. In the adjusted analyses, older age (OR 0.98 95% CI 0.96;0.99) and several self-reported outcomes, including reduced mental well-being (WHO-5 OR 7.27 95% CI 4.86;11.52), symptoms of anxiety (HADS-A OR 6.01 95% CI 3.89;9.29) and depression (HADS-D OR 15.03 95% CI 7.33;30.80) were significantly associated with worse caregiver strain. ConclusionNearly one-quarter of relatives of OHCA survivors experience caregiver strain, with this proportion remaining unchanged with time. Several outcomes were associated with caregiver strain, emphasising the need to identify relatives at greater risk of burden following OHCA.

The role of dog therapy in clinical recovery and improving quality of life: a randomized, controlled trial

BackgroundAny illness places a significant burden on patients, including deterioration in quality of life. Animal assisted therapy may be helpful in the rehabilitation process and in the treatment of patients to alleviate this phenomenon.MethodsA randomized, controlled research was conducted in 2019 and 2020 in a rehabilitation center in Budapest. In our study, the control and experimental groups received the same therapy, but the rehabilitation treatment of the intervention group was complemented by dog therapy. Patients were evaluated by means of the short form Beck Depression Inventory, State-Trait Anxiety Inventory, Illness Intrusiveness Ratings Scale, Visual Analog Scale for pain and the WHO-5 Well-being Index. For statistical analysis paired T-test and ANCOVA was performed.Results58 participants in both groups took part in the research. Results confirm that both groups showed statistically significant improvement in all outcome measures, except for depression symptoms in dog therapy group. Quality of life of the participants improved significantly, their pain and anxiety levels were significantly reduced, they felt significantly less burdened by the disease in their daily lives. Therapeutic-dog sessions had a large effect on patients’ quality of life and anxiety.ConclusionsThere is a strong case for animal assisted therapy as a complementary therapy in the rehabilitation program, and it is proposed that consideration should be given to the application of this method on a larger scale within health care. The study was retrospectively registered at ISRCTN Registry (registration number: ISRCTN10208787) on 15/03/2022.

Neighborhood Social Cohesion and Psychological Well-Being Among Older Adults: The Mediating Role of Home Attachment, Neighborhood Attachment, and Social Capital

This study aimed to examine the association between neighborhood social cohesion and psychological well-being among older adults in Iran in 2020. A cross-sectional design was employed, with 414 older adults recruited using a clustered sampling technique. The data collection instruments included the WHO-5 Well-Being Index, the Perceived Neighborhood Social Cohesion scale, the Place Attachment Scale for Older Adults, and the Social Capital Assessment Tool. Data were analyzed using Pearson correlation and the PROCESS Macro model 4 in SPSS24. Neighborhood social capital was found to completely mediate the association between neighborhood cohesion and psychological well-being among older adults. These results suggest that policymakers should consider implementing targeted policies to enhance neighborhood cohesion in order to improve the psychological well-being of older adults.

Interaction between old age and precarious employment on poor mental well-being in workers: Evidence from a nationally representative sample in Korea.

This study examined the relationship between precarious employment (PE) and mental well-being, focusing on age-specific interactions. Nationally representative Korean workers (N=29,961) were surveyed between 2020 and 2021 to collect data on multidimensional PE (categorized as low, moderate, or high) and the WHO-5 well-being index. Workers' ages were classified as young (<35years), middle-aged (35-54years), and older (≥55years). Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The interaction between PE and age on well-being was examined by including interaction terms in the regression models. The prevalence of poor well-being was 25%, 29%, and 39% for low, moderate, and high precariousness, respectively, whereas it was 26%, 30%, and 39% for young, middle-aged, and older workers, respectively. In the overall sample, the OR (95% CI) of the association between PE and poor well-being was 1.24 (1.17-1.32) for moderate and 1.54 (1.43-1.65) for high precariousness, compared with low precariousness. There was a significant interaction between old age and PE on the odds of poor well-being. Compared with young workers with low PE, middle-aged workers with high PE (OR: 1.85, 95% CI: 1.62-2.10) and older workers with high PE (OR: 2.10, 95% CI: 1.83-2.40) exhibited increased odds of having poor mental well-being. PE serves as a social determinant of older workers' psychological well-being. Policy interventions are required to protect older workers' psychological well-being.

Effects of Modified Ramadan Fasting on Mental Well-Being and Biomarkers in Healthy Adult Muslims - A Randomised Controlled Trial.

Ramadan fasting has seen increased attention in research, often with inconsistent findings. This study aims to investigate whether dietary and lifestyle modifications during Ramadan can improve well-being and health in healthy adult Muslims. A randomised controlled trial with two parallel groups was conducted in an outpatient clinic of a university hospital in Essen, Germany, in 2016. Healthy adult Muslims (n = 114) aged 18-60years were randomised to a modified fasting group; i.e., they received educational material prompting dietary and lifestyle modifications pre-Ramadan, and a control group who undertook Ramadan fasting as usual. Primary outcome was quality of life (WHO-5 Well-Being Index). Secondary outcomes included sleep quality, spirituality, and mindfulness (all self-report), body weight, body mass index, body fat, waist circumference, hip circumference, blood pressure, and heart rate, as well as blood serum biomarkers. Safety was examined via adverse events. The modified fasting group reported significantly higher quality of life (WHO-5) compared to the control after Ramadan (MD 5.9; 95% CI, 0.02-11.8; p < 0.05). Group differences in favour of the modified fasting were also found for satisfaction with health (MD 5.9, 95% CI 0.19-11.67), ease of life (MD 4.1, 95% CI 0.38-7.80) and mindfulness (MD 7.6, 95% CI 2.68-12.52), reductions in weight (MD, - 0.9kg; 95% CI - 1.39 to - 0.42), BMI (MD - 0.3kg/m2, 95% CI - 0.50 to - 0.15), hip circumference (MD - 0.3kg/m2, 95% CI - 0.50 to - 0.15), and diastolic blood pressure (MD - 2.8mmHg, 95% CI - 5.15 to - 0.43). About 60% of participants reported adverse events, mostly headaches/migraines, dizziness/fatigue, common cold, and gastrointestinal symptoms, with no group differences. One serious non-related adverse event each occurred in both groups. Pre-Ramadan dietary and lifestyle advice can lead to short-term improvements in mental and physical well-being of adult Muslims observing Ramadan. As such, this study demonstrates the potential benefits of culturally appropriate health interventions in a religious context. ClinicalTrials.gov (Identifier NCT02775175).

A cross-sectional study of the association of exposure to web-based streaming platforms on the psychosocial behaviour and the sleep pattern of Indian youth

Background The rapid proliferation of web-based streaming platforms has become a ubiquitous aspect of contemporary life, especially among the youth in urban areas. This study seeks to delve into the usage patterns and discern potential associations between web-based streaming platforms and the psychosocial behaviour, sleep patterns, and work and study routines of Indian youth in the Wardha District of Maharashtra and Central India. With the escalating prevalence of digital entertainment, understanding the impact on this demographic's mental well-being and lifestyle is imperative. Methods Employing a cross-sectional design, this study will involve youth aged 15-29 from urban communities and schools in the designated district. The sample size, determined by the Cochran formula, is 170 participants. A comprehensive data collection process will unfold by utilising validated assessment tools, including the Young's Internet Addiction Test, WHO (Five) Well-Being Index, Pittsburgh Sleep Quality Index, and Eysenck's Personality Inventory. Statistical analyses, encompassing descriptive statistics, association tests, and regression analyses, will be conducted using SPSS version 23 software. Expected Outcome Anticipated outcomes of this study encompass a nuanced understanding of web-based streaming platform usage patterns, unveiling potential associations with psychosocial behaviours, sleep patterns, and work and study routines among Indian youth. The results are poised to contribute valuable insights into the intricate interplay between digital entertainment and the well-being of the urban youth population. Such findings can inform future interventions and strategies to foster a balanced and healthy digital lifestyle.

Schema therapy versus treatment as usual for outpatients with difficult-to-treat depression: study protocol for a parallel group randomized clinical trial (DEPRE-ST)

BackgroundAbout one third of patients with depression are in a condition that can be termed as “difficult-to-treat”. Some evidence suggests that difficult-to-treat depression is associated with a higher frequency of childhood trauma and comorbid personality disorders or accentuated features. However, the condition is understudied, and the effects of psychotherapy for difficult-to-treat depression are currently uncertain. The aim of this trial is to investigate the beneficial and harmful effects of 30 sessions of individual schema therapy versus treatment as usual for difficult-to-treat depression in the Danish secondary, public mental health sector.MethodsIn this randomized, multi-centre, parallel-group, superiority clinical trial, 129 outpatients with difficult-to-treat depression will be randomized (1:1) to 30 sessions of individual schema therapy or treatment as usual; in this context mainly group-based, short-term cognitive behaviour or psychodynamic therapy. The primary outcome is the change from baseline in depressive symptoms 12 months after randomization, measured on the observer-rated 6-item Hamilton Rating Scale for Depression. The secondary outcomes are health-related quality of life assessed with the European Quality of Life 5 Dimensions 5 Level Version, functional impairment assessed with the Work and Social Adjustment Scale, psychological wellbeing assessed with the WHO-5 Well-being Index, and negative effects of treatment assessed with the Negative Effects Questionnaire. Exploratory outcomes are improvement on patient self-defined outcomes, personal recovery, anxiety symptoms, anger reactions, metacognitive beliefs about anger, and perseverative negative thinking. Outcomes will be assessed at 6, 12, and 24 months after randomization; the 12-month time-point being the primary time-point of interest. Outcome assessors performing the depression-rating, data managers, statisticians, the data safety and monitoring committee, and conclusion makers for the outcome article will be blinded to treatment allocation and results. To assess cost-effectiveness of the intervention, a health economic analysis will be performed.DiscussionThis trial will provide evidence on the beneficial and harmful effects, as well as the cost-effectiveness of schema therapy versus treatment as usual for outpatients with difficult-to-treat depression. The results can potentially improve treatment for a large and understudied patient group.Trial registrationClinicalTrials.gov NCT05833087. Registered on 15th April 2023 (approved without prompts for revision on 27th April 2023).

The cortisol awakening response is blunted in healthy women early postpartum

IntroductionThe dynamic capacity of the hypothalamic-pituitary-adrenal (HPA) axis supports healthy adaptions to stress and play a key role in maintaining mental health. Perinatal adaptations in the HPA-axis dynamics in terms of the Cortisol Awakening Response (CAR), may be involved in dysregulation of perinatal mental health. We aimed to determine if CAR and absolute evening cortisol early postpartum differed from non-perinatal women and evaluate the association between the CAR and maternal mental well-being. MethodsThe CAR was computed as the area under the curve with respect to increase from baseline from serial home-sampling of saliva across 0–60 minutes from awakening. We evaluated differences in CAR and absolute evening cortisol between postpartum women (N=50, mean postpartum days: 38, SD: ±11) and non-perinatal women (N=91) in a multiple linear regression model. We also evaluated the association between CAR and maternal mental well-being in a multiple linear regression model. ResultsWe found that healthy postpartum women had a blunted CAR (p<0.001) corresponding to 84% reduction and 80% lower absolute evening cortisol (p<0.001) relative to non-perinatal healthy women. In the postpartum group, there was a trend-level association between lower CAR and higher scores on the WHO Well-Being Index (WHO-5) (p=0.048) and lower Edinburgh Postnatal Depression Scale (EPDS) scores (p=0.04). ConclusionOur data emphasize the unique hormonal landscape during the postpartum period in terms of blunted CAR and lower absolute evening cortisol in healthy women early postpartum compared to non-perinatal. Our findings show a potential association between a reduced CAR and improved mental well-being during early motherhood, which suggests that reduced CAR might reflect healthy adjustment to early motherhood.

Nature connectedness connects the visibility of trees through windows and mental wellbeing: a study on the “3 visible trees” component of the 3-30-300 rule

ABSTRACT To examine the mediatory role of nature connectedness between tree visibility through windows and mental wellbeing, we conducted a questionnaire survey and examined the mediation effect using both cross-sectional and semi-longitudinal mediation models. We evaluated nature connectedness using the Inclusion of Nature in Self (INS) scale and the Connectedness to Nature Scale (CNS) and measured mental wellbeing using the WHO-5 wellbeing index. Our results showed that participants who could see at least three trees through their windows reported higher levels of both nature connectedness and mental wellbeing compared to those without such visibility. Nature connectedness significantly mediated the relationship between the visibility of trees through windows and mental wellbeing, albeit with a somewhat limited effect. More broadly, this study provides additional evidence in support of the “3” component of the 3-30-300 “rule” for equitable access to greenspace in cities.

Association between sickness presenteeism and depressive symptoms: a cross-sectional study using the 6th Korean working conditions survey.

This study aimed to reveal the relationship of the days of experiencing sickness presentism and depressive symptoms among Korean workers. Sickness presenteeism which defined as the act of going to work despite being feeling unhealthy triggers various adverse effects on mental health, including increased risks of depression. Furthermore, Sickness presenteeism is a major social issue causing substantial socioeconomic costs. The data of 25120 participants from sixth Korean Working Condition Survey was utilized in this cross-sectional study. Sickness presenteeism was defined using a self-reported questionnaire and depressive symptoms were assessed by WHO well-being index. Multivariate logistic regression analysis was conducted to calculate the odd ratios for depressive symptoms regarding the number of days experiencing sickness presenteeism. We calculated odds ratios (ORs) and 95% confidence interval (95% CI) for depressive symptoms after categorizing participants into three groups based on the duration of experiencing sickness presenteeism, using cut-off values of 3 and 5days. Workers who have experienced sickness presenteeism for more than 5days were at highest risk for depressive symptoms than referent group (OR 2.87; 95% CI 2.17-3.76 in male, OR 3.86; 95% CI 3.02-4.91 in female). Furthermore, there was a trend of increasing risk for depressive symptom as the duration of experiencing sickness presenteeism extended. This study presents the association between experiencing sickness presenteeism in the previous 12months and depressive symptoms. Based on the results, we provide individual and organizational strategies of reducing sickness presenteeism. Also, screening for workers who have experienced sickness presenteeism are needed to ensure good mental health.

IJCM_328A: Operational Research on Capacity Building of Community Health Workers in Screening for Depression and Suicide risk

Background: The basic training for ASHA workers in Tamil Nadu include a module on Non-Communicable diseases with inadequate focus on Mental Health. As a part of the Community Based Assessment Checklist, ASHAs are trained in administration of Patient Health Questionnaire-2 to screen for depression. However, there is significant gap in the primary prevention of depression in the communities in terms of screening, basic counselling services and knowledge and attitude among community health workers Objective: This study aimed to assess the feasibility of capacity building of Community Health Workers in screening for depression and suicide risk and provision of Psychological First Aid Services Methodology: 117 Community Health Workers including ASHAs, AWWs, ANMs, WHVs, VHNs and UHNs were trained in WHO Psychological First Aid, PHQ-9 administration and WHO MhGAP 10 questions on suicide risk screening in Thiruvannamalai, Vellore and Tiruvallur District of Tamil Nadu Results: Of the 1371 individuals screened, 13.18% were positive for depression and 38% were positive for atleast one suicide risk. The most common suicide risk observed was chronic pain followed by extreme hopelessness. PHQ-9 and Suicide risk assessment was easy to administer among ANM, VHN and UHNs. However, ASHAs and Women Health Volunteers reported that PHQ-2/WHO Wellbeing Index was an easier tool to use in the field. Psychological First Aid training can be easily delivered by non-medical professionals to health workers. Conclusion: Community Health Workers can provide primary prevention in mental health by provision of Psychological First Aid to their community. Depression screening should be simplified by PHQ-2/WHO Well being index

Management of post COVID arthralgia by Amalaki Rasayana: A case report

Background: COVID-19 is an infectious disease caused by the newly discovered coronavirus. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV2). Post-COVID syndrome for people who still have symptoms for more than 12 weeks after the start of acute symptoms. This may last up to one year. The most common symptoms reported are fatigue, anorexia, joint pain, dyspnoea, headache, anxiety, and critical manifestations like diabetes, hypertension, pulmonary fibrosis, renal failure, Rheumatoid Arthritis (RA), etc. Agnimandya (~diminution of Agni) is a residual symptom of COVID-19 which leads to Dhatukshya (~diminution of Dhatu). Methods: We describe a case of a 50-year-old male who developed arthralgia after the remission of acute COVID-19 infection and post-COVID symptoms. The patient was treated with Haritakyadi yoga for koshtha shuddhi followed by Rasayana chikitsa by Amalaki Rasayana for the next 30 days for post-COVID ailments. The prime aim of treatment was to recover the function of Agni and koshtha shuddhi by administering Haritakyadi yoga followed by rejuvenation treatment by Amalaki Rasayana. The patient was assessed using the WHO well-being index scale, signs- and symptoms of post-COVID, six-minute walk test on the 0th, 15th, and 30th day follow-up. Results: Haritakyadi yoga followed by Amalaki Rasayana reduced symptoms of post-COVID arthralgia, improved energy levels of post-COVID symptoms, and enhanced WHO- well-being score. Conclusions: It is suggested by the mentioned case that Amalaki Rasayana may be used for managing post-COVID arthralgia and for improving general well-being in long COVID.

Investigating the moderating role of social capital between religiosity and psychological well-being among Iranian older adults

ABSTRACT This research investigates the mediating role of social capital, and its subscales in the relationship between religiosity and psychological well-being among older adults. The variables were measured through DUREL, Persian Version of WHO-5 Well-being Index, and SASCAT, respectively. PROCESS Macro model 4 method demonstrated social capital (b = 0.148, z = 3.934, p < .01) and social participation (b = 0.139, z = 3.816, p < .01) mediate the effect of religiosity on psychological well-being. It seems that the social potential of religion can be used to improve the psychological well-being of the older people.