Exploring the Feasibility of Integrating Mental Health into a Family Planning Program in low-resource settings

Introduction: Mental health challenges remain a pressing issue, underscored by the glaring gap between the elevated demand and the scarce resources. Research has highlighted the effectiveness of integrating mental health services with primary care services, particularly in low-resource settings. Purpose: The objective of this research was to evaluate the perceived implications and feasibility of integrating basic mental health services into an existing community-based family planning initiative in Pakistan. By adopting a community-driven and co-produced methodology, our study not only ensured a deeper resonance with local needs but also paved the way for a sustainable and transformative uptake of mental health services in low-resource settings. This co-produced strategy, anchored in mutual collaboration and shared expertise with the community, promises a more holistic, enduring, and adaptive integration of essential health services within community frameworks.Methodology: This study utilized a qualitative research approach to obtain a comprehensive understanding of the program's feasibility and potential for expansion. Interview tools and guides, tailored to the regional language, were developed by the Research Associate to gather insights from the lady health workers involved in delivering the intervention, as well as from the clients. Overall, our team conducted 24 interviews, of which 9 were with the lady health workers and 15 with clients. The interviews were facilitated by the Research Associate and a Psychologist.Results: Utilizing the socio-ecological model, we thematically analyzed factors at individual, interpersonal, and community levels that support or hinder the integration of mental health services with existing community-based programmes. We also examined the intervention's impact on its users and the healthcare providers.Our analysis underscores the significant potential of integrating mental health services into existing community-based health programmes, such as family planning, in low-resource settings. Predominant themes highlighted women's willingness to use these services, influenced by strong relationships and trust in the lady health workers, ease of access to services, and community support. Identified barriers to integration included prevailing poverty, a preference for direct financial incentives in addition to counseling, confidentiality concerns in tight-knit communities, and the lingering stigma surrounding mental health.Conclusion: Our findings highlight the value of community collaboration in healthcare, particularly in low-resource settings. The co-production approach blends professional guidance with local insights, fostering community ownership and enhancing program sustainability. As the first to merge mental health with family planning in Pakistan, our research suggests that future health initiatives can greatly benefit from community-driven methods, leading to more sustainable and transformative health outcomes

Exploring the Feasibility of Integrating Mental Health into a Family Planning Program in low-resource settings

Introduction: Mental health challenges remain a pressing issue, underscored by the glaring gap between the elevated demand and the scarce resources. Research has highlighted the effectiveness of integrating mental health services with primary care services, particularly in low-resource settings

Anti-Parkinson’s evaluation of Brassica juncea leaf extract and underlying mechanism of its phytochemicals

Parkinson’s disease (PD) is asso- ciated with progressive neuronal damage and dysfunction. Oxidative stress helps to regulate neurodegenerative and neuronal dysfunction. Natural compounds could attenuate oxidative stress in a variety of neurological disorders. B. juncea is a rich source of antioxidants. The present study aimed to evaluate the therapeutic potential of B. juncea leaves for the treatment of PD by applying behavioral, in vivo and in silico studies. For in vivo studies rats were divided into six groups (n = 6). Group-I served as nor- mal control (vehicle control). Group-II was disease con- trol (haloperidol 1 mg/kg). Group-III was kept as a stan- dard group (L-Dopa 100 mg/kg + carbidopa 25 mg/kg). Groups (IV–VI) were the treatment groups, receiving ex- tract at 200-, 400- and 600 mg/kg doses respectively, for 21 days orally.Results: In vivo study results showed that the extract was found to improve muscles strength, motor co- ordination, and balance in PD. These behavioral outcomes were consistent with the recovery of endogenous antioxi- dant defence in biochemical analysis which was further cor- roborated with histopathological ameliorations. Dopamine levels increased and monoamine oxidase B (MAO-B) levels decreased dose-dependently in the brain during the study. Herein, we performed molecular docking analysis of the proposed extracted phytochemicals has explained that four putative phytochemicals (sinapic acid, rutin, ferulic acid, and caffeic acid) have presented very good results in terms of protein-ligand binding interactions as well as absorption, distribution, metabolism, excretion & toxicity (ADMET) profile estimations.Conclusion: The undertaken study concluded the anti-Parkinson activity of B. juncea and fur- ther suggests developments on its isolated compounds in PD therapeutics.peer-reviewe

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies