Feasibility, acceptability, and preliminary efficacy of yoga to improve maternal mental health and immune function during the COVID-19 crisis (Yoga-M2 trial): a pilot randomized controlled trial.

Introduction: Women are vulnerable during pregnancy as they experience multiple physical and psychological problems which can lead to stress and poor quality of life ultimately affecting the development of the fetus and their health during and after pregnancy. Prior evidence suggests that prenatal yoga can improve maternal health and well-being and can have a beneficial effect on immune system functioning. To date, no study has been conducted in a rural, low-resource setting in India to assess the feasibility, acceptability, and preliminary efficacy of a yoga-based intervention on perceived stress, quality of life, pro-inflammatory biomarkers, and symptoms of upper respiratory tract infections. Methods: To address this gap and assess whether a yoga-based intervention could improve maternal mental health and immunity during the COVID-19 crisis (Yoga-M2 trial), a single-blind individual randomized parallel group-controlled pilot trial with a 1:1 allocation ratio was implemented. We randomly allocated 51 adult pregnant women, with gestational age between 12-24 weeks in the Yoga-M2 arm (n = 25) or the enhanced usual care arm (EUC) (n = 26). Feasibility and acceptability were assessed using the process data and In-Depth Interviews (IDIs) with the trial participants and yoga instructors. Multiple linear regression was used to compare follow-up scores for quantitative outcomes. Results: A three-month follow-up assessment was completed for 48 out of 51 participants (94.12%). We did not find any statistically significant difference between both arms in total Perceived Stress Scale scores, quality of life (Eq-5D-5L index), and serum C Reactive Protein levels at the three-month follow-up assessment. The critical barriers to practicing yoga were lack of knowledge about the benefits of yoga, lack of 'felt need' to practice yoga, lack of time to practice, lack of space, lack of transport, and lack of peer group to practice yoga. Despite this, women who regularly practiced yoga described the benefits and factors which motivated them to practice regularly. Discussion: The learnings from this trial will help design the explanatory trial in the future and the study findings can also be used by the primary health care system to deliver yoga-based interventions in the newly created health and wellness centers. Trial registration: This trial was prospectively registered with the Clinical Trials Registry of India on 25 January 2022. https://www.ctri.nic.in/Clinicaltrials/showallp.php?mid1=65173&EncHid=&userName=CTRI/2022/01/039701. Trial registration number: CTRI/2022/01/039701.

Yoga to improve maternal mental health and immune function during the COVID-19 crisis (Yoga-M 2 trial): study protocol for a pilot randomized controlled trial.

Background: Mental health of women is adversely affected during pregnancy. A huge proportion of pregnant women suffer from stress and depression which negatively impacts birthweight and neuro-cognitive development of the fetus. The current crisis due to the COVID-19 pandemic further adds to the stressful situation. Yoga practiced during pregnancy has beneficial effects on improving stress and depression and preliminary evidence suggests that yoga-based interventions can improve immunity. This study aims to examine the feasibility, acceptability, and preliminary efficacy of a Yoga-based intervention for maternal Mental health and i Mmunity (Yoga-M 2) in a rural community in India.     Methods: The study design will be a single-blind individual randomized parallel group-controlled pilot trial with 1:1 allocation ratio. Adult pregnant women, with gestational age between 12-24 weeks will be randomly allocated to either the Yoga-M 2 group or the Enhanced Usual Care (EUC) group. Participants in the Yoga-M 2 arm will attend weekly group yoga sessions for 12 weeks and will be encouraged to practice yoga at home. In the EUC arm, participants will receive a single session of health education. Eligibility of the participants, recruitment, retention-in-care, and study completion rates will be estimated and feasibility of delivering Yoga-M 2 and acceptability of this intervention by the participants will be assessed. Change in the scores of the Perceived Stress Scale (PSS), EuroQoL 5 Dimensions Score (EQ-5D-5L), Wisconsin Upper Respiratory Symptom Severity Scale (WURSS-21), and serum C-Reactive Protein at three-months post-randomization will be used to assess preliminary efficacy.   Discussion: The key outputs of this trial will be a structured intervention manual and evidence about the feasibility, acceptability, and preliminary efficacy of the intervention, establishing the foundation to undertake an explanatory randomized controlled trial to assess efficacy and cost-effectiveness of Yoga-M 2 intervention.  Trial registration: CTRI/2022/01/039701. Prospectively registered with the Clinical Trials Registry of India on 25 January 2022.

A Pilot Randomized Controlled Trial of Interval Training and Sleep Hygiene for Improving Sleep in Older Adults.

The primary objective of this pilot randomized controlled trial was to study the feasibility (recruitment and retention rates) for interval training and sleep hygiene (SH) in adults aged above 60 years. Thirteen out of 46 screened individuals from a home for older adults in Shirdi (Maharashtra, India) were randomly assigned by permuted block randomization to either an interval training with SH group (n = 6) or an SH alone group (n = 7). The authors measured sleep with the S+ sleep monitor manufactured by ResMed (USA) Pittsburgh Sleep Quality Index and quality of life with Short Form-12 health survey version 2. Interval training consisted of 8 weeks of stationary cycling, whereas SH consisted of lecture and handouts. Recruitment was 38.2%, retention was >80% for both the interventions, and there was one loss to follow-up in SH. Interval training and SH were feasible for older adults and supported a full-scale randomized controlled trial.

Impact of holistic stress management program on academic stress and well-being of Indian adolescent girls: A randomized controlled trial.

CONTEXT: Academic stress among adolescents is a significant contributor to a variety of mental and behavioral disorders. Holistic stress management interventions equip adolescents with good mental health and improve academic performance. AIM: The aim of the study is to evaluate the effectiveness of holistic group-based stress management program in reducing academic stress, depression, anxiety, and improving well-being among adolescent girls. SETTINGS AND DESIGN: Randomized control trial was adopted and the study was conducted at selected colleges of Dharwad city, Karnataka, India. MATERIALS AND METHODS: Two hundred and thirty adolescent girls were randomly selected and assigned to either experimental (n = 115) or control group (n = 115). Both group participants were initially assessed for academic stress, depression, anxiety, general stress, and well-being. The experimental group participants participated in eight sessions of holistic group-based stress management program over a period of 1 month. The intervention comprises of body-mind-spirit strategies focusing on techniques to handle stressful situations, accept responsibility for their own well-being, and take charge of self-health. Control group participants did not receive any intervention. Postintervention assessments were conducted for all the participants on monthly intervals for 6 months. RESULTS: Over 6 months follow-up compared to control group, the experimental group participants showed statistically significant decrease in academic stress (F = 131.60, P < 0.01, n2 G = 0.14), depression (F = 156.70, P < 0.01, n2 G = 0.13), anxiety (F = 190.50, P < 0.01, n2 G = 0.16), general stress (F = 166.10, P < 0.01, n2 G = 0.16), and improvement in well-being (F = 156.40, P < 0.01, n2 G = 0.13). CONCLUSIONS: These findings indicate that holistic stress management program has a positive effect on reducing stress, anxiety, depression, and improving well-being.

HIV-Related Stigma Among Nursing Students Attending a College of Nursing that Promotes Nondiscriminatory Care in India.

Bel-Air College of Nursing in India promotes nondiscriminatory care of persons living with HIV throughout its programs, albeit with no specific intervention. We examined whether nursing students' stigmatizing attitudes were related to number of years at Bel-Air. At the start of the 2015 and 2016 academic years, 310 Bachelor's (BScN; 4-year program) and 119 Auxiliary Nurse Midwife (ANM; 2-year program) students completed the Zelaya and colleagues (2008) Stigma Scale (24 Likert-type items). Three subscales (Fear, Blame, Personal Discrimination) measured Overall Personal Stigma. The fourth subscale measured Perceived Community Discrimination. BScN students' mean Overall Personal Stigma and subscales scores declined and Perceived Community Discrimination scores increased from Year 1 to 4. For ANM students, Overall Personal Stigma, Fear, and Personal Discrimination scores were lower for Year 2 than Year 1 students. Bel-Air emphasizes effective and nondiscriminatory care throughout the entire curriculum, providing a model for reducing student nurses' stigmatizing attitudes.

Methamphetamine use and other club drug use differ in relation to HIV status and risk behavior among gay and bisexual men.

This study compared associations between methamphetamine use, drug use other than methamphetamine, and HIV transmission factors among men who have sex with men, attending an sexually transmitted disease clinic. Of 6435 participants, newly recognized HIV status (OR: 3.02 95% CI: 2.30, 3.99) was associated with methamphetamine use compared with nondrug users, an association not found among other club drug users.