Kratom (Mitragynaspeciosa), a natural existing plant found in South-East Asia, is tradi-tionally used as an herb to help to elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (μ) and kappa (κ). The role of neural reward pathway linked to μ-opioid receptors and both dopaminergic and GABA-ergic interneurons that express μ-opioid receptors were deliberated. However, kratom has been reported to be abused together with other illicit substances with high risk of potential addiction. There are also anecdotes of an adverse effect and toxicity of kratom, i.e. tremor, fatigue, seizure, and death. Different countries have distinctive regulation and policy on the plantation and use of this plant when most of the countries banned the use of it because of its addiction problems and side effects. The aim of this review is to highlight on the potential use of kratom, a unique 'herbs" as a substitution therapy for chronic pain and opioid addiction, based on the neurobiological perspective of pain and the underlying mechanism of actions of drug addiction.
The ultra-brief psychological interventions (UBPI) was created in 2018 to empower healthcare providers with psychological skills that can be delivered within a short period. Techniques used within UBPI were adopted from a variety of well established psychotherapies and distilled into its core essentials. This enabled practitioners of UBPI to deliver specific psychological skills in the appropriate context to the client within a period of 15–20 min. UBPI was also manualised to standardised training of practitioners. During the novel coronavirus disease of 2019 (COVID-19) pandemic, UBPI was modified to suit the unique psychological demands of the pandemic. This article presents how UBPI was adapted and used with healthcare providers dealing with COVID-19 and also with the public who required psychological first aid (PFA).
Inaccessibility to clinical supervision is an issue faced by solo clinical psychologist practitioners. To overcome this problem, the authors described the innovative combination use of web-based instant messaging application and video call application in conducting a peer-led group tele-supervision among 28 clinical psychologists, including WhatsAppTM, SkypeTM and ZoomTM. The regular peer clinical supervision group started since October 2017 and it served as a platform to: 1) address important clinical care related issues, 2) discuss case assessment and management, 3) provide technical instruction, 4) explore resistance and analyse countertransference, 5) provide emotional support, and 6) share knowledge and update guidelines. The challenges include: 1) difficulty of facetime session arrangement, 2) limited time for in-depth discussion, 3) internet connection issue, and 4) dilemma on documentation. With more than one year of experience of using this tele-supervision model, it is seen to be a potential solution for other resource-scarce developing countries and other clinical disciplines although more structured and larger prospective studies are required.
Considerable efforts and concurrent studies have been made to substantiate the control of tuberculosis (TB). The control was not achieved significantly, as the stigma is one of the significant barriers to controlling tuberculosis. It hampers the TB treatment's determined targeted completion. However, despite countless measures to improve therapy completion, non-adherence to therapy remains a global issue. This systematic review is aimed at evaluating tuberculosis-related measures to increase adherence to treatment among patients with tuberculosis in developing countries. A systematic search of electronic databases (PubMed, Google Scholar, Pro-Quest science Direct, Ovid, Spring, Global Health, and Cochrane) covering articles published between 2003 and 2019 was carried out using truncated search words such as "tuberculosis-related stigma," TB Stigma," "intervention," "treatment adherence," "treatment compliance" and "developing countries." We included information from developing countries addressing the stigma between TB patients and their anti-stigma intervention. Eight hundred sixty-seven articles have been retrieved, 346 have been excluded due to duplication, and 397 other non-relevant articles have been excluded at the title screening stage. Subsequently, after full-text articles were assessed for failing to meet inclusion criteria, 118 articles were excluded, and only six studies remained. The six articles have improved TB treatment outcomes with stigma intervention, including health education and counseling, TB club self-support, and psychological support interventions. Setting, resources and local TB epidemiology may vary in the optimal implementation of stigma interventions.
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