Background Young adults, particularly university students might be at greater risk of developing psychological distress, and exhibiting symptoms of anxiety and depression during the COVID-19 pandemic. The primary objective of this study was to explore and compare the determinants and predictors of mental health (anxiety and depression) during and after the COVID-19 lockdown among university students. Methods This was an observational, cross-sectional study with a sample size of 417 students. An online survey utilizing International Physical Activity Questionnaire–Short Form (IPAQ-SF), General Anxiety Disorder–7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) was distributed to Universiti Tunku Abdul Rahman students via Google forms. Results During lockdown, family income [χ2 (1, n = 124) = 5.155, p = 0.023], and physical activity (PA) [χ2 (1, n = 134) = 6.366, p = 0.012] were associated with anxiety, while depression was associated with gender [χ2 (1, n = 75) = 4.655, p = 0.031]. After lockdown, family income was associated with both anxiety [χ2 (1, n = 111) = 8.089, p = 0.004], and depression [χ2 (1, n = 115) = 9.305, p = 0.002]. During lockdown, family income (OR = 1.60, p = 0.018), and PA (OR = 0.59, p = 0.011) were predictors for anxiety, while gender (OR = 0.65, p = 0.046) was a predictor for depression. After lockdown, family income was a predictor for both anxiety (OR = 1.67, p = 0.011), and depression (OR = 1.70, p = 0.009). Conclusion Significant negative effects attributed to the COVID-19 lockdown, and certain factors predisposed to the worsening of mental health status in university students. Low family income, PA, and female gender were the major determinants and predictors linked to anxiety and depression.

The likelihood of a pre-hypertensive young adult to develop hypertension has been steadily increasing over the past few years. Aerobic exercise training (AET) has been found to reduce high blood pressure, however, efficacy of different types of aerobic exercise is yet to be determined among the pre-hypertensive young adults. The objective of this study was to evaluate the effectiveness of high-intensity interval training (HIIT) and continuous moderate-intensity training (CMT) on blood pressure (BP) in young physically inactive pre-hypertensive adults. 32 adults (age 20.0±1.1) were randomly assigned into 3 groups; HIIT, CMT, and control (CON). HIIT and CMT groups participated in 5 weeks of AET with CON group not participating in any exercise. The HIIT protocol consisted of 1:4 minute work to rest ratio of participants 80%-85% heart rate reserve (HR-reserve) and 40%-60% HR-reserve respectively for 20 minutes, CMT group exercised at 40%-60% of HR-reserve continuously for 20 minutes. In both HIIT and CMT groups, systolic blood pressure (SBP) (3.8±2.8 mmHg, P=0.002 VS 1.6±1.5 mmHg, P=0.011) was significantly reduced. While, significant reductions were noted in the diastolic blood pressure (DBP) (2.9±2.2 mmHg, P=0.002) and mean arterial pressure (MAP) (3.1±1.6mmHg, P<0.0005) only in the HIIT group. No significant difference in SBP (-0.4±3.7 mmHg, P=0.718), DBP (0.4±3.4 mmHg, P=0.714), or MAP (0.1±2.5mmHg, P= 0.892) was observed in the CON group. Both HIIT and CMT decreased the BP in physically inactive pre-hypertensive young adults; however, HIIT yielded more beneficial results in terms of reducing the SPB, DBP, and MAP.

The COVID-19 global health crisis has inflicted a tremendous amount of mental tribulation, especially in developing nations1. Since the COVID-19 outbreak has been declared as a public health crisis, many countries across the South Asian region reported a sharp increase in suicide cases. For instance, suicide cases in Thailand, Singapore, and Nepal have surged tremendously during the outbreak of COVID-19. Thailand health officials revealed that 2,551 suicide cases were reported in the first half of 2020, which is a 22% increment from the same period in 20192. In parallel, Singapore reported 452 suicides in 2020, the nation's highest number of cases since 2012, amid the isolation and psychological distress brought about by the COVID-19 pandemic3. Furthermore, in Nepal, the number of suicide cases increased by almost 25% compared with previous years amidst the COVID-19 outbreak, whereby 559 suicide incidents occurred every month4. In Malaysia, there has been a dramatic upsurge in suicide cases since the beginning of the COVID-19 outbreak in January 2020. According to recent statistics by the Royal Malaysian Police Department, a total of 631 suicide cases were recorded in 2020 and 468 cases were reported between January to May 20215. Compared to the year 2019, suicide cases in Malaysia almost doubled on average in all age categories in the 5 months of 2021 that is 94 cases per month compared to 51 cases per month in 20195. The increased psychological distress and poor mental health status amidst COVID-19 supports the escalating suicide mortality subjectively. Hence, this unexpected pandemic situation demands a comprehensive framework for tackling the massive upsurge of suicide among people from developing countries. In line with that, the aim of this viewpoint is to revisit the efforts implemented by the current Malaysian government and propose several prevention strategies to combat suicide during this global health crisis.

Mental and physical training (MAP) has been reported to improve outcomes related to mental health issues, but there is scarcity in current literature with regards to its effect on blood pressure (BP) in prehypertensive population. Therefore, aim of this study was to evaluate the effect of MAP on BP and resting heart rate (RHR) among prehypertensive young male adults. Methods – A single blinded randomized controlled trial with 43 prehypertensive (BP 120-139/80-89 mmHg) participants were divided into 2 experimental and 1 control groups. Mental training group (MT) participated in mindfulness meditation, while physical training group (PT) engaged in moderate intensity aerobic exercise. Both groups underwent training for 6-weeks, 3 sessions/week, each session lasting for 20 minutes. Control group did not participate in any training and was debriefed about Dietary Approaches to Stop Hypertension (DASH) eating plan. Participants in all 3 groups were instructed not to engage in any type of relaxation training or physical activity throughout this study. Systolic BP, diastolic BP, and RHR were assessed at baseline, at end of 3-weeks and 6-weeks intervention. Results – Mean age of participants in MT, PT and DASH group were 20.8±1.5, 20.1±1.8 and 19.8±1.8 respectively. Within group time effect demonstrated a significant difference in SBP (F=42.392, P=0.000), DBP (F=1836.863, P=0.000) and a non-significant difference in RHR (F=1.856, P=0.171), while between group analysis did not show significant difference in SBP (F=0.222, P=0.802); DBP (=0.325, P=0.739), and RHR (=0.63, P=0.939). Conclusions – All 3 interventions are equally effective in reducing the BP in pre-hypertensive young adults, however they did not have any effect on RHR.

Since, children are affected by the coronavirus in the same way as adults, examining the children's knowledge, attitude, and practice (KAP) on COVID-19 would help in building a pandemic-resilient society. Therefore, the present study aims to investigate the knowledge, attitude, and practice regarding COVID-19 among primary school students. This online, cross-sectional study was conducted from May 18 to 20, 2021 among students aged 9 to 12 years old and having access to WhatsApp messenger on their smartphones. The study participants were selected from 17 primary schools in Kedah, Malaysia by convenience , and the Google form invitation link was shared by the schools’ guidance and counselling teachers. Analysis revealed higher females (53%) and majority aged 12 years (27.8%) out of 1207. 56% of respondents possessed good knowledge on COVID-19 (M=4.21, SD=1.16) with 73.75% overall correct responses. Children demonstrated positive attitudes (M=3.64, SD=0.67) but had a higher perceived risk of becoming infected with COVID-19 (M=3.60, SD=1.23). For practices, low scores were discovered on avoid visiting crowded places (M=2.51, SD=1.22). Knowledge has a significant effect on children’s attitudes (Beta=0.17, p<0.001) and practices (Beta=0.25, p<0.001). Comparatively, females scored lower COVID-19 knowledge than males (Beta= -0.01, p=0.65). While age was significantly associated with increased knowledge (Beta=0.13, p<0.001), whereof, year 6 students (12 years; M=4.69, SD=1.23) scored the highest. Since knowledge is a critical tool in comprehending any phenomenon, and influencing one’s attitude and practice towards it, much effort is warranted to enhance the effectiveness of government strategies and mitigate the COVID-19 outbreak.

Background: Gender Based Violence (GBV) represents a severe violation of women's human rights beyond geographical, cultural, religious, social, and economic aspects. This study aimed to identify the prevalence of GBV, its association with mental health status, and familial and social determinants among the higher socio-economic married working women in Bangladesh. Methods: A cross-sectional study was conducted from June to November 2019 among the higher socio-economic married women working in Dhaka. To reach the targeted participants, five hundred sixty participants were recruited using multistage sampling. Women with a minimum graduate degree, monthly income >35000, and working outside were included in this study. A semi-structured questionnaire was used to collect data through a face-to-face interview. Mental health status was measured by 20 items on the CES-D scale. Descriptive statistics and bivariate (unadjusted) and multivariate (adjusted) logistic regression were used to explore the determinants and mental health status. Results: The mean age of participants was 35.7 ± 4.8 years. Around 13.6% of women faced GBV. The age, marriage duration, family type, monthly income, parental status, number of children, and education level showed a significant association with GBV. The binary logistic regression model found that the status of mental health was strongly significant in both unadjusted and adjusted models, OR (95% CI) =2.589 (1.577-4.252) and 4.542 (2.362-8.734). Participation in the family's decision-making process was strongly associated with GBV OR (95% CI) = 4.529 (2.332- 8.796). The attitude of the husband or in-laws was strongly significant in both unadjusted OR (95% CI) = 10.605 (4.988 - 22.548) and adjusted models 5.972 (1.836-19.421). Having a good understanding of the husband was strongly significant in two models, OR (95% CI) = 27.383 (13.568 -55.263) and 17.553 (6.160 -50.018). The odds of GBV, if any family members are suffering from chronic disease, were around six-fold higher among married working women in the unadjusted model OR (95% CI) =5.935 (2.791 - 12.623) and almost eight-fold higher in adjusted model 7.679 (2.293 -25.719). Time for attending social obligation was strongly significant in both unadjusted OR (95% CI)= 11.633 (5.239 -25.832) and adjusted model 24.402 (7.511 -79.277). Conclusion: The GBV prevalence was comparatively low, and it was found to be related to working women with higher socio-economic status. This issue should not be neglected as it impedes the empowerment of women, which is a global concern and developmental plan. Hence, there is a need to formulate better policies and programs to attain a gender-based, violence-free society.

The likelihood of a pre-hypertensive young adult to develop hypertension has been steadily increasing over the past few years. Aerobic exercise training (AET) has been found to reduce high blood pressure, however, efficacy of different types of aerobic exercise is yet to be determined among the pre-hypertensive young adults. The objective of this study was to evaluate the effectiveness of high-intensity interval training (HIIT) and continuous moderate-intensity training (CMT) on blood pressure (BP) in young physically inactive pre-hypertensive adults. 32 adults (age 20.0&plusmn;1.1) were randomly assigned into 3 groups; HIIT, CMT, and control (CON). HIIT and CMT groups participated in 5 weeks of AET with CON group not participating in any exercise. The HIIT protocol consisted of 1:4 minute work to rest ratio of participants 80%-85% heart rate reserve (HR-reserve) and 40%-60% HR-reserve respectively for 20 minutes, CMT group exercised at 40%-60% of HR-reserve continuously for 20 minutes. In both HIIT and CMT groups, systolic blood pressure (SBP) (3.8&plusmn;2.8 mmHg, P=0.002 VS 1.6&plusmn;1.5 mmHg, P=0.011) was significantly reduced. While, significant reductions were noted in the diastolic blood pressure (DBP) (2.9&plusmn;2.2 mmHg, P=0.002) and mean arterial pressure (MAP) (3.1&plusmn;1.6mmHg, P&lt;0.0005) only in the HIIT group. No significant difference in SBP (-0.4&plusmn;3.7 mmHg, P=0.718), DBP (0.4&plusmn;3.4 mmHg, P=0.714), or MAP (0.1&plusmn;2.5mmHg, P= 0.892) was observed in the CON group. Both HIIT and CMT decreased the BP in physically inactive pre-hypertensive young adults; however, HIIT yielded more beneficial results in terms of reducing the SPB, DBP, and MAP.

Background: Young adults, particularly university students might be at greater risk of developing psychological distress, and exhibiting symptoms of anxiety and depression during the COVID-19 pandemic. Objective: The primary objective of this study was to explore and compare the determinants and predictors of mental health (anxiety and depression) during and after COVID-19 lockdown among university students. Methods: This was an observational, cross-sectional study with a sample size of 417 students. An online survey utilizing International Physical Activity Questionnaire&ndash;Short Form (IPAQ-SF), General Anxiety Disorder&ndash;7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) was distributed to Universiti Tunku Abdul Rahman students via Google forms. Results: During lockdown, family income [&chi;2 (1, n=124) = 5.155, p=0.023], and physical activity [&chi;2 (1, n=134) = 6.366, p=0.012] were associated with anxiety, while depression was associated with gender [&chi;2 (1, n=75) = 4.655, p=0.031]. After lockdown, family income was found to be associated with both anxiety [&chi;2 (1, n=111) = 8.089, p=0.004], and depression [&chi;2 (1, n=115) =9.305, p=0.002]. During lockdown, family income (OR=1.60, p=0.018), and physical activity (OR=0.59, p=0.011) were predictors for anxiety, and gender (OR=0.65, p=0.046) being the only predictor for depression. After lockdown, family income was a predictor for both anxiety (OR=1.67, p=0.011), and depression (OR=1.70, p=0.009). Conclusion: Significant negative effects attributed to the COVID-19 lockdown, and certain factors predisposed to the worsening of mental health status in university students. Family income, physical activity level, and gender were some of the major determinants that influenced the anxiety and depression.