Publications by authors named "Zul Merali"

Background: With a shortage of mental health specialists and a significant rural population in Pakistan, leveraging community-based healthcare workers becomes crucial to address mental health needs. Equipping the healthcare workers with digital tools such as mobile applications have the potential to increase access to mental health support in low-resource areas. This study examines the acceptability, appropriateness, barriers, and facilitators to implementing a technology-assisted mental health intervention (mPareshan) delivered by Lady Health Workers (LHWs) in rural Pakistan.

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Background: Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI from Pakistan. This study aimed to assess HRQoL and its determinants in the Pakistani population.

Methods: A single-center cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan.

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Optimal brain health is essential to smoothing major global skill-intensive economic transitions, such as the bioeconomy, green, care economy and digital transitions. Good brain health is vital to socio-economic sustainability, productivity and well-being. The care transition focuses on recognizing and investing in care services and care work as essential for economic growth and social well-being.

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Background: The risk of dementia, including the most common form, Alzheimer's disease, is forecasted to increase in low- and middle-income countries due to longer lifespans and the rising prevalence of non-communicable diseases. However, little research has been conducted on the knowledge and perceptions about dementia in rural communities in Kenya.

Objective: To explore the community's knowledge, attitudes, and perceptions about dementia in Kilifi County, a resource constrained rural coastal area in Kenya.

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Dementia prevention in Africa is critically underexplored, despite the continent's high prevalence of modifiable risk factors. With a predominantly young and middle-aged population, Africa presents a prime opportunity to implement evidence-based strategies that could significantly reduce future dementia cases and mitigate its economic impact. The multinational Africa-FINGERS program offers an innovative solution, pioneering culturally sensitive, multidomain interventions tailored to the unique challenges of the region.

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Article Synopsis
  • Diagnosing Alzheimer's disease is tough for doctors, which can lead to delays in getting the right care for patients.
  • Blood tests that check for signs of Alzheimer's could help doctors find the disease earlier and treat it better, but there are still some big challenges to overcome.
  • A special group of leaders in Alzheimer's research is working on solutions, like creating better guidelines, training healthcare workers, and making sure patients understand their test results.
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  • Blood-based biomarkers (BBMs) are new tests that help doctors check for Alzheimer's disease in a simpler and cheaper way than older methods like brain scans or spinal fluid tests.! -
  • A special group called the Global CEO Initiative on Alzheimer's Disease is suggesting two ways to use these BBMs: one for initial testing and another to confirm more serious cases.! -
  • Using BBMs can make it easier for doctors to diagnose Alzheimer's, which means that patients can start getting needed treatments faster.!
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Community engagement (CE) has increasingly been recognized as a critical element for successful health promotion and intervention programs. However, the term CE has been used to mean different things in different settings. In this article, we explore how CE has been conceptualized in the field of mental and brain health in Kilifi County, Kenya.

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Background: There is a dearth of specialized mental health workforce in low- and middle-income countries. Use of mobile technology by frontline community health workers (CHWs) is gaining momentum in Pakistan and needs to be explored as an alternate strategy to improve mental well-being.

Objective: The aim of this study is to assess the feasibility, acceptability, and usefulness of an app-based counseling intervention delivered by government lady health workers (LHWs) to reduce anxiety and depression in rural Pakistan.

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Background: The increasing emergencies and humanitarian challenges have worsened the mental health condition of women in the Eastern Mediterranean Region.

Aim: To assess the prevalence, determinants and interventions to address mental health among women in fragile and humanitarian settings in the Eastern Mediterranean Region.

Methods: Using the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, we reviewed 59 peer-reviewed published studies (PubMed, IMEMR) and grey literature (WHO/IRIS) from January 2001 to February 2023, focusing on women's mental health in the Eastern Mediterranean Region.

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Objectives: There are irregularities in investment cases generated by the Mental Health Compartment Model. We discuss these irregularities and highlight the costing techniques that may be introduced to improve mental health investment cases.

Methods: This analysis uses data from the World Bank, the World Health Organization Mental Health Compartment Model, the United Nations Development Program, the Kenya Ministry of Health, and Statistics from the Kenyan National Commission of Human Rights.

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Objective: This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya.

Approach: The study will deploy a mobile application (app) platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya.

Expectation: This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient healthcare workforce to develop sustainable economic growth in Kenya, East Africa, and ultimately neighboring countries in sub-Saharan Africa.

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Article Synopsis
  • There are significant inconsistencies in HIV mortality data reported by IHME, UNAIDS, and StatsSA, with IHME and UNAIDS showing improvements while StatsSA suggests worsening trends.
  • The analysis reveals that the IHME and UNAIDS data is based on a mathematical model that may not fully capture the dynamics of HIV epidemiology, leading to potentially inflated mortality improvements.
  • To enhance the quality of HIV research and programming in South Africa, it is essential to reconcile and streamline the data from these organizations.
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The technical advisory group of the World Health Organization (Geneva, Switzerland) has suggested person-centered and community-based mental health services in response to the long-term and far-reaching mental health impacts of the COVID-19 pandemic. Task shifting is a pragmatic approach to tackle the mental health treatment gap in low- and middle-income countries. Pakistan is dismally resourced to address the mental health challenges.

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  • Adolescent parenthood can lead to serious mental health issues like depression and substance abuse, highlighting the need for understanding these risks in pregnant teens, especially in Nairobi, Kenya.
  • A survey of 153 pregnant adolescents revealed that 43.1% showed signs of depression, with key risk factors including school attendance, intimate partner violence, and family substance use.
  • The study's limitations include its cross-sectional design and the lack of local validation for the depression screening tool used, stressing the need for improved mental health screening in health services for adolescents.
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Background: Interventions targeting combined sexual and reproductive health, Human Immunodeficiency Virus (HIV) management and mental health care in sub-Saharan Africa (SSA) are few. There is a need to address common determinants of poor mental, psychosocial and sexual and reproductive health and rights (SRHR) through multimodal and multipronged interventions for adolescents. The main objective of this study was to identify whether and how interventions targeting adolescent SRHR and HIV with a focus on pregnant and parenting adolescents in SSA include mental health components and how these components and their outcomes have been reported in the literature.

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This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya. The study will deploy a mobile app platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya. This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient healthcare workforce to develop sustainable economic growth in Kenya, East Africa, and ultimately neighboring countries in sub-Saharan Africa.

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In South Africa, men were traditionally eligible to receive government pensions at 65 years. However, that eligibility criterion was changed in 2008 to allow men to receive a pension payout at 60 years. This study is designed to quantify the impact of the 2008 pension reform on mental health outcomes (depression and traumatic stress) and deaths among 60-year-old men from disadvantaged households without advanced education.

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The first aim of the present review is to provide an in-depth description of the cannabinoids and their known effects at various neuronal receptors. It reveals that cannabinoids are highly diverse, and recent work has highlighted that their effects on the central nervous system (CNS) are surprisingly more complex than previously recognized. Cannabinoid-sensitive receptors are widely distributed throughout the CNS where they act as primary modulators of neurotransmission.

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A novel botanical dietary supplement, formulated as a chewable tablet containing a defined mixture of spp. vine and spp. Bark, was tested as a canine anxiolytic for thunderstorm noise-induced stress (noise aversion).

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Gilg. is a neotropical vine native to Central America, investigated as part of a targeted study of the plant family Marcgraviaceae. Our previous research showed that extract of leaf and small branch extract had anxiolytic effects in animals and acts as an agonist for the GABA receptor at the benzodiazepine binding site.

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