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Purpose: This paper aims to describe a response to the needs of mental health workers (MHWs) in India during COVID-19 pandemic, through an online training program on trauma-informed intervention and care. Design/methodology/approach: A four-module online training program was developed. Two modules were aimed to bridge the knowledge gap on trauma for MHWs, so that they could effectively address the associated symptoms of fear and grief. The other two modules aimed to support MHWs' self-care and create supportive connections among colleagues. In this mixed method evaluation study, needs expressed before the training and lessons derived from the training were collected through questionnaires, focus group discussion and interviews. Findings: Of the 3,168 MHWs who registered for the training, 534 completed the pre-questionnaire. Of the 125 post-questionnaire records, 38 had watched all four modules. A great need for learning to work with grief and manage the increased workload without burnout was observed. Post-training gains included skills for working with fear and grief, which increased the confidence of MHWs. The importance of self-care was an eye-opener for many. Social implications: This study indicates a way to equip MHWs to address the trauma that will continue to live in people in the aftermath of crises. Originality/value: This study examined the challenges MHWs in India faced during the COVID-19 pandemic, revealing a knowledge gap on dealing with this level of trauma. It can contribute to the knowledge on how to support MHWs in such crises. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

Background: Birth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors. Methods: A community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text. Results: The study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27–5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34–12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92–12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39–3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08–3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14–16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39–0.97) were less likely to respond. Conclusion: The present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended. [ABSTRACT FROM AUTHOR]

This study examines the health care utilization pattern, associated financial catastrophes, and inequality across Indian states to understand the subnational variations and aid the policy makers in this regard. Data from recent National Sample Survey (2017–2018), titled, "Household Social Consumption: Health," covering 113,823 households, was employed in the study. Descriptive statistics, Erreygers concentration index (CI), and recentered influence function decomposition were applied in the study. We found that, in India, 7 percent of households experienced catastrophic health expenditure (CHE) and 1.9 percent of households were pushed below poverty line due to out-of-pocket expenditure on hospitalization. Notably, outpatient care was more burdensome (CHE: 12.1%; impoverishment: 4%). Substantial interstate variations were observed, with high financial burden in poorer states. Utilization of health care services from private health care providers was pro-rich (hospitalization CI 0.31; outpatient CI 0.10), while the occurrence of CHE incidence was pro-poor (hospitalization CI −0.10; outpatient CI −0.14). Education level, economic status, health insurance, and area of residence contributed significantly to inequalities in utilization of health care services from private providers and financial burden. The high financial burden of seeking health care necessitates the need to increase public health spending and strengthen public health infrastructure. Also, concerted efforts directed towards increasing awareness about health insurance and introducing comprehensive health insurance products (covering both inpatient and outpatient services) are imperative to augment financial risk protection in India. [ABSTRACT FROM AUTHOR]

Introduction Community health workers are crucial in improving health and bridging gaps between communities and health care services. They are integral to various national health initiatives to prevent diseases and enhance well-being. Providing health care services to adolescents is a pivotal responsibility for auxiliary nurse midwives (ANMs) and Accredited Social Health Activist (ASHA) workers. Objectives This study aims to evaluate the community health workers' comprehension, implementation practices, and viewpoints regarding the implementation of the Rashtriya Kishor Swasthya Karyakram (RKSK) program. Methodology The research was conducted across primary health centers in Hagaribommanahalli and Huvina Hadagali taluks. A two-stage sampling technique was utilized to gather data from 404 participants, who were administered a semi-structured questionnaire. Data analysis was performed using SPSS version 20 software. Results Out of the total community health workers, 336 (83.2%) were ASHA workers, while 68 (16.8%) were ANMs. The mean age of the community health workers was 38 ± 6 years, and 79% had received training in the RKSK program. Of the respondents, 60.9% demonstrated adequate knowledge, and 79.5% correctly executed the RKSK activities. In addition, 80.5% of the participants strongly concurred with statements reflecting their perception of the RKSK program. Conclusion The study findings indicate that community health workers possess a commendable understanding of the RKSK program. Furthermore, their effective implementation practices and positive perceptions regarding the RKSK program and its activities suggest a genuine commitment to supporting the RKSK program and other health-related endeavors targeting adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate the relationship between inclusive leadership (IL), psychological safety (PS), affective commitment (AC) and organizational citizenship behavior (OCB) at the workplace. By understanding the sequential linkages, the research aims to provide insights for fostering a positive organizational culture that promotes employee commitment and employees' willingness to go the extra mile for the organization. Design/methodology/approach: The authors study how IL and OCB are related through PS and AC. For this purpose, cross-sectional data from 384 nursing professionals in India was collected and structural equation modeling was conducted on the same using IBM AMOS. Findings: The study found that IL has a major impact on OCB. The study further found that perceived IL leads to PS which is associated with OCB through AC. Research limitations/implications: The study has many theoretical and practical implications. This study uses a framework that is based on Affective events theory. In a health-care environment, IL can foster AC by promoting a culture of respect, collaboration and value for diverse perspectives, which enhances health-care professionals' emotional attachment to their work and the organization. Additionally, by encouraging open communication and a sense of belonging, IL contributes to OCB, as health-care staff are more likely to engage in discretionary behaviors that support the overall effectiveness and positive functioning of the health-care team if PS is improved, ultimately improving patient care outcomes. Originality/value: To the best of the authors' knowledge, this is one of the primary studies that looks into the sequential mechanism through which IL impacts OCB. [ABSTRACT FROM AUTHOR]

Purpose: There are over 300,000 male migrant workers in Singapore. Around 600 major workplace injuries are reported in Singapore each year, mainly in the manufacturing and construction injuries. Migrant workers who are affected by workplace injuries often face many challenges, including not being able to work and thus may be repatriated to their home countries, which affects their financial status and that of their families, whom they support. This research aims to explore the knowledge, attitudes and beliefs of injured migrant workers in Singapore, towards disability and vocational rehabilitation. Design/methodology/approach: Fifteen male migrant workers, from Bangladesh, China and India, who had acquired disabling injuries in their workplaces in Singapore, were identified through purposive sampling. They were interviewed by a male interviewer, either in Mandarin Chinese or with the assistance of interpreters for Bengali-English and Tamil-English. Interviews were recorded, transcribed, translated to English, then analysed thematically. Findings: The interviewees generally had a pessimistic outlook on their disability, which often impacted negatively on their self-worth and familial relationships. Many of them also had little knowledge of vocational rehabilitation and had not yet seriously considered future job prospects. Originality/value: To the best of the authors' knowledge, there are no similar studies exploring the knowledge, attitudes and beliefs of injured migrant workers in Singapore towards disability and vocational rehabilitation. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India's 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients. Methodology: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed. Results: Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality. Conclusions: Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups. [ABSTRACT FROM AUTHOR]

Background: User satisfaction in healthcare is an important measure of the quality of services provided to the patient and their carers. Since treatment of psychiatric patients requires long follow-up periods, and this long follow-up treatment patients depends on their initial experience with health service,therefor user satisfaction is of increasing importance in the mental health field. Aims and Objectives: Assess the user satisfaction and perceptions of the attitude of emergency health- care professionals (including paramedical staff and physicians of respective specialties) toward psychiatric and nonpsychiatric patients as experienced by the patients and carers. To compare the user satisfaction and perceived attitude of emergency staff in patients with psychiatric illness and nonpsychiatric illness. To determine the service users' decision to revisit the same health-care facility in case of the same problem. Materials and Methods: This study was done in the hospital wing of a tertiary care teaching university hospital in northern India, and ethics approval was obtained from the institutional ethics committee patients' sociodemographic details and psychiatric and other relevant medical history after obtaining informed consent. The psychiatric diagnosis was made according to the ICD-10. A self-report questionnaire, comprising 9 questions, and was designed to assess the perceived attitudes of health-care workers toward the patient of psychiatric illness. The questionnaire was designed in Hindi. Descriptive statistics for categorical variables were done. Inferential statistics were calculated using the Chi-square test. Results: Out of a total of 95 respondents, 69 patients were diagnosed with a psychiatric disorder and the remaining 26 patients had medical illness or other non-psychiatric disorders. Females were a majority in both groups. Our study majorly showed that service users perceived the attitudes of medical and paramedical staff in emergency units mostly as satisfactory or extremely satisfactory, as well as the majority of service users reported that they were satisfied with the reaction of emergency paramedical staff towards the emotional well-being of the patient. Conclusions: The major strengths of this study were the quantitative analysis of health workers' attitudes toward patients with psychiatric illnesses, which showed user-rated satisfactory attitudes. There was less stigma and more of a positive impact noted. The semi-structured questionnaire was designed in the local language and tailored to cover topics such as emotional well-being and psychoeducation that can all affect the user experience. [ABSTRACT FROM AUTHOR]

Introduction: Suicide has become a societal crisis owing to the recent increasing trends globally. Of the total suicide deaths globally, two-thirds occur in the developing countries including India. The available data on suicide in India reflect a rate of 11% (according to the National Crime Records Bureau 2013) with the highest rates in older adult males and an increasing trend of suicide deaths in younger age groups. Much of the literature is from the southern part of India with a relatively sparse data from North India. Aim and Methodology: The aim was to examine the 15-year (2004-2019) trend of suicide (age and gender distribution, methods used, and reasons) in an urban city in North India. Information was collected from the leading newspapers (English, Hindi, and Punjabi) of the area. Duplication of information was avoided, and statistical analysis was done using SPSS version 20. Results: Fluctuations in the total number of suicide cases over the 15-year period were observed with nearly 63% of people committing suicide being younger than 30 years of age, of whom 53% were male. More females in the younger age group and more males in the older age group were suicide victims. Of all the methods used, hanging was the most common (70%), followed by consuming poisonous substance, jumping from height, shooting self, and stabbing in the descending order. A ceiling fan was used for hanging by 32% of victims who hanged themselves, of whom 65% were male. Among the cited reasons, stress/depression was experienced by 19% of victims. Discussion and Conclusion: The trends with respect to age distribution, gender, and method used that is reported in the current study are in line with the trends reported globally. The preventive measures, especially using technological advances in designing fans not suitable for tying noose around it, can be explored. [ABSTRACT FROM AUTHOR]

Background: The amount and frequency of internet use are often used to forecast its pros and cons, with mixed findings. After COVID-19, technological advances and sociological upheavals have shown the internet's ability to support numerous activities, necessitating a change in internet use. Beyond internet use frequency, it has been advised to examine why people use it and how it affects their well-being. Hence, we aimed to investigate the various mediators and moderators in the relationship between the quality of internet use (type of activity) and well-being. Further, we investigated whether user attributes such as initial age and frequency of internet use moderate the influence of internet use quality on problematic internet use, loneliness, and well-being. Methods: 131 students in Manipur who were 18 years old were included in this cross-sectional study. Self-rated measures of the Adult Internet Usage questionnaire, Internet Addiction Test, and Mental Health Continuum-Short Form assessed internet use, dependence, and well-being. Results: Loneliness mediates the association between well-being and internet behaviors related to personal use-self-actualization (BootSE = .53, BootLLCI = .10, BootULCI = 2.18), cultural use-belonging (BootSE =.57, BootLLCI = -2.23, BootULCI = -.02). Average online hours moderate economic use-education, loneliness, and well-being (BootSE =.13, BootLLCI = -.55, BootULCI = -.04). Conclusion: To conclude, the effectiveness of internet use affects well-being differently depending on the type of activity. After a certain point, even seemingly good internet activities may have diminishing returns. [ABSTRACT FROM AUTHOR]

Background: Adolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healthcare and social support services. The Adolescents' Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) study, is testing an intervention intended to improve mental health outcomes for adolescents living in urban slums in India combining an anti-stigma campaign with a digital health intervention to identify and manage depression, self-harm/suicide risk or other significant emotional complaints. Methods: In the formative phase, we developed tools and processes for the ARTEMIS intervention. The two intervention components (anti-stigma and digital health) were implemented in purposively selected slums from the two study sites of New Delhi and Vijayawada. A mixed methods formative evaluation was undertaken to improve the understanding of site-specific context, assess feasibility and acceptability of the two components and identify required improvements to be made in the intervention. In-depth interviews and focus groups with key stakeholders (adolescents, parents, community health workers, doctors, and peer leaders), along with quantitative data from the digital health platform, were analysed. Results: The anti-stigma campaign methods and materials were found to be acceptable and received overall positive feedback from adolescents. A total of 2752 adolescents were screened using the PHQ9 embedded into a digital application, 133 (4.8%) of whom were identified as at high-risk of depression and/or suicide. 57% (n = 75) of those at high risk were diagnosed and treated by primary health care (PHC) doctors, who were guided by an electronic decision support tool based on WHO's mhGAP algorithm, built into the digital health application. Conclusion: The formative evaluation of the intervention strategy led to enhanced understanding of the context, acceptability, and feasibility of the intervention. Feedback from stakeholders helped to identify key areas for improvement in the intervention; strategies to improve implementation included engaging with parents, organising health camps in the sites and formation of peer groups. Trial Registration: The trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries, Reference number: CTRI/2022/02/040307. Registered 18 February 2022. [ABSTRACT FROM AUTHOR]

Background: Families with children diagnosed with ADHD often experience elevated levels of stress compared to families with typically developing children. This stress manifests in various forms including family conflicts, disciplinary challenges, financial strain, parental depression, and difficulties in marital relationships. Objectives: The objective was to assess parenting stress, coping, and resilience among parents of children with ADHD, as well as the psychosocial problems of children with ADHD as reported by parents. Method and Materials: his descriptive cross-sectional study was conducted at the Child Guidance Clinic, Psychiatry Department, Government Medical College & Hospital, Chandigarh. It included 40 consecutive mothers of children diagnosed with ADHD according to DSM-5 criteria, aged 6 to 14 years, fluent in Hindi or English, and residing with their child. Exclusion criteria comprised major medical or psychiatric illnesses, specific learning disabilities (SLD), and comorbid disabilities in children, as well as significant psychiatric or medical illnesses, disabilities, or substance dependencies (excluding nicotine) in mothers, and multiple family members with major disabilities. Assessment tools used were the Socio-demographic and Clinical Data Sheet, Chandigarh Parent Related Stress Scale (CPRSS), Bref-COPE, The Connor-Davidson Resilience Scale (CD-RISC), Screening Tool for Assessment of Psychosocial Problems (STAPP), and Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS). Result: The study revealed high levels of stress among mothers of children with ADHD, who employed a range of coping strategies including instrumental support, active coping, and planning, as well as emotional support, acceptance, positive reframing, and religious coping. Some also used maladaptive strategies like behavioural disengagement, venting, and self-blame. Participants showed a moderate level of resilience, with mild overall problems noted. Issues related to financial resources and high expressed emotion were most prevalent, followed by challenges with medication/treatment compliance and social support. Conclusion: This study underscores the need for increased focus on supporting parents in ADHD management, informing the development of comprehensive psychosocial intervention programs. [ABSTRACT FROM AUTHOR]

CONTEXT: Pottery is defined as clay that has been fashioned into the desired shape and then dried to reduce its water content before being fried or baked to fix its form. The artisans living in traditional societies are normally influenced by their environment as well as by their myths, legends, rituals, ceremonies, festivals, social organization, and cultural norms which are reflected in their creations. The poor environmental conditions and the lack of protective equipment in these pottery workshops are key contributing factors to the development of these occupational diseases. Most pottery industries are small- to medium-scale industries and have longer and irregular working hours, a higher percentage of elderly employees, limited opportunities for health education or health inspection, and insufficient health promotion facilities compared with large companies. These factors are considered to play an important part in the development of occupational diseases and some nonspecific diseases such as psychosomatic, cardiovascular, and locomotor diseases among pottery workers. Traditional pottery making has its unique method of potter-work where it demands prolonged squatting without back support for hours which can develop musculoskeletal disorders (MSDs). AIMS: The study aimed to estimate the prevalence of work-related musculoskeletal disorders (WRMD) among traditional pottery makers at selected places in Bengaluru. SETTINGS AND DESIGN: A cross-sectional study was conducted in two rural communities of Bengaluru. One hundred and ten traditional pottery makers were randomly selected. MATERIALS AND METHODS: Subjects were screened for work-related musculoskeletal disorders (WRMD) using the Nordic Musculoskeletal Questionnaire, following which the pottery makers who reported low back pain (LBP) were screened for the severity of disability using the Modified Oswestry LBP Disability Questionnaire (M-OSW). The results obtained were statistically analyzed using SPSS 25.0. RESULTS: The result showed the highest prevalence of MSDs in the lower back, the findings of this study confirmed the work-related stress on traditional pottery makers. In the present study, the highest prevalence of musculoskeletal disorder was found in the lower back, of which had trouble in the last 12 months, 56.36% were having trouble during the last 7 days, and 19.09% were prevented from doing normal activities during the last 12 months. The prevalence of MSDs during the last 12 months revealed that the maximum of them, i.e., 24.54%, were having pain in the lower back. The present study also found MSDs prevalent in the hip joint and knee joint due to the occupational need to complete the work on prolonged squatting. CONCLUSIONS: This study concluded that prolonged work exposure and awkward work postural demand increase the incidence of MSD among traditional pottery makers in Bengaluru. [ABSTRACT FROM AUTHOR]

Background: Adolescents are at risk of various psychosocial problems, due to pressure from parents, educational agencies, peers, and society. Often, it is not recognized and goes unnoticed. There is an immense need to screen this group for early detection and proper management. Aim: The aim of this study was to assess the prevalence of psychosocial problems among adolescents and to determine their risk factors. Methodology: The study employed a nonexperimental, exploratory, cross-sectional research design with a quantitative approach. Using a two-stage random sampling technique, a total of 2030 adolescents from 37 schools were chosen. The data collection tool for study participants consisted of three parts: (a) A sociodemographic proforma, (b) a pediatric symptom checklist-youth report, and (c) a checklist for assessing determinants of psychosocial problems. Results: Three hundred five (15.02%) of the 2030 respondents had significant impairment to internalizing problems, 350 (17.24%) to attention deficit problems, and 378 (18.62%) to externalizing problems. Pediatric symptom checklist scores and academic performance showed a moderately positive correlation. There is a significant association between psychosocial problems and adolescent characteristics at a P = 0.05 level of significance. Conclusion: Adolescents have a high prevalence of psychosocial problems such as anxiety and attention deficit. Periodic screening, counseling, and referral to psychotherapy can help to lessen the severity of the condition and improve psychosocial well-being. [ABSTRACT FROM AUTHOR]