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Fulltext Comparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP+) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial

Zelenev A, Huedo-Medina TB, Shrestha R, Mistler CB, Altice FL, Sibilio B, et al.

PLoS One, 2024;19(11):e0312165.
PMID: 39509356 DOI: 10.1371/journal.pone.0312165

Few evidence-based interventions have been widely adopted in common clinical settings, particularly for opioid-dependent people with HIV (PWH) seeking drug treatment. We developed a brief evidence-based intervention, Holistic Health for HIV (3H+), specifically for ease of implementation and integration within drug treatment settings. In this study, we compared 3H+ to the gold standard, Holistic Health Recovery Program (HHRP+) using a non-inferiority trial. Between 2012 and 2017, 106 participants were randomly assigned to either the brief 3H+ intervention or the gold standard HHRP+. HIV treatment (ART adherence, viral suppression) and risk behaviors (sharing injection equipment, condom use) were compared between the two arms at baseline, end-of-intervention (EOI-12 weeks) and at follow-up (24 weeks). Average treatment effect was calculated based on the difference-in-difference (DID) estimator and a non-parametric bootstrap was used to assess non-inferiority. At the 12-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to multiple outcomes: percent sharing syringes and needles (DID:1.4, 95%CI [-18.6,21.5], p<0.01) and attainment of high ART adherence (DID: 9.7, 95%CI: [-13.1, 32.2], p = 0.04). At the 24-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to percent sharing syringes and needles (DID: 8.9, [-10.1, 28.30], p = 0.04) and attainment of viral suppression (DID: 18.9, 95% CI:[-7.1, 42.0], p = 0.01). For other indicators, such as consistent condom use, the hypothesis test for non-inferiority was inconclusive at the 12-week EOI (DID: -20.2, 95%CI [-48.9-10.7], p = 0.51). For HIV treatment as prevention to be effective, PWH need to achieve viral suppression. In the absence of this success, they must reduce HIV risk behaviors. The finding that 3H+ was non-inferior to HHRP+ suggests that brief behavioral interventions can be deployed in real world settings to help more efficiently achieve Ending the HIV Epidemic goals.

Matched MeSH terms: Holistic Health*
The struggle for wholeness: addressing individual and collective trauma in violence-ridden societies

C CL

Explore (NY), 2011 Sep-Oct;7(5):300-13.
PMID: 21907153 DOI: 10.1016/j.explore.2011.06.001

The present article begins with an overview of how staff at the Center for Dialogue and Human Wellbeing (CDBH)-at Tecnológico de Monterrey University in Chihuahua, México-approach the process of conflict transformation. Specifically, it focuses on CDBH's strategies for dealing with historical injury, as well as the individual and collective trauma existing between and among communities engaged in ongoing conflict. It proceeds to examine how traumatic memories are stored in the mind/brain, and how trauma can impact on individuals and communities locked into a cycle of violence. The ensuing section provides an overview of the debate and the literature concerning psychotherapeutic and holistic-kinesthetic approaches for addressing individual and collective trauma. A hypothetical workshop is then offered to give readers a clear idea of how trauma work is actually carried out. The article ends by asking what approaches can best be applied for transforming collective trauma into sacred memories, which can become the driving force for a continuing commitment to building and sustaining peace among segments of communities that had previously been in conflict with one another.

Matched MeSH terms: Holistic Health*
Malaysian dental graduates' competence in holistic care: what do graduates and employers think?

Yusof ZY, Jaafar N, Jallaludin RL, Abu-Hassan MI, Razak IA

J Dent Educ, 2010 Dec;74(12):1380-7.
PMID: 21123505

The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.

Matched MeSH terms: Holistic Health*
Exploring terminally ill patients' and their families' perceptions of holistic care in Malaysia

Loh KY

Int J Palliat Nurs, 2006 Jan;12(1):38-41.
PMID: 16493304 DOI: 10.12968/ijpn.2006.12.1.20396

AIM: To document the perception of terminally ill patients and their family members on the care provided to them, and to look at the components of holistic care that are viewed as inadequate.
METHODS: Thirty cancer patients from a 10-bed palliative ward and their family members who were the chief carers were interviewed. They were asked to give their perceptions on four major areas of care: physical, social, psychological and spiritual. The participants were asked to report which area(s) of the service were inadequate.
RESULTS: Most patients and family members perceived that they received adequate physical care. However, the psychosocial and spiritual aspect of care were perceived as inadequate by the majority of patients and their families. None of the patients interviewed had ever been asked about spiritual distress.
CONCLUSION: The holistic model of care in caring for terminally ill patients is not practised fully. Further development in the psychosocial and spiritual aspects of care is necessary. There is a need to conduct further research to address these domains.

Matched MeSH terms: Holistic Health*
The NurseLink model of care

Nugent J

Contemp Nurse, 2003 Aug;15(1-2):110-3.
PMID: 14649514
Matched MeSH terms: Holistic Health
First Asian ISSAM Meeting on the Aging Male, Kuala Lumpur, Malaysia, 1-3 March 2001--an overview

Leinmüller R, Lunenfeld B

Asian J Androl, 2001 Jun;3(2):151-4.
PMID: 11488424
Matched MeSH terms: Holistic Health
Obesity, metabolic syndrome, adipocytes and vascular function: A holistic viewpoint

Achike FI, To NH, Wang H, Kwan CY

Clin Exp Pharmacol Physiol, 2011 Jan;38(1):1-10.
PMID: 21083697 DOI: 10.1111/j.1440-1681.2010.05460.x

1. Obesity is a metabolic disease of pandemic proportions largely arising from positive energy balance, a consequence of sedentary lifestyle, conditioned by environmental and genetic factors. Several central and peripheral neurohumoral factors (the major ones being the anorectic adipokines leptin and adiponecin and the orexigenic gut hormone ghrelin) acting on the anorectic (pro-opiomelanocortin and cocaine- and amphetamine-regulated transcript) and orexigenic (neuropeptide Y and agouti gene-related protein) neurons regulate energy balance. These neurons, mainly in the arcuate nucleus of the hypothalamus, project to parts of the brain modulating functions such as wakefulness, autonomic function and learning. A tilt in the anorectic-orexigenic balance, perhaps determined genetically, leads to obesity. 2. Excess fat deposition requires space, created by adipocyte (hypertrophy and hyperplasia) and extracellular matrix (ECM) remodelling. This process is regulated by several factors, including several adipocyte-derived Matrix metalloproteinases and the adipokine cathepsin, which degrades fibronectin, a key ECM protein. Excess fat, also deposited in visceral organs, generates chronic low-grade inflammation that eventually triggers insulin resistance and the associated comorbidities of metabolic syndrome (hypertension, atherosclerosis, dyslipidaemia and diabetes mellitus). 3. The perivascular adipose tissue (PVAT) has conventionally been considered non-physiological structural tissue, but has recently been shown to serve a paracrine function, including the release of adipose-derived relaxant and contractile factors, akin to the role of the vascular endothelium. Thus, PVAT regulates vascular function in vivo and in vitro, contributing to the cardiovascular pathophysiology of the metabolic syndrome. Defining the mechanism of PVAT regulation of vascular reactivity requires more and better controlled investigations than currently seen in the literature.

Matched MeSH terms: Holistic Health
Fulltext An exploratory qualitative assessment of self-reported treatment outcomes and satisfaction among patients accessing an innovative voluntary drug treatment centre in Malaysia

Ghani MA, Brown SE, Khan F, Wickersham JA, Lim SH, Dhaliwal SK, et al.

Int J Drug Policy, 2015 Feb;26(2):175-82.
PMID: 25577322 DOI: 10.1016/j.drugpo.2014.10.002

BACKGROUND: In Malaysia, compulsory drug detention centres (CDDCs) hold suspected drug users for two years without adjudication. Acute detoxification without healthcare access has been documented. CDDCs are criticized globally due to ineffectiveness in treating addiction and human rights violations. In response, the Malaysian government began transitioning these facilities into voluntary drug treatment centres known as "Cure and Care" (C&C) centres that embrace a holistic treatment-based approach to drug addiction rehabilitation.
METHODS: An explorative qualitative study was undertaken to explore patient perspectives and satisfaction regarding treatment and services at the new Cure and Care centre in Kota Bharu, Malaysia. A convenience sample of 20 patients was recruited to participate in semi-structured in-depth interviews. Content analysis was used to identify the salient themes.
RESULTS: Patients identified methadone treatment, psychosocial programs, religious instruction, and recreational activities as important factors contributing to treatment success for addressing both health and addiction needs. Though many had previously been in a CDDC, adherence to treatment in the C&C centre was perceived to be facilitated by the degree of social support, the voluntary nature and the array of new programs available for selection.
CONCLUSION: C&Cs represents a dramatic shift in the Malaysian government's approach to drug addiction. Our findings demonstrate positive patient experiences associated with the holistic treatment-based approach of these centres. This exploratory study provides additional evidence to document this ongoing policy transition and may guide continued expansion of new holistic drug treatment programs across the country.

Matched MeSH terms: Holistic Health