METHOD: This review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses 2020) statement. The initial electronic search yielded a total of 3710 articles. The search identified 2354 potential papers after removing duplicates and 2301 articles were excluded by title and abstract. The full texts of the remaining 53 articles and nine articles from the citation searching were screened and 15 articles matched the inclusion criteria. The Mixed-Method Appraisal Tool (MMAT) was used for quality appraisal.
RESULTS: The thematic analysis resulted in four main themes which were educational intervention, physical intervention, clinical intervention, and a combination of both educational and clinical intervention.
CONCLUSION: We presented the findings in a narrative synthesis with the primary outcomes which served as answers to our main research question that prompted this systematic review.
METHODS: In total, 60 regular kratom users and 50 healthy control-group participants were recruited and administered a sociodemographic and clinical characteristics questionnaire. While participants who used kratom were also administered a kratom use characteristics questionnaire. Blood samples were collected from all participants, and targeted ER stress sensor protein expression was determined via Western blot analysis.
RESULTS: The study's findings revealed first that kratom users registered significantly higher protein expression in all targeted ER stress sensors compared to the control group. Second, higher protein expression of CHOP (B = 5.061, standard error [SE] = 2.547, Wald = 3.948, adjusted odds ratio [AOR] = 5.382, 95% confidence interval [CI] = 1.071 to 9.656, p = 0.047) and p-JNK (B = 5.795, SE = 2.635, Wald = 4.544, AOR = 17.025, 95% CI = 1.395 to 24.123, p = 0.017) increased the odds of kratom use disorder occurrence. Kratom use characteristics and other ER stress sensor protein expression were not associated with kratom use disorder.
CONCLUSION: Regular kratom use may induce protracted ER stress, leading to the decompensation of the unfolded protein response to maintain ER homeostasis. This effect may be linked to kratom use disorder occurrence.
AIMS: This paper describes an evidence based approach to culturally adapt CBT in Asian context, areas of focus for such adaptation and lessons learned.
METHODS: An environmental scan of the literature, description of local CBT associations and perspectives from these organizations.
RESULTS: Cultural adaptation of CBT focuses on three main areas; 1 awareness of culture and related issues, 2 assessment and 3 adjustment in therapy techniques.
CONCLUSIONS: The last decade has seen an increase in culturally adapted CBT in Asia, however, more work needs to be done to improve access to CBT in Asia.