Screening nursing students to identify those at high risk of poor mental health: a cross-sectional survey.

OBJECTIVES: This study aimed to identify those at high risk of poor mental health among nursing students and to examine the relationships and consistency among five mental health assessments. DESIGN: A cross-sectional design with purposive sampling was used. Four mental health screening tools plus previous mental health history/information were conducted during June 2015 to October 2016. SETTING: A nursing major university in Taiwan. PARTICIPANTS: A total of 2779 participants aged between 19 and 45 years were recruited. MAIN OUTCOME MEASURES: Five mental health risks were identified: increased risk for ultra-high risk, putative prepsychosis states, high trait anxiety, high state anxiety with genetic risk and depression. RESULTS: Out of the 3395 collected questionnaire, 2779 (82%) were found valid and included in the study. 612 (22%) of the participants were identified to be at mental health risk. 12 of them appeared positive in four, 79 in three, 148 in two and 373 in one of the adopted mental health screening tools. 69 participants had the experience of seeking medical help due to mental health issues, and 58% of them were identified to be at risk of mental health during the screening. Trait and state anxiety scored the highest in correlation analysis (r(2620)=0.76, p<0.001). Correlations were observed in the scores on the subscales of Chinese Version of Schizotypal Personality Questionnaire-Brief (CSPQ-B) and those of Brief self-report Questionnaire for Screening Putative Prepsychotic States (BQSPS), and the highest correlation coefficients was (r(2740)=0.70, p<0.001). Although both of the screening tools are used to assess mental illness risk at its prodromal phase, but CSPQ-B in general appeared to have more rigorous screening criteria than BQSPS. CONCLUSION: For expediting early identification high risk of poor mental health, easy-to-use screening questionnaires can be adopted to assess the mental health state of nursing students whose mental well-being and overall health are of vital importance to the entire healthcare industry.

Supplementation with Selenium yeast on the prooxidant-antioxidant activities and anti-tumor effects in breast tumor xenograft-bearing mice.

Selenium (Se) is essential for antioxidant activity involved in immune function and anti-carcinogenic action, whereas at higher concentrations, Se may have pro-oxidant properties. The present study was aimed at determining the effects of Se supplementation, as Se yeast, on oxidative stress in non-tumor/tumor tissues, as well as regulation of the apoptotic process, and immune responses in mice-bearing breast tumor xenografts. Female BALB/cByJNarl mice were divided into control (CNL and CNL-con), Se-supplemented control (CNL-HS, given as a single oral dose of 912 ng Se daily), breast tumor-bearing (TB and TB-con), TB-LS (228 ng Se), TB-MS (456 ng Se) and TB-HS (912 ng Se) groups. All mice were treated with/without Se for 14 days. A number of variables were further measured. Compared with the TB groups, tumor bearing mice with Se supplement had increased plasma Se concentrations, reduced erythrocyte Se-dependent glutathione peroxidase (GPx) activity and malondialdehyde (MDA) products and inhibited tumor growth. They have also higher Se concentrations in non-tumor and tumor tissues. Significantly elevated concentrations of MDA and reduced GPx activities, as well as increased anti-apoptotic bcl-2 and tumor suppressor p53 concentrations in tumor tissues were observed as Se accumulated in tumor, whereas lower MDA products were found in various non-tumor tissues than did the corresponding values. Further, there were elevated concentrations of Th1-derived cytokines and decreased Th2-type interleukin (IL)-4 in tumor-bearing mice with the treatment of Se. In conclusion, accumulation of Se in tumors may induce oxidative stress and p53-dependent pro-oxidative apoptosis, thus inhibiting the growth of breast tumor.

[The Discursive Analysis of Mental Health Promotion Efforts Targeting Community-Dwelling Young Adults at High Risk of Mental Illness].

The mental health of adolescents and young adults is an issue of concern worldwide due to the increase in violent incidents that have been perpetrated by members of this age group. Young people at high-risk of mental disability are easily ignored. Therefore, social tensions in society have increased due to safety issues arising from the problems that are associated with mental disabilities in this population. This paper discusses the importance of early identification and early prevention of mental disabilities in high-risk young people, defines high-risk mental illness, and identifies the various subcategories of mental diseases. Based on our review of the literature, the present paper suggests targeting young people in high-risk categories with health promotion that addresses the following six health-promotion lifestyle habits: engaging in regular exercise, eating a balanced diet, managing stress, engaging in social relationships, taking responsibility for personal health, and fulfilling self-actualization. This discursive analysis discusses these strategies as safe and sustained interventions for adolescents and young adults that may improve self-awareness and thus maintain health and enhance opportunities to promote an ideal health status.

Using non-invasive assessment methods to predict the risk of metabolic syndrome.

This study aimed to develop non-invasive assessment indicators for predicting the risk of metabolic syndrome. A cross-sectional study design with 154 convenient subjects recruited from the family clinics was used for this study. Physical assessment sheet, lifestyle profile, the heart rate variability assessment and standard blood sample tests were used to measure variables. The subjects were categorized into four groups based on the number of factors meeting the criteria for metabolic syndrome. After excluding invasive blood tests, the results of multivariate logistic regression identified non-invasive assessment (blood pressure, body mass index and very lower frequency of heart rate variability) were the significantly predictors of the risks of metabolic syndrome. When invasive blood test cannot be performed, community health care providers can use the non-invasive physical assessments to predict the risk of early-stage metabolic syndrome, consequently enabling them to implement related health education and interventions.

Arsenic, cadmium, lead, and aluminium concentrations in human milk at early stages of lactation.

BACKGROUND: Human milk is considered to be the best nutrition for all infants because it provides the optimal source of nutritional, immunological, developmental, psychological, economic, practical, and environmental benefits in both the short and long terms. To the best of our knowledge, few studies in Taiwan have examined the toxicant levels in breast milk and associated factors. METHODS: The research was carried out over a 6-month period. Forty-five healthy lactating women, who delivered full-term newborns at our maternity ward, were recruited, and all participants had been living in coastal urban areas of mid-Taiwan for at least 3 years. One hundred and eighty human milk samples were collected on four occasions, which were classified into four lactation stages as follows: colostrums, transitional milk, early mature milk, and mature milk. RESULTS: We found that lead, cadmium, aluminium, and arsenic concentrations were the highest in colostrums: 13.22 ± 3.58 ng/mL, 1.37 ± 0.94 ng/mL, 56.45 ± 22.77 ng/mL, and 1.50 ± 1.50 ng/mL, respectively. The results of lead, cadmium, aluminium, and arsenic determination in human milk samples demonstrated a trend of decline of microelement concentrations with advancing stages of lactation. We found that the infants of smoking mothers were exposed to more cadmium than infants of nonsmoking mothers (p < 0.05). CONCLUSION: According to our findings, frequent routine sampling of breast milk is worthwhile. Prevention strategies including behavior modification and education on proper nutrition should be provided to women who are at high risk of toxicant exposure. In summary, breastfeeding is still generally encouraged and recommended.

Cu/Zn ratios are associated with nutritional status, oxidative stress, inflammation, and immune abnormalities in patients on peritoneal dialysis.

OBJECTIVES: We evaluated the relationship of the plasma copper/zinc (Cu/Zn) ratio with nutritional status, inflammation, oxidative stress, and immune function in peritoneal dialysis patients. DESIGN AND METHODS: Clinical and laboratory parameters were measured in patients (n=45) and age- and sex-matched healthy individuals (n=30). RESULTS: There were significant negative correlations of the Cu/Zn ratio with nutrition-related parameters (body mass index [BMI], creatinine, hemoglobin, and albumin) and antioxidant (vitamin C and E) levels and positive correlations of the Cu/Zn ratio with the levels of high sensitivity C-reactive protein (hs-CRP) and oxidation products (malondialdehyde [MDA] and protein carbonyl). The Cu/Zn ratio was negatively correlated with the percentages of B- and T-lymphocyte subsets and the ratio of CD4/CD8 antigens. CONCLUSIONS: In peritoneal dialysis patients, elevated Cu/Zn ratios are associated with malnutrition, increased oxidative stress, inflammation, and disrupted immune status.

[Psychiatric patient continuum community care in Taichung Country].

Deinstitutionalization and the implementation of community psychiatry rehabilitation models define the future of psychiatric medical care in Taiwan. As such, managing and caring for psychiatric patients at the community level are increasingly important public health issues for county and city governments. A local public health authority in Taichung County established a collaborative relationship with a university-level nursing department during 2007 - 2008 in order to provide more effective continuous community care for psychiatric patients. This cooperative arrangement provided continuous community care for psychiatric patients in the County by implementing aftercare for psychiatric patients that was delivered through community-level public health centers, which conducted patient visits, developed discharge notifications for severe psychiatric patients in mental health institutions, and strengthened connections among related resources. To establish continuous community care for psychiatric patients, it is necessary to enhance training and support for health recipients as well as nursing staff in public health centers through measures that include: implementing discharge preparations and notifications in mental health institutions, improving the quality of community-based psychiatric patient visits, and connecting and integrating relevant resources effectively.

[Discharge planning: practical implementation in psychiatric care].

Care extension programs that bridge hospitals into the community are today a mainstream component of psychiatric care around the world. Stronger linkages amongst community resources can help patients and their families transition successfully through the hospital discharge process and reenter the community. Discharge planning is a service that provides the needs-oriented care necessary to link the hospital and community. Such planning, handled in accordance with case management procedures, focuses on medical team cooperation, follow-up services and recovery evaluation. Using a review of the literature and a real case study, this article demonstrates the practical use of discharge planning services, analyzes problems frequently encountered during the discharge process and related interventions. By increasing the proper disease management knowledge of patients and their families, strengthening staff support to families through the creation of "medical leagues", establishing community care and better support networks, and implementing a discharge process evaluation procedure, discharge planning services may provide efficient and continuous medical care essential to prevent re-admission, reduce hospitalization expenses, and strike a better balance between medical service quality and cost.