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Lee P.-Y.,Mackay Medicine Nursing and Management College | Chang S.-J.L.,National Taiwan University
Journal of Educational Media and Library Science | Year: 2012

This study aims to explore the participation of the elderly in voluntary services in public libraries. The subjects for this study have been chosen from the elderly volunteers of the Taipei Public Library. The research questions attempt to investigate the followings: the motivations and purposes of elderly participation in volunteer services, the factors that influence their choices of entering the public library service, and the experience of volunteer services. This study uses a semi-structured interview and a small questionnaire to collect data. In order to obtain a comprehensive understanding of the research subjects and to interpret the research results appropriately, the findings have been supplemented with the background information of research subjects collected from personal profile forms to achieve the relevance to the volunteer services experience of elderly participation. The total of 30 elderly volunteer aged from 56 to 85 have been interviewed. Based on the research findings, the authors propose a framework for understanding elderly volunteers participating in public library services, and offer suggestions to voluntary service units of public libraries and elderly volunteers. Source

Yamaguchi S.,National Institute of Mental Health | Wu S.-I.,Mackay Medicine Nursing and Management College | Biswas M.,Kings College London | Yate M.,Kings College London | And 3 more authors.
Journal of Nervous and Mental Disease | Year: 2013

Although there are many interventions to reduce mental health-related stigma in university or college students, their overall effect is unknown. This article systematically reviews intervention studies and aims to identify the effective approaches. We searched 11 bibliographic databases, Google, Web sites of relevant associations, and reference lists and contacted specialists. A total of 35 studies (N = 4257) of a wide range of interventions met the inclusion criteria. Social contact or video-based social contact interventions seemed to be the most effective in improving attitudes and reducing desire for social distance. Evidence from one study suggests that a lecture that provided treatment information may enhance students' attitudes toward the use of services. However, methodological weaknesses in many studies were also found. There was a lack of evidence for interventions in medical students, for long-term effects of interventions, or for having a positive impact on actual behaviors. Further research having more rigorous methods is needed to confirm this. Copyright © 2013 by Lippincott Williams & Wilkins. Source

Wu C.-Y.,National Taiwan University | Whitley R.,Dartmouth Psychiatric Research Center | Stewart R.,Kings College London | Liu S.-I.,Mackay Memorial Hospital | Liu S.-I.,Mackay Medicine Nursing and Management College
Journal of Nursing Research | Year: 2012

Background: Help-seeking behavior may protect people from harming themselves. However, few studies have discussed how and why people access lay or professional help prior to self-harm. Purpose: This study explored the subjective experiences of individuals with deliberate self-harm in terms of help-seeking behavior and medical care pathways. Methods: Researchers performed qualitative in-depth interviews and content analysis and used a sampling grid to recruit participants. Twenty emergency attendees between the ages of 18-55 years were interviewed on their help-seeking pathways and experiences using a standardized topic guide. Results: Participants identified friends, family members, healthcare personnel, and their own initiative as the primary medical care pathways. Analysis showed help-seeking experiences significantly related to the physician-patient relationship, social support, and treatment adherence. These factors were also identified as prominent themes related to medical help-seeking behavior. Conclusions: Supportive attitudes and continuous care from formal and informal sources of help may facilitate help-seeking behavior, whereas negative influences from close friends or relatives may trigger a self-harm episode. Medication stockpiling and the negative aspects of close relationships should be addressed and minimized to raise the effectiveness of self-harm or suicide prevention efforts. © 2012 Taiwan Nurses Association. Source

Wu N.-L.,National Taiwan University | Wu N.-L.,Mackay Medicine Nursing and Management College | Huang D.-Y.,National Taiwan University | Hsieh S.-L.,National Yang Ming University | And 4 more authors.
Biochimica et Biophysica Acta - Molecular Basis of Disease | Year: 2013

Decoy receptor 3 (DcR3) is a soluble receptor of Fas ligand (FasL), LIGHT (TNFSF14) and TNF-like molecule 1A (TL1A) and plays pleiotropic roles in many inflammatory and autoimmune disorders and malignant diseases. In cutaneous biology, DcR3 is expressed in primary human epidermal keratinocytes and is upregulated in skin lesions in psoriasis, which is characterized by chronic inflammation and angiogenesis. However, the regulatory mechanisms of DcR3 over-expression in skin lesions of psoriasis are unknown. Here, we demonstrate that DcR3 can be detected in both dermal blood vessels and epidermal layers of psoriatic skin lesions. Analysis of serum samples showed that DcR3 was elevated, but FasL was downregulated in psoriatic patients compared with normal individuals. Additional cell studies revealed a central role of epidermal growth factor receptor (EGFR) in controlling the basal expression of DcR3 in keratinocytes. Activation of EGFR by epidermal growth factor (EGF) and transforming growth factor (TGF)-α strikingly upregulated DcR3 production. TNF-α[U+F020]enhanced DcR3 expression in both keratinocytes and endothelial cells compared with various inflammatory cytokines involved in psoriasis. Additionally, TNF-α-enhanced DcR3 expression in keratinocytes was inhibited when EGFR was knocked down or EGFR inhibitor was used. The NF-κB pathway was critically involved in the molecular mechanisms underlying the action of EGFR and inflammatory cytokines. Collectively, the novel regulatory mechanisms of DcR3 expression in psoriasis, particularly in keratinocytes and endothelial cells, provides new insight into the pathogenesis of psoriasis and may also contribute to the understanding of other diseases that involve DcR3 overexpression. © 2013 Elsevier B.V. Source

Tseng H.-K.,National Yang Ming University | Tseng H.-K.,Mackay Medical College | Tseng H.-K.,Mackay Medicine Nursing and Management College | Liu C.-P.,Mackay Memorial Hospital | And 10 more authors.
PLoS ONE | Year: 2013

Background:Among members of Cryptococcus neoformans- Cryptococcus gattii species complex, C. neoformans is distributed worldwide whereas C. gattii is considered to be more prevalent in the subtropics and tropics including Taiwan. This nationwide study was undertaken to determine the distribution of genotypes, clinical characteristics and outcomes of 219 patients with proven cryptococcosis at 20 hospitals representative of all geographic areas in Taiwan during 1997-2010.Methods and Findings:Of 219 isolates analyzed, C. neoformans accounted for 210 isolates (95.9%); nine isolates were C. gattii (4.1%). The predominant genotype was VNI (206 isolates). The other genotypes included VNII (4 isolates), VGI (3 isolates) and VGII (6 isolates). Antifungal minimal inhibition concentrations higher than epidemiologic cutoff values (ECVs) were found in nine VNI isolates (7 for amphotericin B). HIV infection was the most common underlying condition (54/219, 24.6%). Among HIV-negative patients, liver diseases (HBV carrier or cirrhosis) were common (30.2%) and 15.4% did not have any underlying condition. Meningoencephalitis was the most common presentation (58.9%), followed by pulmonary infection (19.6%) and "others" (predominantly cryptococcemia) (18.7%). The independent risk factors for 10-week mortality, by multivariate analysis, were cirrhosis of liver (P = 0.014) and CSF cryptococcal antigen titer ≥512 (P = 0.020). All except one of 54 HIV-infected patients were infected by VNI genotype (98.1%). Of the 13 isolates of genotypes other than VNI, 12 (92.3%) were isolated from HIV-negative patients. HIV-infected patients compared to HIV-negative patients were more likely to have meningoencephalitis and serum cryptococcal antigen ≥1:512. Patients infected with C. gattii compared to C. neoformans were younger, more likely to have meningoencephalitis (100% vs. 57%), reside in Central Taiwan (56% vs. 31%), and higher 10-week crude mortality (44.4% vs. 22.2%).Conclusions:Cryptococcus neoformans in Taiwan, more prevalent than C. gatii, has a predominant VNI genotype. Isolates with antifungal MIC higher than ECVs were rare. © 2013 Tseng et al. Source

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