[Human Health Rights: Discussing Health Inequality for Taiwanese Indigenous Peoples and the Appropriateness of Current Epidemic Policies].

Many studies from around the world demonstrate that COVID-19 has had significantly higher rates of infection, hospitalization, and mortality among indigenous and other vulnerable groups than among mainstream population groups. This situation has exposed and reinforced pre-existing health inequalities. This article investigates the rates of infection and mortality among different cultural groups during the COVID-19 pandemic, and then deconstructs the key elements related to systemic or structural racism. The impacts on the human rights and health of indigenous peoples and issues of policy formulation and resource equity during the epidemic are also mentioned. Based on the identified root causes of health inequality, suggestions for reducing health inequality for Taiwanese indigenous peoples are proposed. Further, during epidemics, policymakers must design and implement culturally appropriate epidemic prevention policies, systems, and strategies for indigenous and other disadvantaged populations.

Resveratrol inhibits MUC5AC expression by regulating SPDEF in lung cancer cells.

BACKGROUND: MUC5AC was recently identified to play important roles in the proliferation and metastasis of malignant mucinous lung tumor cells. Resveratrol (Res), a natural compound with anticancer effects in lung cancer cells, has been reported to inhibit mucin production in airway epithelial cells. This study aimed to investigate the inhibitory effect of Res on MUC5AC expression in lung mucinous adenocarcinoma cells and the potential mechanisms. METHODS: Mucus-producing A549 human lung carcinoma cells were used to test the effects of Res on SPDEF and MUC5AC expression. Gene and protein expression was assessed by real-time quantitative PCR (qPCR), immunofluorescence and western blotting assays. SPDEF lentivirus was used to upregulate SPDEF expression levels in mucus-producing A549 human lung carcinoma cells. Cell proliferation was assessed by Cell Counting Kit-8 (CCK-8) assay. RESULTS: Res decreased MUC5AC expression in an SPDEF-dependent manner in mucus-producing A549 human lung carcinoma cells, and this change was accompanied by decreased ERK expression and AKT pathway activation. Moreover, SPDEF was found to be overexpressed in lung adenocarcinoma (LUAD), especially in mucinous adenocarcinoma. In-vitro functional assays showed that overexpression of SPDEF reduced the chemosensitivity of A549 cells to cisplatin (DDP). In addition, Res treatment increased A549 cell chemosensitivity to DDP by inhibiting the SPDEF-MUC5AC axis. CONCLUSION: Our results indicate that the SPDEF-MUC5AC axis is associated with DDP sensitivity, and that Res decreases SPDEF and MUC5AC expression by inhibiting ERK and AKT signaling in A549 cells, which provides a potential pharmacotherapy for the prevention and therapeutic management of mucinous adenocarcinoma.

Trends in the use of antimuscarinics and alpha-adrenergic blockers in women with lower urinary tract symptoms in Taiwan: A nationwide, population-based study, 2007-2012.

BACKGROUND: We aim to examine the trend in the use of antimuscarinics and off-label alpha-adrenergic blockers for treatment of lower urinary tract symptoms (LUTS) in a Taiwanese Women Cohort between 2007 and 2012. METHODS: This population-based National Health Insurance Research Database (NHIRD) was used to examine the trends in the use of antimuscarinics or off-label alpha-adrenergic blockers in Taiwan. A sample of 1,000,000 individuals randomly drawn from the whole population of 23 million individuals who were registered in the NHI in 2005. From 2007 through 2012, women aged over 18 years whose claim record contained prescriptions of either of the two drugs for treatment of any of the LUTS-related diagnoses were identified and analyzed. The annual usage of the two drug classes were calculated by defined daily dose (DDD). RESULTS: From 2007-2012, there was a 0.80 fold (69676.8 to 125104.3) increase in DDD of antimuscarinics in our cohort. The overall healthcare seeking prevalence of LUTS was 7.33% in 2007 and 12.38% in 2012, in a rising trend. The prevalence of antimuscarinics-treated LUTS in our cohort increased from 2.53 in 2007 to 3.41 per 1000 women in 2012. The prevalence of LUTS treated by antimuscarinics increased especially for those older than 60 years during the study period. CONCLUSIONS: This 6-year observational study provided the epidemiologic information of clinically significant LUTS of Asian female population. Moreover, there was a rising trend in the use of antimuscarinics and off-label alpha-adrenergic blockers in the population-based cohort.

The effect of music therapy on reducing depression in people with dementia: A systematic review and meta-analysis.

The aim of this study was to determine the effectiveness of music therapy on reducing depression for people with dementia during different intervention intervals. A systematic review with a meta-analysis of randomized controlled trials. The databases surveyed include AgeLine, CINAHL, MEDLINE, PsycINFO, PubMed, and Cochrane. Seven studies were included in this review. The result revealed that music therapy significantly reduced depression at six, eight, and 16 weeks. This study also supported that music therapy significantly improved depression when the results of six studies with medium-term interventions were pooled. However, no evidence of effect of music therapy on depression was observed at three, four, 12 weeks, and five months during intervention, and one and two months after the cease of music therapy. Music therapy without a music therapist involved did not significantly reduce depression at any time. Medium-term of music therapy might be appropriate in reducing depression for people with dementia.

[Spiritual Care of Patients With Depression].

Spiritual care is a component of holistic care. Patients with depression often experience body-mind-spirit health problems and may suffer from spiritual crises, particularly during the acute stage of a diseases, due to low self-esteem, negative attitudes toward life goals, daily life issues, and beliefs caused by physical, psychological, and occupational dysfunctions. Nonetheless, psychical care is the main treatment for patients with depression. This paper focuses on patients with depression and addresses the concepts of spiritual needs and spiritual care, identifying the factors that influence spiritual needs, the essentials of spiritual intervention, and the health effects of spiritual intervention outcomes on patients with depression. Courses that teach practical spiritual interventions are recommended for nurses. These courses should address topics such as individual approaches, building trusting relationships, setting diverse goals for spiritual interventions based on disease stage, and spiritual interventions involving the body-mind-spiritual aspects for patients with depression.

Lifestyle in Visually Impaired or Blind Massage Therapists: A Preliminary Study.

BACKGROUND: Lifestyle is among the most important factors affecting individual health status. Limited access to health information may limit the ability of people with visual impairment or blindness to practice healthy lifestyles. However, no studies have investigated how lifestyle practices affect health specifically in visually impaired and blind populations. PURPOSE: The aim of this study was to investigate the lifestyle behaviors of visually impaired and blind massage therapists (VIBMTs) in Taiwan. METHODS: This exploratory study used a purposive sampling technique to recruit 50 VIBMTs who were employed at massage stations in southern Taiwan. All of the participants completed the Health-Promoting Lifestyle Profile II (HPLP-II) and a survey of demographic characteristics. Descriptive and inferential statistical tests, including the Mann-Whitney U test and the Kruskal-Wallis H test, were used. Statistical significance was defined as p < .05 in two-tailed tests. RESULTS: Fifty participants completed both the HPLP-II and the demographic survey. The mean subscale score for the HPLP-II was 2.52 ± 0.37. The lowest scores were on the physical activity (2.09 ± 0.67) and nutrition (2.35 ± 0.39) subscales, and the highest scores were on the spiritual growth (2.89 ± 0.56) and interpersonal relations (2.79 ± 0.46) subscales. Scores on the stress management and physical activity subscales were significantly higher in men than in women (p < .05). In addition, mean HPLP-II scores were significantly higher in VIBMTs who exercised regularly compared with those who did not (p < .05). Compared with nonsmokers, current smokers had significantly higher scores on the stress management subscale (p < .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The low physical activity scores in this population may be improved by developing physical activity programs for the home and workplace and by establishing community recreational and exercise facilities for visually impaired populations. The low scores for nutrition may be improved by establishing nutrition education programs that are designed specifically for VIBMTs to increase their consumption of fresh produce and other healthy foods and by requiring food manufacturers to use labels that may be easily read or understood by visually impaired populations.

Development and validation of the Chinese Version of Spiritual Interests Related Illness Tool for patients with cancer in Taiwan.

PURPOSE: The purpose of the study was to develop and validate the Chinese Version of Spiritual Interests Related Illness Tool (C-SpIRIT) for patients with cancer in Taiwan. METHODS: Translation, adaptation, and content validation were performed based on the 44-item Spiritual Interests Related Illness Tool. The psychometric validation was conducted based on 260 participants who were recruited from the oncology outpatient clinic of a medical center in southern Taiwan. The data were analyzed using exploratory factor analysis, Cronbach's alpha, and Pearson's correlations. RESULTS: Five subscales (related to beliefs/religion, positive attitudes toward life, love to/from others, seeking for the meaning of life, and peaceful mind) were extracted from an exploratory factor analysis. The five subscales (with 21 items) accounted for 50.43% of the variance. The evidence based on concurrent validity was supported by a significant correlation (r = 0.95) between the 33-itm C-SpIRIT and the 21-item C-SpIRIT. Cronbach's α values (0.73-0.88) demonstrated internal item consistency of the C-SpIRIT. CONCLUSIONS: This preliminary 21-item and 5-factor constructed C-SpIRIT demonstrated a valid and reliable instrument to assess the spiritual needs of patients with cancer in Taiwan. In addition, it is a handy tool for oncology nursing practitioners to gage their patients' spiritual needs.

A cross-sectional survey of the symptom experience of kidney transplant recipients.

BACKGROUND: Previous studies have shown that being able to assess and improve kidney transplant recipients' experience of the common side effects of long-term post-operative immunosuppressive drug therapy can positively affect their treatment compliance, and thus, their quality of life. However, more needs to be learned about the factors affecting the symptom experience of kidney transplant patients in Taiwan. OBJECTIVE: The purpose of this study was to further our understanding of kidney transplant recipients' symptom experience in Taiwan in order to improve their symptom experience, drug and other therapies, and overall quality of life. METHODS: A cross-sectional study was conducted with purposive sampling of transplant recipients from a hospital in southern Taiwan. Data were collected from August 23, 2003 to June 30, 2004. One hundred subjects participated and self-reported using a structured questionnaire. The reliability (alpha) of social support and symptom experience was 0.96 and 0.78, respectively. RESULTS: The results indicated that there were significant differences in physical symptom experience by gender and herbal medicine use, and in psychosocial symptom experience by educational level and herbal medicine use. Women, on an average, had more severe physical symptoms than men. A higher level of social support and herbal medicine use was associated with less severe physical symptoms among men and women. These three factors explained 22.5% of the variance in physical symptom experience: gender (13.0%), value support (6.1%) and herbal medicine use (3.4%). The factor with the highest explanatory value for the variance in psychosocial symptom experience was herbal medicine (7.8%), its use being associated with slightly lower levels of psychosocial symptoms. CONCLUSIONS: A better understanding of kidney transplant patients' symptom experience can improve health professionals' symptom appraisal efforts, enabling them to provide better quality care, encourage greater patient compliance, and ultimately, improve the quality of life for kidney transplant recipients.