Conserved molecular chaperone PrsA stimulates protective immunity against group A Streptococcus.

Group A Streptococcus (GAS) is a significant human pathogen that poses a global health concern. However, the development of a GAS vaccine has been challenging due to the multitude of diverse M-types and the risk of triggering cross-reactive immune responses. Our previous research has identified a critical role of PrsA1 and PrsA2, surface post-translational molecular chaperone proteins, in maintaining GAS proteome homeostasis and virulence traits. In this study, we aimed to further explore the potential of PrsA1 and PrsA2 as vaccine candidates for preventing GAS infection. We found that PrsA1 and PrsA2 are highly conserved among GAS isolates, demonstrating minimal amino acid variation. Antibodies specifically targeting PrsA1/A2 showed no cross-reactivity with human heart proteins and effectively enhanced neutrophil opsonophagocytic killing of various GAS serotypes. Additionally, passive transfer of PrsA1/A2-specific antibodies conferred protective immunity in infected mice. Compared to alum, immunization with CFA-adjuvanted PrsA1/A2 induced higher levels of Th1-associated IgG isotypes and complement activation and provided approximately 70% protection against invasive GAS challenge. These findings highlight the potential of PrsA1 and PrsA2 as universal vaccine candidates for the development of an effective GAS vaccine.

Relationship between Quality of Nursing Work Life and Uniformed Nurses' Attitudes and Practices Related to COVID-19 in the Philippines: A Cross-Sectional Study.

(1) Background: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. Uniformed nurses have played a critical role during the COVID-19 pandemic in the Philippines; however, uptake of literature is limited. This study assessed the relationship between quality of nursing work life (QNWL) and nurses' attitudes and practices during the COVID-19 pandemic. (2) Methods: A descriptive cross-sectional design was used. Participants were recruited from four government hospitals in the Manila metropolitan area of the Philippines. Participants completed three questionnaires in an online survey: a demographic questionnaire, a QNWL questionnaire, and the attitude and practices toward COVID-19 questionnaire. Descriptive statistics, an independent t-test, a one-way analysis of variance, the Pearson correlation coefficient, and hierarchical linear regression were applied for data analysis. (3) Results: The mean age of the participants was 29 years. Most of the participants were single women who were not certified in their specialties. A total of QNWL scores were high, indicating that the participants displayed favorable attitudes and practices in relation to COVID-19. A statistically significant relationship was observed between QNWL, specialty certification, and practices related to COVID-19. Practices related to COVID-19 were a significant predictor of QNWL and one of its subscales, work design. (4) Conclusion: Young adult uniformed nurses in the Philippines have assumed numerous responsibilities during the COVID-19 pandemic. Providing these frontline nurses with comprehensive specialized education and training is crucial.

[Creative Theory in Psychiatric & Mental Health Nursing, Alternative Teaching Model, and a New Breakthrough in Psychiatric Home Care Nursing].

Although many resources have been explored and applied in our environment, personal internal and external resources have yet to be adequately exploited. A nursing theory and model for internal and external resources may be developed and discussed deeply (Zauszniewski, 2018) to provide newer vision and direction, while helping face the challenges of caring for patients with psychiatric disorders or mental obstacles. Recently, many breaking news stories have highlighted the hidden worries affecting our society due to patients with psychiatric disorders who live in the community. This has resulted in people, including student nurses, to retain their stigma toward mental illnesses and psychiatric patients and express negative perceptions and fear toward psychiatric patients (Choi et al., 2016). Therefore, it has been a challenge of psychiatric nursing education to develop and use a new and more-acceptable teaching model to help student nurses better understand and hold a more-correct perception toward psychiatric patients. The practice of clinical nursing profession still needs to be focused while we remain committed to psychiatric nursing education. The number of psychiatric patients who need more continuous care in community settings has increased significantly. The needs of psychiatric home care nursing should be particularly emphasized, as the manpower / capabilities necessary for psychiatric nursing are limited in community health nursing practice (Huang & Wang, 2015). More resources and psychiatric practice nursing professionals should be made available to communities for continuous psychiatric care (Wu et al., 2016). Strong and authentic partnerships are very important to acute care, education, evidence-based research, and practical policy development in psychiatric & mental health nursing (McInnis-Perry et al., 2015). In this column, resourcefulness theory is introduced as a new theory that may be applied in the psychiatric and mental health nursing practice; alternative teaching models are recommended for psychiatric nursing education; and finally, the importance of overcoming the difficulties and addressing the needs in community psychiatric home care nursing is also emphasized. It is hoped that this approach will help facilitate the further, positive advance of psychiatric and mental health nursing.

[Resourcefulness Theory and Its Research and Application in Psychiatric and Mental Health Nursing].

Resourcefulness theory has been developed and applied for nearly four decades in the West and been recommended by scholars in Taiwan for almost two decades. Research into the concept and theory of resourcefulness has been conducted in the nursing profession, especially in psychiatric and mental health nursing, in Taiwan, making the country the earliest Chinese and Taiwanese culture to adopt and use this theory. The concept of resourcefulness was derived from psychology and refers to the ability to effectively use internal (personal) and external (social) resources. It thus covers the two dimensions of skills application (e.g., personal resourcefulness and social resourcefulness). Beyond applying the concept of resourcefulness in academia and in the clinical practice of psychology and nursing, an instrument, the Resourcefulness Scale, has also been developed to measure resourcefulness with robust reliability and validity. Resourcefulness has been studied and tested in different populations, including patients with mental illness, elderly, adolescents, caregivers, nurses, and others, and has been found to correlate with depressive symptoms, self-harm behaviors, work stress, care burden, adaptation functioning, recovery, and quality of life. Moreover, resourcefulness training based on theory of resourcefulness and quality of life has also been fully developed and tested. The evolution of resourcefulness theory may be expected to be rooted and developed broadly to benefit more populations. The scientific development of psychiatric and mental health nursing may be seen in another field.

TMSOTf-catalyzed synthesis of substituted quinazolines using hexamethyldisilazane as a nitrogen source under neat and microwave irradiation conditions.

In this article, we report an efficient and mild synthetic route for the construction of substituted quinazolines from functionalized 2-aminobenzophenones with various benzaldehydes using cat. TMSOTf and hexamethyldisilazane (HMDS) under neat, metal-free and microwave irradiation conditions in which gaseous ammonia was formed in situ. This synthetic protocol provided the desired quinazolines with a broad substrate scope in good to excellent yields. Some structures were confirmed by X-ray single-crystal diffraction analysis.

Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance.

PURPOSE: Patients with central serous chorioretinopathy (CSC) typically present with acute visual impairment and metamorphopsia. The disease previously has been associated with psychological stress. Population-based cohort studies on the risk of CSC among patients with nonorganic sleep disturbance (NOSD) are limited. An early sign of psychiatric disorder was probably sleep disturbance. Furthermore, psychological stress may be caused by sleep disturbance. We investigated the relationship between NOSD and the incidence of CSC. DESIGN: Longitudinal cohort study. Participants. We used the Longitudinal Health Insurance Database and collected the data of 53,743 NOSD patients without CSC between 2000 and 2005 as the study group. Four-fold controls were selected randomly from those without neither sleep disturbance nor a CSC history with frequency matching of age, sex, and index-year. METHODS: The difference in sex, age group, comorbidities, and steroid use between the two groups was analyzed by the χ 2 test. Cox-proportional hazard regression was utilized to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for comparison of the two groups. Kaplan-Meier analysis was applied to measure the cumulative incidence of CSC. Furthermore, the log-rank test was used to test the incidence difference between the two groups. Main Outcome Measures. The incidence rate of CSC in the following years until 2011 was detected. RESULTS: During a mean follow-up of 7.36 ± 2.88 years, NOSD patients had a higher incidence of CSC than the controls (3.10 vs. 1.86 per 10,000 person-years; adjusted HR, 1.65; 95% CI, 1.34-2.02). Men had a higher risk of CSC than women. Sensitivity analyses stratified by sex, age group, or comorbidity condition showed consistently that NOSD patients had a higher risk of CSC than their controls. Dose-response showed that higher NOSD severity had even higher CSC risk. CONCLUSIONS: NOSD is an independent indicator for the increased risk of subsequent CSC development.

p-TsOH-mediated synthesis of substituted 2,4-diaryl-3-sulfonylquinolines from functionalized 2-aminobenzophenones and aromatic ß-ketosulfones under microwave irradiation.

This study describes an efficient protocol for the preparation of substituted 2,4-diaryl-3-sulfonylquinolines from functionalized 2-aminobenzophenones and aromatic ß-ketosulfones by using p-toluenesulfonic acid monohydrate under microwave irradiation. In this atom-economical synthetic route, a series of pharmaceutically active 3-arylsulfonylquinolines with good functional group tolerance are prepared in good to excellent yields. Some structures are confirmed by single-crystal X-ray diffraction analysis.

Mediating Effect Of The Motivation For Medication Use On Disease Management And Medication Adherence Among Community-Dwelling Patients With Schizophrenia.

BACKGROUND: Nearly half of patients with schizophrenia do not adhere to the long-term medical treatment needed to manage their disease. Programs to promote medication adherence include promotion of motivation as a critical element to influence task performance. PURPOSE: This study investigated the mediating effect of motivation for medication use on disease management and medication adherence in schizophrenia. METHODS: This cross-sectional, descriptive correlational study enrolled a convenience sample of 373 community-dwelling patients with schizophrenia in the northern and central regions of Taiwan. Data were collected with questionnaires and a series of validated assessment tools. Hierarchical regression was used to analyze the mediating effect of motivation for medication use on disease management and medication adherence. RESULTS: The medication adherence rate of the patients was 47.2%. The mediating effect of motivation for medication use on therapeutic alliance and medication adherence was 50%, whereas that on insight and medication adherence was 41% and that on medical social support and medication adherence was 72%. CONCLUSION: Developing a medication motivation care model may be more effective than promoting therapeutic alliance, insight, or medical social support for promoting medication adherence. It also had greater impact on preventing relapses of community-dwelling patients with schizophrenia.

The symptoms, resourcefulness and quality of life in community-based patients with schizophrenia.

AIMS AND OBJECTIVES: To test Zauszniewski's resourcefulness and quality of life theory in community-based patients with schizophrenia. The objectives were to: (a) examine the relationship among psychotic symptoms, resourcefulness and quality of life, and (b) explore the determinants of quality of life. BACKGROUND: According to Zauszniewski's resourcefulness and quality of life theory, for patients, the skills constituting resourcefulness should centre on helping oneself or the use of resources to achieve their health. While the significant associations between resourcefulness and quality of life have been consistently delineated in published research, little is known about resourcefulness in patients with schizophrenia. DESIGN: A cross-sectional study design was used in this study. METHODS: A total of 120 patients were recruited with convenience sampling who received home care service and community rehabilitation programme. The participants were assessed with the Brief Psychiatric Rating Scale, the Resourcefulness Scale and the World Health Organization Quality of Life Scale-BREF. The psychotic symptoms were rated by the researchers with structured face-to-face interviews. Resourcefulness and quality of life were assessed through self-reporting. STROBE checklist was followed. RESULTS: The data were analysed using one-way analysis of variance, t test, Pearson's correlation coefficients and stepwise multiple regression analysis. Results showed that employment status and psychotic symptoms were correlated with resourcefulness, while employment status, psychotic symptoms and resourcefulness were correlated with quality of life. Resourcefulness and psychotic symptoms were the determinants of quality of life. CONCLUSION: Patients with employment and less psychotic symptoms had greater resourcefulness. In addition, patients with employment, less psychotic symptoms and greater resourcefulness had better quality of life. RELEVANCE TO CLINICAL PRACTICE: Community rehabilitation programmes should include supported employment, symptom management and resourcefulness skills training to enhance patients' resourcefulness and quality of life.

The Depressive Symptoms, Resourcefulness, and Self-Harm Behaviors of Adolescents.

BACKGROUND: A report published by the World Health Organization indicates that depression typically first manifests during youth. However, adolescents usually lack the capacity for self-help or to seek help proactively from health professionals or other related resources to relieve their emotional distress. Failing to manage depression appropriately places adolescents at risk for self-harm and suicide. PURPOSE: This study explored the correlations among the depressivesymptoms, resourcefulness, and self-harm behaviors of adolescents. In addition, the impact of depressive symptoms and resourcefulness on the self-harm behaviors of adolescents was examined. METHODS: A cross-sectional and correlational design was used. One hundred forty secondary school (junior and senior high school) students in southern Taiwan were recruited for data collection using three questionnaires that measured, respectively, their depressivesymptoms, resourcefulness, and self-harm behaviors. RESULTS: Depressive symptoms and self-harm behaviors correlated significantly and positively (r = .79, p < .001). Resourcefulness correlated significantly and negatively with both depressive symptoms (r = -.35, p < .001) and self-harm behaviors (r = -.29, p < .001). Finally, depressive symptoms significantly predicted self-harm behaviors. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study provides new findings regarding the significant relationship between resourcefulness and self-harm behaviors in adolescents. Future research is suggested to explore the effect of interventions about resourcefulness training on the mental health of adolescents.

The relationships among work stress, resourcefulness, and depression level in psychiatric nurses.

Psychiatric nurses are exposed to highly stressful work environments that can lead to depression over time. This study aimed to explore the relationships among work stress, resourcefulness, and depression levels of psychiatric nurses. A cross-sectional design with randomized sampling was used; 154 psychiatric nurses were recruited from six medical centers in Taiwan. Psychiatric nurses' work stress was found positively correlated with their depression level, and negatively related to resourcefulness. Work stress significantly predicted depression level. These results suggest that the hospital administrative units may develop training courses about resourcefulness skills to reduce psychiatric nurses' work stress, and improve their mental health.

Harmful alcohol use among Aboriginal people in southern Taiwan: the prevalence, correlates, and adverse drinking effects.

This cross-sectional study aims to examine the prevalence and correlates of harmful alcohol use among aboriginal people in southern Taiwan and to examine the associations between harmful alcohol use and adverse drinking effects. Four hundred forty-nine aboriginal adults were recruited from two townships in southern Taiwan to complete the questionnaires. Among the aborigines, 59.7% scored an 8 or above on the Alcohol Use Disorders Identification Test, including 26.7% who were found to be hazardous drinkers (AUDIT level II), 18.5% who were harmful drinkers (level III), and 14.5% who were with likely dependence (level IV). Male aborigines who participated less in religious activities, had stressful life events, were cigarette smokers, or were betel quid chewers were more likely to have harmful alcohol use. Harmful alcohol use was also associated with an inability to work and with arguments with other people. Our study suggests that aboriginal people in southern Taiwan experience alcohol-related risks at rates as high as other worldwide populations for which AUDIT results are available. Individuals with AUDIT scores at levels II and III are generally candidates for brief interventions delivered in generalist health settings. Individuals with AUDIT scores at level IV should be referred for an addiction specialty evaluation and possible treatment as well as lower-risk individuals (those with AUDIT levels II-III) if they have concurrent physical or psychiatric disorders.

The associations between suicidal ideation and attempt and anxiety symptoms and the demographic, psychological, and social moderators in Taiwanese adolescents.

The objectives of this study were to examine the associations between suicidal ideation and attempt and anxiety symptoms and the moderators in 5,027 Taiwanese adolescents. The associations between suicidal ideation and attempt and anxiety symptoms on the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T) were examined using logistic regression analysis. The moderating effects of demographic (gender and age), psychological (problematic alcohol use, severe depressive symptoms, and low self-esteem), and social factors (bullying victimization, and low family function) on the associations were examined. Adolescents who had anxiety symptoms were more likely to have suicidal ideation and attempt than those who did not have anxiety symptoms. Bullying victimization had a moderating effect on the association between suicidal ideation and anxiety symptoms. Assessment of suicidal ideation and attempt should be routine practice among adolescents who present with anxiety symptoms.

Prenatal predictors for father-infant attachment after childbirth.

AIMS AND OBJECTIVES: This study aims to assess expectant fathers' social support, marital intimacy and health status during the third trimester of their partners' pregnancies. Further, we investigate the predictors of father-infant attachment after childbirth. BACKGROUND: Becoming a father is a transition. Research has focused more on mothers than on fathers, even though the philosophy of the maternal care system is about providing family-centred care. The psychological status of first-time fathers and the attachment they have to their infants have received little attention in the research. DESIGN: A repeated measures study design. METHODS: A total of 195 first-time fathers were recruited during the third trimester of their partners' pregnancies. During that time, they completed the Social Support Scale, the Marital Intimacy Scale and the Chinese Health Questionnaire. After childbirth, they completed the Paternal Attachment Inventory during the one-week postpartum period. RESULTS: The fathers who perceived more marital intimacy and support from their partners were more attached to their infants. Moreover, marital intimacy and partner support were important predictors for father-infant attachment. CONCLUSIONS: Future research is warranted to determine the prenatal predictors of father-infant attachment for high-risk families. RELEVANCE TO CLINICAL PRACTICE: The philosophy of maternal care is family oriented; for health professionals, pregnancy is an important time to provide information and counsel couples. Interventions should not only target the health and well-being of expectant mothers but should also actively invite fathers to participate in prenatal care with their partners to facilitate marital intimacy and father-infant attachment.

Alcohol consumption after the recognition of pregnancy and correlated factors among indigenous pregnant women in Taiwan.

To examine the rates and factors associated with alcohol consumption after the recognition of pregnancy among indigenous pregnant women, as well as the rates and factors associated with continuing alcohol consumption after the recognition of pregnancy among indigenous pregnant women who drank alcohol before the recognition of pregnancy in 10 hospitals in southern and eastern Taiwan. A total of 806 indigenous women who had just given birth in 10 hospitals in southern and eastern Taiwan were recruited. They were interviewed to collect their substance use information, demographic characteristics, psychological health status, history of physical abuse, and pregnancy history. The rates of alcohol consumption after the recognition of pregnancy in all indigenous pregnant women and the rates of continuing alcohol consumption after the recognition of pregnancy among those who drank alcohol before the recognition of pregnancy were calculated. The factors relating to alcohol consumption and continuing alcohol consumption after the recognition of pregnancy were examined using logistic regression analyses. The results of this study found that 26.6% of indigenous pregnant women drank alcohol at any stage after the recognition of pregnancy, and 52.5% of indigenous pregnant women who drank alcohol before the recognition of pregnancy persisted in drinking alcohol after the recognition of pregnancy. Multiple parities, smoking or chewing betel quid after the recognition of pregnancy, and a higher frequency of drinking alcohol before the recognition of pregnancy were significantly associated with alcohol consumption and continuing alcohol consumption after the recognition of pregnancy. Meanwhile, being single or divorced, and intimate partner violence after the recognition of pregnancy were significantly associated with alcohol consumption after the recognition of pregnancy. High prevalence rates of alcohol consumption and continuing alcohol consumption after the recognition of pregnancy were found among indigenous pregnant women in Taiwan. Early detection of alcohol consumption and effective intervention for alcohol consumption during pregnancy are needed.

Mental health implications of music: insight from neuroscientific and clinical studies.

Neuroscientific and clinical studies of music over the past two decades have substantially increased our understanding of its use as a means of therapy. The authors briefly review current literature related to music's effect on people with different mental illnesses, and examine several neurobiological theories that may explain its effectiveness or lack thereof in treating psychiatric disorders. Neuroscientific studies have shown music to be an agent capable of influencing complex neurobiological processes in the brain and suggest that it can potentially play an important role in treatment. Clinical studies provide some evidence that music therapy can be used as an alternative therapy in treating depression, autism, schizophrenia, and dementia, as well as problems of agitation, anxiety, sleeplessness, and substance misuse, though whether it can actually replace other modes of treatment remains undetermined. Future research should include translational studies involving both neuroscience and clinical medicine that investigate the long-term effects of music intervention and that lead to the development of new strategies for music therapy.

[Applying Neuman's Systems Model to a neuroleptic malignant syndrome psychiatric patient and his caregiver].

This article describes a nurse's experience using Neuman's Systems Model to care for a chronic psychiatric patient and his caregiver. The patient was diagnosed as suffering from neuroleptic malignant syndrome (NMS). Nursing care described in this article was administered from October 23 to December 4, 2007. The patient developed NMS in the third month of a three-month period of hospitalization, which endangered his life as well as the health of his caregiver. Nursing care was provided to the patient and his caregiver based on Neuman's Systems Model, which included assessments of intrapersonal, interpersonal, and extra-personal forces as well as of environmental factors affecting the health of the patient and his caregiver. The four nursing care issues identified included: existing self-care deficit, sensory/perceptual alteration, sleep pattern disturbance, and caregiver role strain. Following Neuman's systems model, primary, secondary, and tertiary prevention were used to strengthen the flexible lines of defense, internal lines of resistance, and supporting existing strengths of both patient and caregiver, as well as to conserve client system energy. Significant improvements in patient and caregiver abilities were apparent in nursing intervention outcomes. This experience shows the Neuman's systems model to be an efficient model in psychiatric nursing care.

The associations between menopausal syndrome and depression during pre-, peri-, and postmenopausal period among Taiwanese female aborigines.

AIM: The aim of the study was to evaluate the association between physiological menopausal symptoms and depression during the pre-, peri-, and postmenopausal period among female Taiwanese aborigines. METHODS: A total of 672 Taiwanese aboriginal women, aged 40-60 years, were recruited in the interviewing study and classified as pre-, peri-, and postmenopausal according to menstrual bleeding patterns in the previous 12 months. Then, the postmenopausal symptoms, depression, self-perceived health, family support, and associated demographic variables were assessed by questionnaire based on the results of interviewing by research assistants. RESULTS: The results revealed that perimenopausal statuses are associated with depression and women with a perimenopausal status had a higher prevalence of depression than those with a premenopausal status. A higher score on physiological postmenopausal symptoms was found to be significantly associated with depression. Furthermore, somatic symptoms were associated with depression for pre-, peri-, and postmenopausal statuses. Moreover, sexual dysfunction and vasomotor symptoms were associated with depression only in the premenopausal status and postmenopausal status, respectively. CONCLUSION: Depression should be routinely evaluated for female Taiwanese aborigines consulting with physicians for menopause symptoms, especially for somatic symptoms. Furthermore, attention should be provided to premenopausal women with sexual dysfunction and postmenopausal women with vasomotor symptoms for depression.

The impact of learned resourcefulness on quality of life in type II diabetic patients: a cross-sectional correlational study.

It is well recognized that patients with diabetes encounter a host of daily self-care issues, including controlling blood sugar and preventing and managing complications, which impact significantly upon quality of life. Studies have indicated that learned resourcefulness has a potentially positive effect in dealing with psychosocial and health problems. The purpose of this study was to test the relationship between learned resourcefulness and quality of life in type II diabetic patients. The mediating and moderating effects of learned resourcefulness on the relationship between metabolic control and quality of life of diabetic patients was also examined. This cross-sectional and correlational study included a convenience sample of 131 type II diabetic patients recruited from three hospitals in southern Taiwan. Data were collected through questionnaires, which included the Rosenbaum's Self Control Schedule and World Health Organization's Quality of Life (Short Version). Multiple regression techniques were used to analyze outcome predictors. Study findings include identification of a mediating effect of learned resourcefulness between metabolic control and quality of life. While most DM patients were not satisfied with their health, we found that those with greater learned resourcefulness enjoyed a better quality of life. Learned resourcefulness, gender, and HbA1C explained 35.2% of variance in DM patient quality of life. Male diabetic patients enjoyed a better quality of life than females, even though levels of learned resourcefulness between the two groups were not significantly different. Results indicate that poor metabolic control of diabetic patients has a detrimental effect on quality of life, and when diabetic patients use more self-control skills, they may achieve better quality of life. Results suggest that nurses who use cognitive behavior coping strategies (resourcefulness) may help diabetic patients achieve better metabolic control and promote better quality of life.