Knowledge, attitudes, practice and related factors of oral cancer prevention among public health nurses in Taiwan.

OBJECTIVES: Public health nurses (PHNs) in Taiwan act as individual/family-based primary care providers and as population-based community care providers. A little information is currently available on the ability of PHNs to prevent oral cancer. We surveyed knowledge, attitudes and behaviour of oral cancer prevention among PHNs. METHODS: This study recruited 400 PHNs through the Taiwan Public Health Center. A structured electronic questionnaire was used to collect PHNs' demographics and scale scores for oral cancer knowledge, attitudes and preventive behaviour. RESULTS: Providing PHNs with oral cancer prevention education, having the supervisor's support for preventive work and receiving in-service education would improve PHNs' knowledge, attitude and behaviour for oral cancer prevention. Attitude, oral cancer-related courses arranged by current employer (major factor), supervisor's support for work and having responsibility for oral cancer prevention were associated with the oral cancer preventive behaviour of PHNs, and explain 41.1% of total variance. CONCLUSIONS: We established a linear regression model for understanding the role of PHNs in the practice of preventing oral cancer. It may be useful for the government in improving school-based and in-service oral cancer prevention education programmes for PHNs as well as developing programmes for increasing public awareness and education of oral cancer prevention.

A Novel Strategy for TNF-Alpha Production by 2-APB Induced Downregulated SOCE and Upregulated HSP70 in O. tsutsugamushi-Infected Human Macrophages.

Orientia (O.) tsutsugamushi-induced scrub typhus is endemic across many regions of Asia and the Western Pacific, where an estimated 1 million cases occur each year; the majority of patients infected with O. tsutsugamushi end up with a cytokine storm from a severe inflammatory response. Previous reports have indicated that blocking tumor necrosis factor (TNF)-α reduced cell injury from a cytokine storm. Since TNF-α production is known to be associated with intracellular Ca2+ elevation, we examined the effect of store-operated Ca2+ entry (SOCE) inhibitors on TNF-α production in O. tsutsugamushi-infected macrophages. We found that 2-aminoethoxydiphenyl borate (2-APB), but not SKF96365, facilitates the suppression of Ca2+ mobilization via the interruption of Orai1 expression in O. tsutsugamushi-infected macrophages. Due to the decrease of Ca2+ elevation, the expression of TNF-α and its release from macrophages was repressed by 2-APB. In addition, a novel role of 2-APB was found in macrophages that causes the upregulation of heat shock protein 70 (HSP70) expression associated with ERK activation; upregulated TNF-α production in the case of knockdown HSP70 was inhibited with 2-APB treatment. Furthermore, elevated HSP70 formation unexpectedly did not help the cell survival of O. tsutsugamushi-infected macrophages. In conclusion, the parallelism between downregulated Ca2+ mobilization via SOCE and upregulated HSP70 after treatment with 2-APB against TNF-α production was found to efficiently attenuate an O. tsutsugamushi-induced severe inflammatory response.