Pathways linking mental health literacy to professional help-seeking intentions in Korean college students.

WHAT IS KNOWN ON THE SUBJECT?: People in their twenties, including college students, experience a high level of stress and prevalence of related mental health problems including depression, anxiety and alcohol addiction, but they are the least likely age group in Korea to utilize professional help for mental health issues. Mental health literacy (MHL) refers to the knowledge and abilities necessary for maintaining mental health and preventing mental health problems. MHL also plays an important role in help-seeking for mental health issues. Therefore, studying MHL and other variables related to help-seeking is likely to enhance our overall understanding of students' mental health. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: Although there have been some studies of college students' MHL in Korea, this is the first study to identify the paths and relationships between MHL and help-seeking intentions in Korean college students. Additionally, this study examined the mediating role of stigma in the relationship between MHL and attitudes toward help-seeking. The findings of this study suggest that MHL promotion can have a positive impact on the mental health of Korean college students by improving their attitudes toward help-seeking and increasing their help-seeking intentions. This study supports the idea that increased social support among Korean college students may reduce stigma and facilitate their seeking of professional help. The paths and relationships found in the present study provide evidence that a nursing intervention on-campus that improves students' MHL and reduces stigma may facilitate more effective use of help-seeking services among college students. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: MHL plays a significant role in how college students manage their mental health and the likelihood that they will seek professional help for mental health issues. Increasing MHL reduces mental health-related stigma and promotes positive attitudes toward help-seeking. A mental health nursing intervention that includes MHL improvement strategies would likely enhance students' utilization of mental health services on campus. Although students' MHL is improved by existing campus programmes and educational efforts to raise awareness of mental health, interventions should also address campus culture and stigma to facilitate mental health help-seeking. Ultimately, enhancing MHL will contribute to the prevention of mental health problems and protect the deterioration of mental health among college students. ABSTRACT: Introduction There is a high prevalence of mental health problems among college students in Korea. Although the usage rate for mental health services among Korean college students was not reported, it is known that the usage rate for Koreans is low compared to that in the United States. Aim To explore the relationships linking mental health literacy (MHL) to intentions of help-seeking in a sample of Korean college students. Method Using a cross-sectional study, data from 200 participants were analysed using a structural equation modelling approach. Results Mental health literacy had both direct and indirect effects on attitudes toward help-seeking and an indirect effect on attitudes toward help-seeking through stigma. The direct effect of MHL on attitudes toward help-seeking was fully mediated by stigma. Discussion Mental health nursing professionals have a responsibility and a challenge to enhance MHL in college students through individual or group interventions. Implications for practice MHL plays a significant role in individuals' willingness to seek professional help when in need of mental health care. Thus, mental health nursing interventions that include MHL improvement strategies would favourably enhance students' use of adequate sources of care and contribute to the prevention of mental health problems in college students.

Aspergillus Tracheobronchitis and Influenza A Co-infection in a Patient with AIDS and Neutropenia.

Aspergillus tracheobronchitis (AT), an unusual form of invasive pulmonary aspergillosis (IPA), is characterized by pseudomembrane formation, ulcer or obstruction that is predominantly confined to tracheobronchial tree. Hematologic malignancies, neutropenia, solid organ transplantation, chronic corticosteroid therapy and acquired immunodeficiency syndrome (AIDS) are known to be major predisposing conditions. However, since the introduction of highly active antiretroviral therapy, there is only one reported case of AT in AIDS patient. After pandemic of influenza A/H1N1 2009, there are several reports of IPA in patient with influenza and most of them received corticosteroid or immunosuppressive therapy before the development of IPA. We present a 45 year-old AIDS patient with influenza A infection who developed pseudomembranous AT without corticosteroid use or immunosuppressive therapy.

Primary tumor maximum standardized uptake value measured on 18F-fluorodeoxyglucose positron emission tomography-computed tomography is a prognostic value for survival in bile duct and gallbladder cancer.

BACKGROUND/AIMS: Few studies have assessed the prognostic value of the primary tumor maximum standardized uptake value (SUV max) measured by 2-[(18)F]-fluoro-2-deoxy-D-glucose PET-CT for patients with bile duct and gallbladder cancer. METHODS: A retrospective analysis of 61 patients with confirmed bile duct and gallbladder cancer who underwent FDG PET-CT in Kangbuk Samsung Medical Center (Seoul, Korea) from April 2008 to April 2011. Prognostic significance of SUV max and other clinicopathological variables was assessed. RESULTS: Twenty-three patients were diagnosed as common bile duct cancer, 17 as hilar bile duct cancer, 12 as intrahepatic bile duct cancer, and nine as gallbladder cancer. In univariate analysis, diagnosis of intrahepatic cholangiocarcinoma and gallbladder cancer, mass forming type, poorly differentiated cell type, nonsurgical treatment, advanced American Joint Committee on Cancer (AJCC) staging and primary tumor SUV max were significant predictors of poor overall survival. In multivariate analysis adjusted for age and sex, primary tumor SUV max (hazard ratio [HR], 4.526; 95% CI, 1.813-11.299), advanced AJCC staging (HR, 4.843; 95% CI, 1.760-13.328), and nonsurgical treatment (HR, 6.029; 95% CI, 1.989-18.271) were independently associated with poor overall survival. CONCLUSIONS: Primary tumor SUV max measured by FDG PET-CT is an independent and significant prognostic factor for overall survival in bile duct and gallbladder cancer.

The relationship of body composition and coronary artery calcification in apparently healthy korean adults.

BACKGROUND: We investigated the association of coronary artery calcium score (CACS) with body composition and insulin resistance in apparently healthy Korean adults. METHODS: Nine hundred forty-five participants (mean age, 48.9 years; 628 men) in a medical check-up program were selected for analysis. Body composition was assessed by bioelectrical impedance analysis (BIA). Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). The CACS was assessed by multidetector computed tomography. RESULTS: One hundred forty-six subjects (15.4%) showed coronary artery calcification and 148 subjects (15.7%) had metabolic syndrome. CACS showed a significant positive correlation with age, fasting glucose level, waist circumference (WC), blood pressure, hemoglobin A1c, HOMA-IR, and waist-hip ratio (WHR) assessed by BIA. CACS had a negative correlation with high density lipoprotein cholesterol (HDL-C). Subjects with high CACS showed significantly higher mean WHRs and lower mean values for lean body mass compared with subjects without coronary artery calcification. In logistic regression analyses with coronary artery calcification as the dependent variable, the highest quartile of WHR showed a 3.125-fold increased odds ratio for coronary artery calcification compared with the lowest quartile after adjustment for confounding variables. When receiver operating characteristics analyses were performed with coronary artery calcification as the result variable, WHR showed the largest area under the curve (AUC) value among other variables except for age and WC in women (AUC=0.696 for WHR, 0.790 for age, and 0.719 for WC in women). CONCLUSION: In our study population of apparently healthy Korean adults, WHR was the most significant predictor for coronary artery calcification among other confounding factors, suggesting that it may have implication as a marker for early atherosclerosis.

A case of elderly-onset Crescentic Henoch-Schönlein purpura nephritis with hypocomplementemia and positive MPO-ANCA.

Henoch-Schönlein purpura (HSP) is common in childhood and often self-limiting. There have been limited studies on elderly-onset HSP nephritis (HSPN). A 76-yr-old man was transferred to our hospital with a 1-month history of oliguria, abdominal pain, edema and palpable purpura in the legs. Three months ago, he was admitted to another hospital with jaundice, and consequently diagnosed with early common bile duct cancer. The patient underwent a Whipple's operation. Antibiotics were administrated because of leakage in the suture from the surgery. However, he showed progressive renal failure with edema and purpura in the legs. Laboratory investigations showed serum creatinine 6.4 mg/dL, 24-hr urine protein 8,141 mg/day, myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) 1:40 and C(3) below 64.89 mg/dL. Renal biopsy showed crescentic glomerulonephritis, as well as mesangial and extracapillary Ig A deposition. We started steroid therapy and hemodialysis, but he progressed to end-stage renal failure and he has been under maintenance hemodialysis. We describe elderly onset HSPN with MPO-ANCA can be crescentic glomerulonephritis rapidly progressed to end stage renal failure.