International human rights law and the right to mental health

Purpose: Why did the WHO claim that there is “no health without mental health”? In its reform of the Ministry of Health and Welfare (MOHW), why did the Taiwan government add oral health into the Department of Mental Health? This paper explores normative accounts for the right to health which include physical and mental health as a highest state for everyone. Challenge the government should not excuse for inadequate resource to add oral to Department of mental health. Methods: We apply an analysis of international human rights law and international conventions to justify how mental health is a human right. Results: The right to the highest attainable standard of health is enshrined in the Universal Declaration of Human Rights, the International Covenant on Economic, Social, and Cultural Rights, as well as the constitution of the World Health Organization. A person’s state of health is conceptualized with a holistic perspective. Mental health, by definition and elements, is critical to an individual’s personal dignity, lifestyle, and living condition. Thus, as the fundamental basis of personal development and functioning, physical and mental health are recognized as a human right in international human rights law. The governments need to take responsibilities to build a mental healthy environment to their people. Conclusions: We found that in practice, governments (including Taiwan) often ignore people’s mental health needs when initiating health or welfare policies, especially if mental health is not regarded as a human right by the government. In fact, some governments refuse to honor mental health as a right although it is a legal obligation under international law. We urge Taiwan’s government to return the structure of the MOHW back to include an independent Department of Mental Health. To influence governmental policies, a change is needed in the research community, because researchers and practitioners in mental health and psychiatry still rarely view mental health from an international human rights perspective as well as for all public not disease oriented. We hope to initiate a review of the basic requirements of the right to mental health in terms of its positive, rather than negative, aspects

Aortic Wave Reflection Following Maximal Exercise in Healthy Young Adults

Increased magnitude and early return of aortic wave reflection decrease coronary perfusion during diastole and augment systolic blood pressure (SBP). Exaggerated SBP in responses to maximal exercise is an indicator of future cardiovascular disease. Several studies investigated aortic wave reflection in response to maximal exercise. However, most of these studies did not provide a comprehensive assessment of wave reflection, including the forward and backward components of the pressure waves. The former are generated by ventricular contraction and the latter are the function of forward waves and waves reflected from the periphery. PURPOSE: This study was to investigate aortic wave reflection in response to maximal exercise using wave separation analysis. METHODS: Twenty-eight healthy young adults (17 male, age: 28±4 yrs, body mass index: 24.0±2.6 kg/m2; mean±SD) underwent maximal graded cycle ergometry tests. Aortic wave reflection was assessed at pre-exercise and immediately after the exercise (0-5 min). Using a cuff-based SphygmoCor device (XCEL, AtCor Medical), aortic SBP, pulse pressure (PP), and augmentation pressure (AP) were derived from the aortic pressure waveforms generated from the brachial pressure waveforms. Augmentation index (AIx), expressing AP as a percentage of PP, was then calculated. Aortic pressure waveforms were separated into forward (Pf) and backward pressure waves (Pb). Reflection magnitude (RM) was calculated as Pb divided by Pf × 100%. RESULTS: After exercise, aortic SBP and PP increased (P=0.021 and P=0.016 respectively), while AP (5±4 to 4±5 mmHg, P=0.017) and AIx decreased (13.2±9.9 to 9.5±12.0%, P=0.022). Both Pf (26±4 to 34±6 mmHg, P=0.002) and Pb (13±3 to 15±2 mmHg, P=0.015) increased, but RM was decreased following exercise (49.0±7.0 to 43.6±5.9 %, P=0.036). After exercise, aortic SBP was positively associated with Pf (B=0.57, P=0.002), but not Pb, AP, AIx, and RM (P≥0.2). CONCLUSION: Our findings suggested that in young healthy adults, increased SBP following maximal exercise may be primarily due to increased ventricular contraction. Although the magnitude of wave reflection increases following maximal exercise, this reflected wave may arrive relatively later within a cardiac cycle, which may benefit coronary perfusion instead of causing exaggerated SBP. This study helps extend our understanding of aortic hemodynamics during maximal exercise

Asian Students’ Cultural Orientation and Computer Self-Efficacy Significantly Related to Online Inquiry-Based Learning Outcomes on the Go-Lab Platform

Learning and teaching Mendelian genetics are central topics in school science. This study explored factors associated with the learning outcomes of Taiwanese junior high school students in an online inquiry learning environment. Research within face-to-face classroom settings had revealed that Asian students are more likely to be tutor-oriented and collectivistic learners. However, results of how these orientations affect learning in online environments are needed. In this analysis, seventh-grade students from Taiwan (N = 290) completed a genetics lesson using an Inquiry Learning Space (ILS) on the Go-Lab platform. Students were randomly assigned conditions in which support was provided either by general text or by an expert person in the form of a cartoon figure. In addition, students completed questionnaires assessing their cultural orientations, as well as their computer self-efficacy. Results revealed that the presence of a virtual expert did not influence students’ learning outcomes. However, the extent to which students identified as collectivistic and their level of computer self-efficacy were positively associated with the learning outcomes. Students’ computer self-efficacy was positively related to their behavioral intentions as well. These results illustrate the importance of Asian students’ disciplined personality and computer self-efficacy for online inquiry-based learning.</p

Hormone Replacement Therapy and Menopause: A Review of Randomized, Double-Blind, Placebo-Controlled Trials

Hormone replacement therapy (HRT) is frequently prescribed to healthy women to ameliorate menopausal symptoms. HRT is used long term (≥ 1 year) to prevent chronic disease in older women. The objective of this study was to review the benefits and risks of HRT and studies of menopause or HRT in Taiwan via a MEDLINE search. Recommendations are provided for future HRT research in Taiwan. Randomized, double-blind, placebo-controlled clinical trials are considered the gold standard of scientific evidence. A MEDLINE literature search (January 1966-July 2002) identified 23 papers on trials (≥ 1 year) that met the inclusion criteria. The results showed that various HRT regimens used for more than 1 year caused more harm than good in healthy menopausal women and that there was no benefit for women with coronary artery disease, Alzheimer's disease, hysterectomy, hysterosalpingooophorectomy, and ischemic stroke. None of this research was conducted in Taiwan. A MEDLINE search using the key words “estrogen replacement therapy and menopause in Taiwan” identified 16 studies. There was only one, short-term, HRT trial. No evidence suggested benefits from long-term HRT in menopausal women in Taiwan

Antiviral Ability of Kalanchoe gracilis Leaf Extract against Enterovirus 71 and Coxsackievirus A16

Pandemic infection or reemergence of Enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) occurs in tropical and subtropical regions, being associated with hand-foot-and-mouth disease, herpangina, aseptic meningitis, brain stem encephalitis, pulmonary edema, and paralysis. However, effective therapeutic drugs against EV71 and CVA16 are rare. Kalanchoe gracilis (L.) DC is used for the treatment of injuries, pain, and inflammation. This study investigated antiviral effects of K. gracilis leaf extract on EV71 and CVA16 replications. HPLC analysis with a C-18 reverse phase column showed fingerprint profiles of K. gracilis leaf extract had 15 chromatographic peaks. UV/vis absorption spectra revealed peaks 5, 12, and 15 as ferulic acid, quercetin, and kaempferol, respectively. K. gracilis leaf extract showed little cytotoxicity, but exhibited concentration-dependent antiviral activities including cytopathic effect, plaque, and virus yield reductions. K. gracilis leaf extract was shown to be more potent in antiviral activity than ferulic acid, quercetin, and kaempferol, significantly inhibiting in vitro replication of EV71 (IC50 = 35.88 μg/mL) and CVA16 (IC50 = 42.91 μg/mL). Moreover, K. gracilis leaf extract is a safe antienteroviral agent with the inactivation of viral 2A protease and reduction of IL-6 and RANTES expressions

Osseous wound repair under inhibition of the axis of advanced glycation end-products and the advanced glycation end-products receptor

Background/PurposeBlockade of advanced glycation end-products (AGE) is able to reduce diabetic complications and control periodontitis. This study aimed to determine whether the application of aminoguanidine (AG), an AGE inhibitor, or N-phenacylthiazolium bromide (PTB), an AGE breaker, facilitates the healing of an osseous wound in non-diabetic animals.Methods2.6 mm diameter full-thickness osseous wounds were created bilaterally in 54 healthy Sprague–Dawley rats. Rats received daily normal saline, AG, or PTB injections respectively and were euthanized after 7 days, 14 days, or 28 days (n = 6). The wound healing pattern was assessed by micro-computed tomography, histology, histochemistry for the fiber arrangement, and the gene expression levels of AGE receptor, tumor necrosis factor-α, type I collagen, and fibronectin.ResultsUnder the AG and PTB administration, osteogenesis was apparently promoted in the early stages of healing, but the union of the osseous wound and the fibril re-arrangement was apparently retarded. No significant difference was found in any of the micro-computed tomography parameters as compared to the control in the first 14 days, whereas the relative bone volume was significantly higher in the control at Day 28. AGE receptor and tumor necrosis factor-α were depressed in the PTB group, but only temporarily at Day 14 in the AG group. Therefore, at Day 14, type I collagen was significantly upregulated in the PTB group, and fibronectin was significantly increased in the AG group.ConclusionAnti-AGE agents reduced inflammation but did not apparently facilitate osteogenesis during the osseous wound repair

Engineering microbes to sense and eradicate Pseudomonas aeruginosa, a human pathogen

A synthetic genetic system is designed and characterized that allows Escherichia coli to sense and eradicate Pseudomonas aeruginosa, providing a novel antimicrobial strategy that could potentially be applied to fighting infectious pathogens