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

ANALYZING MEDICAL TRANSACTION DATA BY USING ASSOCIATION RULE MINING WITH MULTIPLE MINIMUM SUPPORTS

The quick development of IS has a huge impact on the healthcare industry. almost all the existing hospitals, clinics and other healthcare-related institutes have adopted a functionally powerful and highly integrated Hospital Information System (HIS) for management of clinic or medical-related affairs. The medical data stored in the HIS are collected from many different medical subsystems, However, problems of failed data sharing and inconsistent data content often occur among these subsystems, resulting in many hospitals collect a large amount of medical data, but not the ability to process and analyse these data properly, letting the valuable data in the HIS all go to waste. In this study, we made a practical visit to a certain hospital in Taiwan and collected radioimmunoassay (RIA) data from the Laboratory Information System (LIS) and the Departmental Registration System (DRS) of this hospital. Further, we proposed a method of the association rule mining in combination with the concept of multiple minimum supports to analyse and find valuable association rules from the RIA data. The analytical results found the method we proposed can indeed find association rules that would not be able to be found with the traditional association mining methods. It is very helpful in improving doctor-patient relationship and upgrading health care quality

A study for sustainable development in optoelectronics industry using multiple criteria decision making methods

This study assessed the operational efficiency of the optoelectronics industry in the Southern Taiwan Science Park (STSP) between 2007 and 2011 by using multiple criteria decision making methods (data envelopment analysis, Malmquist productivity index and Bootstrap). The data analysis showed that during the study period, meaning that the operational efficiency gap among manufacturers in STSP is widening. Among these manufacturers, eight manufacturers exhibited constant returns to scale, which was more than a half of the overall decision making unit (DMU), indicating that the operational scale of these manufacturers was nearing the optimal scale. Based on Malmquist productivity index (MPI) analysis, the factors that affect the operational efficiencies of optoelectronics manufacturers’ were as follow: operational cost, the number of employees, and the amount of fixed assets. The development should be focused on increasing technological efficiency and technological change in the future. Finally, based on Bootstrap, the results showed that the focus should be on the production technology while improving productive efficiency to ensure sustainable development of the entire domestic optoelectronics industry in the future. First published online: 02 Nov 201

Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report

BACKGROUND: Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation. CASE PRESENTATION: A 14-year-old Chinese boy suffering from β–thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors. CONCLUSION: This case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy

Mechanical Characterization of Rabbit Pulmonary Vein Sleeves in In Vitro Intact Ring Preparation

BackgroundPulmonary vein (PV) sleeves, composed of cardiomyocytes, play certain roles in arrhythmogenesis. In the literature, it has been frequently reported that PV sleeves possess intrinsic spontaneous pacemaking activity and triggered activity in normal dogs and rabbits. In contrast, other research groups presented totally opposite findings which showed absence of such pacemakers in dogs, rabbits and rats. The present study was designed to clarify this puzzle and contradiction.MethodsA novel methodology using in vitro experimentation was used to examine the electromechanical activity of whole segments of PV sleeves. The ring preparation was composed of a small piece of left atrial (LA) free wall, PV ostium and sleeve from rabbits. A circumferential contraction of the PV sleeve was measured when the preparation was electrically driven from the LA free wall. Mechanical force of the ring preparation was measured using a force transducer. The action potentials were recorded using conventional intracellular recording technique in strip preparation.ResultsIn 15 rabbits, no spontaneous pacemaking activity or triggered activity was found in the in vitro ring preparation of PV sleeve. The circumferential contraction of PV sleeves was external calcium-dependent. Frequency-force relation displayed a negative staircase at 0.1–0.5 Hz and a positive staircase at 1–5 Hz. Post-rest potentiation was prominent between 15 s and 120 s. Intracellular action potential recording did not display any automaticity or triggered activity in PV sleeves.ConclusionIn an intact ring preparation of rabbit PV sleeves, intrinsic spontaneous pacemaking activity or triggered activity was not found

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

AbstractAimRefractory ventricular fibrillation, resistant to conventional cardiopulmonary resuscitation (CPR), is a life threatening rhythm encountered in the emergency department. Although previous reports suggest the use of extracorporeal CPR can improve the clinical outcomes in patients with prolonged cardiac arrest, the effectiveness of this novel strategy for refractory ventricular fibrillation is not known. We aimed to compare the clinical outcomes of patients with refractory ventricular fibrillation managed with conventional CPR or extracorporeal CPR in our institution.MethodThis is a retrospective chart review study from an emergency department in a tertiary referral medical center. We identified 209 patients presenting with cardiac arrest due to ventricular fibrillation between September 2011 and September 2013. Of these, 60 patients were enrolled with ventricular fibrillation refractory to resuscitation for more than 10min. The clinical outcome of patients with ventricular fibrillation received either conventional CPR, including defibrillation, chest compression, and resuscitative medication (C-CPR, n=40) or CPR plus extracorporeal CPR (E-CPR, n=20) were compared.ResultsThe overall survival rate was 35%, and 18.3% of patients were discharged with good neurological function. The mean duration of CPR was longer in the E-CPR group than in the C-CPR group (69.90±49.6min vs 34.3±17.7min, p=0.0001). Patients receiving E-CPR had significantly higher rates of sustained return of spontaneous circulation (95.0% vs 47.5%, p=0.0009), and good neurological function at discharge (40.0% vs 7.5%, p=0.0067). The survival rate in the E-CPR group was higher (50% vs 27.5%, p=0.1512) at discharge and (50% vs 20%, p=0. 0998) at 1 year after discharge.ConclusionsThe management of refractory ventricular fibrillation in the emergency department remains challenging, as evidenced by an overall survival rate of 35% in this study. Patients with refractory ventricular fibrillation receiving E-CPR had a trend toward higher survival rates and significantly improved neurological outcomes than those receiving C-CPR

Surgical treatment for thyrotoxic hypokalemic periodic paralysis: case report

Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare, potentially life-threatening endocrine emergency. It is characterized by recurrent muscle weakness and hypokalemia. Because many THPP patients do not have obvious symptoms and signs of hyperthyroidism, misdiagnosis may occur. The published studies revealed that definitive therapy for THPP is control of hyperthyroidism by medical therapy, radioactive iodine or surgery, but the long-term post-operative follow-up result was not observed. We reported two cases of medically refractory THPP with recurrent paralysis of extremities and hypokalemia, and both were combined with thyroid nodules. Both patients were treated with total thyroidectomy; the pathology revealed that one is Graves' disease with thyroid papillary carcinoma, and the other is adenomatous goiter with papillary hyperplasia. No episode of periodic paralysis was noted and laboratory evaluation revealed normal potassium level during the post-operative follow up. Our experience suggests that total thyroidectomy by experienced surgeon is an appropriate and definite treatment for medically refractory THPP, especially in cases combined with thyroid nodules

Oral health of community dwelling elders in Hong Kong

Introduction: The world’s population is ageing and the elders are vulnerable to oral health problems. This project aimed to observe the oral health status of community dwelling elders in Hong Kong, investigate the oral health impact on their quality of life and nutritional status, and provide oral health education and preventive service. Methods: Community dwelling elders (65 or above) were recruited from five community centers. An interviewer-administered questionnaire was completed to collect information on their socio-demographic background and oral health perception/practice. Their oral health related quality of life (OHQoL) and nutritional status were measured by using the Geriatric Oral Health Assessment Index (GOHAI) and Mini-Nutritional Assessment (MNA), respectively. Their tooth and periodontal status, oral hygiene and soft tissues were examined. Individualized advice, oral health education and scaling were provided. Results: A total of 195 elders participated. Despite their sound knowledge on dental caries, their awareness of the causes and risk factors of periodontal diseases was low. Several misconceptions of oral health were common and their expectation towards oral health was low. Although 81% brush their teeth at least twice a day, over 75% did not perform interdental cleaning mainly due to unawareness of the necessity (32%) and lack of skills (42%). Their dental visits were treatment-driven and mainly for pain-relieving and emergency care. Only 19% were regular dental attendees. The mean (SD) DMFT was 8.9 (7.8). Over 60% had periodontal pockets; 6% were edentulous and 38% had fewer than 20 teeth. The mean (SD) total GOHAI score was 56.4 (8.0); 60% reported negative impact of oral health on their quality of life. The mean (SD) MNA score was 25.2 (2.9); 30% had malnutrition or were at risk. Multivariate analysis showed that tooth loss and untreated decayed teeth (DT) were significant determinants of poor OHQoL; older age, higher education level, and poorer OHQoL were significantly associated with higher risk of malnutrition (all p<0.05). Conclusions: Oral health problems are common among community dwelling elders in Hong Kong. Their oral health awareness and practice are yet to be improved. Tooth loss and unmet treatment need for dental caries significantly compromise elders’ quality of life, which in turn increases their risk for malnutrition. Outreach oral health education and service are well received by the community.published_or_final_versio

Antiviral Activity of a Zymolytic Grain Based Extract on Human Immunodeficiency Virus Type 1 In Vitro

Increasing evidence shows that grains may play a role in disease prevention beyond the simple provision of energy and nutrients. It has been reported that some components contained in grains exert their functional effects on viral and bacterial infections and protect against various cancers. However, until now, hardly any intervention studies have investigated the effects of grains or grain based extracts on the inhibition of HIV-1 infection. In this study, the antiviral function of a zymolytic grain based extract (ZGE) was detected in vitro and in rats, and the antiviral mechanism was investigated. Results showed that ZGE had an inhibition effect on HIV-1 infection in vitro with low cytotoxic effects. The study of the mechanism demonstrated that this functional food possibly acted on the viral surface structure protein gp120 which is responsible for cell binding, as well as on the postattachment stage of the virus. The sera of model rats administrated with this food by gavage presented anti-infection abilities against HIV-1 in vitro during a serum concentration associated period of time. These findings provide valuable insights into the application of ZGE on the control of viral load, which may contribute to future anti-HIV treatment with less adverse effects