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Growing evidence suggests the link between gut microbiota and mood regulation. The current study aimed to identify microbiota targets for major depressive disorder (MDD) and mood-related traits in Taiwanese samples, while taking into account the influence of dietary patterns. We recruited 36 MDD patients and 37 healthy controls for 16S rRNA gene sequencing. We assessed nutrient content using food frequency questionnaire, and mood related phenotypes, including depressive severity, anxiety, and perceived stress. Analysis of composition of microbiomes (ANCOM) models were performed to evaluate microbiota compositions between patients and controls, while adjusted for fat intake% and sequencing platforms. We found 23 taxa (4 phyla, 7 families and 12 genera) to be associated with depression and beta diversity was differed between groups. Phylum Actinobacteria and Firmicutes were overrepresented in MDD patients. At genus level, Bifidobacterium (7%) and Blautia (8%) had relatively high abundance among MDD patients, while Prevotella (16%) had high abundance in controls. Holdemania exhibited moderate correlation with anxiety (r = 0.65) and perceived stress level (r = 0.49) mainly in MDD patients but not controls. Pathway analyses revealed that pentose phosphate and starch and sucrose metabolism processes were important pathways for depression via microbiota functions. In conclusion, our results revealed microbiota targets for depression that are independent of fat intake. It is worthwhile to conduct further studies to replicate the current findings and to integrate with biochemistry and metabolomics data to better understand the functions of identified targets., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Non-Hodgkin's lymphoma is a heterogeneous group of lymphoproliferative malignancies. Chemotherapy can improve patient survival rates, yet it is also associated with many adverse physical and psychosocial effects. It is suggested that qigong practices may be used to reduce patient distress and side effects., Objectives: To evaluate the effects of Chan-Chuang qigong on fatigue, complete blood cells, sleep quality, and quality of life for patients with non-Hodgkin lymphoma who had undergone the first course of chemotherapy., Design: A randomized controlled study., Settings: An oncology ward of medical centre in northern Taiwan., Participants: Fifty participants in each of the two groups., Methods: Participants were randomly assigned to either the qigong group (n=50) that received a 21-day Chan-Chuang qigong programme, or the control group (n=50). The primary outcome was fatigue measured by Brief Fatigue Inventory. The secondary outcomes were complete blood cell counts, sleep quality measured by Verran and Snyder-Halpern Sleep Scale, and quality of life measured by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire., Results: After 21 days of intervention, the results obtained from ninety six participants were analysed. Participants in the qigong group exhibited decreased fatigue intensity and fatigue interference from 5.49 (SD=1.02) and 5.53 (SD=1.27) to 0.37 (SD=1.39) and 0.20 (SD=1.93), respectively. Generalized estimating equations analyses revealed that the qigong group, when compared to the control group, had significant improvement in fatigue intensity and fatigue interference over time (β=-1.04, 95% confidence interval [CI] from -1.59 to -0.48, p<0.001; and β=-1.22, 95% CI from -1.86 to -0.59, p<0.001, respectively). There was a significant between-group difference in the improvement in white blood cell counts (t=5.14, p<0.001), hemoglobin levels (t=3.17, p=0.002), and sleep quality (t=17.73, p<0.001), but not in platelet counts (p=0.05). With regard to quality of life, the scores of the qigong group improved in all subscales and all symptom items when compared to that of the control group. No adverse effects were observed in the qigong group., Conclusions: The findings of this study indicate that the 21-day Chan- Chuang qigong can reduce fatigue intensity and fatigue interference, and improved white blood cell counts, haemoglobin levels, sleep quality, and quality of life for patients with non-Hodgkin lymphoma who had undergone the first course of chemotherapy. Further studies involving a prolonged extended intervention period and follow-up are necessary for determining the long-term effect of qigong exercise., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Although it can be reduced, postoperative pain remains a problem. Acupressure with electric stimulation may be more effective for postoperative pain management than acupressure alone., Objectives: This study aimed to evaluate the effects of integrative acupoint stimulation (IAS) on the relief of postoperative pain and on the reduction of morphine-related side effects., Design: A single-blinded, sham-controlled study with three groups., Setting: An orthopedic ward in a 2900-bed teaching medical center., Participants: Forty-five subjects in each of three groups., Methods: Each subject received a multimedia course on patient-controlled analgesia (PCA) before surgery to learn about the use of narcotic analgesics and the operation of the PCA device. Treatment was as follows: (1) for the IAS group, auricular acupressure combined with transcutaneous electric acupoint stimulation (TEAS) at the true acupoint; (2) for the sham group, acupoint stimulation in the same manner but at a sham acupoint or without embedding seeds and pressure; (3) for the control group, no IAS intervention., Results: Pain scores were significantly lower in the IAS group than the other two groups at 2h and 4h after returning to the ward, and 24h after surgery. The analgesic requirement during the 72h after surgery and the overall incidence of morphine-related side effects were significantly lower in the IAS group., Conclusion: The study demonstrates that combined auricular acupressure and TEAS decreased postoperative pain, the use of equianalgesic morphine, and morphine-related side effects. IAS provides better analgesia when used in conjunction with PCA after lumbar spine surgery and can be regarded as a component of multimodal analgesia., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Critical thinking (CT) is essential to the exercise of professional judgment. As nurses face increasingly complex health-care situations, critical thinking can promote appropriate clinical decision-making and improve the quality of nursing care., Objectives: This study aimed to evaluate the effects of a program of case studies, alone (CS) or combined with concept maps (CSCM), on improving CT in clinical nurses., Design: The study was a randomized controlled trial. The experimental group participated in a 16-week CSCM program, whereas the control group participated in a CS program of equal duration., Methods: A randomized-controlled trial with a multistage randomization process was used to select and to assign participants, ultimately resulting in 67 nurses in each group. Data were collected before and after the program using the California Critical Thinking Skill Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI)., Results: After the programs, there were significant differences between the two groups in the critical thinking skills of analysis, evaluation, inference, deduction, and induction. There was also an overall significant difference, and a significant difference in the specific disposition of open-mindedness., Conclusions: This study supports the application of case studies combined with concept maps as a hospital-based teaching strategy to promote development of critical thinking skills and encourage dispositions for nurses. The CSCM resulted in greater improvements in all critical thinking skills of as well as the overall and open-minded affective dispositions toward critical thinking, compared with the case studies alone. An obvious improvement in the CSCM participants was the analytic skill and disposition. Further longitudinal studies and data collection from multisite evaluations in a range of geographic locales are warranted., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Acupoint electrical stimulation (AES) is commonly used for pain management. However, its true or placebo effect to achieve pain relief needs to be verified., Objective: This study aimed to examine the true effect of AES to reduce postoperative pain in patients with spinal surgery receiving patient-controlled analgesia (PCA)., Method: A placebo- and sham-controlled study was conducted. Participants were randomly assigned to intervention with AES at true acupoints (the AES group, n=30), AES at sham acupoints (the sham group, n=30), or no intervention with AES (the control group, n=30). Outcomes were assessed according to the amount of pain experienced and analgesics used., Results: There were significant differences among the three groups in pain relief across time, and the occurrence of PCA button pushed and amount of analgesics used. The beneficial effects of AES were discernible when compared to the sham and the control., Conclusions: AES at the true acupoints effectively reduced postoperative pain and analgesic usage. AES has now been implemented into healthcare and it is recommended that nurses be provided with the opportunity to earn their AES skills. More studies evaluating the effects of AES over a longer period and on pain after different surgical procedures are suggested., (Copyright © 2010 Elsevier Ltd. All rights reserved.)