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The major objective of this study was to investigate how smoking behavior mediates the relationship between life stress and depressive symptoms in adolescents. A descriptive correlational study was conducted from February to June 2017 at a vocational high school in northern Taiwan, and 226 students were recruited through convenience sampling. Results indicated that smoking behavior played a pivotal role by partially mediating the relationship between life stress and depressive symptoms in adolescents. Life stress in adolescents significantly increased the risk of experiencing depressive symptoms, and adolescents who smoked were also at a greater risk. Assessments between the objective and self-reported smoking behavior were significantly correlated. Therefore, integrated methods for assessing life stress, smoking behavior, and depressive symptoms in adolescents are needed for teachers and clinical professionals. Implementing appropriate policies for discouraging tobacco use for adolescents experiencing life stress in order to decrease depressive symptoms in school settings is paramount., (© 2020 John Wiley & Sons Australia, Ltd.)

Objective: The alternate healthy eating index has been associated with depression. However, results reported in the literature are inconsistent. The present meta-analysis determined the association between the AHEI or AHEI-2010 and depression in adults without chronic disease. Methods: Nine electronic databases and the reference lists of identified studies were systematically searched for studies published up to December 2016. Articles examining the association between depression and the AHEI or AHEI-2010 in adults were included. Results: We identified eight observational studies with 10 effect sizes involving a total of 38,360 participants. When both the AHEI and AHEI-2010 were considered, the dietary index score was associated with a significant reduction in depression risk (odds ratio OR=0.70, 95% confidence interval CI=0.57-0.87). However, the subgroup analysis indicated that the AHEI-2010 (OR=0.69, 95% CI=0.56-0.89), but not the AHEI (OR=0.60, 95% CI=0.30-1.17), was significantly associated with reduced odds of depression. The heterogeneity among the included studies was significantly high ( Q =48.9, P <0.01, I 2 Our findings suggest that the AHEI-2010 is associated with a reduction in depression risk. However, well-designed randomized controlled trials must be conducted to confirm the causal relationship between the AHEI-2010 and depression.Discussion: Our findings suggest that the AHEI-2010 is associated with a reduction in depression risk. However, well-designed randomized controlled trials must be conducted to confirm the causal relationship between the AHEI-2010 and depression.

Prostate cancer ranks second among male cancers in the United States in terms of death rate. Robot-assisted surgery (RAS) is now offered as the standard surgical procedure performed for radical prostatectomy. Urinary incontinence and erectile dysfunction were common complications after RAS prostatectomy. Patients felt ill-prepared after surgery, resulting in negative impacts on their quality of life. Pelvic floor muscle exercise is prioritized for patients with mild-to-moderate incontinence. The purpose of this study was to examine the effects of using resistance band pelvic floor muscle exercise for patients after RAS prostatectomy. A preexperimental single-group study was conducted for this study. A total of 43 patients completed the program. Urinary incontinence scale, Incontinence Impact Questionnaire, and Hospital Anxiety and Depression Scale were assessed at 0.5 months, 1 month, 2 months, and 3 months after urinary catheter removal. The results revealed that urinary incontinence, life impact, and depression and anxiety improved significantly as time went on. This study suggests that using simple and easy-to-learn resistance band pelvic floor muscle exercise program at home can benefit patients financially and reduce travel time.

Purpose: The purpose of this study was to determine effects of group music intervention and self-directed music intervention on anxiety, depression, and cognitive appraisal among women with breast cancer., Methods: A quasi-experimental design randomly assigned 60 women undergoing chemotherapy to 3 groups: group music intervention, self-directed music intervention, or a control group. The Hospital Anxiety and Depression Scale and the Mini-Mental Adjustment to Cancer Scale were administered before, after the 8-week interventions, and at 3-month follow-up., Results: Of the 52 women completing the study, results indicated that group music intervention had a significant (p < .01) immediate effect to decrease helplessness/hopelessness and anxious preoccupation and significant effects for reducing anxiety, depression, helplessness/hopelessness, and cognitive avoidance compared to the other two groups at 3-month follow-up., Conclusions: Group music intervention can be considered an effective supportive care in alleviating the chemotherapy-related distress and enhancing cognition modification of women with breast cancer. Further research is needed to determine the role of cognitive appraisal in the illness trajectory.

Objective: To examine the effects of home-based supportive care on improvements in physical function and depressive symptoms in home-dwelling patients after stroke., Data Sources: Seven electronic databases (eg, MEDLINE, PubMed, CINAL, EMBASE, the Cochrane Central Register of Controlled Trials, ProQuest, and Google Scholar) and 4 Chinese databases (eg, WANFANG MED ONLINE, Chinese Electronic Periodical Services, China Academic Journals Full-text Database, and National Central Library) were fully searched for all relevant articles up to June 25, 2016., Study Selection: Randomized controlled trials examining the effects of home-based supportive care on physical function and depressive symptoms in home-dwelling patients after stroke were included. Finally, 16 articles in Chinese (n=4) and English (n=12) met the inclusion criteria., Data Extraction: Data on patient characteristics, study characteristics, intervention details, and outcome were extracted. Two reviewers independently extracted data and assessed methodological quality using the Cochrane risk of bias tool., Data Synthesis: Home-based supportive care had a small size effect on physical function (Hedges' g=.17; 95% confidence interval, .09-.26) and a moderate size effect on depressive symptoms (Hedges' g=-.44; 95% confidence interval, -.83 to -.05) in home-dwelling patients after stroke. The moderator analysis revealed that some components of study participants and intervention programs improved the effects on physical function and depressive symptoms; however, no significant moderators were further identified to have superiorly improved physical function and depressive symptoms., Conclusions: Regular performance of home-based supportive interventions should be considered for inclusion as routine care for managing and improving physical function and depressive symptoms in home-dwelling patients after stroke. The present findings provide further evidence with which to design appropriate supportive interventions for home-dwelling stroke survivors., (Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Undergraduate students face tremendous stressors from learning, interpersonal relationships, and life. Stress may cause adaptation exhaustion and stress-related disorders. While the results of recent clinical studies indicate that music interventions may alleviate stress, there is a dearth of research exploring the discrete effects of various genres of music on psycho-physiological status., Purpose: To explore the effects of listening to different genres of music on the psycho-physiological responses of undergraduates., Methods: A one-group, pretest-posttest design was used. A total of 122 undergraduates were assigned to the following four music subgroups according to their musical preference: joyful, tense, sad, and peaceful. Students in each subgroup listened to the self-selected music for 15 minutes during the experiment. A physiological data acquisition systems, the State Anxiety Inventory, and the Visual Analogue Scale for anxiety and depression were used to measure the psycho-physiological responses of participants before, during, and after music listening. Descriptive and inferential analyses were performed using SPSS 20.0., Results: Results: Depression significantly decreased in the peaceful music group compared to the sad music group after the intervention. Further, significant differences in heart rate variability were identified during the intervention among the groups. The change in low frequency (LF) in the joyful music group was lower than the other three groups; the change in high frequency (HF) in the peaceful music group was lower than in the tension and joyful music groups; and the change in LF/HF in the peaceful music group was lower than in the sad and joyful music groups. Additionally, the subsamples with high state anxiety experienced more change in HF while listening to tense music than to peaceful music, reflecting an upward trend after listening for 10 minutes., Conclusions / Implications for Practice: The findings indicate that listening to different genres of music induces different psycho-physiological responses. In the present study, participants with high-state anxiety registered elevated parasympathetic activity after listening to 10 minutes of tense and sad music. Simultaneous listening effects were detected only in joyful and peaceful music, which reduced subjective anxiety and depression. The results of the present study advocate that music interveners and clinical care providers select joyful, peaceful, and tense music to help alleviate the anxiety and negative emotions of their patients. Furthermore, the psycho-physiological changes of these patients should be assessed after listening to this music.

Background: People older than 65 years old account for about 10.9% of Taiwan's total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services., Objective: This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities., Methods: We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms., Results: The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors., Conclusions/implications for Practice: Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression.

Learned resourcefulness (LR) is important in facilitating mental health in individuals experiencing depression, and positive ideation plays a further protective role in the prevention of suicidal ideation. The purpose of this study was to explore whether LR mediates or moderates the relationship between depressive symptoms and positive ideation in hospital nurses. Participants were 807 full-time hospital nurses. The relationship between depressive symptoms and positive ideation was both mediated and moderated by LR after controlling for age, job title, and marital status. Continuing education and counseling strategies may increase nurses' LR and thereby enhance positive ideation and reduce risk of depression and suicide., (Copyright © 2012 Wiley Periodicals, Inc.)

Aims: The aim of this study was to examine the effect of an Interactive Computerized Psycho-Education System on patients suffering from depression and to compare the use of an Interactive Computerized Psycho-Education System vs. traditional pamphlet education approach., Background: Depression management depends on pharmacological treatment and psychotherapy and on appropriate and timely patient education. Whilst multimedia learning concepts have been applied in areas such as education, this approach has not been widely used in psychiatric outpatient departments., Design and Method: A preliminary pre and post quasi-experimental design with patients with depression was employed at an hospital. Participants in the experimental group (n = 19) received an Interactive Computerized Psycho-Education System intervention programme (Interactive Computerized Psycho-Education System and the educational manual). Participants in the control group (n = 13) were exposed only to the traditional pamphlet education approach (consultation from psychiatrists and information sheets). Primary outcome was depression knowledge scores. Secondary outcomes were scores on the Compliance Behaviour Assessment Scale., Results: In the experimental group (n = 19), the time spent working on the Interactive Computerized Psycho-Education System was about 30-180 minutes per session, with an average of 67 minutes. Participants in the experimental group had a considerably decreased incidence of medication non-compliance compared with participants in the control group. Knowledge scores of the experimental group ranged from 30-100, with an average score of 74.7., Conclusion: The Interactive Computerized Psycho-Education System is acceptable and may be as more effective than a traditional education approach to achieve adherence to medications for depression., Relevance to Clinical Practice: Compared with a traditional approach, the combination of the Interactive Computerized Psycho-Education System and a nursing-consulting clinic may assist patients with depression to achieve and maintain better medication compliance in addition to improving their knowledge of depression.

Objective: The study was designed to test whether neuroticism moderated the effect of extroversion and mediated the impact of menopause status on depressive symptoms among women in Taiwan during their menopausal transition., Design: A sample of 197 women, aged 40 to 60 years, were recruited from the community. We used Ko's Depression Inventory, the Five-Factor Inventory-Chinese version, the Menopausal Symptoms Scale, and the Chinese version of the Modified Schedule of Affective Disorders and Schizophrenia-Lifetime to gather data. Moreover, each woman underwent a semistructured diagnostic interview in person to obtain her lifetime psychiatric history., Results: The hierarchy regression analyses showed that the interaction between neuroticism and extroversion was statistically significant. Further analyses indicated that in the high neuroticism group, extroversion was negatively associated with depressive symptoms; however, in the low neuroticism group, extroversion was not correlated with depressive symptoms. Menopause status was correlated with depressive symptoms, but after adding neuroticism and extroversion, the main effect of menopause status became insignificant. Results of the Sobel test showed that depressive symptoms of women during the menopause transition largely represented neuroticism., Conclusions: The present study revealed that the lower levels of extroversion are associated with depression among all stages of menopausal women with high levels of neuroticism; moreover, all stages of menopausal women who have high levels of neuroticism are more vulnerable to depression. The results support that personality may play an important role in women's depression during the transition of menopausal status.

Background: Adolescent suicide has been a major concern in Taiwan and continues to be an important research issue for mental health workers. The cognitive triad, which refers to an adolescent's views of the self, the world, and the future, was found previously to be related to both depressive symptoms and suicidal ideation. However, researchers have paid less attention to exploring the roles of mediation and moderation which the cognitive triad plays in the relationship between depressive symptoms and suicidal ideation., Objectives: To test the mediating and moderating effects of the cognitive triad on the relationship between depressive symptoms and suicidal ideation in a sample of school-aged adolescents., Methods: A cross-sectional and correlational design was used in this study. Instruments were administered anonymously to a sample of 1,245 school-aged adolescents recruited from nine middle and high schools of Taipei City. Instruments used included the Children's Depression Inventory, the Cognitive Triad Inventory for Children, and the Positive and Negative Suicide Ideation., Results: Regression analysis revealed that the cognitive triad significantly mediated and moderated the relationship between depressive symptoms and suicidal ideation., Conclusions: These findings have implications for theoretical development and health policies related to suicide prevention programs in schools.

Objective: To examine alteration of serum interleukin-6 and its clinical significance in burning mouth syndrome (BMS) patients., Methods: 48 BMS patients and 31 healthy controls participated in the study. Serum interleukin-6 was measured by means of ELISA. Hamilton rating scale of depression (HRSD) and visual analogue scale (VAS) were used to quantitate depressive status and pain levels of subjects, respectively., Results: 15 (31%) patients displayed substantial depressive symptoms (HRSD > or = 16). HRSD scores of patients were significantly higher than controls and positively correlated to their VAS values (P = .002). Serum interleukin-6 in patients was much lower than controls and negatively correlated to their VAS values (P = .011). However, no significant relations were found between interleukin-6 and HRSD scores (P = .317)., Conclusions: Serum interleukin-6 in patients with burning mouth syndrome is decreased and negatively correlated to chronic pain. Both psychological and neuropathic disorders might act as precipitating factors in BMS etiopathogenesis.

This study examined potential modifying effects of income and education on the relationship between chronic obstructive pulmonary disease (COPD) and depression. The analysis was based on 44,963 Canadians aged 35 years or more who participated in the Canadian National Population Health Survey in 1996-1997. Logistic regression analysis was used to examine the association between prevalence of depression and COPD according to sex, income adequacy or educational level. We used a bootstrap procedure to take sampling weights and design effects into account. People with COPD had twice the prevalence of depression compared to those without COPD. The association tended to be stronger in well-educated men [adjusted odds ratio (OR) = 3.02, 95% confidence interval (CI) = 1.04, 8.75] and women (OR = 2.60, 95% CI = 1.55, 4.38) than those less educated (men: OR= 1.19, 95% CI = 0.47, 3.05; women: OR = 1.93, 95% CI = 0.96, 3.87). An increased prevalence of depression associated with COPD was also found in women with higher household income (adjusted odds ratio = 4.57, 95% CI = 2.27, 9.19) than those with lower income. However, this pattern was not found in men. In conclusion, COPD patients with higher education are more likely to be depressed. The modifying effect of income may vary by gender. Possible reasons for these findings are explored.

Background: The co‐occurrence of depression and diabetes mellitus has been linked to an increased risk of developing cancer. This study aimed to investigate whether depression further amplifies the risk of cancer among individuals with diabetes. Methods: This population‐based matched cohort study utilized Taiwan's National Health Insurance claims database. A total of 85,489 newly diagnosed diabetic patients with depressive disorders were selected, along with 427,445 comparison subjects. The matching process involved age, sex, and the calendar year of diabetes onset. The average follow‐up duration for the two cohorts was 6.4 and 6.5 years, respectively. The primary outcome of interest was the occurrence of overall cancer or cancer at specific anatomical sites. Results: The adjusted hazard ratios for overall cancer incidence were 1.08 (95% CI, 1.05–1.11). For site‐specific cancers, depression exhibited significant associations with oropharyngeal, esophageal, liver, gynecological, prostate, kidney, and hematologic malignancies among patients with diabetes. Notably, a severity‐response relationship was observed, indicating that patients with recurrent episodes of major depressive disorders exhibited a higher incidence of cancer compared to those diagnosed with dysthymia or depressive disorder not otherwise specified. Furthermore, the strength of the association between depression and cancer risk was more pronounced among younger patients with diabetes as opposed to older adults. However, no significant relationship was observed between adherence to antidepressant treatment and cancer risk. Conclusions: The findings of this study indicate a significant association between depression and an elevated risk of cancer among individuals diagnosed with diabetes. Future investigations should replicate our findings, explore the effects of pharmacological and non‐pharmacological treatments on cancer risk, and identify the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Introduction: Mental health is a major concern among migrant workers worldwide. More than 200,846 female migrant workers in Taiwan are from Indonesia. The study's purpose was to investigate mediating effects of coping strategies on the relationship between mental health problems and the quality of life (QoL). Method: This cross-sectional study was conducted in Taiwan. In total, 500 Indonesian female migrant workers completed four questionnaires. A mediation test was conducted to estimate direct and indirect effects. Results: Coping strategies, namely substance use, behavioral disengagement, denial, and religious dedication, partially mediated the relationship between mental health problems (depression, anxiety, and stress) and QoL among Indonesian female migrant workers in Taiwan. Discussion: Health promotion programs should be developed for Indonesian female migrant workers in Taiwan to help them detect and overcome their mental health problems. Interventions that facilitate effective coping strategies should be administered to improve their QoL. [ABSTRACT FROM AUTHOR]

Depression is a risk factor for subsequent Parkinson's disease (PD). Some patients with depression undergo acupuncture treatment because of other diseases in Taiwan. Therefore, the present study used data from Taiwan's National Health Insurance Research Database (NHIRD) to investigate the incidence of PD in patients having depression with and without acupuncture treatment. We conducted a retrospective study of a matched cohort of 48,981 patients with newly diagnosed depression between 2000 and 2012 who were selected from the NHIRD. The 1:1 propensity score method was utilized to match an equal number of patients (N = 9,189) in the acupuncture and non-acupuncture cohorts. We employed Cox proportional hazard models to evaluate the risk of PD. The cumulative incidence of PD in both cohorts was estimated using the Kaplan–Meier method, and the difference was examined through a log-rank test. Patients with depression who received acupuncture treatment demonstrated a lower risk of PD [adjusted hazard ratio (aHR) = 0.39, 95% confidence interval = 0.31–0.49] than those who did not undergo acupuncture treatment, after adjusting for age, sex, insurance amount, geographic region, urbanization levels, comorbidities, and drugs. The cumulative incidence of PD was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001). The database did not indicate the severity of depression and acupoints. The results suggest that acupuncture treatment significantly reduced the development of PD in patients with depression; however, a future study should be conducted to provide more objective evidence. [ABSTRACT FROM AUTHOR]

Background: Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors. Objectives: To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records. Design: This is a cohort study of Taiwan’s national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010. Participants: The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950–E959) according to the International Classification of Disease, Ninth Revision, Clinical Modification. Results: Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder), had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide-related behaviors, had a catastrophic illness, or had adopted a single lethal method had an increased risk of death by suicide. Conclusions: High-risk factors should be considered when devising suicide-prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Emerging data have demonstrated that peroxisome proliferator-activated receptor δ (PPARδ) activation confers a potentially neuroprotective role in some neurodegenerative diseases. However, whether PPARδ is involved in depression is unknown. Methods: In this study, PPARδ was firstly investigated in the chronic mild stress (CMS) and learned helplessness (LH) models of depression. The changes in depressive behaviors and hippocampal neurogenesis were investigated after PPARδ overexpression by microinfusion of the lentiviral vector, containing the coding sequence of mouse PPARδ (LV-PPARδ), into the bilateral dentate gyri of the hippocampus or PPARδ activation by repeated systemic administration of PPARδ agonist GW0742 (5 or 10mg/kg.d, i.p., for 21 d). Results: We found that both CMS and LH resulted in a significant decrease in the PPARδ expression in the hippocampi of mice, and this change was reversed by treatment with the antidepressant fluoxetine. PPARδ overexpression and PPARδ activation each suppressed the CMS- and LH-induced depressive-like behavior and produced an antidepressive effect. In vivo or in vitro studies also showed that both overexpression and activation of PPARδ enhanced proliferation or differentiation of neural stem cells in the hippocampi of mice. Conclusions: These results suggest that hippocampal PPARδ upregulation represses stress-induced depressive behaviors, accompanied by enhancement of neurogenesis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the roles of adherence attitude to antidepressants and patient education as mediators in mediating patients' attitudes toward antidepressant use. A sample of 201 outpatients, 50 years of age or older, with major depressive disorder, completed a drug use questionnaire, attitudes toward and patient education about antidepressants questionnaire, and Adherence Attitude Inventory. Attitudes toward antidepressants were positively associated to antidepressant use, an association explained by the mediating variable, patient education about antidepressants. Adherence attitudes to antidepressants were a mediator that accounted to a significant degree for the causal relationship between attitudes toward antidepressants and antidepressant use. Adequate patient education and an understanding of patients' adherence attitude to antidepressant use are needed in nursing practice to reduce patients' uncertainty about treatment and increase successful treatment. [ABSTRACT FROM AUTHOR]

Aims. To explore pivotal moments and changes during the Bonny Method of Guided Imagery and Music from the perspective of patients with depression. Background. Depression has been described as an extremely difficult experience for people and is characterised by emotional distress and suffering. As depression progresses, symptoms increase and gradually influence all aspects of the lives of those affected. Few studies have been undertaken into the essence of inner and pivotal experiences during Guided Imagery and Music in patients with depression. Design. A qualitative research design and discovery-oriented approach were used as the method of both data gathering and textual analysis. Methods. This study conducted semi-structured interviews with five patients with depression after each of eight sessions of the Bonny Method of Guided Imagery and Music. Each session took place in a music therapy laboratory. Forty transcripts were organised into categories and analysed according to the discovery-oriented approach of Mahrer and Boulet, considering the dimensions of the Bonny Method of Guided Imagery and Music. Results. Nine patients with depression were recruited from a medical centre in southern Taiwan from 2004–2005. Five successfully completed eight Bonny Method of Guided Imagery and Music sessions. There were 141 statements coded into 10 subthemes and three themes describing pivotal moments: pushing aside the barrier, gaining new insight, moving forward. Each category was supported by three-four themes. The analysis also yielded three meaningful moments: releasing mind–body rigidity, awareness and inspiration, acceptance and inner transformation. Patients described personal emotional, cognitive and behavioural transformation during the Bonny Method of Guided Imagery and Music experiences. Conclusions. The discovery-oriented approach fulfilled the aim of gaining a valuable understanding of the psychological growth experiences of patients with depression during the Bonny Method of Guided Imagery and Music. Relevance to clinical practice. Patients with depression particularly need comfort and caring. It is important that nurses offer interventions as adjuvants to medication. This study supports the feasibility of incorporating the Bonny Method of Guided Imagery and Music into the nursing management of patients with depression. Future studies are suggested to examine the interactive process of music stimulus and the multidimensional nature of imagery. [ABSTRACT FROM AUTHOR]

Background: Patient activation has been described as a potential strategy to improve chronic disease self-management. However, the effects of patient activation interventions on psychological and behavioral outcomes have not been systematically evaluated. Purpose: This study was designed to evaluate the effects of patient activation interventions on physiological, psychological, behavioral, and health-related quality of life outcomes in patients with chronic diseases. Methods: We systematically searched four databases (PubMed, Cochrane, CINAHL, and Embase) from inception to September 1, 2017. We identified English- and Chinese-language published reports of randomized controlled trials that evaluated the effects of patient activation interventions for adults with chronic diseases. Study selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized the intervention effects with Hedges's g values and 95% confidence intervals using a random-effects model. We used the Cochrane Handbook to assess the methodological quality of the randomized controlled trials. Results: Twenty-six randomized controlled trials were included in the qualitative synthesis and meta-analysis. In terms of overall study quality, most of the included studies were affected by performance and detection bias. Patient activation interventions produced significant effects on outcomes related to physiological, psychological, behavioral, and health-related quality of life in the context of chronic diseases. The following effect sizes were obtained: (a) physiological, namely, glycated hemoglobin = −0.31 (p <.01), systolic blood pressure = −0.20 (p <.01), diastolic blood pressure = −0.80 (p =.02), body weight = −0.12 (p =.03), and low-density lipoprotein = −0.21 (p =.01); (b) psychological, namely, depression = −0.16 (p <.01) and anxiety = −0.25 (p =.01); (c) behavioral, namely, patient activation = 0.33 (p <.01) and self-efficacy = 0.57 (p <.01); and (d) health-related quality of life = 0.25 (p =.01). Conclusions: Patient activation interventions significantly improve patients' physiological, psychosocial, and behavioral health statuses. Healthcare providers should implement patient activation interventions that tailor support to the individual patients' level of patient activation and strengthen the patients' role in managing their healthcare to improve chronic-disease-related health outcomes. [ABSTRACT FROM AUTHOR]

Panax ginseng C. A. Meyer is a valuable medicinal herb and "alternative" remedy for the prevention and treatment of depression. Dysfunction of connexin43 (Cx43)-gap junction in astrocytes is predisposed to the precipitation of depression. Ginsenoside Rg1 (Rg1), the main bioactive constituent extracted from ginseng, is efficacious in the management of depression by upregulating the content of Cx43. Our previous results indicated that pretreatment with Rg1 significantly improved Cx43-gap junction in corticosterone (CORT)-treated astrocytes. However, the antidepressant mechanism underlying how Rg1 upregulates Cx43-gap junction in astrocytes hasn't been proposed. To dissect the mechanisms of Rg1 controlling Cx43 levels in primary astrocytes. We examined the changes of the level of Cx4 3 mRNA, the degradation of Cx43, as well as the ubiquitin-proteasomal and autophagy-lysosomal degradation pathways of Cx43 followed by Rg1 prior to CORT in rat primary astrocytes isolated from prefrontal cortex and hippocampus. Furthermore, the recognized method of scrape loading/dye transfer was performed to detect Cx43-gap junctional function, an essencial indicator of the antidepressant effect. Pretreatment with Rg1 could reverse CORT-induced downregulation of Cx43 biosynthesis, acceleration of Cx43 degradation, and upregulation of two Cx43 degradation pathways in primary astrocytes. The findings in the present study provide the first evidence highlighting that Rg1 increases Cx43 protein levels through the upregulation of Cx4 3 mRNA and downregulation of Cx43 degradation, which may be attributed to the effect of Rg1 on the ubiquitin-proteasomal and autophagy-lysosomal degradation pathways of Cx43. [Display omitted] • Rg1 reversed CORT-induced reduction of Cx43 expression in rat primary astrocytes. • Rg1 increased Cx4 3 mRNA levels in rat primary astrocytes exposed to CORT. • CORT accelerated the degradation of Cx43, while Rg1 reduced Cx43 degradation. • Rg1 reduced the ubiquitin and autophagy degradation pathways of Cx43. [ABSTRACT FROM AUTHOR]