Objective To evaluate the efficacy of MoodGYM Internet-delivered Cognitive Behavior-al Therapy in the treatment of anxiety and depression among nurses. Methods A total of 180 nurses with anxiety or depression were randomly divided into three groups,60 in each group,and 2 months of intervention with MoodGYM and health education ( once a week,30-45 minutes each time) in MoodGYM group and health education group,respectively. Another group was as a control group. Before and after intervention,De-pression Anxiety Stress Scale 21 ( DASS-21),Minnesota Satisfaction Questionnaire ( MSQ) and Subjective Happiness Scale (SHS) were used to evaluate psychological status. Results Compared with pre-interven-tion,the scores of anxiety in DASS-21 ((16. 76±7. 61) vs (9. 67±5. 78),t=21. 339,P<0. 01) and depres-sion in DASS-21 ((13. 86±7. 60) vs (10. 91±7. 12),t=16. 716,P<0. 01) decreased,meanwhile job satis-faction in MSQ((65. 11±11. 12) vs (67. 97±11. 10),t=-16. 400,P<0. 01) and subjective well-being in SHS((17. 67 ± 4. 59) vs (21. 83 ± 3. 53),t=-20. 221, P<0. 01) increased in post-intervention in the MoodGYM group. The scores of anxiety((15. 81±8. 24) vs (12. 45± 7. 68),t=17. 566,P<0. 01) and de-pression((12. 44± 8. 23) vs ( 12. 09 ± 7. 95), t=3. 934,P<0. 01) decreased, meanwhile job satisfaction ((67. 37±9. 76) vs (68. 91± 9. 67),t=-4. 474,P<0. 01) and subjective well-being(( 17. 93± 3. 80) vs (19. 85±3. 96),t=-14. 897,P<0. 01) increased in post-intervention in the health education group. After in-tervention,the effect of improving anxiety, depression, job satisfaction and subjective well-being in the MoodGYM group was more obvious than that in the health education group (P<0. 01). Conclusion -MoodGYM intervention can relieve anxiety and depression of nurses,improve their job satisfaction and sub-jective well-being.

INTRODUCTION: Polypharmacy and inappropriate prescribing are associated with negative health outcomes in the elderly. Several prescribing tools have been developed to assess medication appropriateness. Explicit (criteria-based) tools often do not take into account patients' preferences and comorbidities, and have little room for individualised clinical judgement. METHODS: A cross-sectional observational study was conducted in 243 elderly patients admitted to the Geriatric Medicine service in a Singapore tertiary hospital over one month. We incorporated an implicit (judgement-based) tool developed by Scott et al into a mnemonic, 'S-I-R-E', to assess medication appropriateness: S = symptoms ('Have symptoms resolved?'), I = indication ('Is there a valid indication?'), R = risks ('Do risks outweigh benefits?') and E = end of life ('Is there short life expectancy limiting clinical benefit?'). RESULTS: Inappropriate prescribing was present in 27.6% of patients. The most common reason for inappropriateness of medications was lack of valid indication (62.2%), followed by high risk-benefit ratio (20.7%). The most common medications that lacked valid indication were supplements and proton pump inhibitors. Polypharmacy was found in 93% of patients and was significantly associated with inappropriate prescribing (p = 0.047). CONCLUSION Inappropriate prescribing and polpharmacy are highly prevalent in the hospitalised elderly. The 'S-I-R-E' mnemonic can be used as a memory aid and practical framework to guide appropriate prescribing in the elderly.

BACKGROUND: Previous investigations have shown that local application of nanoparticles presenting the carbohydrate moiety galactose-a-1,3-galactose (α-gal epitopes) enhance wound healing by activating the complement system and recruiting pro-healing macrophages to the injury site. Our companion in vitro paper suggest α-gal epitopes can similarly recruit and polarize human microglia toward a pro-healing phenotype. In this continuation study, we investigate the in vivo implications of α-gal nanoparticle administration directly to the injured spinal cord. METHODS: α-Gal knock-out (KO) mice subjected to spinal cord crush were injected either with saline (control) or with α-gal nanoparticles immediately following injury. Animals were assessed longitudinally with neurobehavioral and histological endpoints. RESULTS: Mice injected with α-gal nanoparticles showed increased recruitment of anti-inflammatory macrophages to the injection site in conjunction with increased production of anti-inflammatory markers and a reduction in apoptosis. Further, the treated group showed increased axonal infiltration into the lesion, a reduction in reactive astrocyte populations and increased angiogenesis. These results translated into improved sensorimotor metrics versus the control group. CONCLUSIONS Application of α-gal nanoparticles after spinal cord injury (SCI) induces a pro-healing inflammatory response resulting in neuroprotection, improved axonal ingrowth into the lesion and enhanced sensorimotor recovery. The data shows α-gal nanoparticles may be a promising avenue for further study in CNS trauma.GRAPHICAL ABSTRACT Putative mechanism of therapeutic action by α-gal nanoparticles. A. Nanoparticles injected into the injured cord bind to anti-Gal antibodies leaked from ruptured capillaries. The binding of anti-Gal to α-gal epitopes on the α-gal nanoparticles activates the complement system to release complement cleavage chemotactic peptides such as C5a, C3a that recruit macrophages and microglia. These recruited cells bind to the anti-Gal coated α-gal nanoparticles and are further polarized into the M2 state. B. Recruited M2 macrophages and microglia secrete neuroprotective and prohealing factors to promote tissue repair, neovascularization and axonal regeneration (C.).

OBJECTIVES: There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression. METHODS: A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory. RESULTS: The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables. CONCLUSIONS Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.
Adaptation, Psychological ; Child ; China/epidemiology* ; Extraversion, Psychological ; Humans ; Only Child ; Surveys and Questionnaires