Purpose: The purpose of this study was to explore the experience of case management for early psychosis and identify factors influencing care management. Methods: We conducted in-depth interviews with 10 mental health professionals who implemented the Social Treatment for Early Psychosis (STEP) program. The collected data were analyzed using qualitative content analysis. Results: The findings consisted of 4 categories and 15 subcategories. Case management should develop expertise considering the desires of young adults, and grew as experts by promoting family cooperation and coping with mental crises. Administrator's support and peer support programs had a positive impact, while the absence of collaborative systems with psychiatric institution were identified as limitations in the operating system of the basic center. Consulting and monitoring of the metropolitan center provided a foundation for case management at the basic center, while the government's support policy is needed to improve of working environment and set up the youth-friendly early intervention system. Conclusion The results suggest that case management for early psychosis requires multilateral and cooperative efforts by strengthening the capabilities of case managers, establishing an integrated case management network of basic and metropolitan centers, and expanding the government's human and physical infrastructure.

Purpose: The purpose of this study was to explore the experience of case management for early psychosis and identify factors influencing care management. Methods: We conducted in-depth interviews with 10 mental health professionals who implemented the Social Treatment for Early Psychosis (STEP) program. The collected data were analyzed using qualitative content analysis. Results: The findings consisted of 4 categories and 15 subcategories. Case management should develop expertise considering the desires of young adults, and grew as experts by promoting family cooperation and coping with mental crises. Administrator's support and peer support programs had a positive impact, while the absence of collaborative systems with psychiatric institution were identified as limitations in the operating system of the basic center. Consulting and monitoring of the metropolitan center provided a foundation for case management at the basic center, while the government's support policy is needed to improve of working environment and set up the youth-friendly early intervention system. Conclusion The results suggest that case management for early psychosis requires multilateral and cooperative efforts by strengthening the capabilities of case managers, establishing an integrated case management network of basic and metropolitan centers, and expanding the government's human and physical infrastructure.

Purpose: The purpose of this study was to systematically review peer support services related to mental health services utilization by people with severe mental illness and to identify core strategies essential for effective peer support services. Methods: A systematic search was conducted using keywords in English, 4 electronic databases, including CINAHL, EMBASE, MEDLINE, and PubMed. Of the 1,305 publications identified, 14 studies were finally included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for the quality assessment. Results: The 14 studies consisted of 8 randomized controlled trials (RCTs), 4 cohort studies, and 2 quasi-experimental studies. Overall, peer support services were found to be effective in reducing hospitalization rates, hospitalization days, number of emergency room visits, and total medical costs. There was inconsistent evidence that the services were associated with positive effects on measures of psychiatric symptoms, quality of life, and social support. Conclusion Peer support services for people with severe mental illness can be a cost-effective way to increase crisis stabilization and continuity of treatment. The core strategies of the services is the development of structured programs to cultivate professional peer providers and the establishment of a cooperative system between mental health professionals and peer providers.

OBJECTIVES: This study aims to evaluate the size-dependent toxicity of spherical silver nanoparticles (Ag NPs) to an endemic benthic organism, Glyptotendipes tokunagai. METHODS: Ag nanoparticles of three nominal sizes (50, 100, and 150 nm) capped with polyvinyl pyrrolidone (PVP-Ag NPs) were used. Their physicochemical properties, acute toxicity (48 hours), and bioaccumulation were measured using third instar larvae of G. tokunagai. RESULTS: The aggregation and dissolution of PVP-Ag NPs increased with exposure time and concentration, respectively, particularly for 50 nm PVP-Ag NPs. However, the dissolved concentration of Ag ions was not significant compared with the median lethal concentration value for AgNO3 (3.51 mg/L). The acute toxicity of PVP-Ag NPs was highest for the smallest particles (50 nm), whereas bioaccumulation was greatest for the largest particles (150 nm). However, larger PVP-Ag NPs were absorbed and excreted rapidly, resulting in shorter stays in G. tokunagai than the smaller ones. CONCLUSIONS: The size of PVP-Ag NPs significantly affects their acute toxicity to G. tokunagai. In particular, smaller PVP-Ag NPs have a higher solubility and stay longer in the body of G. tokunagai, resulting in higher toxicity than larger PVP-Ag NPs.
Chironomidae ; Ions ; Larva ; Nanoparticles* ; Polyvinyls ; Silver* ; Solubility

OBJECTIVES: This study aims to evaluate the size-dependent toxicity of spherical silver nanoparticles (Ag NPs) to an endemic benthic organism, Glyptotendipes tokunagai. METHODS: Ag nanoparticles of three nominal sizes (50, 100, and 150 nm) capped with polyvinyl pyrrolidone (PVP-Ag NPs) were used. Their physicochemical properties, acute toxicity (48 hours), and bioaccumulation were measured using third instar larvae of G. tokunagai. RESULTS: The aggregation and dissolution of PVP-Ag NPs increased with exposure time and concentration, respectively, particularly for 50 nm PVP-Ag NPs. However, the dissolved concentration of Ag ions was not significant compared with the median lethal concentration value for AgNO3 (3.51 mg/L). The acute toxicity of PVP-Ag NPs was highest for the smallest particles (50 nm), whereas bioaccumulation was greatest for the largest particles (150 nm). However, larger PVP-Ag NPs were absorbed and excreted rapidly, resulting in shorter stays in G. tokunagai than the smaller ones. CONCLUSIONS: The size of PVP-Ag NPs significantly affects their acute toxicity to G. tokunagai. In particular, smaller PVP-Ag NPs have a higher solubility and stay longer in the body of G. tokunagai, resulting in higher toxicity than larger PVP-Ag NPs.
Chironomidae ; Ions ; Larva ; Nanoparticles* ; Polyvinyls ; Silver* ; Solubility

Background: Regeneration of soft tissue defects is essential for adipose tissue pathologies and disease, trauma, or injury-induced damage. Here, we show that umbilical cord blood-derived mesenchymal stem cells could potentially be tailored and used for the reconstruction of specific damaged sites. Adipogenesis can be exploited in soft tissue reconstruction. Also, primary cilia play a role in the control of adipogenesis. Methods: The adipogenic differentiation capacity of mesenchymal stem cells (MSCs) was shown to influence ciliogenesis. MSCs transfected with intraflagellar transport 88 (IFT88) small interfering RNA (siRNA), which blocks the assembly and maintenance of cilia, were examined to confirm the relationship between adipogenesis and ciliogenesis. Also, 1,2-Bis(2-aminophenoxy) ethane-N,N,N′,N′-tetraacetic acid tetrakis(acetoxymethyl ester) (BAPTA-AM), calcium chelator, inhibited the ciliogenesis of MSCs in adipogenic differentiation. Results: IFT88-knockdown led to decreased cilia formation and limitation of cilia elongation in adipogenesis. Additionally, intracellular calcium triggered cilia formation in MSCs adipogenesis. Interestingly, intracellular calcium cannot overcome the inhibition of adipogenesis caused by low numbers of cilia in MSCs. Conclusion Our data suggested that ciliogenesis was negatively regulated by Wnt5a/β-catenin signaling during adipogenesis. Thus, we suggest that calcium induction triggers adipogenesis and ciliogenesis.