A Philosophical and Empirical Investigation into Buddhist Economics

There is a growing body of literature on Buddhist economics from a philosophical perspective; however, no work to date has sought to empirically validate it as an effective economic theory at a global scale. In my paper, I draw on the long history of Buddhist metaphysics to construct an account of Buddhist ethics and then proceed to derive a set of Buddhist economic principles. I draw on the World Happiness Report’s methodology to quantitatively demonstrate the relationship between Buddhist economic principles and the psychological wellbeing of a country’s citizens, as measured through their own evaluation of their quality of life and the dispersion of those evaluations within a given country. Overall, I find that the implementation of Buddhist economic principles at a national government level is positively correlated with higher average levels of wellbeing and lower dispersion of life evaluations. However, I also find significant differences between how Buddhist principles affect wellbeing between countries with initial higher and lower rates of wellbeing dispersion

Shooting to Kill

Terrorism, the use of military force in Afghanistan, Iraq and Syria, and the fatal police shootings of unarmed persons have all contributed to renewed interest in the ethics of police and military use of lethal force and its moral justification. In this book, philosopher Seumas Miller analyzes the various moral justifications and moral responsibilities involved in the use of lethal force by police and military combatants, relying on a distinctive normative teleological account of institutional roles. His conception constitutes a novel alternative to prevailing reductive individualist and collectivist accounts. As Miller argues, police and military uses of lethal force are morally justified in part by recourse to fundamental natural moral rights and obligations, especially the right to personal self-defense and the moral obligation to defend the lives of innocent others. Yet the moral justification for police and military use of lethal force is to some extent role-specific. Both police officers and military combatants evidently have an institutionally-based moral duty to put themselves in harm's way to protect others. Under some circumstances, however, police have an institutionally based moral duty to use lethal force to uphold the law; and military combatants have an institutionally based moral duty to use lethal force to win wars. Two key notions in play are joint action and the natural right to self-defense. Miller uses a relational individualist theory of joint actions to construct the notion of multi-layered structures of joint action in order to explicate organizational action. He also provides a novel theory of justifiable killing in self-defense. Over the course of his book, Miller covers a variety of urgent topics, such as police shootings of armed offenders, police shooting of suicide-bombers, targeted killing, autonomous weapons, humanitarian armed intervention, and civilian immunity

Differential Predictive Value of Depressive Versus Anxiety Symptoms in the Prediction of 8-Year Mortality After Acute Coronary Syndrome.

ObjectiveBoth depression and anxiety have been associated with poor prognosis in patients with acute coronary syndrome (ACS). However, certain symptoms and how they are measured may be more important than others. We investigated three different scales to determine their predictive validity.MethodsPatients with ACS (N = 598) completed either the Hospital Anxiety and Depression Scales (HADS-A, HADS-D; n = 316) or the Beck Depression Inventory-Fast Screen (n = 282). Their all-cause mortality status was assessed at 8 years.ResultsDuring follow-up, 20% (121/598) of participants died. Cox proportional hazards modeling showed that the HADS-D was predictive of mortality (hazard ratio [HR] = 1.11, 95% confidence interval [CI] = 1.04-1.19), and this association remained significant after adjustment for major clinical/demographic factors, whereas the HADS-A (HR = 0.96, 95% CI = 0.85-1.09) and the Beck Depression Inventory-Fast Screen (HR = 0.99, 95% CI = 0.91-1.08) were not. The following depression items from the HADS-D predicted mortality: \u22I still enjoy the things I used to enjoy\u22 (HR = 1.38, 95% CI = 1.05-1.82), \u22I can laugh and see the funny side of things\u22 (HR = 1.48, 95% CI = 1.11-1.96), \u22I feel as if I am slowed down\u22 (HR = 1.66, 95% CI = 1.24-2.22), and \u22I look forward with enjoyment to things\u22 (HR = 1.36, 95% CI = 1.08-1.72).ConclusionsDepressive symptoms related to lack of enjoyment or pleasure and physical or cognitive slowing, as measured by the HADS-D, predicted all-cause mortality at 8 years ACS patients, whereas other depressive and anxiety symptoms did not. Whether symptoms of distress predict prognosis in ACS seems to be dependent on the measures and items used

Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis

Objective To determine which particular depressive symptom scales, derived from three scales, predicted poorer prognosis in persons with acute coronary syndrome (ACS). Methods Hospitalised ACS patients (n=408) completed questionnaires (depression, vital exhaustion). Mokken scaling derived unidimensional scales. Major cardiac events (cardiac mortality, ACS, unplanned revascularisation) were assessed at median 67 weeks post-event. Results Only depressive symptoms of fatigue-sadness predicted prognosis in univariate (hazard ratio [HR]=1.8, 95% CI 1.1–3.0, p=0.025) and multivariate analysis (HR=1.8, 95% CI 1.1–2.9, p=0.025). Symptoms of anhedonia (HR=1.6, 95% CI 0.9–2.8, p=0.102) and depressive cognitions (HR=1.3, 95% CI 0.7–2.2, p=0.402) did not. Conclusion Symptoms of fatigue-sadness, but not other symptoms, were associated with increased risk of major cardiac events. Depression should be considered as a multidimensional, rather than a unidimensional, entity when designing interventions

What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?

Depression is associated with increased cardiovascular risk in patients with acute coronary syndrome (ACS), but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should be better predictors of depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross-sectional design, hospitalised ACS patients (n=336) completed questionnaires assessing depressive symptoms and vulnerabilities. Nested logistic regression assessed the relative contribution of demographic or vulnerability factors, or disease indices or vulnerabilities to depression. In multivariate analysis, all vulnerabilities were independent significant predictors of depression. Demographic variables accounted fo

Latent structure of the hospital anxiety and depression scale: a 10 year systematic review

Objective: To systematically review the latent structure of the Hospital Anxiety and Depression scale (HADS). Methods: A systematic review of the literature was conducted across Medline, ISI Web of Knowledge, CINAHL, PsycINfo and EmBase databases spanning articles published between May 2000 and May 2010. Studies conducting latent variable analysis of the HADS were included. Results: Twenty-five of the 50 reviewed studies revealed a two-factor structure, the most commonly found HADS structure. Additionally, five studies revealed unidimensional, 17 studies revealed three-factor, and two studies revealed fourfactor structures. One study provided equal support for two- and three-factor structures. Different latent variable analysis methods revealed correspondingly different structures: exploratory factor analysis studies revealed primarily twofactor structures, confirmatory factor analysis studies revealed primarily threefactor structures, and item response theory studies revealed primarily unidimensional structures. Conclusion: The heterogeneous results of the current review suggest that the latent structure of the HADS is unclear, and dependent on statistical methods invoked. While the HADS has been shown to be an effective measure of emotional distress, its inability to consistently differentiate between the constructs of anxiety and depression means that its use needs to be targeted to more general measurement of distres

Physical activity and core depressive symptoms in the older Irish adult population.

Research indicates that the prevalence of depression is increasing and that by 2020 depression will become the second leading cause of disease worldwide, as measured by disability adjusted life years. Interventions which involve physical activity have shown that becoming active, even at a moderate level; can be effective in treating depression. In addition, physically active individuals are less likely to develop depressive symptoms than those who are not active, making physical activity an important strategy in the prevention of ill health. The aim of this study was to investigate the associations between physicalactivity levels and core depressive symptoms in Irish adults aged 50 years or more. The study used data from the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007, a national survey of individuals living in the Republic of Ireland (n=4,255 adults aged 50 years or older) and The Northern Ireland Health and Social Wellbeing Survey (NIHSWS), 2005-2006, a survey of individuals living in Northern Ireland (n=1,904 adults aged 50 years or older). Measures of depressed mood and anhedonia (two core depressive symptoms according to diagnostic criteria (DSM IV)) were derived using items from the surveys. Physical activity patterns were categorised using the International Physical Activity Questionnaire (IPAQ) Short Form (Craig et al. 2003). Demographic factors (age, gender and social class), smoking status and health service use were also considered. Just over 5% (5.4%) of SLÁN 2007 participants and 11.1% of NIHSWS 2005-2006 participants had experienced both depressed mood and anhedonia in the recent past. In the overall sample this was 7.2% of participants. Overall 45% of participants reported being moderately physically active but 36.6% of participants reported activity at low levels (SLÁN 2007: 35.6%; NIHSWS 2005-2006: 38.8%). For the overall sample, depressive symptoms were negatively associated with being male, being older and high levels of physical activity. Depressive symptoms were significantly and positively associated with being separated/divorced or widowed, and social classes 3-6. Overall, people over 50 years who were engaged in moderate to high levels of physical activity had a 50-56% reduction in the odds of having elevated depressive symptoms. Consistent with other research findings, this study suggests that physical activity levels are strongly associated with depressive symptoms. Increasing levels of physical activity among adults over 50 years has the potential to improve mental health

Ethical approval for national studies in Ireland: an illustration of current challenges.

BACKGROUND: Ethical approval of research projects is, appropriately, an essential prerequisite in health settings. AIMS: This paper outlines difficulties encountered with procedures for gaining ethical approval for two multicentre surveys in Ireland. METHODS: The experiences of two national surveys were documented. RESULTS: Delays in processing ethics applications led to substantial delays in both surveys. Research ethics committees (RECs) assessed applications in an idiosyncratic manner. CONCLUSION: In Ireland, there is currently no accepted mechanism for single location ethical approval for multicentre studies. Instead, they require separate approval from all participating centres. The challenges of this system of application to multiple committees are outlined in this paper, and possible solutions presented

Increase in observed mental health difficulties one year after acute coronary syndrome: general practitioner survey.

BACKGROUND: General practitioners (GPs) are often the first to assess mental health difficulties after acute coronary syndrome (ACS). AIMS: To determine whether GPs observed an increase in mental health difficulties one-year post-hospitalisation for ACS. METHODS: Postal survey. RESULTS: GPs rated patients (n = 442) as having probable (GP assessed 10%) or definite (formally assessed 7%) mental health difficulties pre-hospitalisation. Post-hospitalisation the prevalence of probable cases increased significantly to 19% (OR = 4.3, 95% CI 2.1-10.2, P \u3c 0.001). In multivariate analysis, only smoking at index hospitalisation was associated with being assessed as a new case of probable/formal mental health difficulties (RR = 2.1, 95% CI 1.3-3.4, P = 0.003). Forty-seven percent of cases were prescribed some medication for this problem. CONCLUSIONS: GPs recorded a significant increase in mental health difficulties in ACS patients 12 months after hospitalisation, with smoking used as an indicator of new cases

The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality.

OBJECTIVE: The objective of this study was to investigate the use of short-form depression scales in assessing 1-year mortality risk in a national sample of patients with acute coronary syndrome (ACS). METHODS: Patients with ACS (N=598) completed either the Hospital Anxiety and Depression Scale depression subscale (HADS-D) or the Beck Depression Inventory-Fast Scale (BDI-FS). Their mortality status was assessed at 1 year. RESULTS: Cox proportional hazards modeling showed that patients depressed at baseline (combining HADS-D and BDI-FS depressed cases) were more likely to die within 1 year [hazard ratio (HR)=2.8, 95% CI=1.4-5.7, P=.005], even when controlling for major medical and demographic variables (HR=4.1, 95% CI=1.6-10.3, P=.003). Scoring above the threshold on the HADS-D predicted mortality (HR=4.2, 95% CI=1.8-10.0, P=.001), but scoring above the threshold on the BDI-FS did not (HR=1.8, 95% CI=0.6-5.6, P=.291). CONCLUSION: The HADS-D predicted increased risk of 1-year mortality in patients with ACS