A Qualitative Comparison of Secular and Buddhist-Informed Mental Health Practitioners’ Perceptions of Non-Attachment

Objectives Buddhist non-attachment has been shown to be effective for improving mental health and wellbeing. Non-attachment refers to the ability to engage with phenomena without psychologically clinging to experiences or rejecting them. The present qualitative investigation sought to compare secular and Buddhist-informed counselors’ and psychotherapists’ perceptions of the non-attachment construct, including their views on its relevance for client-therapist practice. Method Two data sets were collected. In Sample 1, semi-structured interviews were administered to nine qualified counselors and psychotherapists with limited prior knowledge of non-attachment or related Buddhist principles. In Sample 2, five Buddhist-informed counselors and psychotherapists completed an open questionnaire. Both data sets were analysed using Reflexive Thematic Analysis. Results Analysis of the first sample generated four themes concerning participants’ understanding of non-attachment: (1) misunderstanding non-attachment, (2) who non-attachment might be useful for, (3) potential impact on the therapeutic relationship and (4) the importance of experiential understanding on the part of the therapist. The analysis of Sample 2 generated two themes: (1) considerations for assimilating non-attachment, and (2) positive experiences of applying the construct in client-therapist contexts. Conclusions The secular mental health practitioners in Sample 1 recognised the potential utility of non-attachment but harboured some misunderstandings as to its meaning as well as reservations regarding its suitability for all client groups. This was in contrast to Sample 2 participants, who felt that with appropriate therapeutic skill and discernment, non-attachment can be beneficial for a broad range of mental health conditions. Raising awareness of non-attachment amongst secular mental health practitioners is crucial to improving comprehension of the concept and its integration into client-therapist settings

The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong Kong population

<b>Background</b> There has been an increasing prevalence of both depression and chronic medical conditions globally but the relationship between depression and multi-morbidity is not well understood. The aim of the present study was to investigate the relationship between depression, multi-morbidity (number of chronic medical conditions, and measures of socioeconomic standing (SES) in an elderly Hong Kong population.<p></p> <b>Methods</b> Cross sectional study. Information on clinically relevant depressive symptoms, measured by the Geriatric Depression Scale (GDS), and demographic and chronic medical conditions were collected using standardized questionnaires. Information collected on SES included educational status (ES), maximum ever income (MEI), and self-perceived social standing in local community (SES-COM) and in Hong Kong generally (SES-HK). Analysis was conducted using multiple logistic regression.<p></p> <b>Results</b> Depression rates were similar in men and women (GDS caseness 8.1% vs 8.4%). Multi-morbidity of chronic medical conditions was common (40% of men and 46% of women had three or more). In the overall sample, the prevalence of depression was associated with the number of chronic medical conditions (OR 1.27; CI: 1.16–1.39). In addition, SES-HK and SES-COM were significant independent variables.<p></p> <b>Conclusion</b> In this elderly Hong Kong population, depression prevalence rose markedly with number of chronic medical conditions and SES-HK and SES-COM

COVID-19 related health inequality exists even in a city where disease incidence is relatively low: a telephone survey in Hong Kong

Background: We examined whether COVID-19 could exert inequalities in socioeconomic conditions and health in Hong Kong, where there has been a relatively low COVID-19 incidence. Methods: 752 adult respondents from a previous random sample participated in a telephone survey from 20 April to 11 May 2020. We examined demographic and socioeconomic factors, worry of COVID-19, general health, economic activity, and personal protective equipment (PPE) and related hygiene practice by deprivation status. The associations between deprivation and negative COVID-19 related issues were analysed using binary logistic regressions, while the associations of these issues with health were analysed using linear regressions. Path analysis was conducted to determine the direct effect of deprivation, and the indirect effects via COVID-19 related issues, on health. Interactions between deprivation and the mediators were also tested. Results: Deprived individuals were more likely to have job loss/instability, less reserves, less utilisation and more concerns of PPE. After adjustments for potential confounders, being deprived was associated with having greater risk of low reserve of face masks, being worried about the disease and job loss/instability. Being deprived had worse physical (β=−0.154, p<0.001) and mental health (β=−0.211, p<0.001) and had an indirect effect on mental health via worry and job loss/instability (total indirect effect: β=−0.027, p=0.017; proportion being mediated=11.46%). In addition, significant interaction between deprivation and change of economic activity status was observed on mental health-related quality of life. Conclusion: Even if the COVID-19 incidence was relatively low, part of the observed health inequality can be explained by people’s concerns over livelihood and economic activity, which were affected by the containment measures. We should look beyond the incidence to address COVID-19 related health inequalities

Chinese herbal medicine for symptom management in cancer palliative care systematic review and meta-analysis

© 2016 Wolters Kluwer Health, Inc. All rights reserved. Use of Chinese herbal medicines (CHM) in symptom management for cancer palliative care is very common in Chinese populations but clinical evidence on their effectiveness is yet to be synthesized. To conduct a systematic review with meta-analysis to summarize results from CHM randomized controlled trials (RCTs) focusing on symptoms that are undertreated in conventional cancer palliative care. Five international and 3 Chinese databases were searched. RCTs evaluating CHM, either in combination with conventional treatments or used alone, in managing cancer-related symptoms were considered eligible. Effectiveness was quantified by using weighted mean difference (WMD) using random effect model meta-analysis. Fourteen RCTs were included. Compared with conventional intervention alone, meta-analysis showed that combined CHM and conventional treatment significantly reduced pain (3 studies, pooled WMD:-0.90, 95% CI:-1.69 to-0.11). Six trials comparing CHM with conventional medications demonstrated similar effect in reducing constipation. One RCT showed significant positive effect of CHM plus chemotherapy for managing fatigue, but not in the remaining 3 RCTs. The additional use of CHM to chemotherapy does not improve anorexia when compared to chemotherapy alone, but the result was concluded from 2 small trials only. Adverse events were infrequent and mild. CHM may be considered as an add-on to conventional care in the management of pain in cancer patients. CHM could also be considered as an alternative to conventional care for reducing constipation. Evidence on the use of CHM for treating anorexia and fatigue in cancer patients is uncertain, warranting further research

The Role of Individual Variables, Organizational Variables and Moral Intensity Dimensions in Libyan Management Accountants’ Ethical Decision Making

This study investigates the association of a broad set of variables with the ethical decision making of management accountants in Libya. Adopting a cross-sectional methodology, a questionnaire including four different ethical scenarios was used to gather data from 229 participants. For each scenario, ethical decision making was examined in terms of the recognition, judgment and intention stages of Rest’s model. A significant relationship was found between ethical recognition and ethical judgment and also between ethical judgment and ethical intention, but ethical recognition did not significantly predict ethical intention—thus providing support for Rest’s model. Organizational variables, age and educational level yielded few significant results. The lack of significance for codes of ethics might reflect their relative lack of development in Libya, in which case Libyan companies should pay attention to their content and how they are supported, especially in the light of the under-development of the accounting profession in Libya. Few significant results were also found for gender, but where they were found, males showed more ethical characteristics than females. This unusual result reinforces the dangers of gender stereotyping in business. Personal moral philosophy and moral intensity dimensions were generally found to be significant predictors of the three stages of ethical decision making studied. One implication of this is to give more attention to ethics in accounting education, making the connections between accounting practice and (in Libya) Islam. Overall, this study not only adds to the available empirical evidence on factors affecting ethical decision making, notably examining three stages of Rest’s model, but also offers rare insights into the ethical views of practising management accountants and provides a benchmark for future studies of ethical decision making in Muslim majority countries and other parts of the developing world