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Hong Kong and mainland China’s socioeconomic transitions in the past few decades have led to changes in identity and intergroup attitudes among young adults. However, understanding such changes between local and mainland young adults in Hong Kong’s current social context is limited. This study explores whether local and mainland university students in Hong Kong have different intergroup knowledge, attitudes, and intended behaviors; whether these two groups of students respond to intergroup contact intervention differently; and whether and how has local students’ superior identity been influenced by Hong Kong’s economic, geopolitical, and sociocultural development. Our data came from an intergroup contact intervention among 72 university students in Hong Kong (including 32 local and 40 mainland students, 75% female, MAge = 23). Using a two-arm Randomized Controlled Trial (RCT) design, participants were randomly assigned to either an intervention group (a 1-day workshop with incremental levels of contact intimacy) or a control group (a 1-day workshop with limited contact intimacy). Our findings indicate that local university students displayed relatively more negative attitudes toward mainland students and are less responsive to the intergroup contact intervention, which only enhanced local students’ outgroup knowledge but not their attitudes or intended behaviors. This result may suggest local young adults’ transition out of a superior social identity. Our findings call for more university activities to enhance local and mainland students’ mutual understanding and larger-sample research to explore both groups’ perspectives. Future intergroup interventions should address potential barriers such as varied intervention effectiveness by participants’ background.

Abstract Background Stage of Recovery Instrument-30 (STORI-30) is grounded in a five-stage model of psychological recovery, and serves as measuring recovery stage of people with mental illness. Aims To develop and validate the Chinese version STORI-30 on adults with severe mental illness. Methods STORI-30 was translated to traditional Chinese through forward-backward method. An expert panel and potential users evaluated face validity and content validity. The Chinese version STORI-30 plus other convergent and divergent scales were then administered to 113 participants for field test. Results Face and content validity were confirmed with acceptable Content Validity Index and high inter-rater agreement. Exploratory factor analysis revealed a three-factor structure. An ordinal sequence was presented among the five subscales, similar to the original version. Construct validity was supported by positive correlations with recovery and mental well-being scales, and negative correlation with self-stigma scale. Good internal consistency (Cronbach’s α = 0.78–0.86) and high level of test-retest reliability (Intraclass correlation coefficient = 0.96) were obtained. Conclusions Chinese STORI-30 presents satisfactory psychometric properties in internal consistency, construct convergent and divergent validity, and test-retest reliability. The three-factor structure revealed does not echo the original five-stage recovery model. Further studies exploring the underlying structure are warranted.

Objective: This study investigated the effectiveness of a low-intensity online mindfulness-based Intervention (iMBI) for alleviating anxiety in university students during the COVID-19 pandemic. Methods: In a randomized controlled trial involving 134 participants from a local university in Hong Kong, subjects were randomly assigned to either the intervention group (n = 67) or the inactive control group (n = 67). The intervention group participated in a low-intensity iMBI comprising 16 online modules and two half-day online mindfulness workshops over an eight-week period. Outcomes were measured via an online platform using standardized assessment scales, including the Beck Anxiety Inventory and the Chinese Five Facets Mindfulness Questionnaire, at three different time points: pre-intervention, post-intervention and at a three-month follow-up. Results: Intent-to-treat analysis using 2 (group) × 3 (time) repeated measures of covariance (ANCOVA) showed that the intervention group, compared to the control group, showed a significant reduction in anxiety symptoms with a medium effect size (Cohen's d = 0.5) and a significant improvement in mindfulness skills with a medium effect size (Cohen's d = 0.5) at post-intervention. The effects of the intervention in reducing anxiety and improving mindfulness persisted at the three-month follow-up. Conclusion: The results of this study demonstrate the effectiveness of the low-intensity iMBI in alleviating anxiety among university students.

Abstract Background Many elderly individuals who experience sleep disturbances would consider complementary and alternative medicine as an alternative therapeutic option in light of the limitations of traditional treatments. Mindfulness-based interventions (MBIs) and Tai Chi Chuan (TCC) are two alternative forms of complementary and alternative medicine. They both share the common feature of a focus on breathing but represent distinct approaches with different mechanisms and philosophical orientations. The trial described in this protocol aims to evaluate the effects of an integrated form of mindfulness-based Tai Chi Chuan (MBTCC) programme and the underlying mechanisms of the beneficial effects over a 12-month follow-up. Methods The planned study is a four-armed randomized controlled trial with repeated measures. A total of 256 community-dwelling older adults with sleep problems will be recruited and randomized into four groups: (1) an MBTCC group, (2) an MBI group, (3) a TCC group, and (4) a sleep hygiene education (SHE) control group. The outcome measures in terms of insomnia severity, interoception, sleep-wake pattern, health status, rumination, and hyperarousal level will be collected at four time points: at baseline (T1), after the 8-week intervention (T2), 6 months after the intervention (T3), and 1 year after the intervention (T4). In addition, qualitative evaluation through focus group interviews will be conducted at the end of the 12-month assessment period (T4). Discussion This trial will illuminate the synergetic effect of combining both MBIs and TCC on optimizing improvements in sleep disturbance. The findings from this study can provide empirical support for this integrated treatment, which provides an alternative for healthcare professionals in elderly service to select appropriate practices to treat elderly people with sleep disturbance. It can further help to lessen the growing public health burden of sleep disturbances among the elderly living in the community. Trial registration ClinicalTrials.gov . NCT05396092 . Published on 24 May 2022

Objectives: To determine the effectiveness of a simple, self-administrable moxibustion-cum-massage intervention for relieving chronic pain and improving psychological well-being for older adults in the community. Design: A randomized controlled trial. Setting: Seventy-eight participants with chronic pain were randomly assigned to the intervention and waitlist control groups. Interventions: Participants received two moxa sticks a day to use the moxibustion-cum-massage procedure with the help of trained volunteers or caregivers for five consecutive days. Main outcome measures: Participates’ pain level, sleep quality, depression and subjective well-being were measured before the intervention (T0), immediately after the intervention (T1), and one week after the intervention (T2). Results: Repeated measures ANOVA revealed a significant group × time interaction effect in subjective well-being with a medium effect size. Regarding within-group effects in the intervention group at post-intervention (T1), the subjective pain level was significantly reduced with a small effect size, while sleep quality and depression significantly improved with large effect sizes. The control group showed no significant within-group effects in these variables. Maintenance effects at follow-up (T2) were not significant. Conclusion: Despite the short intervention timeframe of five days, the study revealed preliminary evidence that the moxibustion-cum-massage intervention can be an effective, self-administrable pain relief regime for older adults. A longer period of intervention time is suggested for future studies.

BackgroundExisting studies have unequivocally demonstrated that parents of children with autism spectrum disorder (ASD) experience various stressful daily life events and suffer from psychological distress. Mindfulness level is found to be an effective buffer between parents' appraisal of stress life events and psychological distress. However, the mechanism behind the function of mindfulness is unclear, and traditional mindfulness-based intervention (MBI) in experimental settings is not tailored to personal real-life needs. This study proposes to conduct a randomized controlled trial (RCT) to examine the effectiveness of MBI delivered by ecological momentary intervention (EMI) and assessed by ecological momentary assessment (EMA) in changing participants' cognitive appraisal of stressful life events and thus reducing the psychological distress of parents of children with ASD.MethodThe proposed study will recruit 670 parents of children with ASD and randomly assign them to the intervention and control groups (335 in each group). Participants in the intervention group will install the EMI/A app on their smartphones. In the app, participants can receive practice prompts daily, browse and practice different mindfulness exercises in the intervention library at any time, talk to a virtual counselor (chatbot) when feeling stressed, complete EMA on the cognitive appraisal of life events, and receive the log of change of psychological status daily. Participants in the control group will only receive audio-based standardized mindfulness practice instructions three times per week. The effects of MBI will be assessed based on the EMA data, right after the intervention and at the 2-month follow-up. The primary outcome will be participants' psychological distress measured by the depression anxiety stress scale. The secondary outcomes will include participants' subjective well-being, measured by the satisfaction with life scale, and level of resilience, measured by the psychological empowerment scale. Multilevel structural equational modelling will be applied to examine the pathways of the relationship between daily life events, cognitive appraisal, and psychological distress.DiscussionThe potential benefit of the proposed study is to increase the psychological well-being of parents of children with ASD, and the method may extend to participants suffering from other psychological issues in the future. Trial registration: This trial has been registered on clinicaltrials.gov with the ID of NCT05746468.

BackgroundPsychological distress is a common occurrence among women during the perinatal period. Maternal psychological distress (MPS) can also have a negative influence on neonatal outcomes such as infant health, child development or mother-child interaction. Hence, interventions to improve mental wellbeing during this period are vital. Mindfulness based intervention (MBI) has been found to be effective in reducing psychological distress. Delivery of MBI via the internet, making it accessible and inexpensive, is showing a promising positive effect in reducing psychological distress. A randomized control trial with sufficient power is required to confirm its positive effect among pregnant women. The positive effects of MBI have been found to be associated with heart rate variability (HRV) biofeedback; however, the efficacy of MBI on HRV has been rarely studied among pregnant women. Also, the potential association of HRV with MBI and psychological wellbeing needs further examination. This research aims to test the effectiveness of guided mobile-based perinatal mindfulness intervention (GMBPMI) among pregnant women experiencing psychological distress during the pre- and post-natal period, as well as examining the efficacy of GMBPMI on HRV.MethodThis study is a randomized controlled trial that follows a parallel design. Consenting pregnant women in their second trimester (between 12th and 20th week gestation) will be randomly assigned to an intervention group (GMBPMI) or a control group (psychoeducation). The intended sample size is 198, with 99 participants in each group. Three levels of outcomes will be measured at baseline, post intervention in both the intervention and control groups, and at 36-week gestation and five-week postpartum. The primary outcomes include maternal psychological stress, mindfulness and positive appraisal HRV. Secondary outcomes are psychological and physical wellbeing. Tertiary outcomes include obstetric and neonatal outcomes, and social support. Analyses will follow an intention-to-treat method and repeated measures MANOVA will be conducted to compare changes in primary and secondary outcomes. A series of mixed-effects models will be fitted to assess the mediation effects.DiscussionThis trial expects to increase understanding of GMBPMI on HRV and psychological wellbeing for pregnant women, with extended support in both pre-and post-natal periods. The study could also potentially provide evidence for delivery of cost-effective and accessible services to pregnant women.Trial registrationClinicalTrials.gov: NCT04876014, registered on 30 March 2021. Protocol Version 1.0., 10 May 2021.

COVID-19 has brought tremendous and abrupt threats to various aspects of our daily lives, from school and work to interpersonal relationships. Self-compassion is put forth as a salutogenic perspective on oneself that buffers the adverse mental health impacts of these threats. During the peak of a local outbreak in Hong Kong in Spring 2020, 761 participants completed questionnaires on self-compassion, perceived threats, as well as perceived benefits and psychological distress. Controlling for demographic variables, negative indicators of self-compassion (aka self-coldness) was found to intensify the impacts of threats on psychological distress. The positive indicators of self-compassion also moderated the link between threats and perceived benefits, such that perceived benefits tend to be less related to threats in participants with higher self-compassion. Our findings highlight the impacts of both positive and negative indicators of self-compassion on the adjustment to such unprecedented challenges, and point to the possibility of enhancing people's resilience through fostering self-compassion and alleviating self-coldness.

Background: High expressed emotion (EE) in a patient's family is a known risk factor of relapse in schizophrenia. The three components of high EE – criticism, hostility and emotional over-involvement – were developed through a data-driven approach and a focus on overt abrasive behaviours. The influence of covert abrasive behaviours has not been explored. Aims and methods: This study aims to explore both overt and covert abrasive behaviours through semi-structured interviews conducted with 22 people with schizophrenia, who were recruited through iterative purposive sampling. Results: Thematic analysis suggests that participants' experiences of overt abrasive behaviours resonate with the three-factor structure of high EE, except “emotional over-involvement” is renamed to “over-involvement” to focus on behaviours and embrace different levels or types of emotional reactions. Regarding covert abrasive behaviours, two domains are proposed: disassociation and apathy, which focus on family members' disengaging actions and indifferent attitudes respectively. While both overt and covert abrasive behaviours cause psychological distresses and behavioural reactions on the participants, their precise impacts are not entirely the same. Conclusion: People with schizophrenia experience both overt and covert abrasive behaviours with family members. The findings of this study may expand the conceptualization of high EE, enhance its content validity, and provide an extended conceptual framework for developing more comprehensive measures.

Purpose: Although high expressed emotions (EE) is one of the most significant predictors for schizophrenic relapse, the assessment of EE is often impeded by the demanding Camberwell Family Interview (CFI) that is required to be conducted by specifically trained staff. To enable a more efficient assessment of EE, we developed the 12-item Concise Chinese Level of Expressed Emotion Scale (CCLEES) and reported its predictive and concurrent validity in this study. Methods: A one-year prospective study design was adopted. Totally 101 participants diagnosed with schizophrenia were recruited from the department of psychiatry of a major acute hospital in Hong Kong. CCLEES was administered and subsequent relapse information was collected from all participants. At baseline, 10 family members of the participants were also administered CFI. Results: Participants who scored above the optimal cut-off point (Score 13 on Criticism, and/or 13 on Hostility, and/or 15 on Emotional Over-involvement) showed a 6.3 times elevated 12-month schizophrenic relapse rate compared to those who scored below cut-off. The CCLEES also demonstrated excellent correspondence with CFI, the widely-recognized golden benchmark of EE assessment. Conclusions: The results support the CCLEES as a brief and psychometrically sound self-report measurement for EE in Chinese people with schizophrenia.

Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p

Family psychoeducation (FPE) has been recommended as a major component in the treatment of psychosis. Many previous studies have implemented an intensive program design that often only emphasized improvements in patients’ illness outcomes but the benefits for caregivers were limited. There have been calls for a time-limited but cost-effective FPE program to mitigate the looming reality of the suffering of people with psychosis and their families. A Brief Mindfulness-Based Family Psychoeducation for psychosis program is developed to reduce caregivers’ burden and promote young adult’s recovery. A randomized controlled trial will be conducted to compare this intervention with an ordinary FPE intervention. Both arms will involve six sessions, with a total contact time of 12 h. 300 caregivers of young adults who have experienced first episode psychosis within last 3 years will be recruited. Program effectiveness will be assessed by comparing outcomes measuring the caregivers’ burden, mental health symptoms, positive well-being, and the young adult’s mental health symptoms during the study and at 9-month post-randomization. The role of expressed emotions, interpersonal mindfulness, and non-attachment in mediating these outcomes will be explored. An additional qualitative approach Photovoice is selected to explore the complex family experiences and the benefits of mindfulness from the caregivers’ personal perspectives.Trial Registration: The trial is registered with the United States Clinical Trials Registry (ClinicalTrials.gov): NCT03688009.

Collective psychological ownership (CPO) refers to a collective sense shared by coworkers that they jointly own the organization. It is an emerging research topic in team work experience. Existing literature on CPO is mostly at theoretical construction level. Empirical work to investigate correlates of CPO is lacking. The current study aimed at investigating the variables correlated with CPO in organizational contexts. T-test and ANOVA revealed that there was significant difference in CPO scores for the groups in the following variables: gender, education level, organizational size, job position, and monthly income. Pearson correlations revealed significant positive associations between CPO and the following variables: family economic status, job tenure, hours of work per week, job demands, job resources, membership identification, and work engagement. Multiple regression analyses revealed that family income was significant in all tested models, while job resources and membership identification were the two variables which contributed the most additional R square to the models to predict CPO. Findings of the current study provided insights on further studies on the antecedents and consequences of CPO in organizational contexts.

Our recent study demonstrates that adiponectin signaling plays a significant role in mediating physical exercise-exerted effects on hippocampal neurogenesis and antidepression in mice. Whether the findings can be translated to humans remains unknown. This study aimed to investigate the effects of Baduanjin Qigong exercise on adiponectin and to evaluate whether adiponectin is involved in the antidepressive effects of Qigong exercise on chronic fatigue syndrome (CFS)-like illness. This is a randomized, waitlist-controlled trial. One hundred eight female participants were randomly assigned to either Qigong exercise or waitlist groups. Sixteen 1.5-h Qigong lessons were conducted. Outcome measures were taken at three time points. Baseline adiponectin levels were negatively associated with body weight, body mass index, waist circumference, hip circumference, and waist/hip ratio in women with CFS-like illness. Compared with the waitlist control, Qigong exercise significantly reduced anxiety and depression symptoms and significantly raised plasma adiponectin levels (median = 0.8 vs. −0.1, p < 0.05). More interestingly, increases in adiponectin levels following Qigong exercise were associated with decreases in depression scores for the Qigong group ( r = −0.38, p = 0.04). Moreover, adjusted linear regression analysis further identified Qigong exercise and change in adiponectin levels as the significant factors accounting for reduction of depression symptoms. Baduanjin Qigong significantly increased adiponectin levels in females with CFS-like illness. Decreases in depression symptoms were associated with increases in adiponectin levels following Qigong exercise, indicating that the potential contribution of adiponectin to Qigong exercise elicited antidepressive effects in human subjects.

Objectives: To investigate the effects of a mindfulness-based family psychoeducation (MBFPE) intervention on caregivers and the young adults with first-episode psychosis in mental health care. Methods: Sixty-five caregivers were randomly assigned to the MBFPE program (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32). Eighteen young adults in recovery (YAIR) also participated in the study. All of the participants completed the assessments before participating in the intervention (T1), after the intervention (T2), and at 9-month follow-up (T3). Results: Intention-to-treat analyses were conducted. The caregivers reported a significant and large effect size on positive caregiving experiences based on a Time × Group analysis (g = 0.862, p = 0.006). Among the YAIR participants, between-group differences were significant in their perceptions of caregivers' expressed emotions, including large effect sizes of perceived criticism (g = 1.396, p = 0.049) and hostility (g = 1.444, p = 0.043). Caregiver demographics, including age, education level, socioeconomic status, and number of family members, were found to moderate the effect sizes of the variables studied. Conclusion: This study provides evidence of the effects of MBFPE programs on the outcomes of caregivers and the young adults with first-episode psychosis in their care. Specifically, the MBFPE program in this study played a greater role in promoting positive caregiving experiences and changing caregivers' expressed emotions, especially their expressed criticism of YAIR, compared with the regular FPE program. Therefore, the application of mindfulness training to promote family care and YAIR recovery should be encouraged. [ABSTRACT FROM AUTHOR]

Background: Cell free RNA (cfRNA) contains transcript fragments from multiple cell types, making it useful for cancer detection in clinical settings. However, the pathophysiological origins of cfRNAs in plasma from colorectal cancer (CRC) patients remain unclear. Methods: To identify the tissue-specific contributions of cfRNAs transcriptomic profile, we used a published single-cell transcriptomics profile to deconvolute cell type abundance among paired plasma samples from CRC patients who underwent tumor-ablative surgery. We further validated the differentially expressed cfRNAs in 5 pairs of CRC tumor samples and adjacent tissue samples as well as 3 additional CRC tumor samples using RNA-sequencing. Results: The transcriptomic component from intestinal secretory cells was significantly decreased in the in-house post-surgical cfRNA. The HPGD, PACS1, and TDP2 expression was consistent across cfRNA and tissue samples. Using the Cancer Genome Atlas (TCGA) CRC datasets, we were able to classify the patients into two groups with significantly different survival outcomes. Conclusions: The three-gene signature holds promise in applying minimal residual disease (MRD) testing, which involves profiling remnants of cancer cells after or during treatment. Biomarkers identified in the present study need to be validated in a larger cohort of samples in order to ascertain their possible use in early diagnosis of CRC. [ABSTRACT FROM AUTHOR]

A demonstration showing that the bis(triphenylphosphine)immium (PPN) manganese carbonyls and more interestingly the off-the-shelf reagent PPN(super +)Cl(super -) are good catalysts for the coupling reactions of CO2 with epoxides to yield cyclic carbonates is presented. The reactions are clean with no polycarbonate contamination and are performed in neat substrates with no need of organic solvents.

Background: Alcohol dependence is associated with alcohol-related problems and persistent vulnerability to relapse. Despite newer medications, frequent relapses continue to occur. Hence, there is a need to look at holistic approaches to deal with this problem. Objective: Evaluate the effectiveness of nurse-led body-mind-spirit (BMS)-based relapse prevention intervention on craving and quantity and frequency of alcohol consumption among alcohol-dependent individuals. Methods: Randomized control trial was adopted, and the study was conducted at a mental health care setting in India. Sixty individuals with alcohol use disorder were randomly assigned to a BMSgroup (n = 30) and a treatmentas-usual (TAU) group (n = 30) between June 2017 and March 2018. Subjects of both groups were initially assessed for craving and quantity and frequency of alcohol consumption. BMS subjects received seven sessions of BMS intervention and routine treatment at de-addiction wards. The interventions comprise of body, mind, and spirit strategies that aid in handling triggers, accept responsibility for their own well-being and take charge of self health. TAU group subjects received only routine treatment. All the participants were followed up over 3 months postdischarge. Results: Over 3 months of follow-up, BMS group subjects (vs. TAU group) reported significantly lesser quantity of alcohol consumption (F = 9.74, p < .001, η² = .144), fewer drinking days (F = 14.04, p < .001, η² = .195), lower relapse rates (14 vs. 28), and lesser craving (F = 14.01, p < .001, η² = .195). Regression analysis showed that number of previous attempts (>1) and increased baseline drinking were associated with relapse. Conclusion: Findings provide evidence of BMS intervention in reducing craving and drinking outcomes among alcohol-dependent individuals in India. [ABSTRACT FROM AUTHOR]

Objective: Public stigma has been shown to have multidimensional negative impacts on people with schizophrenia (PWS). A new 1-day intervention grounded on the intergroup contact theory was developed and implemented in the current study to reduce college students' stigma toward PWS. We hypothesized that intergroup contact could better alleviate the stigmatizing situation compared with absence of direct contact and different levels of contact may have different functions on stigma reduction. Methods: To examine the effectiveness of the intervention, a randomized controlled trial was conducted in Hong Kong with 37 college students participating the intervention. Different levels of contact (zero, moderate, and intimate) with PWS were organized in the intervention group while no direct contact with PWS was introduced in the control group. Participants' knowledge of schizophrenia, stigmatizing attitudes and social distance toward PWS were measured at pre-, post, 1-month and 3-month after the intervention. Results: Repeated-measures ANOVA revealed significant changes in all outcome variables in the intervention group with moderate-to-high effect sizes. The results indicated that different levels of contact with PWS had different functions in stigma reduction. Knowledge session without direct contact contributed most to participants' knowledge improvement, and moderate and intimate level of contact led to an obvious improvement in participants' stigmatizing attitudes and social distance changes. Also, psychoeducation and direct contact should be combined to tackle with the 3 components of stigma. Conclusions: The current study provided evidence supporting the efficacy of the new intervention based on intergroup contact theory and practical experience for future research design regarding stigma reduction. [ABSTRACT FROM AUTHOR]

The promotion of a catalytic reaction by the use of a M-H...H-X dihydrogen-bonding interaction in an indenylruthenium hydride system is discussed. The reaction barrier of (eta5-C9H7)Ru(dppm)H is lowered by the presence of a Ru-H...H-OH dihydrogen-bonding interaction in the transition state.

In our previous study, we detected the effects of centrifugal forces on plasma RNA quantification by quantitative reverse transcription PCR. The aims of this study were to perform targeted mRNA sequencing and data analysis in healthy donors' plasma prepared by two centrifugation protocols and to investigate the effects of centrifugal forces on plasma mRNA quality and quantity. Targeted mRNA sequencing was performed using a custom panel with 108 colorectal cancer-related genes in 18 healthy donors' plasma that prepared by (1) 3,500 g for 10min at 4 °C and (2) 1,600 g for 10min at 4°C followed by 16,000 g for 10min at 4°C. Results showed that plasma ribosomal RNA was detected in 16/18 (88.9%) 3,500 g and 6/18 (33.3%) 1,600 g followed by 16,000 g centrifuged plasma. For targeted sequencing, 75/108 (69.4%) and 86/108 (79.6%) genes were detected in 3,500 and 1,600 g followed by 16,000 g, respectively, while 16/108 (14.8%) genes were not detected in both centrifugations. Detailed analysis showed that 2 of 108 (1.85%) genes showed lower expressions in 3,500 g than in 1,600 g followed by 16,000 g. The median expressions of genes in 3,500 g were positively correlated with the expressions in 1,600 g followed by 16,000 g (R2 = 0.9471, P < 0.0001, Spearman rank correlation). Meanwhile, plasma samples were not distinctively clustered based on centrifugal forces according to hierarchical clustering. Targeted mRNA sequencing and subsequent data analysis were performed in this study to investigate the effects of two different centrifugal forces that are commonly used in plasma collection. Our targeted sequencing results help to understand the centrifugal force effects on plasmamRNA, and these findings show that the centrifugation protocol for plasma mRNA research using targeted sequencing can be standardized which facilitates multicenter studies for comparison and quality assurance in the future. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of compassion-mindfulness therapy (C-MT), an adapted version of mindfulness-based cognitive therapy that integrates compassion training. Method: Individuals aged 17-69 with recurrent depressive and anxiety symptoms were recruited from a community mental health service unit. Half of the participants were randomized to an 8-week C-MT program (n = 41) and the other half to a wait-list control condition (n = 41). Results: Intent-to-treat analyses showed significant improvements in all measures in the treatment group. The effect sizes for depression and anxiety were 1.11 and 1.10, respectively, and those for physical distress, daily functioning, positive affect, and negative affect ranged from 0.71 to 1.04. All improvements were sustained at the 3-month follow-up. Conclusions: The results provide preliminary support for C-MT as a viable treatment option for individuals with recurrent depression and anxiety symptoms. Time-limited treatments such as C-MT should be promoted in social work practice. [ABSTRACT FROM AUTHOR]

Background: Patients with schizophrenia are characterized by high prevalence rates and chronicity that often leads to long-term institutionalization. Under the traditional medical model, treatment usually emphasizes the management of psychotic symptoms through medication, even though anti-psychotic drugs are associated with severe side effects, which can diminish patients' physical and psychological well-being. Tai-chi, a mind-body exercise rooted in Eastern health philosophy, emphasizes the motor coordination and relaxation. With these potential benefits, a randomized controlled trial (RCT) is planned to investigate the effects of Tai-chi intervention on the cognitive and motor deficits characteristic of patients with schizophrenia. Methods/design: A 3-arm RCT with waitlist control design will be used in this study. One hundred and fifty three participants will be randomized into (i) Tai-chi, (ii) exercise or (iii) waitlist control groups. Participants in both the Tai-chi and exercise groups will receive 12-weeks of specific intervention, in addition to the standard medication and care received by the waitlist control group. The exercise group will serve as a comparison, to delineate any unique benefits of Tai-chi that are independent of moderate aerobic exercise. All three groups will undergo three assessment phases: (i) at baseline, (ii) at 12 weeks (post-intervention), and (iii) at 24 weeks (maintenance). All participants will be assessed in terms of symptom management, motor coordination, memory, daily living function, and stress levels based on self-perceived responses and a physiological marker. Discussion: Based on a promising pilot study conducted prior to this RCT, subjects in the Tai-chi intervention group are expected to be protected against deterioration of motor coordination and interpersonal functioning. They are also expected to have better symptoms management and lower stress level than the other treatment groups. Trial registration: The trail has been registered in the Clinical Trials Center of the University of Hong Kong (HKCTR-1453). [ABSTRACT FROM AUTHOR]

Background An increasing number of studies have documented the effectiveness of qigong exercise in helping people reduce psychological stress and anxiety, but there is a scarcity of systematic reviews evaluating evidence from randomized controlled trials (RCTs) conducted among healthy subjects. Methods Thirteen databases were searched for RCTs from their inception through June 2013. Effects of qigong exercise were pooled across trials. Standardized mean differences (SMDs) were calculated for the pooled effects. Heterogeneity was assessed using the I2 test. The risk of bias was assessed using the Cochrane criteria. Results Seven RCTs met the inclusion criteria. Two RCTs suggested that qigong exercise immediately relieved anxiety among healthy adults, compared to lecture attendance and structured movements only. Four RCTs suggested qigong exercise relieved anxiety (pooled SMD = −0.75; 95% CI, -1.11 to −0.40), and three RCTs suggested that qigong exercise reduced stress (pooled SMD = −0.88; 95% CI, -1.22 to −0.55) among healthy subjects following one to three months of qigong practice, compared to wait-list controls. Conclusions The available evidence suggests that qigong exercise reduces stress and anxiety in healthy adults. However, given the limited number of RCTs and their methodological flaws, further rigorously designed RCTs are needed. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies have identified different, but highly correlated variables explaining the effects of mindfulness training. Many of them are limited by tautological explanation. Under the framework of the mind--body connection, mindfulness training cultivates body awareness and promotes self-management of illness. Stagnation, a concept from Chinese medicine, may help explain the mechanism of change in mindfulness training. Methods: Individuals with depressive and anxiety symptoms (n = 82) were randomized to either a Compassion-Mindfulness Therapy (C-MT) program or a waitlist control condition. The effect of stagnation as a mediator was investigated for dependent variables including depression, anxiety, and other physical and mental health variables. Major outcome measures: Depression, anxiety, stagnation, physical distress, daily functioning, positive affect, negative affect. Results: Compared with the participants in the control group, those who completed CMT demonstrated significant decreases in depression, F(1, 78) = 15.67, p < .001, anxiety, F(1, 78) = 7.72, p < .001, stagnation, F(1, 78) = 4.96, p < .001, and other body-mind-spirit well-being measures. After entering the change in stagnation as the mediator, the effect of treatment reduced: depression (.35-.22), anxiety (.33-.05), and same patterns in other three secondary measures. The Sobel test was administered and significant reductions between group and depression (z = 2.18, p = .029), anxiety (z = 2.21, p = .027), and three secondary other measures (p < .05) were indicated. Conclusion: The study provides initial support for the role of stagnation in mediating changes in mindfulness training. It adds evidence to body-mind nondualism and offers new possibilities in studying treatment process and change mechanism. [ABSTRACT FROM AUTHOR]

Context • Given that the etiology of chronic fatigue syndrome (CFS) is believed to be multidimensional, interventions generally have been nonspecific and typically produce only mild to moderate effects. In medical practice, treatment for CFS remains largely symptomatic. Preliminary evidence of the efficacy of acupuncture for CFS is available, but the field has lacked high-quality trials. Objective • The research team conducted the study to determine the efficacy of acupuncture for CFS. Design • A two-arm, randomized, controlled, single- blinded design was adopted. Setting • The study took place in a teaching laboratory at the School of Chinese Medicine at the University of Hong Kong, Hong Kong, China. Participants • Recruited through press publicity in Hong Kong, 127 individuals-40 men and 87 women-participated in the study. Intervention • Through careful implementation of sham acupuncture in the control group (CG), the study blinded all participants with regard to their experimental or control status. The treatment regime was 2 sessions/wk for 4 consecutive wk. Outcome Measures • Measures of fatigue (Chalder's Fatigue Scale), health-related quality of life (SF-12), and general mental health (GHQ-12) were taken at baseline and upon completion of treatment. Results • Ninety-nine participants completed the interventions, with 50 and 49 participants in the experimental group (EG) and CG respectively. Repeated measures ANOVA revealed a significant decrease in physical (F1,93 = 4.327; P=.O4O) and mental fatigue (F1,96= 10.451; P=.002) J and improvement in the physical component score of 1 SF-12 (F1,93 = 4.774; P = .031). Considerable effects with Cohen's d were observed in the sham-control group: 0.92, 0.78, and 0.38 for the three scores, respectively. These positive effects could have included some therapeutic effects due to pressure on the acupuncture points from the sham needles in addition to normal placebo effects. The EG showed moderate net effect sizes with Cohen's d: 0.52, 0.63, and 0.54 for the three outcome measures, respectively. Conclusion • Despite considerable positive effects for the CG, the EG demonstrated significant net-effect sizes at a moderate magnitude in physical and mental fatigue and in the physical component of health-related quality of life. The impacts on general mental health outcomes appeared to be smaller. {Altern Ther Health Med. 2013;19(4):21-26.) [ABSTRACT FROM AUTHOR]

The onset of mental illness can have a significant impact on individuals' lives and on the people who they come into contact with in their social networks. This paper presents the findings of the exploratory stage of a larger study that aims to examine the role of social networks in the help-seeking process of Chinese people suffering from severe mental illness in England. The study used a qualitative phenomenological approach in which in-depth interviews were conducted with three Chinese people suffering from severe mental illness and four network ties who were involved in the help-seeking process. The results of the study showed that family may not be involved in every stage of help-seeking. The size of social networks of Chinese people suffering from mental illness became bigger and the composition of social networks became more diverse after their first contact with mental health services. The implications of the study encourage social workers and mental health professionals to explore resources in the wider social networks to ensure that Chinese people suffering from mental illness receive ad- equate support to meet their mental health needs. [ABSTRACT FROM AUTHOR]

Context To summarize and evaluate the available evidence from controlled clinical trials of tai chi (TC) exercise for patients with heart disease. Search Methods Fourteen databases were searched up to November 2010 with the terms tai chi, taichi, tai ji, taiji, taijichuan, cardiac, heart, coronary, myocardial, and atrialfibrillation in the title, abstract, or key words. No language restrictions were imposed. The quality and validity of randomized clinical trials (RCTs) were evaluated using the Jadad Scale. The strength of the evidence for all included studies was evaluated using the Oxford Centre for Evidence-based Medicine Levels of Evidence. Results Nine studies including 5 RCTs and 4 nonrandomized controlled clinical trials met the inclusion criteria. Three studies examined the effectiveness of TC exercise for patients with chronic heart failure (CHF), and 6 studies examined the effectiveness of TC exercise among patients with coronary heart disease (CHD). Overall, these studies demonstrated favorable effects of TC exercise for the patients with heart disease. Conclusions The existing evidence suggests that TC exercise is a good option for heart patients with very limited exercise tolerance and can be an adjunct to rehabilitation programs for patients with CHD or CHF. [ABSTRACT FROM AUTHOR]

Background: Psychotherapy added to pharmacotherapy results in greater improvement in clinical outcomes than does pharmacotherapy alone. However, few studies examined how psychotherapy coupled with pharmacotherapy could produce a long-term protective effect by improving the psychobiological stress response. Methods: The researchers recruited 63 subjects with major depressive disorder (MDD) in an outpatient department of psychiatry at a general hospital. The randomly assigned subjects formed 2 groups: 29 in combined therapy (COMB) and 34 in monotherapy (MT). The COMB included 8 weekly body-mind-spirit group psychotherapy sessions added to pharmacotherapy. MT consisted of pharmacotherapy only. The outcome measures, collected at the subjects' homes, included the Beck Depression Inventory II (BDI-II), the State Trait Anxiety Inventory (STAI) and salivary cortisol on awakening, 45 min after awakening, and at 12.00, 17.00 and 21.00 h. Evaluation of outcome measures was at baseline condition, and at months 2 (end of additional psychotherapy), 5 and 8. Results: While the decreases in symptoms of depression were similar between COMB and MT (p > 0.05), the reductions in anxiety state were greater in COMB than in MT during the 8-month follow-up (p < 0.05). A steeper diurnal cortisol pattern more likely occurred in COMB than in MT in the 3 follow-up periods (p < 0.05, p <0.001 and p < 0.01). Conclusions: The superior outcomes of group psychotherapy added to pharmacotherapy for MDD outpatients could relate to decreasing the anxiety state and to producing long-term impacts on positive stress endocrine outcomes seen as a steeper diurnal cortisol pattern. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The study investigated the relations among suicidal ideation, general mental health status (domains: depression, lack of confidence and uselessness; measured by the shorter General Health Questionnaire [GHQ]), and psycho- social difficulties and strengths with 2638 secondary school students in Hong Kong. A cross-sectional survey using self-report questionnaires was carried out. Suicidal ideation was assessed by four relevant items on GHQ. Overall prevalence of suicidal ideation was revealed to be 14.6%, with 1.9% at severe level. Binary logistic regression indicated that factors associated with increased level of suicidal ideation were being female, lack of confidence, conduct disorder, and emotional symptoms. Factors associated with lowered level of suicidal ideation were spirituality, tranquility, resilience, and being in senior grades. The prevalence of suicidal ideation revealed in this study is lower than findings of other local studies which included non- school participants. This seems to confirm the overemphasis of academic achievements in Chinese culture. Similar to Western studies, being female appeared to be a risk factor in the current study, but showed a relatively lower odds ratio (1.67, versus over .2 in Western studies). Suicidal ideation among male Chinese adolescents appeared to be more prevalent than we used to believe. Apart from addressing risk factors and psychopathology, the findings of the current study point to the desirability of also addressing the spiritual and meaning domains in suicide prevention. [ABSTRACT FROM AUTHOR]

The psychometric properties of a Chinese version of the Death Attitude Profile-Revised (DAP-R) were examined with 100 young adult, 100 middle-age adult, and 100 older adult Chinese respondents in Hong Kong (N= 300). Three of the five subscales from the original DAP-R including Fear of Death, Death Avoidance, and Escape Acceptance were replicated and had acceptable internal reliabilities (Cronbach's alpha ranged from 0.79 to 0.85); comparison between these subscales and scores of the DAS provide evidence of concurrent validity. However, items on the Neutral Acceptance subscale loaded onto two separate factors, replicating findings from an earlier validation study of the DAP-R, and providing further evidence that this subscale may not be measuring a unitary construct. Moreover, items on the Approach [ABSTRACT FROM AUTHOR]

Objectives: To perform a retrospective review of all patients with colonoscopic perforations managed in hospitals within the Eastern New Territories region of Hong Kong and to determine the predictors of mortality and stoma formation in patients with colonoscopic perforations. Design: Retrospective computer-based review. Setting: Multicenter (1 university teaching hospital and 2 district hospitals). Methods: We reviewed the outcomes of patients with colonoscopic perforations surgically managed between January 1, 1998, and December 31, 2005. Predictors of mortality and stoma formation were identified with multivariable analysis. Main Outcome Measures: Mortality and stoma rates and their predictors. Results: A total of 37 971 colonoscopies were performed during the study period, and 43 colonoscopic perforations were identified. The overall perforation rate was 0.113% and represented a decreasing trend. There was no significant difference in the perforation rate between gastroenterologists (0.148%) and surgeons (0.091%) (P=.15). Perforations that occurred during diagnostic colonoscopies were significantly larger than those that occurred during therapeutic colonoscopies (P=.04), and the patients presented earlier (P=.02). Surgical intervention was performed in 39 patients. The overall morbidity and mortality rate was 48.7% and 25.6%, respectively. The stoma rate was 38.5%. The predictors of stoma formation include moderate to severe peritoneal contamination and the presence of malignant colonic neoplasms (P=.01 and P=.008, respectively). The predictors of mortality include American Society of Anesthesiologists class 3 or higher and antiplatelet therapy (P=.009 and P=.001, respectively). Conclusions: Colonoscopic perforations were in a decreasing trend. Patients with predictors of mortality should not be treated conservatively. Other options of large bowel investigations should be considered in high-risk patients when the potential diagnostic yield is low. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study aims to understand the effects of culturally enriched body–mind–spirit group therapy on anxiety, depression and holistic well-being among women with breast cancer and to examine patients’ views on what aspects of group therapy worked to enhance their health. Design. The study was designed using multiple methods, which consisted of a randomised controlled trial and a focus group interview. Methods. A total of 16 subjects in the control group received the standard care of a physician’s treatment at the outpatient department. In addition to standard care, 12 subjects in the experimental group received 10 sessions of weekly body–mind–spirit group therapy for 180 minutes each. This therapy integrates concepts and practices of traditional Chinese medicine and Western medicine (e.g. positive psychology and forgiveness therapy). The subjects in the experimental group were invited to participate in a focus group interview regarding their perceptions of the change mechanisms that occurred in group therapy. Results. The results of analysis of covariance indicated that after a two-month trial, there was a similarity between the experimental and control groups in reducing the scores of Beck depression inventory and increasing the scores of body–mind–spirit well-being. However, subjects in the experimental group had a better reduction of the scores of state anxiety inventory than subjects in the control group. The qualitative analysis yielded eight domains: (i) imparting of information, (ii) interpersonal learning, (iii) catharsis, (iv) universality, (v) group cohesiveness, (vi) altruism, (vii) instillation of hope and (viii) existential factors. These domains illustrate how the therapeutic effects of group therapy worked to reduce patients’ anxiety. Conclusion. The culturally sensitive body–mind–spirit group therapy reduced anxiety among outpatients with breast cancer. Relevance to clinical practice. The involvement of mental health nurses in providing group therapy for cancer patients could enhance the quality of care in psycho-ontological nursing. [ABSTRACT FROM AUTHOR]

Background: Post-haemorrhoidectomy wound pain is often the focus of concern for patients as well as their clinicians. Despite the recent enthusiasm brought about by stapled haemorrhoidectomy, conventional haemorrhoidectomy still remains the mainstay of surgical treatment for symptomatic third and fourth degree haemorrhoids in places where healthcare funding cannot afford these expensive devices. The present study aims at evaluating the effectiveness of pre-emptive analgesia and oral metronidazole in reducing wound pain and complications after open haemorrhoidectomy. Method: Patients with symptomatic third or fourth degree haemorrhoids undergoing open haemorrhoidectomy were randomized into four groups. Group 1 received pre-emptive analgesia (0.5% bupivacaine). Group 2 received oral metronidazole (400 mg three times daily for 1 week). Group 3 received both treatments while group 4 was the control group. Results: Number of patients recruited was 105. There was no significant difference among the four groups in terms of pain scores on the first three postoperative days, analgesic requirements, hospital stay and the time to return to normal daily activities. Patients who received oral metronidazole had significantly less pain at the time of the first bowel motion ( P = 0.037). Conclusion: Oral metronidazole significantly reduces pain during the first bowel motion after open haemorrhoidectomy. Pre-emptive analgesia with 0.5% bupivacaine does not reduce postoperative pain. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to review our experience in the surgical management of patients with obstructing colorectal cancers over an 11-year period, 1987–1997. Patients and methods: Retrospective review of case records of 275 patients (male: 177; female 98) who had undergone emergency surgery for obstructing colorectal cancers was performed. Tumours proximal to splenic flexure were defined as proximal tumours while those at or below the splenic flexure were defined as distal tumours. Results: The obstruction was caused by proximal tumours in 88 (32%) patients. The resection rate and the primary anastomotic rate were higher for proximal tumours compared with distal tumours (95.5% vs 85.6%, P = 0.014; 92% vs 30.5%, P < 0.001). For distal tumours, stoma rate was found to be influenced by the following factors: preoperative albumin level, duration of observation after admission, operating surgeons’ years of experience, bowel perforation and site of the obstructing tumour. Multivariate analysis disclosed that surgeons’ experience was the only independent factor predicting stoma formation. The in-hospital mortality and the anastomotic leakage rates were 15.3% and 5.6%, respectively. Tumour stage was the only prognostic factor affecting the disease-free survival after curative resection. The 5-year disease-free survival rates for Dukes’ B and C disease were 66% and 37.2%, respectively. Conclusions: Tumour stage was a significant prognostic factor for patients with obstructing colorectal cancers. Emergency surgery for distal tumours should preferentially be performed by more experienced surgeons in order to achieve a higher anastomotic rate. [ABSTRACT FROM AUTHOR]