Exploring the Meaning of Spirituality and Spiritual Care in Chinese Contexts: A Scoping Review.

Spirituality is recognised as a fundamental aspect of health and nursing care. Yet, there are few studies exploring how this concept may be understood outside of Western culture. This scoping review seeks to address this omission by focusing specifically on research conducted with Chinese populations. This is important because people from Chinese backgrounds (PBC) are now residing all over the world, and their spirituality and spiritual needs should be considered when providing healthcare. Adopting a purely generalist understanding and application of spirituality may not capture the cultural difference that exists between the East and West. This scoping review adopted Arksey and O'Malley's method to focus on spirituality and spiritual care among PBC in health and nursing. The systematic strategy was adopted and used to search the main databases in health and nursing. Eighteen (n = 18) empirical studies were included in the review: 11 qualitative studies and seven quantitative involving 1870 participants. The scoping review revealed that in the Chinese understanding of spirituality is an abstract and personal concept which can refer to an internal vital force, experiences of suffering, and traditional Chinese cultural and religious values. As the multidimensional understanding of spirituality and spiritual care may cause confusion, these findings may provide a direction for the researchers emphasising the need for cultural and religious sensitivity when understanding of spirituality.

Influence of periodontal disease on risk of dementia: a systematic literature review and a meta-analysis.

Periodontal disease (PD) is common and increases cardiovascular diseases. However, it is unclear whether PD is associated with increased risk of dementia. We carried out a systematic review and meta-analysis to investigate the influence of PD on dementia. We projected the number of dementia cases to be saved by reducing PD prevalence in the world. We searched cohort and case-control studies reporting the association of PD with all dementia (or any specific type of dementia) through PubMed, MEDLINE, PsycINFO, SocINDEX, CINHAL, and CNKI until 7th November 2018. Five cohorts and seven case-control studies were identified for review. We pooled eligible data to calculate relative risk (RR) of dementia in relation to PD and computed the number of dementia cases saved through reducing PD prevalence. Of 12 studies, six were undertaken in Asia, four in Europe and two in America. Eleven studies showed a positive association between PD and the risk of dementia, of which 10 were significant, and one reported a non-significant inverse association. Overall their quality was good. Pooled RR of dementia in relation to PD from all high quality studies was 1.38 (95%CI 1.01-1.90); in the five cohorts was 1.18 (1.06-1.31) and in the two case-control studies 2.25 (1.48-3.42). A 50% reduction in the current prevalence of 20% of PD in the population could save 850,000 (630,000-1,420,000) patients with dementia in the world. PD could increase the risk of incident dementia. Preventing and treating PD could contribute to controlling the global epidemic of dementia.

An understanding of spirituality and spiritual care among people from Chinese backgrounds: A grounded theory study.

AIM: To investigate the meaning of spirituality and spiritual care among people from Chinese backgrounds living in England. DESIGN: Strauss and Corbin's grounded theory design was used. METHOD: Twenty-five participants were recruited from Chinese community centres after which data saturation was reached in September 2016. In-depth interviews in Chinese were carried out. Transcribed digital recordings were translated into English. Data analysis followed the techniques of open coding, axial coding, and selective coding, using NVivo11. Data collection and analysis were conducted simultaneously. RESULTS: Three themes emerged from the data which provide an understanding of spirituality and spiritual care in the study context: 'essence and nature of life', 'driving forces', 'self-support'. CONCLUSION: This study provides an understanding of spirituality and spiritual care from a Chinese cultural perspective. From a Daoist tradition, spirituality is seen as essence and driving force in the human body. From a Confucian viewpoint, it appears that patients saw themselves or the 'self' as a supporting resource. IMPACT: The knowledge gained from this study has potential to support nurses and healthcare practitioners to identify the spiritual needs of people from Chinese backgrounds and to remove some of the Chinese misconceptions Chinese people hold about spiritual care by explaining what these concepts could mean. It could also improve cultural awareness for student nurses around what constitutes spiritual care. Further research is recommended among the wider community of health and social care workers to explore spirituality and spiritual care among people from Chinese backgrounds living in England.

Relationships and power: An exploration of person-centredness in an intellectual disability service in Ireland.

Institutionalised cultures and imbalances of power have been identified within the literature as risk factors for the abuse of adults with intellectual disability living in residential services. Governments in the Republic of Ireland and internationally continue to support person-centredness as a framework of care that can promote cultural change within disability services as a safeguard against abuse. However, there is limited research which seeks to explore if person-centredness as a framework of care has had much impact on changing cultures within disability services as a protective factor against abuse. This study aims to explore how adults with intellectual disability living in residential services and staff experience the professional caring relationship and the framework of person-centredness. The study was based on a phenomenological approach using thematic analysis which enabled six adults with intellectual disability and six staff to participate through one-to-one interviews. The thematic analysis resulted in three main themes: (1) Conflict within the relational dynamic between service users and staff. (2) Challenges to delivering person-centred care. (3) Shared needs. Participants reported that there was conflict within the relationship between service users and staff influenced by relational and cultural issues. Participants also experienced challenges in delivering person-centred care within the service. This study revealed that as a result of wider organisational and cultural influences, person-centred cultures, which are vital to underpin changes in power imbalances, were often undermined. This research highlights that it is not enough to have a system of quality of care guided by the principles of person-centredness alone to ensure a shift in culture and safeguard against abuse of adults with intellectual disability. Rather, consideration of the relational and cultural factors that impact their lives also needs to be built into the values and practices of services offered to adults with intellectual disability.

The Perceptions of Spirituality and Spiritual Care Among People From Chinese Backgrounds Living in England: A Grounded Theory Method.

Introduction: There has been a growing number of people from Chinese backgrounds entering England and their perceptions of spirituality and spiritual care need to be addressed when their cultural context changes. Methodology: A Straussian grounded theory method was used. Twenty-five participants were recruited, after which point data saturation was reached. Results: Four themes emerged showing participants' perceptions of the terms: holistic; family involvement; religious care; abstract and sensitive. Discussion: Participants held holistic and culturally sensitive perspectives of spirituality, which demonstrates that patient-centered care is important. Also, health care professionals need to consider methods to involve family member and use religious or cultural values to support their spiritual needs. Particularly, when implementing spiritual care, they need to be aware that people from Chinese backgrounds blend Confucianism, Buddhism, and Daoism together in their understanding of the terms and may provide contradictory information about their religious belief.

Impacts of Overweight and Obesity in Older Age on the Risk of Dementia: A Systematic Literature Review and a Meta-Analysis.

BACKGROUND: It is unclear whether overweight and obesity in older age reduces or increases the risk of incident dementia. OBJECTIVE: To assess the impacts of overweight and obesity in older age on incident dementia. METHODS: We searched cohort studies reporting body weight measured in older age and dementia through PubMed, Embase, Medline, PyschInfo, and Cochrane library until July 2016. Sixteen articles were identified for the review. We pooled data from them and a new unpublished study from China, to calculate relative risk (RR) of incident dementia in relation to body mass index (BMI) and waist circumference (WC). RESULTS: All 16 cohort studies were undertaken in high income countries, with follow-up periods ranging between 3 to 18 years. Thirteen studies showed an inverse association between BMI and dementia, and three studies demonstrated a positive association. Pooled RR of dementia in relation to continuous BMI from 14 studied populations, including the new Chinese data, was 0.97 (95% CI 0.95-1.00); in those followed up <9 years it was 0.95 (0.93-0.96) while in ≥9 years follow-up it was 1.03 (0.96-1.11). In five studied populations examining categorical BMI, RR of dementia in older people classified as overweight and obese was 0.98 (0.54-1.77) and 1.17 (0.65-2.10) respectively, in comparison with other weights. The pooled WC data showed no association between increased WC and reduced risk of dementia. CONCLUSION: The current evidence did not support a paradox on beneficial impacts of overweight and obesity in older age on incident dementia. More studies with long term follow up are needed to clarify the association of body weight in older age with dementia risk.

The impact of personalisation on people from Chinese backgrounds: qualitative accounts of social care experience.

The limited research that considers people from black and minority ethnic communities' experiences of personalisation tends to focus on personal budgets rather than personalisation per se. This article provides an opportunity to hear the voices of people from Chinese backgrounds and their experiences of personalisation. The study used individual semi-structured interviews and focus groups to collect data from physically disabled people from Chinese backgrounds who lived in England, were aged between 18 and 70, and received social care. Data were analysed using an iterative and thematic approach, with early analysis informing the subsequent analytical rounds. The findings reveal that personalisation has the potential to transform the lives of people from Chinese backgrounds, especially when tailored support is available for people to understand and access personal budgets and put them to creative use. However, the impact of personalisation is barely evident because few eligible individuals access personal budgets or participate in co-production. This is related to a lack of encouragement for service users to become genuine partners in understanding, designing, commissioning and accessing a diverse range of social care services to meet their cultural and social care needs.

Satisfaction with social care: the experiences of people from Chinese backgrounds with physical disabilities.

The satisfaction of social care among service users provides an important indication of how services are performing. Although there is evidence to suggest that people from black and minority ethnic communities experience less satisfaction with social care than majority groups, there is little literature which focuses specifically on people from Chinese backgrounds in England. This article provides an opportunity to hear the voices of people from Chinese backgrounds and their experiences of social care for a physical disability. Individual semi-structured interviews and focus groups were conducted in 2012 and 2013 respectively with people from Chinese backgrounds who lived in England, were aged between 18 and 70, and received social care for a physical disability. Interview and focus group transcripts were analysed using a thematic approach. The findings show that language difference created a structural barrier for most participants to negotiating access to and navigating through social care. Language difference and the cultural expectation that families should look after their own were main factors that explained their late utilisation of social care. Because of limited social support, many families struggled to meet the long-term care needs of their relative with a physical disability and hence initially welcome the input of social care. However, many found that social care could not adequately meet their needs but did not feel that they had the right to voice their dissatisfaction. They would either stop using social care services or become more reliant on their family for support. Chinese welfare organisations play a crucial role to meet the cultural and linguistic needs of people from Chinese backgrounds. Closer collaboration between local authorities and Chinese welfare organisations is needed to enable an effective use of social care and community resources to meet the needs of people from Chinese backgrounds with physical disabilities.

Synthesis of di-, tri- and penta-nuclear titanium(IV) species from reactions of titanium(IV) alkoxides with 2,2'-biphenol (H(2)L(1)) and 1,1'-binaphthol (H(2)L(2)); crystal structures of [Ti(3)(mu(2)-OPr(i))(2)(OPr(i))(8)L(1)], [Ti(3)(OPr(i))(6)L(1)(3)], [Ti(5)mu(3)-O)(2)(mu(2)-OR)(2)(OR)(6)L(1)(4)](R = OPr(i), OBu(n)) and [Ti(2)(OPr(i))(4)L(2)(2)].

Reaction of titanium(iv) alkoxides [Ti(OR)(4)](R = OPr(i), OBu(n)) with 2,2[prime or minute]-biphenol [C(12)H(8)(OH)(2), H(2)L(1)] affords two trinuclear species [Ti(3)(OPr(i))(10)L(1)] and [Ti(3)(OPr(i))(6)L(1)(3)] each possessing an open-chain V-shaped arrangement of three titanium atoms with the former having both bridging alkoxide and biphenylate groups and the latter having only biphenylate as bridging groups. Variations in reaction conditions yield the pentanuclear species [Ti(5)([micro sign](3)-O)(2)(OR)(8)L(1)(4)](R = OPr(i), OBu(n)) which have two central bridging oxygen atoms in the Ti(5) framework and bridging alkoxide and biphenylate groups. In contrast 1,1[prime or minute]-binaphthol [C(24)H(12)(OH)(2), H(2)L(2)] yields the dinuclear [Ti(2)(OPr(i))(4)L(2)(2)] where only the binaphthylate ligands act as bridging groups. Some of the compounds show catalytic activity in esterification reactions.

Ruthenium dihydride complexes: NMR studies of intramolecular isomerization and fluxionality including the detection of minor isomers by parahydrogen-induced polarization.

NMR studies reveal that complexes Ru(CO)(2)(H)(2)L(2) (L = PMe(3), PMe(2)Ph, and AsMe(2)Ph) can have three geometries, ccc, cct-L, and cct-CO, with equilibrium ratios that are highly dependent on the electronic properties of L; the cct-L form is favored, because the sigma-only hydride donor is located trans to CO rather than L. When L = PMe(3), the ccc form is only visible when p-H(2) is used to amplify its spectral features. In contrast, when L = AsMe(2)Ph, the ccc and cct-L forms are present in similar quantities and, hence, must have similar free energies; for this complex, however, the cct-CO isomer is also detectable. These complexes undergo a number of dynamic processes. For L(2) = dppe, an interchange of the hydride positions within the ccc form is shown to be accompanied by synchronized CO exchange and interchange of the two phosphorus atoms. This process is believed to involve the formation of a trigonal bipyramidal transition state containing an eta(2)-H(2) ligand; in view of the fact that k(HH)/k(DD) is 1.04 and the synchronized rotation when L(2) = dppe, this transition state must contain little H-H bonding character. Pathways leading to isomer interconversion are suggested to involve related structures containing eta(2)-H(2) ligands. The inverse kinetic isotope effect, k(HH)/k(DD) = 0.5, observed for the reductive elimination of dihydrogen from Ru(CO)(2)(H)(2)dppe suggests that substantial H-H bond formation occurs before the H(2) is actually released from the complex. Evidence for a substantial steric influence on the entropy of activation explains why Ru(CO)(2)(H)(2)dppe undergoes the most rapid hydride exchange. Our studies also indicate that the species [Ru(CO)(2)L(2)], involved in the addition of H(2) to form Ru(CO)(2)(H)(2)L(2), must have singlet electron configurations.