scholarly journals Dipping the Paddle in Unfamiliar Waters: The Ripple Effects of the First End-of-Life Communication Training for Resource Poor, Multicultural, Underdeveloped Island Nations of the United States–Affiliated Pacific Islands (USAPIs) (S771)

2020 ◽  
Vol 59 (2) ◽  
pp. 569-570
Author(s):  
Dawn Gross
Author(s):  
Jennifer Ailshire ◽  
Margarita Osuna ◽  
Jenny Wilkens ◽  
Jinkook Lee

Abstract Objectives Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe. Methods We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). We conducted multinomial logistic regression on 7,113 decedents from 18 European countries and 3,031 decedents from the United States to determine if family caregiving, defined based on assistance with activities of daily living, was associated with death at home versus at a hospital or nursing home. Results Family caregiving was associated with reduced odds of dying in a hospital and nursing home, relative to dying at home in both the United States and Europe. Care from a spouse/partner or child/grandchild was both more common and more strongly associated with place of death than care from other relatives. Associations between family caregiving and place of death were generally consistent across European welfare regimes. Discussion This cross-national examination of family caregiving indicates that family-based support is universally important in determining where older adults die. In both the United States and in Europe, most care provided during a long-term illness or disability is provided by family caregivers, and it is clear families exert tremendous influence on place of death.


2002 ◽  
Vol 10 (3) ◽  
pp. 233-241 ◽  
Author(s):  
Phyllis B. Taylor

More people than ever before are being incarcerated in the United States. Many inmates are infected with HIV and hepatitis C. Sentences are increasing in length. Prison health care is now having to cope with the many chronic illnesses associated with an ill and aging population. The growth of end-of-life care programs in corrections in the United States is a direct result of the changing demographics of inmates. This article examines the need for end-of-life care behind bars and discusses selected hospice programs.


2021 ◽  
Vol 11 (1) ◽  
pp. 143-159
Author(s):  
Vasily D. FILIPPOV

The article is devoted to the work of Irving John Gill during his heyday, and then in conditions when the principles of modernism discovered by him, due to the lack of society’s need for new architecture in the United States, were not needed in this country - from 1909 until his death in 1936. New technologies used by Gill in the construction of public and residential buildings from concrete are described as well as his unsuccessful participation in the Panama-California World Exhibition of 1915-191, the construction near Los Angeles of the “ideal” city of Torrance and end-of-life projects. The reasons why Gill did not become the leader of the American and one of the leaders of world architecture are discussed, and his work is still controversial.


2021 ◽  
Author(s):  
◽  
Sōsefo Fietangata Havea

<p>On April 2, 1987, the Treaty on Fisheries Between Governments of Certain Pacific Island States and the Government of the United States of America was signed. The signatories to the Fisheries were the 16 members of the South Pacific Forum and the United States of America. After six difficult years of negotiations, the Treaty permitted American fishing vessels to fish in Pacific Islands’ waters in exchange for a substantial access fee. This thesis identifies key aspects of that treaty and examines what it meant from both a theoretical and practical standpoint. How did a collection of small, comparatively weak Pacific states strike a satisfactory deal with the most powerful state on the planet? What did the agreement mean in terms of its political, legal and environmental consequences? As well as looking at the events and negotiations that led to the treaty, this thesis also attempts to discern the key political lessons that flow from this case that might be relevant for the future development of the Pacific island States in the key area of fisheries regulation. The thesis argues that disputes between Pacific nations and the United States over tuna resources and the presence of the Soviet Union in the Pacific region were the two critical factors that led to the adoption of the Treaty. From the United States’ perspective, the Treaty was seen (at the time) as the only viable option if it were to reconsolidate its long and prosperous position in the Pacific region. The US did not want the Soviet Union to capitalize on American fishing disputes with the Pacific islands, and it could not afford for the Soviet Union to establish a strong association with the Pacific islands. The Treaty therefore served three purposes for Washington: (i) it maintained its long friendship with the Pacific islands, (ii) it maintained its fisheries interests in the region, (iii) and it kept the Pacific communist-free. This fusion of US economic and strategic interests gave Pacific Island States a stronger hand in the negotiations than their size and power would have otherwise offered.</p>


2018 ◽  
Vol 33 (2) ◽  
pp. 63-64 ◽  
Author(s):  
Lilit Karapetyan ◽  
Om Dawani ◽  
Heather S. Laird-Fick

The immigrant population in the United States has grown over the past years. Undocumented immigrants account for 14.6% of the uninsured population in the United States. Decisions about end-of-life treatment are often difficult to reach in the best of situations. We present a 43-year-old undocumented Mexican female immigrant with metastatic sarcomatoid squamous cell cervical cancer and discuss the barriers that she faced during her treatment. Limited English proficiency, living below the poverty line, low level of education, and lack access to Medicare, Medicaid, or other insurance coverage under the Affordable Care Act are major causes of decreased health-care access and service utilization by the immigrant population. Latinos are less likely to be referred to hospice by oncologists, and nearly a third of hospice agencies offer limited or no services to undocumented immigrants. Undocumented immigrants with terminal diagnoses generally do not have access to comprehensive or multidisciplinary follow-up treatment. Instead, one of their few options is to return to their home countries without any long-term treatment. This article discusses the many barriers and proposes areas for reform.


2021 ◽  
Author(s):  
Joanne Wallis ◽  
Anna Powles

Abstract One of President Joseph Biden's foreign policy priorities is to ‘renew’ and ‘strengthen’ the United States' alliances, as they were perceived to have been ‘undermined’ during the Trump administration, which regularly expressed concern that allies were free-riding on the United States' military capability. Yet the broad range of threats states face in the contemporary context suggests that security assistance from allies no longer only—or even primarily—comes in the form of military capability. We consider whether there is a need to rethink understandings of how alliance relationships are managed, particularly how the goals—or strategic burdens—of alliances are understood, how allies contribute to those burdens, and how influence is exercised within alliances. We do this by analysing how the United States–Australia and Australia–New Zealand alliances operate in the Pacific islands. Our focus on the Pacific islands reflects the United States' perception that the region plays a ‘critical’ role in helping to ‘preserve a free and open Indo-Pacific region’. We conclude that these understandings need to be rethought, particularly in the Pacific islands, where meeting non-traditional security challenges such as economic, social and environmental issues, is important to advancing the United States, Australia and New Zealand's shared strategic goal of remaining the region's primary security partners and ensuring that no power hostile to their interests establishes a strategic foothold.


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