The Difference That Culture Can Make in End-of-Life Decisionmaking

1998 ◽  
Vol 7 (1) ◽  
pp. 27-40 ◽  
Author(s):  
H. EUGENE HERN ◽  
BARBARA A. KOENIG ◽  
LISA JEAN MOORE ◽  
PATRICIA A. MARSHALL

Cultural difference has been largely ignored within bioethics, particularly within the end-of-life discourses and practices that have developed over the past two decades in the U.S. healthcare system. Yet how should culture—specifically cultural differences as reflected among groups defined as ethnically or racially different—be taken into account?

2021 ◽  
pp. 014616722110368
Author(s):  
Brian W. Haas ◽  
Kazufumi Omura

The End of History Illusion (EoHI) is the tendency to report that a greater amount of change occurred in the past than is predicted to occur in the future. We investigated if cultural differences exist in the magnitude of the EoHI for self-reported life satisfaction and personality traits. We found an effect of culture such that the difference between reported past and predicted future change was greater for U.S. Americans than Japanese, and that individual differences in two aspects of the self (self-esteem and self-concept clarity) mediated the link between culture and the magnitude of the EoHI. We also found a robust cultural difference in perceptions of past change; U.S. Americans tended to think about the past more negatively than their Japanese counterparts. These findings yield new insight onto the link between cultural context and the way people remember the past and imagine the future.


1991 ◽  
Vol 127 ◽  
pp. 256-260 ◽  
Author(s):  
T.M. Eubanks ◽  
M.S. Carter ◽  
F.J. Josties ◽  
D.N. Matsakis ◽  
D.D. McCarthy

AbstractThe U.S. Naval Observatory Navnet program monitors changes in the rotation of the Earth on a regular basis using radio interferometric observations acquired with telescopes in Alaska, Hawaii, Florida, West Virginia and, in the past, Maryland; other radio telescopes have also participated occasionally. These observations have been used to derive a radio interferometric celestial reference system, Navy 1990-5, using two years of dual frequency measurements from 24-hour-duration observing sessions. A total of 84 extragalactic radio sources, mostly quasars, have been observed by the Navnet program to date, of which 70 currently have source position formal errors of one milli second of arc or less. The root mean square of the difference between source position estimates from the Navnet data and an independently derived catalog using completely different data is less than one milli second of arc in both right ascension and declination after the adjustment of an arbitrary rotational offset between the two celestial reference frames.


1996 ◽  
Vol 5 (4) ◽  
pp. 570-578
Author(s):  
Jean McDowell

The U.S. healthcare system has been subject to unprecedented scrutiny over the past three years; one of the results of this scrutiny has been recognition of the serious problems that exist in both healthcare delivery and reimbursement mechanisms. While the verbal debate in Washington has essentially ceased, within the healthcare community a historic shift has taken place in the way healthcare reimbursement is structured: increasingly, traditional fee-for-service reimbursement methods are being replaced with capitation reimbursement methods. While this phenomenon originated on the West Coast, it has spread to all geographic sectors of the United States in varying degrees and can be expected to dominate the funding patterns of healthcare over the next decade.


2010 ◽  
Vol 21 (2) ◽  
pp. 71-95
Author(s):  
Nikola Bozilovic

The author of this paper has the intention to reach the new meaning and sense of the primitive mentality by analyzing it in early social communities. He also wants to point out the possible reflections of the spirit and consciousness of our ancestors on us, here and now. The first part of the paper is dedicated to a critical deliberation on anthropological conflicts which have arisen concerning the reasoning power of the so-called primitives. The crucial question lies in the following: Is the difference between the ?primitive? and the ?civilized? mentality fundamental or is it possible only to a certain degree. The author takes the notion of primitive mentality through time and points to the medieval understandings, which are occupied by teratological themes, then to the renaissance comprehension, which relies on the first experiential observations, and, finally, to the enlightenment ideas of exotic peoples out of which the myth of ?the good savage? is born. The nineteenth and twentieth centuries introduce the notions of ?people?s character? and ?national spirit?. The opinions are polarized, on the one hand of ethnocentrism, carried by the prejudice of people and ethnic groups and, on the other hand, of cultural relativism, based on the understanding and appreciation of cultural differences. In the end, the author also recognizes the modern primitive man, one who is not ready to deal with the challenges of his age. The modern primitive recalls the spirits of the past, the surviving and anachronic models of behavior, unaware of the fact that these are the same models that he has ascribed to ?savages?. However, while such thinking and acting was justified by the cultural level at which our ancestors had lived, the mental frame of the contemporary primitives is significantly in contrast with the high level of civilization development.


2018 ◽  
Author(s):  
Sigit Haryadi

We cannot be sure exactly what will happen, we can only estimate by using a particular method, where each method must have the formula to create a regression equation and a formula to calculate the confidence level of the estimated value. This paper conveys a method of estimating the future values, in which the formula for creating a regression equation is based on the assumption that the future value will depend on the difference of the past values divided by a weight factor which corresponding to the time span to the present, and the formula for calculating the level of confidence is to use "the Haryadi Index". The advantage of this method is to remain accurate regardless of the sample size and may ignore the past value that is considered irrelevant.


Author(s):  
D Samba Reddy

This article provides a brief overview of novel drugs approved by the U.S. FDA in 2016.  It also focuses on the emerging boom in the development of neurodrugs for central nervous system (CNS) disorders. These new drugs are innovative products that often help advance clinical care worldwide, and in 2016, twenty-two such drugs were approved by the FDA. The list includes the first new drug for disorders such as spinal muscular atrophy, Duchenne muscular dystrophy or hallucinations and delusions of Parkinson’s disease, among several others. Notably, nine of twenty-two (40%) were novel CNS drugs, indicating the industry shifting to neurodrugs. Neurodrugs are the top selling pharmaceuticals worldwide, especially in America and Europe. Therapeutic neurodrugs have proven their significance many times in the past few decades, and the CNS drug portfolio represents some of the most valuable agents in the current pipeline. Many neuroproducts are vital or essential medicines in the current therapeutic armamentarium, including dozens of “blockbuster drugs” (drugs with $1 billion sales potential).  These drugs include antidepressants, antimigraine medications, and anti-epilepsy medications. The rise in neurodrugs’ sales is predominantly due to increased diagnoses of CNS conditions. The boom for neuromedicines is evident from the recent rise in investment, production, and introduction of new CNS drugs.  There are many promising neurodrugs still in the pipeline, which are developed based on the validated “mechanism-based” strategy. Overall, disease-modifying neurodrugs that can prevent or cure serious diseases, such as multiple sclerosis, epilepsy, and Alzheimer’s disease, are in high demand. 


Author(s):  
Gordon Moore ◽  
John A. Quelch ◽  
Emily Boudreau

Choice Matters: How Healthcare Consumers Make Decisions (and Why Clinicians and Managers Should Care) is a timely and thoughtful exploration of the controversial role of consumers in the U.S. healthcare system. In most markets today, consumers have more options and autonomy than ever before. Empowered consumers easily shop around for products and services that better meet their needs, and they widely share their reviews on social media to inform and influence other consumers. Businesses have responded with better experiences and prices to compete for consumers’ business. Though healthcare has lagged behind other industries in this respect, there is a rising tide of interest in consumer choice and empowerment in healthcare markets. However, most healthcare provider organizations, individual doctors, and health insurers are unprepared to consider patients as consumers. The authors draw upon the fields of medicine, marketing, management, psychology, and public policy as they take a substantive, in-depth look at consumer choice and point out its appropriate use, as well as its limitations. This book addresses perplexing issues, such as how healthcare differs from other consumer-driven markets, how consumers make healthcare decisions, and how increased consumer choice in healthcare can not only aid and empower American consumers but also improve the overall healthcare system.


Author(s):  
Raymond J. Batvinis

Counterintelligence is the business of identifying and dealing with foreign intelligence threats to a nation, such as the United States. Its main concern is the intelligence services of foreign states and similar organizations of non-state actors, such as transnational terrorist groups. Counterintelligence functions both as a defensive measure that protects the nation's secrets and assets against foreign intelligence penetration and as an offensive measure to find out what foreign intelligence organizations are planning to defeat better their aim. This article addresses the Federal Bureau of Investigation's (FBI) foreign counterintelligence function. It briefly traces its evolution by examining the key events and the issues that effected its growth as the principle civilian counterintelligence service of the U.S. government.


Author(s):  
Natasha Ansari ◽  
Eric Johnson ◽  
Jennifer A. Sinnott ◽  
Sikandar Ansari

Background: Oncology provider discussions of treatment options, outcomes of treatment, and end of life planning are essential to care for patients with advanced malignancies. Studies have shown that despite this, many patients do not have adequate care planning, including end of life planning. It is thought that the accessibility of information outside of clinical encounters and individual factors and/or beliefs may influence the patient’s perception of disease. Aims: The objective of this study was to evaluate if patient understanding of treatment goals matched the provider and if there were areas of discrepancy. If a discrepancy was found, the survey inquired further into more specific aspects. Methods: A questionnaire-based survey was performed at a cancer hospital outpatient clinic. 100 consecutive and consenting patients who had stage IV non-curable lung, gastrointestinal (GI), or other cancer were included in the study. Patients must have had at least 2 visits with their oncologist. Results: 40 patients reported their disease might be curable and 60 reported their disease was not curable. Patients who reported their disease was not curable were more likely to be 65 years or older (P-value: 0.055). They were more likely to report that their doctor discussed the possibility of their cancer getting worse (78.3% VS 55%; P-value 0.024), that their doctor discussed end of life plans (58.3% VS 30%; P- value: 0.01), and that they had appointed a health care decision-maker (86.7% VS 62.5%; P-value: 0.01). 65% of patients who thought their disease might be curable reported that their doctor said it might be curable, compared with only 6.7% of patients who thought their disease was not curable (p < 0.001). Or, equivalently, 35% of patients who thought their disease might be curable reported that their doctor’s opinion was that it was not curable, compared with 93% of patients who thought their disease was not curable (p < 0.001). Patients who had lung cancer were more likely to believe their cancer was not curable than patients with gastrointestinal or other cancer, though the difference was not statistically significant (p = 0.165). Patients who said their disease might be curable selected as possible reasons that a miracle (50%) or alternative medicine (66.7%) would get rid of the cancer, or said their family wanted them to believe the cancer would go away (16.7%) or that another doctor said it would (4.2%). Patients who said their disease might be curable said they did so due to alternative medications, another doctor, or their family. Restricting to the 70 patients who reported their doctors telling them their disease was not curable, 20% of them still said that they personally felt their disease might be curable. Patients below 65 years of age were more likely to disagree with the doctor in this case (P-value: 0.047). Conclusion: This survey of patients diagnosed with stage IV cancer shows that a significant number of patients had misunderstandings of the treatment and curability of their disease. Findings suggest that a notable proportion kept these beliefs even after being told by treating physicians that their disease is not curable.


Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2581
Author(s):  
Michala Skovlund Sørensen ◽  
Michael Mørk Petersen

The current era within the field of surgical treatment of metastatic bone disease (MBD) is best described as the beginning of a paradigm shift [...]


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