The Terminal Stage | ScienceGate

Truth-Telling to Terminal Stage Cancer Patients in India: A Study of the General Denial to Disclosure

OMEGA - Journal of Death and Dying ◽

10.1177/00302228211032732 ◽

2021 ◽

pp. 003022282110327

Author(s):

Souvik Mondal

Keyword(s):

Cancer Patients ◽

Urban Areas ◽

Family Members ◽

Public Hospitals ◽

Truth Telling ◽

Full Disclosure ◽

Terminal Stage ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Private And Public

Telling the truth to the terminal-stage cancer patients differs socio-culturally based on the priorities assigned to patients’ autonomy and the principles of beneficence and non-maleficence. After conducting in-depth interviews with 108 terminal-stage adult cancer patients, 306 family members, and 25 physicians, in private and public hospitals in both rural and urban areas, in the state of West Bengal, India it has been found that even though 85.60% of the patients prefer full disclosure, only 22.03% are actually informed. Though demographic characteristics, like age, gender, education etc., have marginal influences over the pattern of truth-telling, the main factor behind non-disclosure is the family members’ preference for principles of beneficence and non-maleficence over patient autonomy. Hence, only 9.32% of those 118 patients’ family members have agreed to full disclosure. Physicians comply with this culture of non-disclosure as family, in India, is the centre of decision-making and acts as the primary unit of care.

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71 NOTCH/RBPJ/HES1 SIGNAL IN CHONDROCYTES MODULATES TERMINAL STAGE OF ENDOCHONDRAL OSSIFICATION DURING SKELETAL GROWTH AND OSTEOARTHRITIS DEVELOPMENT

Osteoarthritis and Cartilage ◽

10.1016/s1063-4584(11)60098-8 ◽

2011 ◽

Vol 19 ◽

pp. S38

Author(s):

Y. Hosaka ◽

T. Saito ◽

S. Sugita ◽

A. Fukai ◽

T. Hikata ◽

...

Keyword(s):

Endochondral Ossification ◽

Skeletal Growth ◽

Terminal Stage

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A Meningo-Leucoencephalomyelitis Resembling Visna in Dutch Zwoeger Sheep

Pathologia veterinaria ◽

10.1177/030098586600300501 ◽

1966 ◽

Vol 3 (5) ◽

pp. 401-411 ◽

Cited By ~ 13

Author(s):

A. A. Ressang ◽

F. C. Stam ◽

G. F. De Boer

Keyword(s):

White Matter ◽

The Netherlands ◽

Final Stage ◽

Chronic Condition ◽

Cerebral Lesions ◽

Terminal Stage ◽

Icelandic Sheep ◽

Close Relationship ◽

Secondary Demyelination ◽

First Time

Zwoegerziekte is a disease in Dutch sheep which morphologically closely resembles an Icelandic sheep disease, Maedi2. Chronic lung affection and emaciation are the principal symptoms of both diseases. Visna is another chronic condition in Icelandic sheep affecting mainly the C.N.S. A virus has been isolated from sheep affected with Maedi or Visna and a close relationship in properties has been found between both viruses. In two Dutch sheep autopsied in the final stage of Zwoegerziekte, lesions were present in the C.N.S., which histologically resembled those in Visna. Another sheep slaughtered at the municipal abattoir, with lung lesions characteristic for the terminal stage of Zwoegerziekte, exhibited early cerebral lesions resembling Visna. The lesions in the C.N.S. of these three sheep were meningitis and severe encephalomyelitis of the glial type affecting the white matter. Secondary demyelination was striking. Though Zwoegerziekte has been known for several decades in the Netherlands, the accompanying C.N.S. lesions are described for the first time.

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A case of myelafibrosis manifesting as multiple tumors in its terminal stage.

Nihon Naika Gakkai Zasshi ◽

10.2169/naika.80.1965 ◽

1991 ◽

Vol 80 (12) ◽

pp. 1965-1966

Author(s):

SHIGEKI NISHIMURA

Keyword(s):

Multiple Tumors ◽

Terminal Stage

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Study on project trajectory of air-to-ground missile with strapdown seeker under multi constraints

Xibei Gongye Daxue Xuebao/Journal of Northwestern Polytechnical University ◽

10.1051/jnwpu/20213910141 ◽

2021 ◽

Vol 39 (1) ◽

pp. 141-147

Author(s):

Junmin Zhao ◽

Cong Nie ◽

Guannan Chang ◽

Meibo Lyu ◽

Xinguo Li

Keyword(s):

Good Condition ◽

Field Of View ◽

Small Field ◽

Target Acquisition ◽

Moving Targets ◽

Proportional Navigation ◽

Terminal Stage ◽

Guidance Law ◽

Terminal Guidance ◽

Small Field Of View

The air-to-ground missile with strapdown seeker may have the problems, including small field of view(FOV), limited overload, and fall angle constraint. To solve the above mentioned problem, a phased guidance scheme is proposed. In this scheme, the attack trajectory is divided into the following six stages, including glided stage, fall angle constraint stage, target acquisition and adjustment stage, terminal guidance stage and blind zone stage. The glided stage is designed to increase range, the terminal fall angle is attained ahead of time at fall angle constraint stage. The aim of target acquisition and adjustment stage is to adjust the missile attitude, so that the target will fall within the FOV of the seeker. It creates good condition to capture the target for strapdown seeker. In the terminal stage, the guidance law of proportional navigation and attitude track are used to fit the needs of FOV constraint and attack accuracy. The simulation result shows that the project trajectory can solve the application of attacking moving targets for air-to-ground missile with strapdown seeker under multi constraints.

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A 40-year-old Woman with Hypercalcemia Crisis Caused by Bone Metastasis in Stage IV Breast Cancer

Biomolecular and Health Science Journal ◽

10.20473/bhsj.v4i2.29633 ◽

2021 ◽

Vol 4 (2) ◽

pp. 117

Author(s):

Wiharjo Hadisuwarno ◽

Merlyna Savitri ◽

Ami Ashariati ◽

S. Ugroseno Yudho Bintoro ◽

M. Noor Diansyah ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Bone Metastasis ◽

Stage Iv ◽

Terminal Stage ◽

Holistic Management ◽

Stage Iv Breast Cancer ◽

Laboratory Examinations ◽

Cancer Diseases

Breast cancer is still global burden especially for woman with 2.3 million cases every year dan 15% mortality among cancer diseases. In developing countries, most of the cases are diagnosed at terminal stage when metastasis already found. Bone metastasis is the highest among other metastasis sites such as: lung, liver and brain. Bone metastasis will cause hypercalcemia and bone pain as complications. Both will gradually decrease patient’s quality of life. Comprehensive and holistic management for these complications will reduce deterioration and hopefully increase patient’s quality of life even they were at terminal stage. We describe a 40-year-old woman who got hypercalcemia crisis. Hypercalcemia usually manifest as a consequence of other diseases. Epidemiologically, majority come from metastasis, but can be other diseases, such as multiple myeloma. Interestingly, during medical investigation through her medical history, and physical examination, and laboratory examinations, we conclude that her hypercalcemia crisis was caused by bone metastasis from breast cancer.

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DIAGNOSTICS OF RESPIRATORY TUBERCULOSIS IN THOSE AT THE TERMINAL STAGE OF CHRONIC KIDNEY DISEASE

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2019-97-1-57-58 ◽

2019 ◽

Vol 97 (1) ◽

pp. 57-58

Author(s):

N. L. Karpina ◽

◽

O. M. Gordeeva ◽

E. E. Larionova. ◽

I. Yu. Аndrievskaya ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Terminal Stage

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Shared decision making for the initiation and continuation of dialysis: a proposal from the Japanese Society for Dialysis Therapy

Renal Replacement Therapy ◽

10.1186/s41100-021-00365-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kazuyoshi Okada ◽

Ken Tsuchiya ◽

Ken Sakai ◽

Takahiro Kuragano ◽

Akiko Uchida ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Japanese Society ◽

Healthcare Management ◽

Maintenance Hemodialysis ◽

Decision Making Process ◽

Healthcare Team ◽

Shared Decision ◽

Dialysis Therapy ◽

Terminal Stage

Abstract Background In Japan, forgoing life-sustaining treatment to respect the will of patients at the terminal stage is not stipulated by law. According to the Guidelines for the Decision-Making Process in Terminal-Stage Healthcare published by the Ministry of Health, Labor and Welfare in 2007, the Japanese Society for Dialysis Therapy (JSDT) developed a proposal that was limited to patients at the terminal stage and did not explicitly cover patients with dementia. This proposal for the shared decision-making process regarding the initiation and continuation of maintenance hemodialysis was published in 2014. Methods and results In response to changes in social conditions, the JSDT revised the proposal in 2020 to provide guidance for the process by which the healthcare team can provide the best healthcare management and care with respect to the patient's will through advance care planning and shared decision making. For all patients with end-stage kidney disease, including those at the nonterminal stage and those with dementia, the decision-making process includes conservative kidney management. Conclusions The proposal is based on consensus rather than evidence-based clinical practice guidelines. The healthcare team is therefore not guaranteed to be legally exempt if the patient dies after the policies in the proposal are implemented and must respond appropriately at the discretion of each institution.

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