JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 4 2003
Kristin Wright
This article describes a qualitative study exploring the experiences of terminally ill patients and their families as they lived with the inevitability of death. Frustrated by the dominant discourse surrounding the culture of dying,namely that of Elisabeth Kübler-Ross's stage theory,I sought to revisit the experiences of the terminally ill by talking directly with them. Instead of focusing on how people reacted to the introduction of death into their lives, this research attended to how the dying began relating to life and death differently as a result of death's presence. Through an analysis of ethnographically collected data, the meanings participants constructed around their experiences were explored,culminating in the creation of seven "relationships" that participants shared with death. [source]

RE: INSTRUCTIVE CASE: ,DELAYED INFANT DEATH FOLLOWING CATASTROPHIC DETERIORATION DURING BREAST-FEEDING'

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2005
P Lewindon Assoc Professor
No abstract is available for this article. [source]

ESTIMATING EFFECTS OF SYSTEMATIC TREATMENT ON RENAL FAILURE AND DEATH WITHOUT A PARALLEL PLACEBO CONTROL GROUP

NEPHROLOGY, Issue 3 2000
Hoy We
Background: Chronic disease programs are poorly developed in most Aboriginal communities. Much disease is unrecognised or inadequately treated, although appropriate interventions profoundly reduce morbidity and mortality in nonAboriginal populations. Programs of improved management must aspire to best practice for all, so that maintaining parallel untreated control groups is unethical. This poses challenges for evaluating effect. Methods: We identified a large burden of chronic disease in a 1990-1995 screening program in one community, and started a renal & cardiovascular-protection program in Nov 1995. This centred around use of ACE inhibitors, rigorous BP control, better control of glycemia and lipids, & health education. By late 1999 about 275 people, or 30% of all adults had enrolled. The courses of BP, albuminuria and GFR was compared with those in the pre-program era (ANZSN, 1999). Treatment effects on renal failure & natural death were estimated in 3 ways. 1) Comparison of these endpoints in the "intention to treat" group with those in persons potentially eligible for treatment on their 1990-1995 screening results, ,controls'. There was 50% overlap between the groups, & controls were younger and had less severe disease than the treatment group. 2.Community-based trends in endpoints. 3. Comparison of these trends with those in other NT Top End communities. Results: 1. Risk ratios of rates, Kaplan Meier survivals, and Cox hazard ratios all showed better survival of the treated group over controls, with estimates of 41%-64% reductions in endpoints, after accounting for disease severity. 2. Dialysis starts in the entire community have fallen by at least 38% and natural deaths by 32%. 3. In contrast dialysis continue to increase at 11% per yr in other communities and deaths have not fallen. These results all suggest a marked benefit from the treatment program. Similar methods might be used where truly controlled observations are not feasible. [source]

ESTIMATING EFFECTS OF SYSTEMATIC TREATMENT ON RENAL FAILURE AND DEATH WITHOUT A PARALLEL PLACEBO CONTROL GROUP

EMPLOYMENT-AT-WILL: THE IMPENDING DEATH OF A DOCTRINE

AMERICAN BUSINESS LAW JOURNAL, Issue 4 2000
DEBORAH A. BALLAM
First page of article [source]

THE HARM OF DEATH, TIME-RELATIVE INTERESTS, AND ABORTION1

PHILOSOPHICAL FORUM, Issue 1 2007
DAVID DEGRAZIAArticle first published online: 22 FEB 200
First page of article [source]

FIDES ANCILLA MEDICINAE: ON THE ERSATZ LITURGY OF DEATH IN BIOPSYCHOSOCIOSPIRITUAL MEDICINE

THE HEYTHROP JOURNAL, Issue 1 2008
JEFFREY P. BISHOP
First page of article [source]

THE SERMON ON MOUNT MORIAH: FAITH AND THE SECRET IN THE GIFT OF DEATH

THE HEYTHROP JOURNAL, Issue 1 2008
ADAM KOTSKO
This essay is an investigation of three attempts to think faith. I find my starting place in Jacques Derrida's The Gift of Death,1 one of the most important treatments of Christianity in Derrida's later thought, which was increasingly insistent in its engagement with religious questions up until his death in 2004. This reading of The Gift of Death will focus particularly on the question of secrecy and its relationship with faith, leading necessarily to an account of Derrida's reading of two of his primary references in this text: the second essay of Nietzsche's Genealogy of Morals2 and Kierkegaard's Fear and Trembling.3 Rather than simply rendering a judgment on Derrida's reading, I will endeavor to read these texts together, extending (or expanding upon) Derrida's reading while questioning some of the positive formulations he makes in his own name , all the while remaining attentive to the gambles involved in thinking faith. [source]

FRIENDSHIP, THE KISS OF DEATH, AND GOD: H. RICHARD NIEBUHR AND JACQUES DERRIDA ON THE OTHER

THE HEYTHROP JOURNAL, Issue 1 2008
ZACHARY SIMPSON
First page of article [source]

THE DEATH OF BIOETHICS (AS WE ONCE KNEW IT)

BIOETHICS, Issue 5 2010
RUTH MACKLIN
ABSTRACT Fast forward 50 years into the future. A look back at what occurred in the field of bioethics since 2010 reveals that a conference in 2050 commemorated the death of bioethics. In a steady progression over the years, the field became increasingly fragmented and bureaucratized. Disagreement and dissension were rife, and this once flourishing, multidisciplinary field began to splinter in multiple ways. Prominent journals folded, one by one, and were replaced with specialized publications dealing with genethics, reproethics, nanoethics, and necroethics. Mainstream bioethics organizations also collapsed, giving way to new associations along disciplinary and sub-disciplinary lines. Physicians established their own journals, and specialty groups broke away from more general associations of medical ethics. Lawyers also split into three separate factions, and philosophers rejected all but the most rigorous, analytic articles into their newly established journal. Matters finally came to a head with global warming, the world-wide spread of malaria and dengue, and the cost of medical treatments out of reach for almost everyone. The result was the need to develop plans for strict rationing of medical care. At the same time, recognition emerged of the importance of the right to health and the need for global justice in health. By 2060, a spark of hope was ignited, opening the door to the resuscitation of bioethics and involvement of the global community. [source]

ETHICAL DEBATE OVER ORGAN DONATION IN THE CONTEXT OF BRAIN DEATH

BIOETHICS, Issue 2 2010
MARY JIANG BRESNAHAN
ABSTRACT This study investigated what information about brain death was available from Google searches for five major religions. A substantial body of supporting research examining online behaviors shows that information seekers use Google as their preferred search engine and usually limit their search to entries on the first page. For each of the five religions in this study, Google listings reveal ethical controversy about organ donation in the context of brain death. These results suggest that family members who go online to find information about organ donation in the context of brain death would find information about ethical controversy in the first page of Google listings. Organ procurement agencies claim that all major world religions approve of organ donation and do not address the ethical controversy about organ donation in the context of brain death that is readily available online. [source]

CLIMATE CHANGE, LUDDITES AND UNNECESSARY DEATHS

ECONOMIC AFFAIRS, Issue 1 2004
Roger Bate
No abstract is available for this article. [source]

COSTLY AGEING OR COSTLY DEATHS?

AUSTRALIAN ECONOMIC PAPERS, Issue 1 2006
UNDERSTANDING HEALTH CARE EXPENDITURE USING AUSTRALIAN MEDICARE PAYMENTS DATA
In health economics and health care planning, the observation that age cohorts are generally positively correlated with per capita health expenditures is often cited as evidence that population ageing is the main driver of health care costs. Several recent studies, however, challenge this view. Zweifel et al. (1999) and Felder et al. (2000), for example, find that individuals incur the highest health care costs around the time before their death. Thus, they argue, it is proximity to death rather than ageing that is driving health care costs. This paper examines the issue by estimating a two-equation exact aggregation demand model using Australian Medicare payments data over an eight-year period (1994,2001). The results suggest that once proximity to death is accounted for, population ageing has either a negligible or even negative effect on health care demand. [source]

Prognosis and Mechanism of Death in Treated Heart Failure: Data From the Placebo Arm of Val-HeFT

CONGESTIVE HEART FAILURE, Issue 3 2006
Jay N. Cohn MD
The magnitude of benefit on mortality of combined angiotensin-converting enzyme inhibitor (ACEI) and ,-blocker (BB) therapy for heart failure cannot be reliably assessed from prospective randomized trials of individual drugs with intent-to-treat analysis. The placebo arm of the Valsartan Heart Failure Trial (Val-HeFT) included patients who remained on background therapy with ACEIs, BBs, neither, or both. The outcomes in these four subgroups should provide a better guide to mortality benefit. Overall mortality (mean follow-up, 23 months) was 31.6% in those receiving neither neurohormonal blocker, 29% and 39% lower in those on ACEIs or BBs, respectively, and 62% lower (11.9% mortality) in those receiving both drugs. In the neither neurohormonal inhibitor group, 48% of the heart failure-related deaths were adjudicated as sudden, whereas in the group receiving ACEIs and BBs, 79% of the deaths were sudden, and pump failure mortality was only 1% per year. The combination of ACEIs and BBs exerts a greater mortality reduction than suggested from clinical trials and reduces pump failure mortality to 1% per year. [source]

Death Rides the Forest: Perceptions of Fire, Land Use, and Ecological Restoration of Western Forests

CONSERVATION BIOLOGY, Issue 4 2004
J. BOONE KAUFFMAN
fuego prescrito; incendios catastróficos; incendios en áreas silvestres; incendios no controlados; reducción de riesgo de combustible; restauración de bosques; tala de bosques Abstract:,Large wild fires occurring in forests, grasslands, and chaparral in the last few years have aroused much public concern. Many have described these events as "catastrophes" that must be prevented through aggressive increases in forest thinning. Yet the real catastrophes are not the fires themselves but those land uses, in concert with fire-suppression policies that have resulted in dramatic alterations to ecosystem structure and composition. The first step in the restoration of biological diversity (forest health) of western landscapes must be to implement changes in those factors that have caused degradation or are preventing recovery. This includes changes in policies and practices that have resulted in the current state of wildland ecosystems. Restoration entails much more than simple structural modifications achieved though mechanical means. Restoration should be undertaken at landscape scales and must allow for the occurrence of dominant ecosystem processes, such as the natural fire regimes achieved through natural and/or prescribed fires at appropriate temporal and spatial scales. Resumen:,En años recientes, grandes incendios en bosques, pastizales y chaparrales han causado bastante preocupación en la opinión pública. Muchos han descrito estos eventos como "catástrofes" que deben ser prevenidas mediante incrementos agresivos en la tala de bosques. Pero los incendios mismos no son las verdaderas catástrofes, sino los usos del suelo en conjunto con políticas de supresión de fuego que han resultado en alteraciones dramáticas de la estructura y composición de ecosistemas. El primer paso en la restauración de la diversidad biológica (salud del bosque) en paisajes occidentales debe ser la implementación de cambios en los factores que causaron la degradación o que están impidiendo la recuperación. Esto incluye cambios en políticas y prácticas que han resultado en el estado actual de ecosistemas en áreas silvestres. La restauración implica mucho más que simples modificaciones estructurales obtenidas mediante medios mecánicos. La restauración debe llevarse a cabo a nivel de paisaje y debe permitir que ocurrencia de procesos ecológicos dominantes (por ejemplo, regímenes de incendios naturales logrados mediante incendios naturales y/o prescritos en escalas temporales y espaciales apropiadas). [source]

Constructing Queer Communities: Marriage, Sex, Death, and Other Fantasies

CONSTELLATIONS: AN INTERNATIONAL JOURNAL OF CRITICAL AND DEMOCRATIC THEORY, Issue 1 2001
Morris Kaplan
[source]

Care for the Adult Family Members of Victims of Unexpected Cardiac Death

ACADEMIC EMERGENCY MEDICINE, Issue 12 2006
Robert Zalenski MD
Abstract More than 300,000 sudden coronary deaths occur annually in the United States, despite declining cardiovascular death rates. In 2000, deaths from heart disease left an estimated 190,156 new widows and 68,493 new widowers. A major unanswered question for emergency providers is whether the immediate care of the loved ones left behind by the deceased should be a therapeutic task for the staff of the emergency department in the aftermath of a fatal cardiac arrest. Based on a review of the literature, the authors suggest that more research is needed to answer this question, to assess the current immediate needs and care of survivors, and to find ways to improve care of the surviving family of unexpected cardiac death victims. This would include improving quality of death disclosure, improving care for relatives during cardiopulmonary resuscitation of their family member, and improved methods of referral for services for prevention of psychological and cardiovascular morbidity during bereavement. [source]

,A Serious and Dangerous Matter': Transgression and the Death of God

CRITICAL QUARTERLY, Issue 2008
Article first published online: 10 APR 200
First page of article [source]

Contingent Selves: Love and Death in a Buddhist Society in Nepal

CULTURAL ANTHROPOLOGY, Issue 2 2002
Ernestine McHugh
First page of article [source]

Multiple adverse outcomes over 30 years following adolescent substance misuse treatment

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009
S. Hodgins
Objective:, To compare outcomes over 30 years experienced by individuals who as adolescents entered substance misuse treatment and a general population sample. Method:, All 1992 individuals seen at the only clinic for substance misusing adolescents in Stockholm from 1968 to 1971 were compared to 1992 individuals randomly selected from the Swedish population, matched for sex, age and birthplace. Death, hospitalization for physical illness related to substance misuse, hospitalization for mental illness, substance misuse, criminal convictions and poverty were documented from national registers. Results:, Relative risks of death, physical illness, mental illness, substance misuse, criminal convictions and poverty were significantly elevated in the clinic compared to the general population sample. After adjustment for substance misuse in adulthood, the risks of death, physical and mental illness, criminality and poverty remained elevated. Conclusion:, Adolescents who consult for substance misuse problems are at high risk for multiple adverse outcomes over the subsequent 30 years. [source]

Death and survival of heterozygous Lurcher Purkinje cells In vitro

DEVELOPMENTAL NEUROBIOLOGY, Issue 8 2009
Hadi S. Zanjani
Abstract The differentiation and survival of heterozygous Lurcher (+/Lc) Purkinje cells in vitro was examined as a model system for studying how chronic ionic stress affects neuronal differentiation and survival. The Lurcher mutation in the ,2 glutamate receptor (GluR,2) converts an orphan receptor into a membrane channel that constitutively passes an inward cation current. In the GluR,2+/Lc mutant, Purkinje cell dendritic differentiation is disrupted and the cells degenerate following the first week of postnatal development. To determine if the GluR,2+/Lc Purkinje cell phenotype is recapitulated in vitro, +/+, and +/Lc Purkinje cells from postnatal Day 0 pups were grown in either isolated cell or cerebellar slice cultures. GluR,2+/+ and GluR,2+/Lc Purkinje cells appeared to develop normally through the first 7 days in vitro (DIV), but by 11 DIV GluR,2+/Lc Purkinje cells exhibited a significantly higher cation leak current. By 14 DIV, GluR,2+/Lc Purkinje cell dendrites were stunted and the number of surviving GluR,2+/Lc Purkinje cells was reduced by 75% compared to controls. However, treatment of +/Lc cerebellar cultures with 1-naphthyl acetyl spermine increased +/Lc Purkinje cell survival to wild type levels. These results support the conclusion that the Lurcher mutation in GluR,2 induces cell autonomous defects in differentiation and survival. The establishment of a tissue culture system for studying cell injury and death mechanisms in a relatively simple system like GluR,2+/Lc Purkinje cells will provide a valuable model for studying how the induction of a chronic inward cation current in a single cell type affects neuronal differentiation and survival. © 2009 Wiley Periodicals, Inc. Develop Neurobiol, 2009 [source]

Prediction of mortality at age 40 in Danish males at high and low risk for alcoholism

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2004
J. Knop
Objective:, This prospective high-risk study examined the influence of father's alcoholism and other archival-generated measures on premature death. Method:, Sons of alcoholic fathers (n = 223) and sons of non-alcoholic fathers (n = 106) have been studied from birth to age 40. Archival predictors of premature death included father's alcoholism, childhood developmental data, and diagnostic information obtained from the Psychiatric Register and alcoholism clinics. Results:, By age 40, 21 of the 329 subjects had died (6.4%), a rate that is more than two times greater than expected. Sons of alcoholic fathers were not more likely to die by age 40. Premature death was associated with physical immaturity at 1-year of age and psychiatric/alcoholism treatment. No significant interactions were found between risk and archival measures. Conclusion:, Genetic vulnerability did not independently predict death at age 40. Death was associated with developmental immaturities and treatment for a psychiatric and/or substance abuse problem. [source]

Speaking of God after the Death of God

DIALOG, Issue 3 2005
By Daniel J. Peterson
Abstract:, This article affirms the ability to talk about God in the twenty-first century 40 years after God died (according to Death-of-God theologians) in the 1960s. It does so by an appeal to the proper combination of mystery and revelation ideally expressed in the paradox that God reveals Godself as hidden. The language of God's revealed hiddenness comprises a "middle way" which avoids the extremes of theological hubris on the one hand and atheism or unbelief on the other, making it possible to speak today of God in a faithful yet humble manner. [source]

After Roosevelt's Death: Dangerous Emotions, Divisive Discourses, and the Abandoned Alliance*

DIPLOMATIC HISTORY, Issue 1 2010
Frank Costigliola
First page of article [source]

Telemetry Monitoring during Transport of Low-risk Chest Pain Patients from the Emergency Department: Is It Necessary?

ACADEMIC EMERGENCY MEDICINE, Issue 10 2005
Adam J. Singer MD
Abstract Background: Low-risk emergency department (ED) patients with chest pain (CP) are often transported by nurses to monitored beds on telemetry monitoring, diverting valuable resources from the ED and delaying transport. Objectives: To test the hypothesis that transporting low-risk CP patients off telemetry monitoring is safe. Methods: This was a secondary analysis of a prospective, observational cohort of ED patients with low-risk chest pain (no active chest pain, normal or nondiagnostic electrocardiogram, normal initial troponin I) admitted to a non,intensive care unit monitored bed who were transported off telemetry monitor by nonclinical personnel. A protocol allowing transportation of low-risk CP patients off telemetry monitoring to a monitored bed was developed, and an ongoing daily log of patients transported off telemetry was maintained for the occurrence of any adverse events en route to the floor. Adverse events requiring treatment included dysrhythmias, hypotension, syncope, and cardiac arrest. The study population included patients who presented during September,October 2004, whose data were abstracted from the medical records using standardized methodology. A subset of 10% of the medical records were reviewed by a second investigator for interrater reliability. Death, syncope, resuscitation, and dysrhythmias during transport or immediately on arrival to the floor were the outcomes measured. Descriptive statistics and confidence intervals (CIs) were used in data analysis. Results: During the study period, 425 patients had CP of potentially ischemic origin, of whom 322 (75.8%) were low risk and met the inclusion criteria and were transported off monitors. Their mean (±standard deviation) age was 58.3 (±16.0) years; 48.1% were female. During transport from the ED, there was no patient with any adverse events requiring treatment and there was no death (95% CI = 0% to 0.93%). Conclusions: Transportation of low-risk ED chest pain patients off telemetry monitoring by nonclinical personnel to the floor appears safe. This may reduce diversion of ED nurses from the ED, helping to alleviate nursing shortages. [source]

Aortic Root Dimension as an Independent Predictor for All-Cause Death in Adults <65 Years of Age (from The Chin-Shan Community Cardiovascular Cohort Study)

ECHOCARDIOGRAPHY, Issue 5 2010
Chao-Lun Lai M.D.
Background: Evidence on aortic root dimension for predicting cardiovascular morbidity and mortality is inconclusive. This cohort study sought to characterize the predictive power of aortic root dimension on cardiovascular morbidity and mortality in an ethnic Chinese population. Methods: We recruited 1,851 participants in the Chin,Shan Community Cardiovascular Cohort (CCCC) study who had received echocardiography without previous cardiovascular events. Aortic root dimension was measured by M-mode echocardiography and indexed by body surface area to obtain aortic root dimension index (AOI). The end points were all-cause death and incident cardiovascular events including coronary heart disease and stroke over a median follow-up of 11.9 years. Results: Although tertiles of AOI was associated with an increased risk of cardiovascular events and all-cause death in univariate analysis, the significance diminished after adjusting for age variable (P for trend = 0.11 for cardiovascular events; P for trend = 0.23 for all-cause death). In subgroup analysis, we found a significant association between tertiles of AOI and risk of all-cause death in the final multivariate Cox regression model in adults <65 years. The adjusted relative risk was 1.88 (95% CI, 1.04 to 3.40) in participants in the upper tertile of AOI compared with participants in the lower tertile (P for trend = 0.037). In adults ,65 years, tertile of AOI was not associated with all-cause death (P for trend = 0.14). Tertiles of AOI was not associated with cardiovascular events throughout this study. Conclusion: Our study showed a significant association between AOI and all-cause death in adults <65 years in an ethnic Chinese population. (Echocardiography 2010;27:487-495) [source]

Myocardial Viability Detected by Myocardial Contrast Echocardiography,Prognostic Value in Patients after Myocardial Infarction

ECHOCARDIOGRAPHY, Issue 4 2010
Maria Olszowska M.D., Ph.D.
Objective: This study aimed to assess the role of myocardial contrast echocardiography (MCE) as a predictor of cardiac events and death in patients with acute myocardial infarction (AMI). Methods: Eighty-six patients underwent primary percutaneous coronary angioplasty for AMI. Segmental perfusion was estimated by MCE in real time at mean 5 days after PCI using low MI (0.3) after 0.3,0.5 ml bolus injection of intravenous Optison. MCE was scored semiquantitatively as: (1) normal perfusion (homogenous contrast effect), (2) partial perfusion (patchy myocardial contrast enhancement), (3) lack of perfusion (no visible contrast effect). A contrast score index (CSI) was calculated as the sum of MCE scores in each segment divided by the total number of segments. The patients were followed up for cardiac events and death. Results: A CSI of >1.68 was taken to be a predictor of cardiac events and death. Death occurred only in patients with CSI >1.68. Patients with CSI >1.68 had a significantly (P = 0.03) higher incidence of cardiac death or cardiac events (75%) compared to those with CSI <1.68 (27%). The absence of residual perfusion within the infarct zone was an independent predictor of death and cardiac events (P = 0.02). Conclusions: The absence of residual myocardial viability in the infarct zone supplied by an infarct-related artery is a powerful predictor of cardiac events in patients after AMI. (Echocardiography 2010;27:430-434) [source]

Prognostic Value of 12-Lead Electrocardiogram During Dobutamine Stress Echocardiography

ECHOCARDIOGRAPHY, Issue 5 2000
Milind R. Dhond M.D.
The aim of this study was to assess the prognostic value of the 12-lead electrocardiogram (ECG) obtained during dobutamine stress echocardiography (DSE) in predicting subsequent cardiac events. We retrospectively analyzed 345 patients undergoing DSE in 1992,1994 and selected those patients with negative echo results for ischemia. Of the 200 patients with negative DSE results, a separate analysis of their ECG data was performed with results reported as either positive, negative, or nondiagnostic for ischemia. Follow-up was performed through a physician chart review and direct telephone contact. Event rates were determined for hard (myocardial infarction or cardiac death) and soft (hospitalization for angina and/or congestive heart failure, coronary angioplasty, or coronary artery bypass graft surgery) cardiac events occurring after the negative DSE for up to 6 years after the test. Death was also determined by referencing the patients' data with mortality data available on the Internet. There were 143 patients with ECG data reported as negative and 40 patients with ECG data reported as positive for ischemia. The hard and soft event rates were 1.5% and 9% per patient per year in the ECG negative group and 2% and 11% in the ECG positive group. There were no statistical differences in event rates between the two groups during the 5-year follow-up period. Our results suggest that the ECG result obtained during DSE does not confer any incremental prognostic value over the echo result. [source]