Displaying publications 41 - 60 of 691 in total

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  1. Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, et al.
    Circulation, 2022 Aug 02;146(5):e18-e43.
    PMID: 35766027 DOI: 10.1161/CIR.0000000000001078
    In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life's Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life's Essential 8. The components of Life's Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.
    Matched MeSH terms: United States
  2. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al.
    Circulation, 2019 03 05;139(10):e56-e528.
    PMID: 30700139 DOI: 10.1161/CIR.0000000000000659
    Matched MeSH terms: United States/epidemiology
  3. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al.
    Circulation, 2021 Feb 23;143(8):e254-e743.
    PMID: 33501848 DOI: 10.1161/CIR.0000000000000950
    BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

    METHODS: The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease.

    RESULTS: Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

    CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

    Matched MeSH terms: United States/epidemiology
  4. Perak AM, Baker-Smith C, Hayman LL, Khoury M, Peterson AL, Ware AL, et al.
    Circ Cardiovasc Qual Outcomes, 2023 Sep;16(9):e000120.
    PMID: 37548024 DOI: 10.1161/HCQ.0000000000000120
    Cardiovascular disease risk factors are highly prevalent among youth in the United States and Canada. Pediatric preventive cardiology programs have independently developed and proliferated to address cardiovascular risk factors in youth, but there is a general lack of clarity on best practices to optimize and sustain desired outcomes. We conducted surveys of pediatric cardiology division directors and pediatric preventive cardiology clinicians across the United States and Canada to describe the current landscape and perspectives on future directions for the field. We summarize the data and conclude with a call to action for various audiences who seek to improve cardiovascular health in youth, reduce the burden of premature cardiovascular disease, and increase healthy longevity. We call on heart centers, hospitals, payers, and policymakers to invest resources in the important work of pediatric preventive cardiology programs. We urge professional societies to advocate for pediatric preventive cardiology and provide opportunities for training and cross-pollination across programs. We encourage researchers to close evidence gaps. Last, we invite pediatric preventive cardiology clinicians to collaborate and innovate to advance the practice of pediatric preventive cardiology.
    Matched MeSH terms: United States/epidemiology
  5. Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, et al.
    Circulation, 2020 08 18;142(7):e101-e118.
    PMID: 32686505 DOI: 10.1161/CIR.0000000000000866
    Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
    Matched MeSH terms: United States
  6. Leelavanich D, Adjimatera N, Broese Van Groenou L, Anantachoti P
    Risk Manag Healthc Policy, 2020;13:2753-2768.
    PMID: 33273873 DOI: 10.2147/RMHP.S281629
    Purpose: The drug classification system, as prescription or non-prescription drug category, has been utilized as a regulatory strategy to ensure patient safety. In Thailand, the same system has been used for decades, though the drug classification criteria were updated to accommodate drug re-classification in 2016. These new criteria, however, have not been applied retroactively. Inconsistency in drug classification has been observed leading to concerns regarding the drug classification system. This has prompted the need for a review of the drug classification system in Thailand. This study aims to explore Thailand and other selected countries' regulatory management regarding the drug classification system, drug classification criteria, and drug classification itself.

    Methods: The drug classification systems of the United States, the United Kingdom, Japan, Singapore, Malaysia, the Philippines, and Canada were selected to study alongside Thailand's system. The regulatory review was conducted through each country's drug regulatory agency website and available published research. Complementary interviews with drug regulatory authorities were conducted when written documentation was unclear and had limited access. Fifty-two common drugs were selected to compare their actual classifications across the different countries.

    Results: All selected countries classified drugs into two major groups: prescription drugs and non-prescription drugs. The studied countries further sub-classified non-prescription drugs into 1-4 categories. Principles of drug classification criteria among countries are similar; they comprised of three themes: disease characteristics, drug safety profile, and other drug characteristics. Actual drug classification of antibiotics, dyslipidemia treatments, and hypertension treatments in Thailand are notedly different from other countries. Furthermore, 77.4% of drugs studied in Thailand fall into the behind-the-counter (dangerous) drug category, which varied from antihistamines to antibiotics, dyslipidemia treatments, and vaccines.

    Conclusion: Thailand's drug classification criteria are comparable with other nations; however, there is a need to review drug classification statuses as many drugs have been classified into improper drug categories.

    Matched MeSH terms: United States
  7. Anderson W
    Bull Hist Med, 1996;70(1):62-7.
    PMID: 8850070
    Matched MeSH terms: United States
  8. Yu CY, Chan KG, Yean CY, Ang GY
    Diagnostics (Basel), 2021 Jan 01;11(1).
    PMID: 33401392 DOI: 10.3390/diagnostics11010053
    The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began as a cluster of pneumonia cases in Wuhan, China before spreading to over 200 countries and territories on six continents in less than six months. Despite rigorous global containment and quarantine efforts to limit the transmission of the virus, COVID-19 cases and deaths have continued to increase, leaving devastating impacts on the lives of many with far-reaching effects on the global society, economy and healthcare system. With over 43 million cases and 1.1 million deaths recorded worldwide, accurate and rapid diagnosis continues to be a cornerstone of pandemic control. In this review, we aim to present an objective overview of the latest nucleic acid-based diagnostic tests for the detection of SARS-CoV-2 that have been authorized by the Food and Drug Administration (FDA) under emergency use authorization (EUA) as of 31 October 2020. We systematically summarize and compare the principles, technologies, protocols and performance characteristics of amplification- and sequencing-based tests that have become alternatives to the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel. We highlight the notable features of the tests including authorized settings, along with the advantages and disadvantages of the tests. We conclude with a brief discussion on the current challenges and future perspectives of COVID-19 diagnostics.
    Matched MeSH terms: United States; United States Food and Drug Administration
  9. Izamin, I., Jamsiah, M., Aniza, I.
    MyJurnal
    Each organization has a particular culture, due to personal interactions, with certain values shared by its members. Corporate culture is defined as ‘the set of shared, taken-for-granted implicit assumptions that a group holds and that determines how it perceives, thinks about, and reacts to its various environments’. Positive corporate culture is linked to increased staff alignment, advanced level of employee commitment, increased employee productivity, enhanced organizational effectiveness and increased profitability. Researchers claimed that most studies suggesting the associations between culture and performance are methodologically weak. Cultural transformation has been a big part of NHS reforms and health system redesign in United States to deliver improvements in quality and performance. Environment, market competition, technology advancement, information age and government policies will influence the cultural change within the organization. Undesirable culture might emerge if the organization does not act appropriately to manage its corporate culture. There are six critical success factors for the implementation of corporate culture changes: committed and effective leadership, clear definition of the desired goals, rigorous implementation of a change management model, effective mitigation of change resistance, active governance structure and a design model, and effective communication. Among the issues in implementing corporate culture within healthcare organizations are middle managers dilemma, cultural diversity and subcultures within the organization, size of healthcare organization and critical mass.
    Matched MeSH terms: United States
  10. Aragon-choudhury P
    MARHIA, 1992 Jan-Mar;5(1):8-9, 12.
    PMID: 12288567
    Matched MeSH terms: United States
  11. Araneta MR
    J ASEAN Fed Endocr Soc, 2019;34(2):126-133.
    PMID: 33442147 DOI: 10.15605/jafes.034.02.02
    Type 2 diabetes prevalence is rising rapidly in Southeast Asia (SEA) where urbanization and adoption of 'western' behavioral lifestyles are attributed as predominant risk factors. The Southeast Asian diaspora to the United States has resulted in a sizable portion of migrant and US born SEAs, with approximately 4 million Filipino Americans, 2 million Vietnamese-Americans, Cambodians (330,000), and Thai (300,000) as the most populous. Their longer exposure to a western lifestyle and participation in clinical studies with other racial/ethnic groups, provide opportunities to evaluate etiologic factors which might inform trends and intervention opportunities among residents of Southeast Asia. Epidemiologic studies in the US have identified higher T2D prevalence among Filipinos (16.1%) compared to groups perceived to be at highest risk for T2D, namely Latinos (14.0%), Black (13.7%), and Native Americans (13.4%), while SEAs (including Burmese, Cambodian, Indonesian, Laotian, Malaysian, and Thai, 10.5%) and Vietnamese (9.9%) had higher T2D risk compared to Whites (7.7%), despite their absence of general obesity. Asian-Americans, including SEAs, East and South Asians, collectively have higher rates of undiagnosed T2D compared to other racial/ethnic groups in the US. Almost half (44%) of Filipinos with newly diagnosed T2D have isolated post-challenge hyperglycemia and will remain undiagnosed if current screening practices remain limited to measures of glycosylated hemoglobin and fasting plasma glucose. The University of California San Diego Filipino Health Study found excess visceral adipose tissue accumulation, low ratio of muscle to total abdominal mass area, low adiponectin concentration, multiparity (≥ 6 live births), and sleep insufficiency (<7 hours) to be unique T2D risk factors among Filipino-American women, even after adjusting for established T2D risk factors including hypertension and parental history of T2D. Social determinants such as low educational attainment (less than college completion), and sustained social disadvantage during childhood and adulthood were independently associated with T2D risk. Gestational diabetes is a known risk factor for future T2DM among women; Northern California data shows that following Asian Indians, gestational diabetes was highest among Filipina and SEA parturients, who had twice the GDM prevalence as Black, Hispanic, and White women. Identification of novel T2D risk factors among SEAs may guide early diagnosis, inform pathophysiology, and identify unique opportunities for T2D prevention and management.
    Matched MeSH terms: United States
  12. Demir M, Jaafar J, Bilyk N, Ariff MR
    J Soc Psychol, 2012 May-Jun;152(3):379-85.
    PMID: 22558831 DOI: 10.1080/00224545.2011.591451
    The present study investigated the associations between social skills, friendship quality, and happiness, and tested a mediational model positing that friendship quality would mediate the relationship between social skills and happiness among American and Malaysian college students. Although American students reported significantly higher levels of psychosocial well-being than Malaysian students, the study variables were positively associated with each other in both cultures. More importantly, findings supported the proposed model in both groups. Results suggest that part of the reason why social skills are associated with positive psychological well-being is because of friendship experiences. Overall, the findings of the present study reinforce, extend and cross-culturally generalize the presumed benefits of social skills in positive well-being elaborated by Segrin and Taylor (2007). The authors also provided suggestions for future research.
    Matched MeSH terms: United States/ethnology
  13. Ahmad N, MuhdYusoff F, Ratnasingam S, Mohamed F, Nasir NH, MohdSallehuddin S, et al.
    PMID: 26000035
    Studying trends in mental health morbidity will guide the planning of future interventions for mental and public health services. To assess the trends in mental health problems among children and adolescents aged 5 through 15 years in Malaysia from 1996 to 2011, data from the children's mental health component of three population-based surveys was analysed using a two-stage stratified sampling design. Mental health problems were assessed using the Reporting Questionnaire for Children. The prevalence of mental health problems among children and adolescents aged 5 through 15 years showed an increasing trend from 13.0% (95% Confidence Interval [CI]: 11.5-14.6) in 1996 to 19.4% (95% CI: 18.5-20.3) in 2006 and 20.0% (95% CI: 18.8-21.3) in 2011. In 2011, male children and adolescents and those who were in less affluent families were significantly associated with mental health problems. The findings indicate that even though mental health problems among children and adolescents in Malaysia are increasing, the rate of increase has decreased in the past five years. Socially and economically disadvantaged groups were most vulnerable to mental health problems.
    Matched MeSH terms: United States; United States Public Health Service
  14. Kumar R, Arya N
    Lancet, 2023 Nov 11;402(10414):1747-1748.
    PMID: 37865109 DOI: 10.1016/S0140-6736(23)02054-8
    Matched MeSH terms: United States
  15. Chow S, Seow CS, Dizon MV, Godse K, Foong H, Chan V, et al.
    Asia Pac Allergy, 2018 Oct;8(4):e41.
    PMID: 30402408 DOI: 10.5415/apallergy.2018.8.e41
    Background: Atopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD.

    Objective: The Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians.

    Methods: Electronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017.

    Results: The Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included.

    Conclusion: The management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.

    Matched MeSH terms: United States
  16. Wang YH, Chen CB, Tassaneeyakul W, Saito Y, Aihara M, Choon SE, et al.
    Clin. Pharmacol. Ther., 2019 01;105(1):112-120.
    PMID: 29569740 DOI: 10.1002/cpt.1071
    Specific ethnic genetic backgrounds are associated with the risk of Stevens-Johnson syndrome / toxic epidermal necrolysis (SJS/TEN) especially in Asians. However, there have been no large cohort, multiple-country epidemiological studies of medication risk related to SJS/TEN in Asian populations. Thus, we analyzed the registration databases from multiple Asian countries who were treated during 1998-2017. A total 1,028 SJS/TEN cases were identified with the algorithm of drug causality for epidermal necrolysis. Furthermore, those medications labeled by the US Food and Drug Administration (FDA) as carrying a risk of SJS/TEN were also compared with the common causes of SJS/TEN in Asian countries. Oxcarbazepine, sulfasalazine, COX-II inhibitors, and strontium ranelate were identified as new potential causes. In addition to sulfa drugs and beta-lactam antibiotics, quinolones were also a common cause. Only one acetaminophen-induced SJS was identified, while several medications (e.g., oseltamivir, terbinafine, isotretinoin, and sorafenib) labeled as carrying a risk of SJS/TEN by the FDA were not found to have caused any of the cases in the Asian countries investigated in this study.
    Matched MeSH terms: United States/epidemiology; United States Food and Drug Administration/standards*
  17. Ahmad P, Dummer PMH, Chaudhry A, Rashid U, Saif S, Asif JA
    Int Endod J, 2019 Sep;52(9):1297-1316.
    PMID: 31009099 DOI: 10.1111/iej.13131
    AIM: To identify and analyse the main features of the top 100 most-cited randomized controlled trials, systematic reviews and meta-analyses published in endodontic journals from 1961 to 2018.

    METHODOLOGY: The Clarivate Analytics' Web of Science 'All Databases' was used to search and analyse the 100 most frequently cited randomized controlled trials, systematic reviews and meta-analyses having 'randomized', 'randomised', 'randomized controlled', 'randomised controlled', 'randomized controlled trial', 'randomized controlled trials', 'clinical trial', 'systematic', 'systematic review', 'meta-analysis', and 'meta-analyses' in the title section. The 'International Endodontic Journal', 'Journal of Endodontics', 'Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology', 'Australian Endodontic Journal', 'Endodontics & Dental Traumatology', 'Endo-Endodontic Practice Today' and 'European Endodontic Journal' were included in the publication name section. After ranking the articles in a descending order based on their citation counts, each article was cross-matched with the citation counts in Elsevier's Scopus and Google Scholar. The articles were analysed, and information on citation counts, citation density, year of publication, contributing authors, institutions and countries, journal of publication, study design, topic of the article and keywords was extracted.

    RESULTS: The citation counts of the 100 most-cited articles varied from 235 to 20 (Web of Science), 276 to 17 (Scopus) and 696 to 1 (Google Scholar). The year in which the top 100 articles were published was 2010 (n = 13). Among 373 authors, the greatest number of articles was associated with three individuals namely Reader A (n = 5), Beck M (n = 5) and Kvist T (n = 5). Most of the articles originated from the United States (n = 24) with the greatest contribution from Ohio State University (USA) (n = 5). Randomized controlled trials were the most frequent study design (n = 45) followed by systematic reviews (n = 30) with outcome studies of root canal treatment being the major topic (n = 35). The Journal of Endodontics published the largest number of included articles (n = 70) followed by the International Endodontic Journal (n = 27). Among 259 unique keywords, meta-analysis (n = 23) and systematic review (n = 23) were the most frequently used.

    CONCLUSION: This study has revealed that year of publication had no obvious impact on citation count. The bibliometric analysis highlighted the quantity and quality of research, and the evolution of scientific advancements made in the field of Endodontology over time. Articles before 1996, that is prior to the CONSORT statement that encouraged authors to include specific terms in the title and keywords, may not have been included in this electronic search.

    Matched MeSH terms: United States
  18. Ahmad P, Alam MK, Jakubovics NS, Schwendicke F, Asif JA
    J Dent Res, 2019 Dec;98(13):1425-1436.
    PMID: 31746684 DOI: 10.1177/0022034519880544
    Since its inception in 1919, the Journal of Dental Research has continually published high-quality articles that span the breadth of research topics relevant to dentistry, oral surgery, and medicine. As part of the journal's centennial celebration, we conducted an electronic search on Scopus to identify and analyze the top 100 most cited articles from 1919 to 2018. Since Scopus does not capture older citations, we conducted an additional analysis by Google Scholar to identify key articles published in the first 50 y of the journal. Based on Scopus, the articles were ranked in descending order per their citation counts. The citation counts of the 100 most cited articles varied from 262 to 1,503. The year in which the largest number of top 100 articles were published was 2004 (n = 6). Within the top 100, the majority of articles originated from the United States (n = 52). Research Reports-Biomaterials & Bioengineering was the most frequent category of cited articles (n = 35). There was no significant association between total citation count and time since publication (correlation coefficient = -0.051, P = 0.656). However, there was a significant negative association of citation density (correlation coefficient = -0.610, P < 0.01) with time since publication. Our analyses demonstrate the broad reach of the journal and the dynamics in citation patterns and research agenda over its 100-y history. There is considerable evidence of the high variance in research output, when measured via citations, across the globe. Moreover, it remains unclear how patients' priorities and dental health care needs are aligned with the perceived influence of single research pieces identified by our search. Our findings may help to inspire future research in tackling these inequalities and highlight the need for conceptualizing research priorities.
    Matched MeSH terms: United States
  19. Kasmini K, Idris MN, Fatimah A, Hanafiah S, Iran H, Asmah Bee MN
    Asia Pac J Clin Nutr, 1997 Sep;6(3):172-4.
    PMID: 24394759
    6239 children aged 7 to 16 years, attending 22 primary and secondary schools in Kuala Lumpur, Malaysia, were screened using a self report questionnaire, with their heights and weights measured using a digital electronic SECA beam balance. The selection was done by a two staged stratified random sampling from a total of 226 schools in Kuala Lumpur. The racial distribution was 56.7% Malays, 33.8% Chinese and 8.1% Indians; 3.6% (n:222) of the children were identified as obese and 6% (n:373) identified as overweight. The definitions of obese and overweight were computed using growth charts of the National Centre for Health Statistics (NCHS) from the median of the reference population. There were no significant differences amongst the 3 major ethnic groups in the obese group. The differences were significant in the overweight group with the Indians most overweight, followed by the Chinese and the Malays.
    Matched MeSH terms: United States
  20. Ngan OMY, Bergstresser SM, Sanip S, Emdadul Haque ATM, Chan HYL, Au DKS
    Dev World Bioeth, 2020 06;20(2):105-114.
    PMID: 31241234 DOI: 10.1111/dewb.12239
    Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient-centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision-making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end-of-life care.
    Matched MeSH terms: United States
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