The role of acculturation in the process of advance care planning among Chinese immigrants:A narrative systematic review

Background: Acculturation is the process of two different cultures coming into contact. It is unclear how acculturation influences Chinese immigrants’ engagement in advance care planning due to the complexity and multifaceted nature of both acculturation and advance care planning. Aims: To synthesize evidence regarding the role of Chinese immigrants’ acculturation in their engagement in advance care planning. Design: Systematic mixed-method review, registered in PROSPERO (CRD42021231822). Data sources: EMBASE, MEDLINE, Web of Science, and Google Scholar were searched for publications until January 21, 2021. Results: Twenty-one out of 1112 identified articles were included in the analysis. Of those 21 articles, 17 had a qualitative design and 13 originated from the United States. Three of four quantitative studies reported that higher acculturation levels were associated with better knowledge or higher rate of engagement in advance care planning. Analysis of qualitative studies showed that Chinese immigrants’ engagement in advance care planning was associated with their: (1) self-perceived cultural identity (native or non-native); (2) interpretation of filial piety (traditional or modern); and (3) interpretation of autonomy (individual or familial). To facilitate their engagement, Chinese immigrants prefer an implicit approach, non-family-related initiators, contextualization advance care planning in Chinese culture and using Chinese language. Conclusion: Chinese immigrants’ willingness to engage in advance care planning varied with their acculturation level. To engage them in advance care planning, we recommend adapting the introduction of advance care planning to address people’s perceptions of their cultural identity, filial piety, and autonomy, as well as their preference for certain approach, initiator, context, and language.</p

The uptake of advance care planning by older adults in New Zealand : a thesis presented in partial fulfilment of the requirements for a Master of Arts in Psychology at Massey University, Manawatu Campus, New Zealand

Advance Care Planning refers to planning for end-of-life care in a proactive and comprehensive manner, preferably using a planning template. This is the first nationwide study since the formal introduction of Advance Care Planning to New Zealand in 2010, to look at the level of uptake among older adults in New Zealand. Four thousand and twenty-eight participants were surveyed about completion of living wills, enduring powers of attorney and advance care plans. Participants were also asked who they had discussed end-of-life matters with. The data was analysed using descriptive and inferential methods, including analysising demographic data for correlations with Advance Care Planning activities. Following the survey, nine participants were chosen by convenience sample to be interviewed. Thematic analysis was applied to the interview data. The interviews explored the contextual factors and decision-making processes underpinning end-of-life-care choices. The study found that uptake was low for all forms of planning documentation although enduring powers of attorney were the most commonly completed document. Advance Care Plan discussions occurred very regularly, with nearly half of the participants having discussions in the six months preceding the survey. These were most often with family and friends and seldom with health professionals. Bivariate correlation analysis showed weak to moderate correlations between age, physical health, gender, ethnicity, and Advance Care Plan activities. Logistic regression was used to explore the completion of advance care planning templates. This revealed that the most influential factors were completing a living will or enduring power of attorney; having a discussion with a legal representative; speaking with a spiritual advisor; and being non-Māori. The qualitative interviews found seven major themes covering knowledge of ACP, the process and timing of planning, independence, who should be part of the planning process and what had been learned from previous experiences. Overall, this study reveals that, despite health promotion efforts, uptake of formal Advance Care Planning remains low in New Zealand. Further work is needed to educate the public about Advance Care Planning and to support health professionals to initiate and maintain the ACP process

The Stochastic Advance-Retreat Course: An Approach to Analyse Social-Economic Evolution

The paper presents the basic theory and conceptual model for advance-retreat course and provides the analytic model the stochastic advance-retreat course and the solving method of it, discusses the relations between the endogenous resistance and subject interests increase with the periodic vibration in an advance-retreat course, gets some results, like heightening appropriately the risk-free interest rate will be favorable to subject interests’ increasing in stable, interests increasing in high-speed will result in the fast increase of resistance, the subject progress in a appropriate pace may bring the conclusion such as lasting interests increase and return with higher-level interests, etc. Finally, the empirical researches empirical, on data of USA GDP (chained) price index, has been made to the stochastic advance-retreat model, and the results show that the stochastic advance-retreat model can describe USA economic development process in recent 65 years.Economic process; advance-retreat course; the basic theory; analytic model

Hysteresis of Backflow Imprinted in Collimated Jets

We report two different types of backflow from jets by performing 2D special relativistic hydrodynamical simulations. One is anti-parallel and quasi-straight to the main jet (quasi-straight backflow), and the other is bent path of the backflow (bent backflow). We find that the former appears when the head advance speed is comparable to or higher than the local sound speed at the hotspot while the latter appears when the head advance speed is slower than the sound speed bat the hotspot. Bent backflow collides with the unshocked jet and laterally squeezes the jet. At the same time, a pair of new oblique shocks are formed at the tip of the jet and new bent fast backflows are generated via these oblique shocks. The hysteresis of backflow collisions is thus imprinted in the jet as a node and anti-node structure. This process also promotes broadening of the jet cross sectional area and it also causes a decrease in the head advance velocity. This hydrodynamic process may be tested by observations of compact young jets.Comment: 9 pages, 5 figures, accepted for publication in ApJ

Optimizing a Law School’s Course Schedule

[Excerpt] “Just like other educational institutions, law schools must schedule courses by taking into consideration student needs, faculty resources, and logistical support such as classroom size and equipment needs. Course scheduling is an administrative function, typically handled by an Assistant Dean or an Associate Dean, who works with the faculty and the registrar to balance these considerations in advance of the registration process. Usually, the entire academic year is scheduled in advance, although the spring semester may be labeled tentative until registration begins for that semester. It’s hard to imagine, but some schools even publish a two-year schedule of upper-division courses so that students can plan their entire law school career in advance. In order to give assistance to those academics involved for the first time in the scheduling process, this article discusses the law school scheduling process and how a scheduling software package has worked to successfully automate what has been seen as one of the most abysmal administrative tasks of an Associate Dean. We first provide a background to course scheduling at a typical law school. We then present a review of the tools for, and literature on, course scheduling, followed by a discussion of how technology can be applied to course scheduling in general, and our outcomes of applying this technology in a law school environment. We close with a brief summary.

Hysteresis of Backflow Imprinted in Collimated Jets

We report two different types of backflow from jets by performing 2D special relativistic hydrodynamical simulations. One is anti-parallel and quasi-straight to the main jet (quasi-straight backflow), and the other is bent path of the backflow (bent backflow). We find that the former appears when the head advance speed is comparable to or higher than the local sound speed at the hotspot while the latter appears when the head advance speed is slower than the sound speed bat the hotspot. Bent backflow collides with the unshocked jet and laterally squeezes the jet. At the same time, a pair of new oblique shocks are formed at the tip of the jet and new bent fast backflows are generated via these oblique shocks. The hysteresis of backflow collisions is thus imprinted in the jet as a node and anti-node structure. This process also promotes broadening of the jet cross sectional area and it also causes a decrease in the head advance velocity. This hydrodynamic process may be tested by observations of compact young jets.Comment: 9 pages, 5 figures, accepted for publication in ApJ

A website supporting sensitive religious and cultural advance care planning (ACPTalk): Formative and summative evaluation

Background: Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations. ACPTalk aimed to provide religion-specific advance care planning content and complement existing resources. Objective: The purpose of this paper was to utilize the context, input, process, and product (CIPP) framework to conduct a formative and summative evaluation of ACPTalk. Methods: The CIPP framework was used, which revolves around 4 aspects of evaluation: context, input, process, and product. Context: health professionals’ solutions for the website were determined through thematic analysis of exploratory key stakeholder interviews. Included religions were determined through an environmental scan, Australian population statistics, and documentary analysis of project steering committee meeting minutes. Input: Project implementation and challenges were examined through documentary analysis of project protocols and meeting minutes. Process: To ensure religion-specific content was accurate and appropriate, a website prototype was built with content review and functionality testing by representatives from religious and cultural organizations and other interested health care organizations who completed a Web-based survey. Product: Website analytics were used to report utilization, and stakeholder perceptions were captured through interviews and a website survey. Results: Context: A total of 16 key stakeholder health professional (7 general practitioners, 2 primary health nurses, and 7 palliative care nurses) interviews were analyzed. Website solutions included religious and cultural information, communication ideas, legal information, downloadable content, and Web-based accessibility. Christian and non-Christian faiths were to be included in the religion-specific content. Input: Difficulties gaining consensus on religion-specific content were overcome by further state and national religious organizations providing feedback. Process: A total of 37 content reviewers included representatives of religious and cultural organizations (n=29), health care (n=5), and community organizations (n=3). The majority strongly agree or agree that the content used appropriate language and tone (92%, 34/37), would support health professionals (89%, 33/37), and was accurate (83%, 24/29). Product: Resource usage within the first 9 months was 12,957 page views in 4260 sessions; majority were (83.45%, 3555/4260) from Australia. A total of 107 Australian-based users completed the website survey; most felt information was accurate (77.6%, 83/107), easy to understand (82.2%, 88/107), useful (86.0%, 92/107), and appropriate (86.0%, 92/107). A total of 20 nurses (general practice n=10, palliative care n=8, and both disciplines n=2) participated in stakeholder interviews. Qualitative findings indicated overall positivity in relation to accessibility, functionality, usefulness, design, and increased knowledge of advance care planning. Recommended improvements included shortened content, a comparable website for patients and families, and multilingual translations. Conclusions: The CIPP framework was effectively applied to evaluate the development and end product of an advance care planning website. Although overall findings were positive, further advance care planning website development should consider the recommendations derived from this study

Boating Against the Current: The Advance-Retreat Analysis for Socio-Economic Process

Boating against the current is a kind of human behavior which can generalize many real socio-economic processes. Starting from the view of point, this paper suggests the problem for advance-retreat course and builds the general analytic models of advance-retreat. By the models, we could see the endogenous resistances, instead of exogenous resistances, causes the periodic fluctuation in socio-economic process, and get the critical condition under which the periodic fluctuation is occured. A series of results for developing motivity and investing strategies are obtained. Finally, the conclusions and strategies are illuminated to be rational and maneuverable by two examples.socio-economic development; advancing motivity; environment resistance; advance-retreat course

The meaning of life in a developing universe

The evolution of life on Earth has produced an organism that is beginning to model and understand its own evolution and the possible future evolution of life in the universe. These models and associated evidence show that evolution on Earth has a trajectory. The scale over which living processes are organized cooperatively has increased progressively, as has its evolvability. Recent theoretical advances raise the possibility that this trajectory is itself part of a wider developmental process. According to these theories, the developmental process has been shaped by a larger evolutionary process that involves the reproduction of universes. This evolutionary process has tuned the key parameters of the universe to increase the likelihood that life will emerge and develop to produce outcomes that are successful in the larger process (e.g. a key outcome may be to produce life and intelligence that intentionally reproduces the universe and tunes the parameters of ‘offspring’ universes). Theory suggests that when life emerges on a planet, it moves along this trajectory of its own accord. However, at a particular point evolution will continue to advance only if organisms emerge that decide to advance the evolutionary process intentionally. The organisms must be prepared to make this commitment even though the ultimate nature and destination of the process is uncertain, and may forever remain unknown. Organisms that complete this transition to intentional evolution will drive the further development of life and intelligence in the universe. Humanity’s increasing understanding of the evolution of life in the universe is rapidly bringing it to the threshold of this major evolutionary transition