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• Academy Chair in Pharmacology Education
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• University of California, San Francisco

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Patients with heart failure given cilazapril generally have some discount in blood strain cheap 100mg furadantin fast delivery. The threat-profit evaluation signifies that administration of ciprofloxacin to 100mg furadantin paediatric sufferers is acceptable on this setting discount furadantin 100 mg without prescription. Ciprofloxacin has in vitro exercise in opposition to a variety of gram-unfavorable and gram positive microorganisms and has been shown to order 50 mg furadantin mastercard be lively in opposition to most strains of the next microorganisms, each in vitro and in clinical infections. Aerobic Gram-Positive Microorganisms Enterococcus faecalis (many strains are only moderately susceptible), Staphylococcus aureus (methicillin-susceptible strains only), Staphylococcus epidermidis (methicillin-susceptible strains only), Staphylococcus saprophyticus, Streptococcus pneumoniae (penicillin-susceptible strains only), Streptococcus pyogenes. Aerobic Gram-Negative Microorganisms Campylobacter jejuni, Citrobacter diversus, Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Morganella morganii, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Pseudomonas aeruginosa, Salmonella typhi, Serratia marcescens, Shigella boydii, Shigella dysenteriae, Shigella flexneri, Shigella sonnei. Most strains of Burkholderia cepacia and a few strains of Stenotrophomonas maltophilia are proof against ciprofloxacin as are most anaerobic micro organism, including Bacteroides fragilis and Clostridium difficile. Hypersensitivity to ciprofloxacin or any member of the quinolone class of antimicrobials Ciprofloxacin! Severe hypersensitivity reactions characterised by rash, fever, eosinophilia, jaundice, and hepatic necrosis with fatal outcome have also been not often reported in sufferers receiving ciprofloxacin together with different drugs. Pseudomembranous Colitis Pseudomembranous colitis has been reported with nearly all antibacterial agents, including ciprofloxacin, and should range in severity from delicate to life-threatening. Peripheral Neuropathy Rare cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or giant axons resulting in paraesthesias, hypoesthesias, dysesthesias and weak spot have been reported in sufferers receiving quinolones, including ciprofloxacin. Tendon Effects Ruptures of the shoulder, hand, achilles tendon or different tendons that required surgical restore or resulted in prolonged disability have been reported in sufferers receiving quinolones, including ciprofloxacin. These reactions have included cardiac arrest, seizure, status epilepticus, and respiratory failure. Altered serum levels of phenytoin (elevated and decreased) have been reported in sufferers receiving concomitant ciprofloxacin. The concomitant administration of ciprofloxacin with the sulfonylurea glyburide has, on rare occasions, resulted in severe hypoglycaemia. Some quinolones, including ciprofloxacin, have been related to transient elevations in serum creatinine in sufferers receiving cyclosporin concomitantly. Quinolones, including ciprofloxacin, have been reported to improve the consequences of the oral anticoagulant warfarin or its derivatives. Renal tubular transport of methotrexate may be inhibited by concomitant administration of ciprofloxacin doubtlessly leading to elevated plasma levels of methotrexate. Therefore, sufferers underneath methotrexate remedy should be carefully monitored when concomitant ciprofloxacin remedy is indicated. Non-steroidal antiinflammatory drugs (however not aspirin) in combination of very high doses of quinolones have been shown to provoke convulsions in preclinical research. Respiratory: Dyspnea, epistaxis, laryngeal or pulmonary edema, hiccough, haemoptysis, bronchospasm, pulmonary embolism. Central Nervous System: Restlessness, dizziness, lightheadedness, insomnia, nightmares, hallucinations, manic reaction, irritability, tremor, ataxia, convulsive seizures, lethargy, drowsiness, weak spot, malaise, anorexia, phobia, depersonalization, despair, paraesthesia, abnormal gait, grand mal convulsion. Digestive System: Painful oral mucosa, oral candidiasis, dysphagia, intestinal perforation, gastrointestinal bleeding, cholestatic jaundice, hepatitis. Renal/Urogenital: Interstitial nephritis, nephritis, renal failure, polyuria, urinary retention, urethral bleeding, vaginitis, acidosis, breast pain. Skin: Allergic reaction, pruritus, urticaria, photosensitivity, flushing, fever, chills, angioedema, edema of the face, neck, lips, conjunctivae or palms, cutaneous candidiasis, hyperpigmentation, erythema nodosum, sweating. In these sufferers, despair is usually situational and the risks of medications outweigh the advantages. Caution is advisable in using Citalopram in sufferers with ailments or circumstances that produce altered metabolism or haemodynamic responses. All sufferers with these events have recovered with discontinuation of citalopram and/or medical intervention. Seizures Although anticonvulsant results of citalopram have been noticed in animal research, citalopram has not been systematically evaluated in sufferers with a seizure disorder. Citalopram should be introduced with care in sufferers with a history of seizure disorder. Thus, sufferers should be cautioned about using such drugs concurrently with citalopram. The initial reconstituted solution is stable for twenty-four hours when stored at room temperature or refrigerated. The ultimate diluted solution should be used within 6 hours when stored at room temperature or with 24 hours if refrigerated. Clarithromycin exerts its antibacterial action by binding to the 50S ribosomal subunit of susceptible microorganisms resulting in inhibition of protein synthesis. Monitoring of serum theophylline concentrations should be thought-about for sufferers receiving high doses of theophylline or with baseline concentrations within the higher therapeutic range. Elevated digoxin serum concentrations in sufferers receiving clarithromycin and digoxin concomitantly have also been reported in postmarketing surveillance. Some sufferers have shown clinical signs in keeping with digoxin toxicity, including doubtlessly fatal arrhythmias. Serum digoxin concentrations should be carefully monitored whereas sufferers are receiving digoxin and clarithromycin simultaneously. There have been postmarketing reviews of colchicine toxicity with concomitant use of clarithromycin and colchicine, especially within the aged, a few of which occurred in sufferers with renal insufficiency. Rare reviews of rhabdomyolysis have been reported in sufferers taking these drugs concomitantly. A similar interaction could occur with clarithromycin; discount of sildenafil dosage should be thought-about. It has exercise in opposition to Gram-positive aerobes and anaerobes as well as the Gram-unfavorable anaerobes. Immediately earlier than use, mix the clonazepam solution totally with contents of the diluent vial.

Machado et al206 performed a scientific randomly allocated to furadantin 50mg line obtain both exercise/mobilization evaluate and meta-analysis of eleven trials utilizing the McKenzie selling lumbar backbone extension or lumbopelvic strength treatment approach cheap furadantin 100mg visa. Subjects in both teams attended eight physical therapy proved outcomes compared to buy discount furadantin online passive remedies cheap furadantin 50mg otc. The observe-up at 12 weeks favored advice to stay energetic over sufferers who acquired the extension-oriented treatment ap McKenzie exercise, raising questions on the lengthy-time period clini proach skilled higher reductions in incapacity compared cal efectiveness of the McKenzie methods for administration to these topics who acquired lumbopelvic strengthening of sufferers with low again ache. The authors concluded that these sufferers who centralize with lumbar ex Long and colleagues202 investigated whether a rigidity movements preferentially beneft from an extension McKenzie examination and observe-up on 312 pa oriented treatment approach. I tients with acute, subacute, and persistent low again ache would elicit a directional desire in these sufferers. The authors also sought to determine if these extension (83%), fexion (7%), and lateral responders (10%). Therapists expert in using the McKenzie exercises matching the affected person�s directional desire, (2) methodology participated within the research. The authors discovered directional exercises opposite the affected person�s directional pref that the general prevalence of directional desire and cen erence, or (3) nondirectional exercises. Results indicated tions in ache, ache treatment use, and incapacity occurred that sufferers whose symptoms confirmed directional desire within the directional exercise group that was matched to their with centralization at consumption reported better useful sta directional desire. The authors counsel that implication of this research is that the affected person response criteria this research �provides further validity by demonstrating that a sub concerning directional desire and centralization ought to be ject-specifc treatment is superior to others in creating good thought-about as impartial variables when analyzing affected person outcomes. In addition to the affected person education, the ma concluded from the analyses that these topics who exhib nipulation group acquired thrust and nonthrust manipu ited a directional desire or centralization response who lation in addition to trigger-level massage at the discretion of then acquired a matched treatment had a 7. McKenzie methodology teams acquired interventions according to the McKenzie methodology (centralization exercises and pro A multicenter randomized controlled trial by cedures) at the discretion of the treating clinician however have been Browder et al36 looked to examine the efectiveness not allowed to use mobilization/manipulation interventions. I of an extension-oriented treatment approach in At 2 months� observe-up, the McKenzie treatment was supe sufferers with low again ache. The authors included a homo rior to manipulation with respect to the variety of sufferers geneous subgroup of sufferers who responded with central who reported success after treatment (71% and 59%, respec journal of orthopaedic & sports physical therapy | volume 42 | quantity four | april 2012 | a35 Low Back Pain: Clinical Practice Guidelines tively). The imply improvement in incapacity as of incapacity compared to the manipulation group, reaching a measured by the Roland-Morris Disability Index score was statistical signifcance at 2 and 12 months� observe-up. Pain at worst was ments, exercises, or procedures to promote central also decreased by a imply of 3. All sufferers have been handled with end-range presentation according to central lumbar spinal stenosis. All sufferers demonstrated reduc nosis to 1 of two six-week physical therapy applications: (1) a person tions in numeric ache ranking. Five of 6 sufferers reported a ual therapy, exercise, and physique weight�supported treadmill discount or elimination of their thigh, lower-leg, or foot walking group; and (2) a lumbar fexion exercise, treadmill symptoms, in which 2 sufferers now not had symptoms and walking, and walking program group. Patients within the handbook 3 sufferers reported the situation of symptoms to be in a extra therapy group reported higher restoration at 6 weeks, with a proximal location at discharge. At discharge, the droop-stretch ercise emphasizing lumbar fexion and extension to enhance ing group exhibited signifcantly decreased incapacity; general a36 | april 2012 | volume 42 | quantity four | journal of orthopaedic & sports physical therapy Low Back Pain: Clinical Practice Guidelines perceived ache; and thigh, lower-leg, or foot symptoms. Hall and pared traction to a sham traction intervention, I colleagues137,138 demonstrated an increase in straight leg increase with no signifcant diferences discovered between range of motion following treatment utilizing end-range nerve teams. Beurskens et al24 randomized 151 topics with a mobilization (straight leg raising combined with handbook 6-week history of nonspecifc low again ache to obtain both lower-limb traction) in a cohort of sufferers with neurogenic traction (35%-50% of physique weight) or sham traction (maxi lower extremity complaints. Schimmel et al267 compared trac mobilization procedures in affected person status submit�lumbar backbone tion via the Intervertebral Diferential Dynamics Therapy surgery (discectomy, laminectomy, or fusion). In addition to device (50% physique weight + 10 lb of force) to sham interven baseline measures, observe-up data for ache and incapacity tion with the identical device (10 lb of force) in topics with a have been collected at 6 weeks, 6 months, and 12 months after history of higher than 3 months of nonspecifc low again and surgery. Subjects acquired 20 visits over 6 weeks, with ache, ferences between the teams for any of the outcomes at any incapacity, and high quality of life measured at 2, 6, and 14 weeks. Due to the heterogeneity of affected person popula Both treatment regimens confirmed signifcant improvement tion and treatment, results must be interpreted with warning. However, no sig However, presently, no different data counsel that nerve mobili nifcant between-group diferences have been current at observe-up. The results confirmed Clinicians ought to consider utilizing lower-quarter a higher discount in incapacity and concern-avoidance beliefs nerve mobilization procedures to scale back ache and for topics within the traction group at the 2-week observe-up. C incapacity in sufferers with subacute and persistent low However, at 6 weeks, there was no statistical diference. Although this subgroup of sufferers with 25 randomized controlled trials that included sufferers with low again ache is probably going small, the authors conclude that this acute, subacute, or persistent low again ache, with or without subgroup is characterized by the presence of sciatica, signs of sciatica. Of the 25 chosen randomized controlled trials, only nerve root compression, and both peripheralization with ex 5 trials have been thought-about prime quality. Based on the obtainable rigidity movements or a optimistic crossed straight leg increase check. The authors concluded that intermittent again ache and proof of a degenerative and/or journal of orthopaedic & sports physical therapy | volume 42 | quantity four | april 2012 | a37 Low Back Pain: Clinical Practice Guidelines herniated intervertebral disc at 1 or extra levels of the lumbar and graded publicity, in quite a lot of populations; and (3) backbone. Each affected person acquired prone lumbar traction utilizing the education of sufferers on the physiology of ache. The numeric ache ranking scale and the Roland-Morris Dis Previous medical practice guidelines typically rec ability Questionnaire have been accomplished at preintervention, at ommend clinicians to counsel their sufferers to (1) I discharge, and at 30 days and 180 days after discharge. The investigators discovered that Treatment of Low Back Pain� from the American College sufferers reported signifcantly improved ache and Roland of Physicians and the American Pain Society state, �Clini Morris Disability Questionnaire scores after 16 to 24 visits cians ought to present sufferers with proof-primarily based informa of prone traction at discharge, and at 30 days and 180 days tion on low again ache with regard to their expected course, postdischarge. It ought to be famous that there was no control advise sufferers to stay energetic, and supply info group and that there have been giant variations within the magnitude about efective self-care options (robust recommendation, of change within the consequence measures used. More concerned education regarding appro acute, nonradicular low again ache or in sufferers with persistent priate exercise and useful actions to promote energetic low again ache. A survey of acknowledged booklet in sufferers with low again ache being seen in a pri medical specialists in orthopaedic physical therapy identi mary care setting. Traditional info and advice about fed that affected person education strategies consisting of �Educate again ache have been primarily based on a biomedical model with em affected person in home care treatment program� and �Recommends phasis on anatomy, biomechanics, and pathology.

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Careful monitoring of serum theophylline concentrations in sufferers receiving fluconazole and theophylline is recommended cheap generic furadantin uk. Dermatological: Skin rash generic 100mg furadantin with amex, exfoliative skin issues together with Stevens-Johnson Syndrome and poisonous epidermal necrolysis Fluconazole! Flumazenil might produce convulsions in sufferers bodily dependent on benzodiazepines 100mg furadantin fast delivery. Possible danger factors for seizures include: concurrent major sedative-hypnotic drug withdrawal discount furadantin 100mg online, recent therapy with repeated doses of parenteral benzodiazepines, myoclonic jerking or seizure activity prior to flumazenil administration in overdose circumstances, or concurrent cyclic anti-depressant poisoning. Nervous System: Agitation (nervousness, nervousness, dry mouth, tremor, palpitations, insomnia, dyspnea, hyperventilation), dizziness (vertigo, ataxia), emotional lability (crying irregular, depersonalisation, euphoria, increased tears, melancholy, dysphoria, paranoia). Special Senses: Abnormal Vision (visual field defect, diplopia), Paraesthesia (sensation irregular, hypoaesthesia). Caution is advisable in using Prozac in sufferers with illnesses or situations that could have an effect on metabolism or haemodynamic responses. Hyponatraemia Cases of hyponatraemia (some with serum sodium decrease than a hundred and ten mmol/L) have been reported. Doses of 100mg/hr by infusion could also be required in those with significant renal impairment. Ototoxicity Cases of tinnitus and reversible or irreversible listening to impairment have been reported. Usually, reports point out that frusemide ototoxicity is associated with rapid injection, severe renal impairment, doses exceeding several occasions the usual recommended dose, or concomitant therapy with aminoglycoside antibiotics or different ototoxic drugs. Digitalis therapy might exaggerate metabolic effects of hypokalaemia, especially myocardial effects. Systemic Hypersensitivity Reactions: Systemic vasculitis, interstitial nephritis, and necrotising angiitis. Central Nervous System Reactions: Tinnitus and listening to loss, paraesthesias, vertigo, dizziness, headache, blurred vision, and xanthopsia. Haematologic Reactions: Aplastic anaemia (uncommon), thrombocytopaenia, agranulocytosis (uncommon), haemolytic anaemia, leukopaenia, and anaemia. Dermatologic-Hypersensitivity Reactions: Exfoliative dermatitis, erythema multiforme, purpura, photosensitivity, urticaria, rash, and pruritus. Cardiovascular Reaction: Orthostatic hypotension might occur and be aggravated by alcohol, barbiturates or narcotics. Other Reactions: Hyperglycaemia, glycosuria, hyperuricaemia, muscle spasm, weaknesses, restlessness, urinary bladder spasm, thrombophlebitis, and fever. Each vial incorporates 500mg of powder Reconstitute every vial with 10ml of water for injection (giving a focus of 50mg/ ml). Prepare immediately before use; reconstituted answer is secure at room temperature for 12 hours Store at room temperature. Granulocytopaenia (neutropaenia), anaemia and thrombocytopaenia have been observed in sufferers handled with ganciclovir. The frequency and severity of these events range extensively in different patient populations. Generalized seizures have been reported in sufferers who acquired ganciclovir and imipenem-cilastatin. It is lively towards a wide variety of pathogenic micro organism together with Escherichia coli, Proteus species (indole-constructive and indole-adverse), Pseudomonas aeruginosa, species of the Klebsiella-Enterobacter-Serratia group, Citrobacter species, and! The following micro organism are often resistant to aminoglycosides: Streptococcus pneumoniae, most species of streptococci, particularly group D and anaerobic organisms, corresponding to Bacteroides species or Clostridium species. The danger of nephrotoxicity is greater in sufferers with impaired renal perform and in those who obtain high dosage or prolonged therapy. Ototoxicity Neurotoxicity manifested by ototoxicity, each vestibular and auditory, can occur in sufferers handled with gentamicin, primarily in those with pre-current renal damage and in sufferers with regular renal perform handled with higher doses and/or for longer periods than recommended; nevertheless, it could occur within the absence of these danger factors. The concurrent use of gentamicin with potent diuretics, corresponding to frusemide, ought to be avoided, since certain diuretics by themselves might cause ototoxicity. In addition, when administered intravenously, diuretics might enhance aminoglycoside toxicity by altering the antibiotic focus in serum and tissue. Instead, reconstitute 25 vials of glucagon using water for injection, then dilute to a total of 25ml using 5% dextrose. Glucagon has constructive inotropic and chronotropic effects just like those of beta adrenergic agonists. Transdermal: Usually begin with 5mg/24 hours patch; most two 10mg/24 hours patches! Dilation of the postcapillary vessels, together with giant veins, promotes peripheral pooling of blood and decreases venous return to the center, thereby lowering left ventricular end-diastolic stress (preload). Arteriolar relaxation reduces systemic vascular resistance and arterial stress (afterload). Protection towards the peripheral muscarinic effects of cholinergics given to reverse neuromuscular blockade 2. Glycopyrrolate, like different anticholinergic (antimuscarinic) agents, inhibits the action of acetylcholine on structures innervated by postganglionic cholinergic nerves and on easy muscle tissue that reply to acetylcholine but lack cholinergic innervation. Exposure to excessive amounts of benzyl alcohol has been associated with toxicity (hypotension, metabolic acidosis), particularly in neonates. Use with caution in sufferers with: coronary artery disease; congestive coronary heart failure; cardiac arrhythmias; hypertension; hyperthyroidism. Infants, sufferers with Down�s syndrome, and paediatric sufferers with spastic paralysis or brain damage might experience an increased response to anticholinergics, thus increasing the potential for unwanted effects. Avoid repeated dosage because of accumulation 10-20 Dose as in regular renal perform >20-50 Dose as in regular renal perform! The syndrome often develops with high doses given over a prolonged interval; nevertheless, it could possibly develop, although a lot much less generally, after relatively brief treatment periods at low doses.

Vivat B Measures of religious issues for palliative care patients: a literature evaluate Palliat Med 2008;22(7):859-868 cheap 100mg furadantin with visa. Wachholtz A discount furadantin 50mg fast delivery, Pearce M cheap furadantin american express, Koenig H Exploring the connection between spirituality purchase furadantin 100mg online, coping, and pain J Behav Med. Wall R, Engelberg R, Gries C, Glavan B, Curtis J Spiritual care of households within the intensive care unit Crit Care Med. Winkelman W, Lauderdale K, Balboni M et al the connection of religious considerations to the quality of lifetime of advanced most cancers patients: Preliminary fndings. Provider diffculties with religious and forgiveness communication on the finish of life Am J Hosp Palliat Care. American Association of Colleges of Nursing Culture Competencies for Graduate Nursing Students Washington, District of Columbia: American Association of Colleges of Nursing; 2010 Anderson N, Andrews M, Bent K et al Chapter 5: Culturally primarily based well being and sickness beliefs and practices across the lifespan Based Health and Illness Beliefs and Practices Across the Life Span J Transcul Nurs. Arenella C Hospice and palliative take care of African Americans: Overcoming disparities J Palliat Med 2016;19(2):126-126. Barnato A, Anthony D, Skinner J, Gallagher P, Fisher E Racial and ethnic variations in preferences for finish-of-life therapy J Gen Intern Med. Berkman C, Ko E Preferences for disclosure of information about severe sickness among older Korean American immigrants in New York City J Palliat Med. Bhat A, Wehbe-Alamah H, McFarland M, Filter M, Keiser M Advancing cultural assessments in palliative care utilizing net-primarily based training J Hosp Palliat Nurs. Boucher N, Guadalupe E, Lara L, Alejandro M Health care and finish-of-life decisions: Community engagement with adults in east Harlem J Community Health. Carr D Racial variations in finish-of-life planning: Why don�t Blacks and Latinos put together for the inevitable Carrion I, Cagle J, Van Dussen D, Culler K, Hong S Knowledge about hospice care and beliefs about pain management Am J Hosp Palliat Care. Examining cultural factors that infuence therapy decisions: A pilot research of Latino males with most cancers J Cancer Educ. Carrion I, Park N, Lee B Hospice use among African Americans, Asians, Hispanics, and Whites Am J Hosp Palliat Care. Carteret, M �Cross-cultural Values of Latino Families � Dimensions of Culture 2008 Web 21 Oct 2010 Cartwright C, Hughes M, Lienert T End-of-life take care of homosexual, lesbian, bisexual and transgender people Cult Health Sex. The blessings and the curses of flial piety on dignity on the finish of life: Lived expertise of Hong Kong Chinese adult children caregivers J Ethn Cult Divers Soc Work 2012;21(four):277-296. Chettih M Turning the lens inward: Cultural competence and providers� values in well being care choice making Gerontologist. Coats H, Crist J, Berger A, Sternberg E, Rosenfeld A African American elders� severe sickness experiences Qual Health Res. Colclough Y, Young H Decision making at finish of life among Japanese American households J Fam Nurs 2007;thirteen(2):201-225. Colclough Y Native American dying taboo: Implications for well being care providers Am J Hosp Palliat Care. Colon M Acculturation and attitudes of Latinos towards hospice J Soc Work End Life Palliat Care. Committee on Advancing Pain Research A call for cultural transformation of attitudes towards pain and its prevention and management J Pain Palliat Care Pharmacother. Davies B, Larson J, Contro N, Cabrera A Perceptions of discrimination among Mexican American households of seriously sick children J Palliat Med. Davies B Conducting a qualitative tradition research of pediatric palliative care Qual Health Res. DeSanto-Madeya S, Nilsson M, Loggers E et al Associations between United States acculturation and the tip-of-life expertise of caregivers of patients with advanced most cancers J Palliat Med. Doolen J, York N Cultural variations with finish-of-life care within the critical care unit Dimens Crit Care Nurs. Doorenbos A, Lindhorst T, Schim S et al Development of an internet-primarily based instructional intervention to enhance cross-cultural communication among hospice providers J Soc Work End Life Palliat Care. Elliott A, Alexander S, Mescher C, Mohan D, Barnato A Differences in physicians� verbal and nonverbal communication with Black and White patients on the finish of life J Pain Symptom Manage 2016;fifty one(1):1-eight. Evan B, Ume E Psychosocial, cultural, and religious heatlh disparities in finish-of-life and palliative care: Where are we and the place do we need to go Nurs Outlook. Evans B, Coon D the �Reckoning Point� as a marker for formal palliative and finish-of-life care in Mexican American households J Fam Nurs. Feldstein C, Grudzen M, Johnson A, LeBaron S Integrating spirituality and tradition with finish-of-life care in medical training Clin Gerontol. Gao X, Sun F, Ko E, Kwak J, Shen H Knowledge of advance directive and perceptions of finish-of-life care in Chinese-American elders: the function of acculturation Palliat Support Care. Hampton M, Baydala A, Bourassa C, et al Completing the circle: Elders speak about finish-of-life care with Aboriginal households in Canada J Palliat Care. Heyman J, Gutheil I Older Latinos� attitudes towards and luxury with finish-of-life planning Health Soc Work. Hilliard T, Washington T, Hines C, McGill T Wishes left unspoken: Engaging underserved populations in finish-of-life advance care planning J Health Care Poor Underserved. Hutchinson S, Hersch G, Davidson H, Chu A, Mastel-Smith B Voices of elders J Transcult Nurs 2011;22(four):397-404. Johnstone M, Kanitsaki O Ethics and advanced care planning in a culturally diverse society J Transcultur Nurs. Kataoka-Yahiro M, McFarlane S, Koijane J, Li D Culturally competent palliative and hospice care training for ethnically diverse staff in lengthy-time period care services Am J Hosp Palliat Care 2016;34(four):335-346.