JAPANESE CASE STUDY #1

This case study is a composite of actual situations. Marianne, who is American, and Ken Shimizu, who is Japanese, have worked in Tokyo for over 30 years as Methodist missionaries. They have annual furloughs and occasional sabbaticals, during which they visit relatives and sponsoring organizations and engage in continuing education in the United States. They met as college students in the United States, and their three grown children have established their own careers in the United States.

Ken’s 98-year-old mother resides with Marianne and Ken. She is not Christian but has always been extremely supportive of Ken and Marianne’s work. Ken teaches at a large Christian university, whereas Marianne has served in various church-related positions over the years. As missionaries, they live in subsidized post–World War II housing near Ken’s university. Marianne has been a frugal housewife, preparing local foods in the Japanese style for her family.

Ken, who is nearly 60, recently learned that he has glaucoma. By the time it was discovered, he had lost a significant amount of peripheral vision. Although Marianne delivered all three children at a Christian hospital in Tokyo, she gets her annual physical examination when visiting relatives in the United States. She has never believed that the Japanese health system is as proactive as that in the United States.On her most recent visit to the United States, Marianne learned that she has hypertension. Her physician prescribed a medication that is readily available in Japan, but the physician was concerned about the level of stress in Marianne’s life. Mother Shimizu is quite confused and requires considerable care, but it is unthinkable for Ken, the only child, to put his mother in a long-term-care facility. Even if he would, the

quality of facilities in Japan leaves much to be desired. Most of the responsibility for Mother Shimizu falls on Marianne, in addition to her work. Marianne’s relatives are urging her to consider placing Mother Shimizu in a church-related life-care community near Marianne’s family in the United States, where Marianne and Ken would like to retire. Marianne’s own parents lived in this facility at the end of their lives. She is considering these issues as she returns to Tokyo.

Study Questions

1. Identify some of the cultural issues that may lead to conflict in this international family.
2. What are the family resources for this international family?
3. What factors within the Japanese health system may account for the late diagnosis of Ken’s glaucoma?
4. What practical issues might arise for the Shimizus if Mother Shimizu were placed in a long-term-care facility in the United States?
5. What dietary factors may contribute to Marianne’s hypertension?
6. In what ways might you consider Ken to be countercultural as a Japanese man?
7. What social pressures might Marianne have faced, given some of her choices, as a housewife in Japan?
8. What pressures will Ken likely experience as he considers how to meet the needs of both his mother and his wife?
9. Compare and contrast the fertility and mortality rates of Japan and the United States.
10. Do the traditional Japanese maintain sustained eye contact with strangers? Why or why not?
11. To which drugs might Japanese people have greater sensitivity than that of white ethnic populations?
12. How do most Japanese people meet their need for calcium?

CHINESE CASE STUDY #1

An elderly, Asian-looking man is admitted to the emergency room with chest pain; difficulty breathing; diaphoresis; vomiting; pale, cold, clammy skin; and apprehension. Three people, speaking a mixture of English and a foreign language to one another, accompany him. The nurse tries to speak English with the man, but he cannot understand anything she says. Accompanying the elderly man are two women (one elderly and very upset and one younger who stands back from the other three people) and one younger man.

The younger man states that the elderly man, whose name is Li Ying Bin, is his father; the elderly woman, his mother; and the younger woman, his wife. The son serves as the translator. Li Ying Bin comes from a small village close to Beijing. He is 68 years old, and he has been suffering with minor chest pain and has had trouble breathing for 2 days. He is placed in the cardiac room, and the assessment continues.

Mr. Li is on vacation, visiting his son and daughter-in-law in the city. His son and daughter-in-law have been married for only 1 year, but the son has lived in the West for 7 years. Mr. Li’s daughter-in-law looks Chinese but was born in the United States. She does not speak very many words of Chinese.

Further physical assessment reveals that Mr. Li has a history of “heart problems,” but the son does not know much about them. Mr. Li had been to the hospital in Beijing but did not like the care he received there and returned home as soon as possible. He goes to the local clinic periodically when the pain increases, and the health-care provider in China used traditional Chinese medicine, herbs, and acupuncture. In the past, those

treatments relieved his symptoms.

Medications are ordered to relieve pain, and Mr. Li undergoes diagnostic procedures to determine his cardiac status. The studies reveal that he did sustain massive heart damage. Routine interventions are ordered, including heart medications, anticoagulants, oxygen, intravenous fluids, bedrest, and close monitoring. His condition is stabilized, and he is sent to the cardiac intensive-care unit.

In the cardiac unit, the nurse finds Mrs. Li covering up Mr. Li until he sweats, and Mrs. Li argues with the nurse every time her husband is supposed to dangle his legs. She complains that he is too cold and brings in hot herbal beverages for him to drink. She does not follow the nurse’s and physician’s orders for dietary restrictions, and she begins to hide her treatments from the staff. Her son and daughter-in-law try to explain to her that this is not good, but she continues the traditional Chinese medicine treatments.

Mr. Li is a very quiet patient. He lies in bed and never calls for help. He frequently seems to be meditating and exercising his arms. When he does talk to his son, he speaks of the airplane ride and the problems of being so high. He believes that may have caused his current heart problem. Mr. Li also wonders if Western food could be bad for his system. Mr. Li’s condition gradually deteriorates over the next few days. Nurses and physicians attempt to tell the family about his condition and possible death, but the family will not talk with them about it. Mr. Li dies on the 5th day.

Study Questions

1. If you were to go to China on a business trip, how would you design your name card so that the Chinese would not be confused ?
2. If you wished to have a meeting with a Chinese delegation of health-careproviders, would you expect them to be on time? Why?
3. If the meeting included a meal with Chinese food, what kinds of foodwould you expect to be served? How would it be presented? If somethingwere served that you do not like, would you eat it anyway?
4. Compare and contrast the Chinese meaning of life and way of thinkingwith the Western meaning of life and way of thinking.
5. What are the common health risks for the development of chronicobstructive pulmonary disease among Chinese people?
6. What are some of the reasons that Mr. Li waited so long to enter thehospital?
7. Mr. Li did not complain of chest pain in the cardiac intensive-care unit. Isthis a common behavior? Why?
8. True or False: The Chinese family will expect health-care providers at thehospital to provide most of the care for Mr. Li.
9. Why must the physician be careful with the amounts of medicationordered?
10. Mrs. Li is curt, demanding, and disagreeable toward her daughter-in-law.Why does she act this way?
11. Explain why Mr. Li blames the airplane ride and the Western food for hisheart attack. Why does he meditate and do exercises?
12. Is Mr. Li’s stoicism during dying surprising? Why do the family members refuse to discuss his health and possible death?
13. What is the preferred method for handling the remains of a deceasedChinese person?
14. Describe common mourning rituals for the Chinese.
15. Describe bereavement in a Chinese family.
16. Describe a common view of death among Chinese.

For those who are intending to join any kind of relationship, you need to know how to find a suitable partner. It may be a hard task when you have never attempted this prior to and you are fully unaware about how to go about it. You are able to ask good friends, family and also search the online world to help you with it. When searching a date on the Internet, keep a lot of important points in mind:

Background Checks This is perhaps among the important things to consider while seeking for a suited date on the web: do they have a good enough record or is definitely he/she an individual who has had any sort of bad encounters in the past? Examine their profile and find out how much time they have been internet dating; how many people have they dated, precisely what are their current occupation and hobbies? Seeing that the online environment offers you a broad gamut of options when it comes to dating sites, however, you should also visit a site that wont only cause you to meet like-minded people, nonetheless also easily fit into your compartment and at the same time match like-minded people.

Net Speed in the Internet is likewise of vital importance. Those who are trying to search hot iceland girls for that suitable night out on the Net should seek out sites offering their users unlimited downloads available. Some sites can present you with instant access to their databases and hence you can get all the information you need within minutes. This can definitely make the complete process faster and also save you a lot of time.

Payment Alternatives One very crucial aspect while looking for that suitable date on the Internet is the sort of payment it would be easiest offered. Even though the basic and most necessary option may be the free one, there are certain expertise that come with economic charges, depending upon your choice. Guarantee that the payment you are going to be given is certainly not excessive as you might truly feel left out. If you are a beginner you may try the free sites, otherwise opt for the paid out ones.

Date Acquiring Tools You must also search the net for some trusted dating tools that would be useful for you when searching for a suitable date. There are numerous dating websites that offer free dating tools, but they may well not necessarily end up being useful for those people who are new in neuro-scientific online dating. Therefore , if you are looking for your date on the web and you remain struggling, it would be preferable to seek the help of a dating service or maybe a dating internet site that offers you dating equipment that would make your life easier, such as a chat or a telephone lookup.

Dating is a lot of fun and the best part of it is that the process is completely secret and can be carried out anytime and anywhere you want. But before starting a romantic relationship, you should 1st decide on how you want to go about it and then you can begin to search for a suitable date. With these straightforward tips and tricks, you will be able to find a suitable partner easily.

The real dilemma is “Where can I find an excellent woman? Wherever can I find a hot woman? ” This question is an extremely common one particular and it usually leads to many men requesting the same thing.

A person looking for a great woman should be aware that he needs to know very well what it takes to entice women. A person has to figure out how to talk to women so that he can make sure they are want to be with him. You should also try to learn methods to flirt with them. You should master the ability of attraction, you will not draw in any girls.

To master how to get a good girl is mostly a little harder than you might believe. In fact , in case you are not very careful, you might end up getting some fairly awful ladies. However , there are many tips on how to get a good girl, even if you have bad pasts.

Almost all of we ought to also girls are certainly not too picky. They just like a guy who’s confident and who knows what he wants out of lifestyle. You need to be inclined to work on your confidence in order that you attract ladies and that means you have to start working like a confident person.

If you want to know how to get a fantastic girl, it is advisable to make sure that you are showing the woman that you are in control of the matter. You do not desire to turn her off simply by telling her that your woman cannot accomplish this or that. You also tend not to want to make a statement by being disrespectful. This will cause you to be look like a minimal douchebag.

The best place to find a good girl reaches a nightclub. If you are willing to walk around using a girl, you are going to soon see that it is not a problem to find one particular. Just make an effort to discover a place where everyone is not really trying to talk to you. You might even find that females are just waiting around for you to walk by. Once you know where to find the best girl, you will be able to approach her and to make a good first sight on her.

It does not matter awesome you are if you are bad at coming women. The secret is to use the power of the voice to get her attention. It is the easiest way to begin talking to a lady because almost all indonesian brides for sale you have to do is state something then turn around and walk away.

Another great hint on how to find a good woman is to keep your overall look clean and wonderful. Do not get a bunch of women around along because you do not want all of them smelling your Cologne or your hair. This is an example of the simplest ways to get young ladies to notice you and it is one of the fastest methods to begin speaking with women.

Finding a better half on the net can be complex, specifically if you don’t know where to begin. You might have noticed ads inside the newspaper to find the best wives in the world but if that is certainly all you need to go on then you may be in for the rude awakening. If you want to get yourself a wife via the internet, you will need to carry out some research about them so that you can prevent the most common issues and problems that most persons make.

The first thing you must do is see a search engines and type in ‘wife’wife seeking’. Once you have entered some of those words in to the search box and struck enter you will definately get an entire list of sites that claim to support you in finding your perfect mate. The challenge with a great number of sites is that they are not work by professional women looking for wives. Instead, they are usually created by scammers so, who are looking to get those money or perhaps personal particulars from you in return for advertising their site. So you should ensure that you only apply reputable sites.

You should check the web-site and look for virtually any testimonials from the other users within the site. Crucial check their particular ‘about’ page, this will generally contain a wealth of information about the web page and a list of the products and services they sell. This means make an attempt to check their particular credentials. You might even look for any work references to people which have used the service ahead of so you find out if it’s right for you.

Another great means of finding a partner on the web is normally through the accompanied by a forums. When you hot irish wife examine a community forum regularly, you have to be able to find members in the community diagnosed with recently found their authentic mate online. These people will often give you tips and advice to help you locate the perfect partner online.

The last thing you must do is establish a good relationship with those to help you find your perfect match. This will make sure that you get one of the most from the experience, which is why you must talk to several people as is possible on the subject so that you receive an understanding of what it takes to locate a wife on the internet. Understand that you don’t have to locate a wife per day, and it’s only a few about having lucky, you are going to still need to work hard if you wish to find the a single you have been dreaming of.

So when you are looking for a wife on the web then there is absolutely no reason for one to let life pass you by. May waste time attempting to find the perfect a single; instead take those steps forced to make sure you acquire that special someone. exactly who you will become pleased with.

Finding a woman over the internet is really convenient if you know very well what to look for. There is no need to be a wizard to figure it, all you need should be to have the right information to help you search for the suitable woman in any of the totally free dating websites available on the internet.

Free dating websites are everywhere, they are usually super easy to locate, when you know exactly where to find them. The good news however , is that there are many free of charge viewing websites, yet you need to use them intelligently. When you find a free seeing website, what do you do next?

Well, the great thing you can do should be to type the person or the thoughts that you are looking for into the internet search engine that you are using. After that you should likewise check to see when there is any recommendations left about the person you want to discover japanese mail order brides free on the particular internet site. If there is, you might want to pay a visit to that particular site. A straightforward click and an hour later on you will be able to meet the person of your dreams.

The next thing that you ought to do when you want to find a woman online price tag is to understand who she actually is. If you cannot find this information, then you definitely should very likely stop surfing until you get the info you really want. This is especially true if you think that she is a spammer or perhaps someone that will just spam other people on other sites that are just like hers.

Finally, when you have found a totally free online interacting with site that you like, make sure that you put in the proper contact information that you need for that person. That way you have a better chance at actually getting in contact with her. A lot of people use totally free dating sites as they are afraid of spending money over a paid web page that offers zero contact information. Nevertheless , the truth is there are lots of free sites out there, all you need to do is to recognise how to find all of them.

Remember that if you are able to find the free online meeting web page that you prefer, therefore there is no the reason why you should not give it a shot. You can always contact the owner of this website to verify if you can get added contact information on the paid a regular membership site. Using this method you can be assured that you refuse to waste money on an inferior internet site.