Dying at home: A qualitative study of the perspectives of older South Asians living in East London

South Asians constitute the single largest ethnic minority group in the United Kingdom, yet little is known about their perspectives and experiences on end-of-life care. Aim: To explore beliefs, attitudes and expectations expressed by older South Asians living in East London about dying at home. Methodology and methods: Five focus groups and 29 in-depth semi-structured interviews were conducted with a total of 55 older adults (24 men and 31 women) aged between 52 to 78 years. Participants from six South Asian ethnic groups were recruited via 11 local community organisations. Data were analysed using a constructive grounded theory approach. Findings: Two key themes were identified. The theme of ‘reconsidering the homeland’ draws on the notion of ‘diaspora’ to help understand why for many participants the physical place of death was perceived by many as less important than the opportunity to carry out cultural and religious practices surrounding death. The second theme ‘home as a haven’ describes participants’ accounts of how their home is a place in which it is possible to perform various cultural and religious rituals. Cultural and religious practices were often seen as essential to achieving a peaceful death and honouring religious and filial duties. Conclusion: Older people of South Asian ethnicity living in East London perceive home as more than a physical location for dying relatives. They make efforts to adhere, but also adapt, to important social and cultural values relating to death and dying as part of the wider challenge of living in an emigrant society

Understanding methods of wound debridement

Autolytic debridement describes the body's natural method of wound-bed cleansing, helping it to prepare the wound bed for healing. In acute wounds, autolytic debridement occurs automatically and often does not require intervention, as during the inflammatory stage of a wound, neutrophils and macrophages digest and removes devitalised tissue, cell debris and contaminants, clearing the wound of any cellular barriers to healing. In chronic wounds, by contrast, healing is often delayed, frequently because of inadequate debridement. The autolytic process becomes overwhelmed by high levels of endotoxins released from damaged tissue (Broadus, 2013). Therefore wound debridement becomes an integral part of chronic-wound management and practitioners involved in wound care must be fully competent at wound-bed assessment and have an awareness of the options available for debridement. This article will review wound-bed assessment, highlighting variations in devitalised tissue, and explore options available for wound debridement, taking into consideration patients’ pain and quality of life

Values and behaviours: using the Ten Essential Shared Capabilities to support policy reform in mental health practice

This paper will review aspects of current policy in mental health with specific reference to policy that has a values focus. In this context, values refers to the standards and expectations we hold and which we use to guide aspects of practice performance. Service users state that core values that support, respect choice, collaboration, and customer service are critical foundation stones of a trusting therapeutic relationship. Attending to these foundations for practice has merit in ensuring the quality of care delivery in mental health. This paper will analyse what this means for the mental health workforce in their engagement with service users and delivery of policy priorities. Finally, the paper will explore resources, such as the Ten Essential Shared Capabilities (see Appendix 1), which support engagement and ongoing promotion of person-centred mental health care

Educating the future workforce: building the evidence about interprofessional learning

This paper addresses the theme of interprofessional education for health and social care professionals as it effects on the development of the work force. The drivers for change in the UK, typified by the Bristol Royal Infirmary and Victoria Climbié inquiries and the response to this in the form of Department of Health policy, are discussed. The need for rapid development of the evidence base around this subject is evident form literature reviews of the impact of interprofessional education. Directions for future research and investment in this area are proposed including the need for a stronger theoretical base and for longitudinal studies over extended periods of time in order to examine short, medium and long term outcomes in relation to health care practice

Ultrafilter and Constructible topologies on spaces of valuation domains

Let $K$ be a field and let $A$ be a subring of $K$. We consider properties and applications of a compact, Hausdorff topology called the "ultrafilter topology" defined on the space Zar$(K|A)$ of all valuation domains having $K$ as quotient field and containing $A$. We show that the ultrafilter topology coincides with the constructible topology on the abstract Riemann-Zariski surface Zar$(K|A)$. We extend results regarding distinguished spectral topologies on spaces of valuation domains.Comment: Comm. Algebra (accepted for publication

Neutron scattering study of the field-dependent ground state and the spin dynamics in S=1/2 NH4CuCl3

Elastic and inelastic neutron scattering experiments have been performed on the dimer spin system NH4CuCl3, which shows plateaus in the magnetization curve at m=1/4 and m=3/4 of the saturation value. Two structural phase transitions at T1≈156  K and at T2=70  K lead to a doubling of the crystallographic unit cell along the b direction and as a consequence a segregation into different dimer subsystems. Long-range magnetic ordering is reported below TN=1.3  K. The magnetic field dependence of the excitation spectrum identifies successive quantum phase transitions of the dimer subsystems as the driving mechanism for the unconventional magnetization process in agreement with a recent theoretical model

Dynamic Behavior of Precast Concrete Beam-Column Sub-Assemblages with High Performance Connections Subjected to Sudden Column Removal Scenario

Unbonded posttensioned precast concrete (UPPC) structure has shown its excellent aseismic performance in laboratory tests and earthquake investigation. However, the progressive collapse behavior of UPPC subjected to column removal scenario is still unclear. To fill this knowledge gap, two 1/2 scaled UPPC beam-column sub-assemblages were tested under a penultimate column removal scenario. The dynamic test results indicated that UPPC sub-assemblages have desirable load redistribution capacity to mitigate progressive collapse. The failure modes of the sub-assemblages observed in dynamic test were quite similar to that in static counterparts

The relationship between HIV seroconversion illness, HIV test interval and time to AIDS in a seroconverter cohort.

Seroconversion illness is known to be associated with more rapid HIV disease progression. However, symptoms are often subjective and prone to recall bias. We describe symptoms reported as seroconversion illness and examine the relationship between illness, HIV test interval (time between antibody-negative and anibody-positive test dates) and the effect of both on time to AIDS from seroconversion. We used a Cox model, adjusting for age, sex, exposure group and year of estimated seroconversion. Of 1820 individuals, information on seroconversion illness was available for 1244 of whom 423 (34%) reported symptomatic seroconversion. Persons with a short test interval (< or = 2 months) were significantly more likely to report an illness than people with a longer interval (OR 6.76, 95% CI 4.75-9.62). Time to AIDS was significantly faster (P = 0.01) in those with a short test interval. The HIV test interval is a useful replacement for information on seroconversion illness in studies of HIV disease progression