7 july 2005 and aftermath

Les attentats du 07 juillet 2005 à Londres et les événements qui ont suivi dans la capitale du Royaume-Uni ont été l\u27occasion de revoir les procédures de réaction à une situation d\u27urgence tant du point de vue de l\u27université que de la bibliothèque, tant pour sauver les gens que les collections

End-of-life care: Proactive clinical management of older Australians in the community

Background Due to the changing demographics of ageing and death in Australia, general practitioners (GPs) are caring for greater numbers of people with advanced chronic conditions that will soon lead to death. GPs play a pivotal role in proactively preparing these people for end of life. Objective This article introduces GPs to a framework of care, based on a palliative care approach, which supports proactive management of end-of-life care for older Australians living in the community. Discussion Embedding the above framework into routine practice can help GPs deliver care, aligned with patients’ preferences, at the right time and in the right place. Experience has shown that implementing proactive management of end-of-life care can increase satisfaction with GP care and help GPs meet the clinical, legal and ethical challenges associated with caring for older patients with advanced progressive conditions

Specialist palliative care in care homes: Integrating care could improve quality of life and reduce costs (Pilot study)

The Scottish Government’s Strategic Framework for Action on Palliative and End of Life Care sets out a vision of universal access to palliative care by 2021. This includes individuals, families and carers having timely and focused conversations with appropriately skilled professionals to plan end of life care, in accordance with their needs and preferences. The vision will be achieved by widening the range of health and care staff providing palliative care, delivering appropriate training, and supporting clinical and health economic evaluations of palliative and end of life care models. Despite care homes being a key location where older people die, access to specialist palliative care is limited. Staff often feel inadequately trained or prepared to look after people who are dying. Consequently, care home residents are more likely to die in hospital, with uncontrolled symptoms, or without adequate care planning in place

Reducing time in acute hospitals: A stepped-wedge randomised control trial of a specialist palliative care intervention in residential care homes

Background: Care home residents are frequently transferred to hospital, rather than provided with appropriate and timely specialist care in the care home. Aim: To determine whether a model of care providing specialist palliative care in care homes, called Specialist Palliative Care Needs Rounds, could reduce length of stay in hospital. Design: Stepped-wedge randomised control trial. The primary outcome was length of stay in acute care (over 24-h duration), with secondary outcomes being the number and cost of hospitalisations. Care homes were randomly assigned to cross over from control to intervention using a random number generator; masking was not possible due to the nature of the intervention. Analyses were by intention to treat. The trial was registered with ANZCTR: ACTRN12617000080325. Data were collected between 1 February 2017 and 30 June 2018. Setting/participants: 1700 residents in 12 Australian care homes for older people. Results: Specialist Palliative Care Needs Rounds led to reduced length of stay in hospital (unadjusted difference: 0.5 days; adjusted difference: 0.22 days with 95% confidence interval: −0.44, −0.01 and p = 0.038). The intervention also provided a clinically significant reduction in the number of hospitalisations by 23%, from 5.6 to 4.3 per facility-month. A conservative estimate of annual net cost-saving from reduced admissions was A$1,759,011 (US$1.3 m; UK£0.98 m). Conclusion: The model of care significantly reduces hospitalisations through provision of outreach by specialist palliative care clinicians. The data offer substantial evidence for Specialist Palliative Care Needs Rounds to reduce hospitalisations in older people approaching end of life, living in care homes

Improving the respiratory health of adults with learning disabilities

People with learning disabilities are more likely to die from respiratory tract disease and infections than people without learning disabilities. This article describes a lung health group developed by physiotherapists and speech and language therapists that was set up to improve the respiratory health of people with vulnerable respiratory status, particularly over the period of greatest risk of airborne respiratory infections. Its aim was to reduce the number and/or severity of chest infections and improve carers’ knowledge of respiratory health. The authors describe the group’s content and format, methods trialled to evaluate the group and the benefits of attending the group

Integrating specialist palliative care into residential care for older people: a stepped wedge trial (INSPIRED trial)

Residential facilities for older persons (hereafter “facilities”) are increasingly involved in supporting older people at end of life; consequently, the provision of palliative care is required to improve outcomes for residents. The national palliative care strategy sets a vision which aims to (i) improve awareness and understanding, (ii) be appropriate and effective, (iii) has high quality leadership and governance and (iv) builds capacity and capability. The national palliative care standards re-assert the need for palliative care to be available to all people living with progressive or advanced disease. In 2014-2015, we developed and tested a new approach to integrating specialist palliative care into residential care to meet the objectives of the national strategy and improve the delivery of high quality appropriate care to older Australians. The study was funded by ACT Health

Integrating specialist palliative care into residential care for older people: a stepped wedge trial (INSPIRED trial)

Residential facilities for older persons (hereafter “facilities”) are increasingly involved in supporting older people at end of life; consequently, the provision of palliative care is required to improve outcomes for residents. The national palliative care strategy sets a vision which aims to (i) improve awareness and understanding, (ii) be appropriate and effective, (iii) has high quality leadership and governance and (iv) builds capacity and capability. The national palliative care standards re-assert the need for palliative care to be available to all people living with progressive or advanced disease. In 2014-2015, we developed and tested a new approach to integrating specialist palliative care into residential care to meet the objectives of the national strategy and improve the delivery of high quality appropriate care to older Australians. The study was funded by ACT Health

Negotiating a third space for participatory research with people with learning disabilities: an examination of boundaries and spatial practices

The focus of this paper is participatory research with and by people with learning disabilities. Drawing on presentations and discussions that took place across five funded seminars we use the concepts of space and boundaries through which to examine the development of a shared new spatial practice through creative responses to a number of challenges. We examine the boundaries that exist between participatory research and non-participatory research' participatory research with people with learning disabilities and participatory research with other groups and between different stakeholders of participatory research with people with learning disabilities. With a particular focus on participatory data analysis and participatory research with people with high support needs we identify a number of ways in boundaries are being opened. We argue that the pushing of new boundaries opens up both new and messy spaces and that both are important for the development of participatory research methods

The Aussie, 1918-1931: cartoons, digger remembrance and First World War identity

Feelings of community, cultural definition and memory were kept alive through the soldiers’ mass circulation tabloid, the Aussie, examined here in the light of theorization of memory and representation, applied to both text and cartoons. The publication’s aim for veterans’ values to become shared national values is analysed in the light of its high profile usage of soft cartoon humour and also of nostalgia – highlighting the limitations as well as the effectiveness in terms of Australia’s evolving national identity. When the post-war economic situation worsened, deeper issues of national tension were glossed over by the use of scapegoats such as ‘profiteers’ and ‘lazy workers’. The armed forces were obliged to take on a political role of lobbying for their cause, but the Aussie as ‘cheerful friend’ experienced its own identity crisis that proved to be terminal