Further explorations of illness uncertainty: Carer’s experiences of Parkinson’s disease

Objective: Dominant models of illness uncertainty define uncertainty as ‘an inability to determine the meaning of illness-related events’. Recent research has shown patient uncertainty to be multidimensional encompassing personal issues indirectly affected by illness. The nature of carer uncertainty has yet to be fully explored. The present study aimed to investigate the nature of illness uncertainty in the carers of patients with Parkinson’s disease (PD). Design: Eighteen carers of a spouse with PD participated in semi-structured interviews. Transcripts were thematically analysed, statements were coded as uncertain if they reflected ‘a lack of certainty, or a state of limited knowledge, understanding or worry regarding an existing or future outcome’. Results: The domains of uncertainty expressed by carers closely fitted the five domain framework of patient uncertainty: symptoms and prognosis, medical management, self-management, social functioning and impact. An additional ‘carer-role’ domain was identified. Conclusions: Carer uncertainty about PD went beyond issues directly related to the illness. The findings have implications for research into uncertainty suggesting that widely used measures may not be accurately capturing the nature of carer uncertainty about chronic illness. The breadth of uncertainty reported has implications for the provision of appropriate support to improve caregiver well-being

The narratives of Hardship: : The new and the old poor in the aftermath of the 2008 crisis in Europe

This document is the Accepted Manuscript version of the following article: Hulya Dagdeviren, Matthew Donoghue, and Lars Meier, ‘The narratives of hardship: the new and the old poor in the aftermath of the 2008 crisis in Europe’, The Sociological Review, vol. 65 (2): 369-385, May 2017. The final, definitive version of record is available online at doi: https://doi.org/10.1111/1467-954X.12403. Published by SAGE.This paper examines poverty and hardship in Europe after the 2008 crisis, using household interviews in nine European countries. A number of findings deserve highlighting. First, making a distinction between ‘the old poor’ (those who lived in poverty before as well as after the crisis) and ‘the new poor’ (thosewho fell into hardship after the crisis), we show that hardship is experienced quite differently by these groups. Second, the household narratives showed that while material deprivations constitute an important aspect of hardship, the themes of insecurity and dependency also emerged as fundamental dimensions. In contrast to popular political discourse in countries such as the UK, dependency on welfare or family was experienced as a source of distress and manifested as a form of hardship by participants in all countries covered in this study.Peer reviewedFinal Accepted Versio

Comparative Analysis of Whole-Genome Sequences of Influenza A(H1N1)pdm09 Viruses Isolated from Hospitalized and Nonhospitalized Patients Identifies Missense Mutations That Might Be Associated with Patient Hospital Admissions in Finland during 2009 to 2014

Peer reviewe

How to Pay for Public Education

For years now, public education, and especially public higher education has been under attack. Funding has been drastically reduced, fees increased, and the seemingly irresistible political force of ever-tightening austerity budgets threatens to cut it even more. But I am not going to take the standard line that government financial support for public higher education should be increased. I view that battle as already lost. What I am going to propose is that we stop arguing about the allocation or reallocation of ever more scarce public resources and think of another way to fund public higher education. It's time for a new approach, one that satisfies the left's claim that higher education should be affordable for all, yet one that does not involve increasing expenditure of public funds or commit the government to entitlement programs that it cannot now or at least cannot long afford. What we need is a new proposal that is acceptable to both sides if we are to bring public education into the twenty-first century. And this is what this paper is devoted to providin

Eosinophil deficiency promotes aberrant repair and adverse remodelling following acute myocardial infarction

In ST-segment elevation myocardial infarction of both patients and mice, there was a decline in blood eosinophil count, with activated eosinophils recruited to the infarct zone. Eosinophil deficiency resulted in attenuated anti-inflammatory macrophage polarization, enhanced myocardial inflammation, increased scar size, and deterioration of myocardial structure and function. Adverse cardiac remodeling in the setting of eosinophil deficiency was prevented by interleukin-4 therapy

An exploration of men's experiences of undergoing active surveillance for favourable-risk prostate cancer: A mixed methods study protocol

BACKGROUND: Prostate cancer is one of the most common male cancers worldwide. Active Surveillance (AS) has been developed to allow men with lower risk disease to postpone or avoid the adverse side effects associated with curative treatments until the disease progresses. Despite the medical benefits of AS, it is reported that living with untreated cancer can create a significant emotional burden for patients. METHODS/DESIGN: The aim of this study is to gain insight into the experiences of men eligible to undergo AS for favourable-risk PCa. This study has a mixed-methods sequential explanatory design consisting of two phases: quantitative followed by qualitative. Phase 1 has a multiple point, prospective, longitudinal exploratory design. Ninety men diagnosed with favourable-risk prostate cancer will be assessed immediately post-diagnosis (baseline) and followed over a period of 12 months, in intervals of 3 month. Ninety age-matched men with no cancer diagnosis will also be recruited using peer nomination and followed up in the same 3 month intervals. Following completion of Phase 1, 10-15 AS participants who have reported both the best and worst psychological functioning will be invited to participate in semi-structured qualitative interviews. Phase 2 will facilitate further exploration of the quantitative results and obtain a richer understanding of participants' personal interpretations of their illness and psychological wellbeing. DISCUSSION: To our knowledge, this is the first study to utilise early baseline measures; include a healthy comparison group; calculate sample size through power calculations; and use a mixed methods approach to gain a deeper more holistic insight into the experiences of men diagnosed with favourable-risk prostate cancer

Who will care for the women?

Over 20 million people today, including children, working-age disabled, and elderly persons, require some sort of assistance to live safely. Largely because women live longer than men, well into the ages when the probability of needing care increases, 70 percent of elderly people who need long-term care are women. Furthermore, most long-term care is provided by women, mainly as unpaid care in the home, or as low-paid care in institutions and community settings (Stone & Weiner 2001). The United States faces a severe long-term care crisis because of the nation\u27s inability to plan for the changing demographic balance. The crisis in long term care has two problems: a) that we are putting too many resources into institutional care relative to home- and community-based care and relying too heavily on unpaid care in the home to meet the real needs of the aging population, and b) that we do not, and increasingly will not, have enough people to provide for the volume of care that will be needed in the coming decades. This chapter begins with a description of the long-term care system in the United States – what long-term care is, who needs it, in what settings it is provided, and who pays for it. Using the author\u27s analysis of a national survey of caregivers conducted by the National Alliance for Caregiving and the AARP in 2003 along with other sources, this section shows that a substantial portion of the people who need long-term care rely on unpaid care from family and friends, mainly women. When people do receive paid care, almost half – mostly women -- receive it in institutional settings. The discussion demonstrates that women are far more likely to end up in institutions than men, even controlling for age and level of impairment. It then argues that, for a number of reasons, states and the federal government will have to respond to the preferences of consumers for home- and community-based care