Working with family carers: towards a partnership approach

The use of the term ‘family (informal) carer’, as it is currently conceptualized, is recent and is largely the product of increased attention in the academic and policy literature over the last two decades. Despite their fairly late arrival on the scene, family carers now occupy centre stage in UK government policy, having being described by the Prime Minister, Tony Blair, as the ‘unsung heroes’ of British life, who are essential to the fabric and character of Britain. Such recognition stems from the growing realization that family carers are the lynchpin of community care, providing 80% of all the care needed at an estimated saving to the UK government of some £40 billion annually

Gerontological nursing: professional priority or eternal Cinderella?

Over thirty years ago geriatric nursing, as it was then called, was at the forefront of nursing research in the United Kingdom. Concurrent with the emergence of geriatric medicine as a distinct speciality, the pioneering study of Doreen Norton and colleagues (Norton et al. 1962) served to highlight both the deficits that existed in the hospital care of older people and the enormous potential of nursing to improve the situation, particularly for the ‘irremediable’ patient (Norton 1965). Caring for those who could not be cured but required on-going support was seen to constitute ‘true nursing’ and was identified as an area of practice in which nurses should excel (Norton 1965, Wells 1980). Such potential went largely unrealised, however, as nursing focused on acute, hospital-based care (Nolan 1994). As a consequence, those working in continuing care struggled to find value in their work and patients were subjected to ‘aimless residual care’ (Evers 1991), a situation exacerbated by the continued application of the biomedical model (Reed and Watson 1994). Despite claims that nurses working with older people have ‘special skills’ (Royal College of Nursing 1993), the nature of such skills has therefore never fully been explicated. Indeed, Armstrong-Esther et al. (1994) asked what nurses currently contribute to the well-being of elderly people and, following their study, suggested that nurses must take the initiative and expand their role if ‘we are going to avoid simply warehousing the elderly until they die’. The need to act is particularly pressing at present as the spectre of ‘bed-blockers’ emerges once more and there is growing professional concern that older people may soon be denied the right to receive care from a qualified nurse (Nursing Times 1996)

‘Making the best of things’: relatives' experiences of decisions about care-home entry

Despite the growing awareness of the significance of helping a relative to relocate to a care home as a key phase in the care-giving career, relatively few British studies have explored this experience in depth. Informed by a constructivist perspective, this study sought a better understanding of nursing home placements from the viewpoint of relatives. Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move into a nursing home. Analysis revealed three perceived phases to the transition: ‘making the best of it’, ‘making the move’ and ‘making it better’. The relatives' experiences through these phases had five perceived elements, all of which were continua, from absent to very strong, reflecting the extent to which they were felt. They were: operating ‘under pressure’ or not; ‘in the know’ or ‘working in the dark’; ‘working together’ or ‘working alone’; ‘in control of events’ or not, and ‘supported’ or ‘unsupported’ both practically and emotionally. This paper reports findings about the first phase of the transition, ‘making the best of it’, and documents the experiences of decision-making about nursing home placements. It is argued that health and social care practitioners have enormous potential to influence whether or not helping a relative to move into a nursing home is perceived as a positive choice

Local modulation of chemoattractant concentrations by single cells: dissection using a bulk-surface computational model

Chemoattractant gradients are usually considered in terms of sources and sinks that are independent of the chemotactic cell. However, recent interest has focused on ‘self-generated’ gradients, in which cell populations create their own local gradients as they move. Here, we consider the interplay between chemoattractants and single cells. To achieve this, we extend a recently developed computational model to incorporate breakdown of extracellular attractants by membrane-bound enzymes. Model equations are parametrized, using the published estimates from Dictyostelium cells chemotaxing towards cyclic AMP. We find that individual cells can substantially modulate their local attractant field under physiologically appropriate conditions of attractant and enzymes. This means the attractant concentration perceived by receptors can be a small fraction of the ambient concentration. This allows efficient chemotaxis in chemoattractant concentrations that would be saturating without local breakdown. Similar interactions in which cells locally mould a stimulus could function in many types of directed cell motility, including haptotaxis, durotaxis and even electrotaxis

Reform of the Foreign Intelligence Surveillance Courts: Procedural and Operational Changes

[Excerpt] The Foreign Intelligence Surveillance Act (FISA) of 1978 was the product of sweeping congressional investigation and deliberation prompted by perceived electronic surveillance abuses by the executive branch. Among other things, FISA established the Foreign Intelligence Surveillance Court (FISC) to review government applications to conduct electronic surveillance for foreign intelligence purposes and the Foreign Intelligence Surveillance Court of Review (FISA Court of Review) to review the decisions of the FISC. In the wake of revelations in June 2013 concerning the scope of orders issued by the FISC, many have questioned the efficacy of the current mechanisms for reviewing the executive branch’s intelligence gathering practices. While some have proposed altering the underlying substantive law that regulates such surveillance, other proposals address the practice and procedures of authorizing such surveillance activities. This report begins with an overview of both the FISC and the FISA Court of Review, including the jurisdiction of these courts, how the judges are appointed, and the FISC’s practices and procedures for reviewing and issuing surveillance orders. The report then discusses the scope and underlying legal principles behind congressional regulation of the procedures of the federal courts, and applies those principles with respect to the various proposals to reform the FISA judicial review process. These reforms include requiring the FISC to hear arguments from “friends of the court” or amici curiae, who would brief the court on the privacy or civil liberty interests implicated by a government application; mandating that in certain instances the FISC sit en banc—that is, with all 11 FISC judges; and altering the voting rules of the FISC and FISA Court of Review

The impact of information and communication technology on family carers of older people and professionals in Sweden

Government policy in Sweden, as in other developed countries, pays increasing attention as to how best to support the family carers of older people. New and innovative means of support, such as information and communication technology, are emerging. This paper explores the perceived benefits of, and barriers to, information technology as a means of supporting family carers of older people. Following a brief overview of the care-giving literature, with particular reference to the Swedish context, interview and questionnaire data collected from 34 families who took part in the Swedish ACTION project are used to explore the role of user-friendly information and communication technology to inform and enable family carers of older people to exercise choice, to care more effectively and to work in partnership with professionals. Interview data from two groups of professionals that utilised ACTION are also examined to throw light on its potential benefits for both carers and professionals. Consideration is given to the barriers to using information technology, and to identifying those carers most likely to benefit. Areas for further development are the need for practitioners' education and a wider range of programmes to address carers' diverse needs. Clearly, lessons learned from the Swedish project have wider relevance, given that new forms of support are being developed in most technically advanced countries

The nurses that roared: nurses from history who found their voices and challenged the status quo

In this article we explore how nurses from history challenged norms of nursing and society, and consider how they can influence and inspire nurses today. We discuss the role of nurses in the fight for women’s suffrage, campaigning for the vote and caring for women who suffered in their fight to achieve it, and present examples of outstanding bravery in the past and present day. The article contains examples of the bravery of some relatively unknown nurses in wartime, who also fought for equality and inclusion, and nurses who challenged the care of marginalised groups, campaigning for improved treatment, sometimes at great personal cost. Finally we consider the courage of present-day nurses. Drawing on the global campaign of “Nursing Now”, we suggest that learning from these exceptional nurses and acknowledging and highlighting their contribution can inspire us to strengthen and promote nursing and to empower women globally

Trapping Horizons in the Sultana-Dyer Space-Time

The Sultana-Dyer space-time is suggested as a model describing a black hole embedded in an expanding universe. Recently, in \cite{0705.4012}, its global structure is analyzed and the trapping horizons are shown. In the paper, by directly calculating the expansions of the radial null vector fields normal to the space-like two-spheres foliating the trapping horizons, we find that the trapping horizon outside the event horizon in the Sultana-Dyer space-time is a past trapping horizon. Further, we find that the past trapping horizon is an outer, instantaneously degenerate or inner trapping horizon accordingly when the radial coordinate is less than, equal to or greater than some value.Comment: no figures, 5 pages; PCAS and key words are adde