Nikolaos Efstathiou, Anna Lock, Suha Ahmed, Linda Parkes, Tammy Davies and Susan Law
Following the development of a service that consisted of a “single point of contact” to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response…
Abstract
Purpose
Following the development of a service that consisted of a “single point of contact” to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response team, we aimed to explore whether the provision of coordinated EoLC would support patients being cared or dying in their preferred place and avoid unwanted hospital admissions.
Design/methodology/approach
Using a realist evaluation approach, the authors examined “what worked for whom, how, in what circumstances and why”. Multiple data were collected, including activity/performance indicators, observations of management meetings, documents, satisfaction survey and 30 interviews with service providers and users.
Findings
Advance care planning (ACP) increased through the first three years of the service (from 45% to 83%) and on average 74% of patients achieved preferred place of death. More than 70% of patients avoided an emergency or unplanned hospital admission in their last month of life. The mechanisms and context identified as driving forces of the service included: 7/7 single point of contact; coordinating services across providers; recruiting and developing the workforce; understanding and clarifying new roles; and managing expectations.
Research limitations/implications
This was a service evaluation and the outcomes are related to the specific context and mechanisms. However, findings can be transferable to similar settings.
Practical implications
“Single point of contact” services that offer coordinated EoLC can contribute in supporting people to be cared and die in their preferred place.
Originality/value
This paper provides an evaluation of a novel approach to EoLC and creates a set of hypotheses that could be further tested in similar services in the future.
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This chapter examines the historical development of different conceptions of health among environmental activists in the postwar United States.
Abstract
Purpose
This chapter examines the historical development of different conceptions of health among environmental activists in the postwar United States.
Methodology/approach
The historical analysis combines archival research with oral history interviews.
Findings
This study argues that applications of “health” to describe the environment are more diverse than generally acknowledged, and that environmental activists were at the forefront of connecting the two terms within broader public discourse.
Originality/value of chapter
This study provides a historical context for understanding the contemporary diversity of perspectives on the links between ecology and health. It illustrates the cross-fertilization between scientists, philosophers, and environmental activists in the 1970s that led to this contemporary diversity.
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This chapter explores the episodes of Doctor Who featuring the Weeping Angels, in order to explore how their femininity impacts their monstrosity. Other (male) monsters in Doctor…
Abstract
This chapter explores the episodes of Doctor Who featuring the Weeping Angels, in order to explore how their femininity impacts their monstrosity. Other (male) monsters in Doctor Who kill the victims outright: Daleks exterminate their victims and Cybermen upgrade (essentially extracting all of their humanity, turning them into mindless robots) their victims. The only reoccurring feminine monsters, the Weeping Angels, do not kill anyone. They don’t take away their humanity; they simply transport them to another time. They live out their entire lives in this new time, unharmed beyond the inconvenience of temporal displacement.
The Weeping Angels could be analysed as a reversal of Barbara Creed’s monstrous feminine (1993); as their femininity makes them more human and more compassionate instead of more monstrous. They also could be thought of in terms of feminist ethics à la Nel Noddings’ feminist approach to care. In this chapter, I will argue that though traditionally villainous women are made monstrous via their femininity; in the case of the Weeping Angels, their femininity gives them a sense of humanity and compassion, thus making them less monstrous.
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AT the very outset of this paper it is necessary to make clear that it is not an attempt to compile an exhaustive bibliography of literature relating to special librarianship…
Abstract
AT the very outset of this paper it is necessary to make clear that it is not an attempt to compile an exhaustive bibliography of literature relating to special librarianship. Neither space nor time permit this. In fact, the references given can only claim to be a sample of the wealth of material on the subject and this paper is submitted in the hope that it will stimulate others to more scholarly efforts. Reference numbers throughout this paper refer to items in the ‘Select list of references to the literature of special librarianship’, section 2 onwards.
In little more than one year, seven vendors have introduced CD‐ROM‐based public access catalog systems. They vary widely in price, features, and performance. Three scenarios are…
Abstract
In little more than one year, seven vendors have introduced CD‐ROM‐based public access catalog systems. They vary widely in price, features, and performance. Three scenarios are defined, which represent the requirements of libraries of diverse sizes and groupings. For each scenario, prices of CD‐ROM systems are compared for the first and subsequent two years. The features of the systems are also compared in some detail. The prices and descriptions of features reflect the marketplace as of late summer 1987.
Lorraine Sherr and Joanne Mueller
Parental illness can affect child and adolescent psychosocial well‐being. Mental health effects of parental bereavement generally and HIV‐related bereavement specifically have…
Abstract
Parental illness can affect child and adolescent psychosocial well‐being. Mental health effects of parental bereavement generally and HIV‐related bereavement specifically have been poorly explored in children. HIV‐related illness has a number of specific features that may directly affect mental health considerations. Infection is clustered in families. Bereavement is often multiple. Death is often preceded by severe illness and multiple opportunistic infections. AIDS is stigmatised, which may impede disclosure, social support and adjustment. In low‐income countries where HIV infection is concentrated, access to palliative care as well as medical care may be limited. This review systematically identifies studies on HIV and bereavement in children. Searches of electronic databases for relevant articles revealed 14 studies examining bereavement with sufficient measurement and controlled methodology providing standardised behavioural and emotional outcome measures. Scrutiny of the results revealed the majority (12: 86%) recorded an adverse behavioural or emotional impact on the child. A detailed analysis of the studies provides insights to risks as well as protective factors that may inform future interventions. Only one systematic intervention was identified whereby a coping skills intervention had positive and long‐lasting effects. This paper examines urgent future needs and the requirement for evidence‐based policy and provision.
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Jon Austin, Glen Parkes and Amy Antonio
The purpose of this paper is to use the experience of attempting to locate funding for three contiguous components of a research program to be undertaken in remote areas of…
Abstract
Purpose
The purpose of this paper is to use the experience of attempting to locate funding for three contiguous components of a research program to be undertaken in remote areas of Queensland to reflect upon the increasing challenges to critical qualitative research in the Australian context.
Design/methodology/approach
This paper utilizes forms and formats of the composite narrator, narrative inquiry and autoethnographic techniques in putting their lived experience into the context of the neoliberalized university.
Findings
As the research team developed and pursued a funding application through various university committees, the value of their work and the ways in which they were being increasingly marginalized qua researchers became starkly apparent to them.
Originality/value
While Appadurai’s concern was to try to understand the inexplicable and seemingly inordinate fear of small numbers that, in contemporary times, causes large majority groups to launch horrendous campaigns of erasure against miniscule minority groups, the authors wonder whether the same concern of an ascendant majority is not at play in strategies of erasure being deployed in contemporary research paradigm skirmishes. Regardless, the authors are rapidly approaching the point where perhaps the authors, as critical qualitative researchers, should fear any numbers, big or small.