General Nurses’ Experiences of End-Of-Life Care in the Acute Hospital Setting

Approximately 90% of the UK population spend some time in hospital in their final year of life, and more than half of the population die in hospital. This review aims to explore the experiences of general nurses when providing end-of-life care to patients in the acute hospital setting. Nine studies were identified through a literature search, and each was then analysed and evaluated until themes emerged. Six themes were drawn from the literature: lack of education and knowledge, lack of time with patients, barriers arising in the culture of the health-care setting, communication barriers, symptom management, and nurses' personal issues. The themes cause concern about the quality of end-of-life care being provided in the acute care setting. The literature appears to be consistent in the view that terminally ill patients are best cared for in specialised care settings, such as palliative care units and hospices. However, increasing demands on health services will result in greater numbers of dying patients being admitted to the acute hospital setting. It is therefore paramount that general nurses' educational needs are met to ensure they develop clinical competence to provide high-quality holistic end-of-life care.

Calculation of Critical Clearing Time of Embedded Generation for Relay Setting Based on Optimisation Method

his paper proposes an optimisation-based method to calculate the critical slip (speed) of dynamic stability and critical clearing time (CCT) of a self-excited induction generator (SEIG). A simple case study using the Matlab/Simulink environment has been included to exemplify the optimisation method. Relationships between terminal voltage, critical slip and reactance of transmission line, CCT and inertial constant have been determined, based on which analysis of impact on relaying setting has been further conducted for another simulation case.

Afterword::Innovation, Ecological Modernisation and the ‘Post-Conflict’ Policy Agenda

Perhaps the weakest dimension of the ‘triple bottom line’ understanding of
sustainable development has been the ‘economic’ dimension. Much of the thinking
about the appropriate ‘political economy’ to underpin sustainable development has
been either utopian (as in some ‘environmental’ political views) or ‘business as usual’ approaches. Rejecting both of these utopian and realist views, it is clear from the papers presented here and the conference debates that something like ‘ecological modernisation’ is the preferred conceptualisation of ‘sustainable development’ within policy circles in Northern Ireland, the UK and other European states.

Big Society as Big Government: Cameron's Governmentality Agenda

Cameron’s flagship policy of the ‘Big Society’ rests on a society/government dichotomy, diagnosing a ‘broken society’ caused by ‘big government’ having assumed the role communities once played. The remedy is greater social responsibility and the ‘Big Society’. This article argues that the dichotomy is
deceptive. We aim to show that the Big Society is big government, as it employs techniques for managing the conduct of individuals and communities such that the mentality of government, far from being removed or reduced, is bettered and made more efficient. To illustrate this, we explore two major initiatives: the National Citizen Service and the Community Resilience programme. These
projects demonstrate how practices of informing and guiding the conduct of individuals both produce agents and normalise certain values, resulting in the population being better known and controlled. Thus, far from lessening government and empowering people, the Big Society extends governmentality
throughout the social body.

Nurses' experiences providing palliative care to individuals living in rural communities aspects of the physical residential setting

Introduction: Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses’ experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting.

Methods: This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis.

Results: Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a ‘jack of all trades’, but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather.

Intellectual Property and the EU’s Deep Trade Agenda

The EU is considered to be one of the main proponents of what has been called the deep trade agenda—that is, the push for further trade liberalization with an emphasis on the removal of domestic non-tariff regulatory measures affecting trade, as opposed to the traditional focus on the removal of trade barriers at borders. As negotiations on the Doha Development Round have stalled, the EU has attempted to achieve these aims by entering into comprehensive free trade agreements (FTAs) that are not only limited exclusively to tariffs but also extend to non-tariff barriers, including services, intellectual property rights (IPRs), competition, and investment. These FTAs place great emphasis on regulatory convergence as a means to secure greater market openings. The paper examines the EU's current external trade policy in the area of IP, particularly its attempts to promote its own regulatory model for the protection of IP rights through trade agreements. By looking at the IP enforcement provisions of such agreements, the article also examines how the divisive issues that are currently hindering the progress of negotiations at WTO level, including the demands from developing countries to maintain a degree of autonomy in the area of IP regulation as well as the need to balance IP protection with human rights protection, are being dealt with in recent EU FTAs.