A monster that lives in our lives - experiences of caregivers of people with motor neuron disease and identifying avenues for support.

Background A developing body of evidence has provided valuable insight into the experiences of caregivers of people with motor neuron disease; however, understandings of how best to support caregivers remain limited.

Aim This study sought to understand concepts related to the motor neuron disease caregiver experience which could inform the development of supportive interventions.

Design A qualitative thematic analysis of a one-off semistructured interview with caregivers was undertaken.

Setting/participants Caregivers of people with motor neuron disease were recruited from a progressive neurological diseases clinic in Melbourne, Australia.

Results 15 caregivers participated. Three key themes were identified: (1) The Thief: the experience of loss and grief across varied facets of life; (2) The Labyrinth: finding ways to address ever changing challenges as the disease progressed; (3) Defying fate: being resilient and hopeful as caregivers tried to make the most of the time remaining.

Conclusions Caregivers are in need of more guidance and support to cope with experiences of loss and to adapt to changeable care giving duties associated with disease progression. Therapeutic interventions which target these experiences of loss and change are worth investigation.

The Dynamics of Quadropoly: League Position in English Football between 1888 and 2010

The paper explores competitive balance in top tier English league football from its inception in 1888. It examines the extent to which finishing in the top four positions in successive seasons is the preserve of a small number of clubs. Using a range of statistical measures, the analysis shows that the current high levels of competitive imbalance are not new phenomena. The overall pattern approximates a ‘U curve’: current patterns parallel those in the 1890s. In the early years of English league football, differences in resources between clubs soon became apparent. Clubs from the larger conurbations generated consistently larger revenues than their counterparts in the smaller industrial towns. This was primarily the result of the larger crowds that they could attract to their home games. This enabled them to entice the best players to their clubs away from their smaller rivals. The introduction of the maximum wage in 1901 and the transfer system helped to stem these increasing inequalities between clubs. This coincided with a massive wave of new stadia construction which enabled all the clubs to compete on an increasingly level playing field. These conjunctural changes to English football before 1915 produced the era of relatively competitive football during the inter-war years. This continued until the abolition of the maximum wage in 1961. Since that time, competitive balance has reversed and become increasingly restricted. English top-tier football has re-entered an era of extreme competitive imbalance.