Caregiver burden, time spent caring and health status in the first 12 months following stroke

Objective: To quantify time caring, burden and health status in carers of stroke patients after discharge from rehabilitation; to identify the potentially modifiable sociodemographic and clinical characteristics associated with these outcomes. Methods: Patients and carers prospectively interviewed 6 (n = 71) and 12 (n = 57) months after discharge. Relationships of carer and patient variables with burden, health status and time analysed by Gaussian and Poisson regression. Results: Carers showed considerable burden at 6 and 12 months. Carers spent 4.6 and 3.6 hours per day assisting patients with daily activities at 6 and 12 months, respectively. Improved patient motor and cognitive function were associated with reductions of up to 20 minutes per day in time spent in daily activities. Better patient mental health and cognitive function were associated with better carer mental health. Conclusions: Potentially modifiable factors such as these may be able to be targeted by caregiver training, support and education programmes and outpatient therapy for patients.

The costs of caring for patients in a tertiary referral Australian intensive care unit

We determined the direct cost of an Intensive Care Unit (ICU) bed in a tertiary referral Australian ICU and the cost drivers thereof, by retrospectively analysing a number of prospectively designed Hospital- and Unit-specific electronic databases. The study period was a financial year, from 1 July 2002 to 30 June 2003. There were 1615 patients occupying 5692 fractional occupied bed days at a total cost of A$15,915,964, with an average length of stay of 3.69 days (range 0.5-77, median 1.06, interquartile range 2.33). The main cost driver not incorporated into this analysis was blood products (paid for centrally). The average costs of an ICU day and total stay per patient were A$2670 and A$9852 respectively. Staff-related charges were 68.76%, with consumables related expenditure making up 19.65%, clinical support services 9.55% and capital equipment 2.04%. Overtime charges and nursing agency staff were 19.4% of staff-related charges (2.9% for agency staff), 3.9% lower than expenditure associated with full-time employment charges, such as pension and leave. The emergency nature of ICU means it is difficult to accurately set a nursing establishment to cater for all admissions and therefore it is hard to decide what is an acceptable percentage difference between agency/overtime costs compared with the costs associated with full-time staff appointments. Consumable expenditure is likely to increase the most with new innovation and therapies. Using protocol driven practices may tighten and control costs incurred in ICU.

Neoliberalism, Gender Inequality and the Australian Labour Market

Over the past 25 years neoliberal philosophies have increasingly informed labour market policies in Australia that have led to increasing levels of wage decentralization. The most recent industrial relations changes aim to decentralize wage setting significantly further than has previously been the case. We argue that this is problematic for gender equity as wage decentralization will entrench rather than challenge the undervaluation of feminized work. In this article we provide an overview of key neoliberal industrial relations policy changes pertinent to gender equity and examine the current state of gender equity in the labour market. Results show that women's labour force participation has steadily increased over time but that a number of negative trends exclude women with substantial caring responsibilities from pursuing a career track. The implications of increasing levels of wage deregulation are that gender wage inequality and the potential for discrimination will grow.

An investigation into the nature and consequences of teachers' implicit philosophies of science

The aims of this study were to investigate the beliefs concerning the philosophy of science held by practising science teachers and to relate those beliefs to their pupils' understanding of the philosophy of science. Three philosophies of science, differing in the way they relate experimental work to other parts of the scientific enterprise, are described. By the use of questionnaire techniques, teachers of four extreme types were identified. These are: the H type or hypothetico-deductivist teacher, who sees experiments as potential falsifiers of hypotheses or of logical deductions from them; the I type or inductivist teacher, who regards experiments mainly as a way of increasing the range of observations available for recording before patterns are noted and inductive generalisation is carried out; the V type or verificationist teacher, who expects experiments to provide proof and to demonstrate the truth or accuracy of scientific statements; and the 0 type, who has no discernible philosophical beliefs about the nature of science or its methodology. Following interviews of selected teachers to check their responses to the questionnaire and to determine their normal teaching methods, an experiment was organised in which parallel groups were given H, I and V type teaching in the normal school situation during most of one academic year. Using pre-test and post-test scores on a specially developed test of pupil understanding of the philosophy of science, it was shown that pupils were positively affected by their teacher's implied philosophy of science. There was also some indication that V type teaching improved marks obtained in school science examinations, but appeared to discourage the more able from continuing the study of science. Effects were also noted on vocabulary used by pupils to describe scientists and their activities.

Critical approaches to care:understanding caring relations, identities and cutures

What does ‘care’ mean in contemporary society? How are caring relationships practised in different contexts? What resources do individuals and collectives draw upon in order to care for, care with and care about themselves and others? How do such relationships and practices relate to broader social processes? Care shapes people’s everyday lives and relationships and caring relations and practices influence the economies of different societies. This interdisciplinary book takes a nuanced and context-sensitive approach to exploring caring relationships, identities and practices within and across a variety of cultural, familial, geographical and institutional arenas. Grounded in rich empirical research and discussing key theoretical, policy and practice debates, it provides important, yet often neglected, international and cross-cultural perspectives. It is divided into four sections covering: caring within educational institutions; caring amongst communities and networks; caring and families; and caring across the life-course. Contributing to broader theoretical, philosophical and moral debates associated with the ethics of care, citizenship, justice, relationality and entanglements of power, Critical Approaches to Care is an important work for students and academics studying caring and care work in the fields of health and social care, sociology, social policy, anthropology, education, human geography and politics.

Co-constructed caring research and intellectual disability:an exploration of friendship, intimacy and being human

For this paper, emotional and socio-political questions lie at the heart of relationships in understanding intellectual disability and what it is to be a human. While the sexual and intimate is more often than not based on a private and personal relationship with the self and (an)other, the sexual and intimate life of intellectually disabled people is more often a ‘public’ affair governed by parents and/or carers, destabilizing what we might consider ethical and caring practices. In the socio-political sphere, as an all-encompassing ‘care space’, social intolerance and aversion to difficult differences are played out, impacting upon the intimate lives of intellectually disabled people. As co-researchers (one intellectually disabled and one ‘non-disabled’), we discuss narratives from a small scale research project and our personal reflections. In sociological research and more specifically within disability research it is clear that we need to keep sex and intimacy on the agenda, yet also find ways of doing research in a meaningful, caring and co-constructed way.

Caring for the Caregiver: Emotional Challenges of Pediatric Palliative Care Nurses

Pediatric Palliative Care (PPC) nurses provide quality-of-life for critically ill children. This paper looks at how PPC nurses cope with caregiver emotions within the conceptual framework of emotional labor and emotional intelligence.

*Postsecondary access for individuals with psychological disabilities: An analysis of federal rulings and institutional philosophies, *policies, and practices

This study was a qualitative investigation, with demographic quantitative features, of post-secondary educational access and legal guidelines for individuals with psychological disabilities. Although disability laws have positively influenced post-secondary educational attitudes and practices relative to accommodating many individuals with disabilities, prevailing stigmas regarding mental illness have discouraged the equal access to higher education for individuals with psychological disabilities. Little research concentrating on this area was found.^ Thirty-six relevant legal case decisions, focusing on a variety of realms of higher education, were scrutinized. The policies, procedures, and practices of six Southeastern United States universities were analyzed through official documents and participant responses from disability service providers and other university employees. Comparisons were made between legal cases, and within and between universities. Case findings also provided standards through which participating university practices could be studied.^ The legal analysis revealed that most institutions did not discriminate against individuals with psychological disabilities. Practices of a few of these institutions, however, suggested non-compliance despite favorable decisions on their behalf. Institutions found to have discriminatory practices were cited for inadequate procedures, or for presumptive assessments of the educational functioning levels of individuals with psychological disabilities.^ Participant university practices generally suggested disability law compliance; however, certain campus interventions were determined to be ineffective in identifying, addressing, and communicating about the educational needs of individuals with psychological disabilities. The most effective services for these individuals, who were described as rapidly increasing in number but lagging in self-advocacy and acceptance by others, went beyond legal requirements.^ Recommendations were made for institutional practices concerning disability-related documentation, written standards and operations, and student identification and referral. Directions for future research focused on study skills training for students; exposure of mental health professionals to client educational needs; and expansion of the current research, on a nationwide collegiate level, and a parallel analysis focusing on business and industry. ^