Family Caregivers and Palliative Care: Current Status and Agenda for the Future

The quality of life of the person confronting the end stages of their life may be severely compromised without the support of family caregivers. Indeed, most people requiring palliative care would not be able to fulfill their preferences, such as care at home, without significant family caregiver input. As a consequence, health services are mandated to support the family alongside the person diagnosed with a life-threatening illness. In short, palliative care is supposed to be family centred. However, the quality and type of support made available to family caregivers has been questioned. The purpose of this review is to outline a succinct and empirically informed account of family caregiving within the context of palliative care and to propose an agenda for the future. The appraisal is underpinned by several systematic reviews, and other seminal publications from the last decade.

What now for the contact hypothesis? Towards a new research agenda

This article begins with a review of recent research on the Contact Hypothesis. It will be shown that the literature in this area has become essentially closed and self-referential where the core political and theoretical premises that underpin the Hypothesis have been taken for granted and the debates have therefore become restricted simply to how best to measure the influence of inter-group contact. One of the key reasons for this is the lack of critical engagement with the Contact Hypothesis from those of a more structuralist and/or ‘radical’ perspective. This may be because the individualistic focus of the Hypothesis is seen from such a perspective as largely irrelevant to addressing racial and ethnic divisions and/or because it may be felt that to engage with the concept is to give it undue legitimacy. It will be argued in this article, however, that the wholesale dismissal of the Contact Hypothesis is a little premature. Just as recent research on racial and ethnic divisions has drawn attention to the way in which such divisions exist at a number of layers within the social formation – from the structural, political and ideological through to the sub-cultural, interactional and biographical – so must any initiatives aimed at addressing these divisions be similarly ‘multi-layered’ in their approach. However, it will be argued that for research to help inform specific strategies at the interactional level, there needs to be a significant change in the way that inter-group contact, and the Contact Hypothesis more generally, is studied. The article will ‘model out’ one potentially fruitful way in which such research can develop through the use of an ethnographic case study involving a cross-community scheme arranged for Protestant and Catholic children in Northern Ireland.

Defining a Research Agenda in Value Driven Design: Questions That Need to be Asked

Value driven design is an innovative design process that utilizes the optimization of a system level value function to determine the best possible design. This contrasts with more traditional systems engineering techniques, which rely on satisfying requirements to determine the design solution. While ‘design for value’ is intuitively acceptable, the transformation of value driven design concepts into practical tools and methods for its application is challenging. This, coupled with the growing popularity of value-centric design philosophies, has led to a proposed research agenda in value driven design. This research agenda asks fundamental questions about the design philosophy and attempts to identify areas of significant challenge. The research agenda is meant to stimulate discussion in the field, as well as prompt research that will lead to the development of tools and methodologies that will facilitate the application of value driven design and further the state of the art.

European Law and New Health Technologies: The Research Agenda

Maps the research agenda that underpinned the edited collection 'European Law and New Health Technologies', that this pieces introduces.

EURODIAB childhood type 1 diabetes incidence registers - results from the first 20 years. Oral presentation at the 47th EASD Annual Meeting, Lisbon, Portugal.

Background and aims: In 1989 a number of registers in Europe began recording new cases of type 1 diabetes diagnosed in children aged under 15 years using a common protocol. Trends in incidence rate during the 20 year period 1989-2008 are described.
Materials and methods: All registers operate in geographically defined regions and are based on a clinical diagnosis. When possible, completeness of registration in each register is assessed using capture-recapture methodology by identifying primary and secondary sources of ascertainment. The completeness estimate is obtained by identifying the numbers of cases identified by the primary source only, by the secondary source only and by both the primary and the secondary sources.
Results: Other registers have joined the Group since 1989, and 21 registers in 15 countries continue to submit registration data. In the first five years (1989-93) incidence rates varied from 3.2 per 100,000 in the Former Yugoslav Republic of Macedonia to 25.8 per 100,000 in the Stockholm area of Sweden. In the last five years (2004-2008) these same two registers again had the lowest and highest incidence, but rates had increased to 5.8 per 100,000 and 36.6 per 100,000, respectively. During the 20 year period all but two of the 21 registers showed statistically significant rates of increase (median rate of increase 4% per annum), and similar figures were obtained when this median rate of increase was estimated for the first half of the period (1989-98) and for the second half (1999-2008) . However, rates of increase differed significantly between the first half and the second half of the period for eight of the 17 registers with adequate coverage of both periods; four registers showing significantly higher rates of increase in the first half and four significantly higher rates in the second half.
Conclusion: The childhood type 1 diabetes incidence rate continues to rise across Europe by approximately 4% per annum, but the increase within a register is not necessarily uniform with periods of less rapid and more rapid increase in incidence occurring in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions are warranted.