Working together-apart : exploring the relationships between formal and informal care networks for people dying at home

Introduction Informal caring networks contribute significantly to end-of-life (EOL) care in the community. However, to ensure that these networks are sustainable, and unpaid carers are not exploited, primary carers need permission and practical assistance to gather networks together and negotiate the help they need. Our aim in this study was to develop an understanding of how formal and informal carers work together when care is being provided in a dying person's home. We were particularly interested in formal providers’ perceptions and knowledge of informal networks of care and in identifying barriers to the networks working together. Methods Qualitative methods, informed by an interpretive approach, were used. In February-July 2012, 10 focus groups were conducted in urban, regional, and rural Australia comprising 88 participants. Findings Our findings show that formal providers are aware, and supportive, of the vital role informal networks play in the care of the dying at home. A number of barriers to formal and informal networks working together more effectively were identified. In particular, we found that the Australian policy of health-promoting palliative is not substantially translating to practice. Conclusion Combinations of formal and informal caring networks are essential to support people and their primary carers. Formal service providers do little to establish, support, or maintain the informal networks although there is much goodwill and scope for them to do so. Further re-orientation towards a health-promoting palliative care and community capacity building approach is suggested.

End-of-life care in the intensive care unit : a systematic review of qualitative studies investigating the experiences and perceptions of the patient's family

Review question/objective The review objective is to synthesise the best available evidence on experiences and perceptions of family members of intensive care unit patients on the adequacy of end-of-life care, where life-support modalities have been withheld or withdrawn. Inclusion criteria Types of participants This review will consider studies that report on the experiences and perceptions of patients’ families on EOLC in the ICU, where life-support modalities have been withheld or withdrawn. The family is defined as “those who are closest to the patient... the family may include the biological family, family by acquisition, and the family of choice and friends”. Phenomena of interest The phenomena of interest for this review are the patients’ families experiences, perceptions or views on the adequacy of EOLC delivered in the ICU, where life-support modalities were withheld or withdrawn. These experiences may refer to the following views on domains of care considered important at the end-of-life in the ICU, which have been described already in the existing literature: timely, consistent, and compassionate communication, clinician availability, clinical decision making based on patients’ preferences, goals and values, physical care implemented to maintain patient comfort, holistic interdisciplinary care and bereavement care for families of patients who died.

Nutritional influences over the life course on lean body mass of individuals in developing countries

The double burden of childhood undernutrition and adult-onset adiposity in transitioning societies poses a significant public health challenge. The development of suboptimal lean body mass (LBM) could partly explain the link between these two forms of malnutrition. This review examines the evidence on both the role of nutrition in “developmental programming” of LBM and the nutritional influences that affect LBM throughout the life course. Studies from developing countries assessing the relationship of early nutrition with later LBM provide important insights. Overall, the evidence is consistent in suggesting a positive association of early nutritional status (indicated by birth weight and growth during first 2 years) with LBM in later life. Evidence on the impact of maternal nutritional supplementation during pregnancy on later LBM is inconsistent. In addition, the role of nutrients (protein, zinc, calcium, vitamin D) that can affect LBM throughout the life course is described. Promoting optimal intakes of these important nutrients throughout the life course is important for reducing childhood undernutrition as well as for improving the LBM of adults.

Constructing the Architext : Georges Perec's life a user's manual

Mitchell critiques Georges Perec's Life a User's Manual, which articulates compellingly the confluence of literature and architecture studies that emerged in the late twentieth century. He argues the Perec's novel diverges from this tradition, for, rather than being a search for origins and true expression, Life a User's Manual denies the very possibility of originality. He adds that Perec's architext is de-constructive and ironic.

Structures of life : the role of molecular structures in scientists' work

The visual and multidimensional representations like images and graphical structures related to biology provide great insights into understanding the complexities of different organisms. Especially, life scientists use different representations of molecular structures to answer biological questions and to better understand cellular processes. Combining results from two field studies, we explore the role of molecular structures in life scientists’ current work from a humanfactors perspective. Our main conclusion is that different representations of molecular structures, due to their visual nature, are important for supporting collaboration, constructing new knowledge and supporting scientists’ professional activities in general.

Framework of whole life cycle costing for Malaysian high rise residential property development

This project was an initial stage in formulating and management of the optimum budget allocation during the operational, maintenance and rehabilitation phases in high rise residential property development in Malaysia. The principal objective of this project is to develop a framework of Whole Life Cycle Costing for high rise residential property development that will enhance the quality and cost effectiveness of this building type in Malaysia. The researcher investigated 13 building components from 6 high rise residential property developments in Johor, Malaysia to determine the affect and economic impact of component initial cost and quality by applying them to a Whole Life Cycle Cost model approach. The results provide valuable data in respect to the overall cost of specific components over the whole life of a large high rise building. In addition, Dr. Mat Noor also determined the impact and satisfaction of quality of building components through WLCC.

Higher uptake of long-acting reversible and permanent methods of contraception by Australian women living in rural and remote areas

Objectives: To examine factors associated with the uptake of i) long-acting reversible, ii) permanent and iii) traditional contraceptive methods among Australian women. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1973–78 reported on their contraceptive use at three surveys: 2003, 2006 and 2009. The participants were 5,849 women aged 25–30 in 2003 randomly sampled from Medicare. The main outcome measure was current contraceptive method at age 28–33 years categorised as long-acting reversible methods (implant, IUD, injection), permanent (tubal ligation, vasectomy), and traditional methods (oral contraceptive pills, condoms, withdrawal, safe period). Results: Compared to women living in major cities, women in inner regional areas were more likely to use long-acting (OR=1.26, 95%CI 1.03–1.55) or permanent methods (OR=1.43, 95%CI 1.17–1.76). Women living in outer regional/remote areas were more likely than women living in cities to use long-acting (OR=1.65, 95%CI 1.31–2.08) or permanent methods (OR=1.69, 95%CI 1.43–2.14). Conclusions: Location of residence is an important factor in women's choices about long-acting and permanent contraception in addition to the number and age of their children. Implications: Further research is needed to understand the role of geographical location in women's access to contraceptive options in Australia.

Does withdrawing life-sustaining treatment cause death or allow the patient to die?

The paper discusses the view of Franklin Miller and Robert Truog that withdrawing life-sustaining treatment causes death and so is a form of killing. I reject that view. I argue that even if we think there is no morally relevant difference between allowing a patient to die and killing her (itself a controversial view), it does not follow that allowing to die is a form of killing. I then argue that withdrawing life-sustaining treatment is properly classified as allowing the patient to die rather than as killing her. Once this is accepted, the law cannot be criticised for inconsistency by holding, as it does, that it is lawful to withdraw life-sustaining treatment but unlawful to give patients a lethal injection.

“Scary” heterosexualities in a rural Australian mining town

This paper draws upon Hubbard's (1999, p. 57) term ‘scary heterosexualities,’ that is non-normative heterosexuality, in the context of the rural drawing on data from fieldwork in the remote Western Australian mining town of Kalgoorlie. Our focus is ‘the skimpie’ – a female barmaid who serves in her underwear and who, in both historical and contemporary times, is strongly associated with rural mining communities. Interviews with skimpies and local residents as well as participant observation reveal how potential fears and anxieties about skimpies are managed. We identify the discursive and spatial processes by which skimpie work is contained in Kalgoorlie so that the potential scariness ‘the skimpie’ represents to the rural is muted and buttressed in terms of a more conventional and less threatening rural heterosexuality.

Doing cultural work : local postcard production and place identity in a rural shire

Studies of place construction in the rural studies literature have largely privileged the role of professionals over that of local lay actors. This paper contributes to redressing this imbalance through a critical case-study of lay postcard production in a rural shire. Drawing on original, qualitative research conducted in the Shire of Ravensthorpe, Western Australia, including in-depth interviews with key participants, the analysis focuses on this lay production—undertaken in the main by women—as cultural work. By emphasising the work of making the postcards along with the cultural work these postcards achieve, this examination foregrounds intersections of material and imagined ruralities. In the process, this study highlights the complexity and importance of this lay contribution to place identity, particularly as positioned within what may be considered rural cultural work.

Gender, emotions and fly-in fly-out work

This paper explores the emotional life of fly‑in fly‑out (FIFO) workers and their families, through an analysis of more than 500 postings made on an online chat forum for mining families. Building on literature on fly‑in fly‑out workers and understandings of emotions as socially constructed, analysis shows how posters to the forum, typically women whose male partners are FIFO workers, construct gendered emotional identities for their partners (sometimes referred to as 'Mr Miner'), and for themselves, as 'mining women', 'mining widows' or the 'mining missus'. Inherent in the creation of gendered emotional subject positions is the process of women undertaking emotion work on and behalf of themselves, their male partners and their children. The findings demonstrate the overarching normative dimensions of women's emotional self‑transformations in the service of their mining partners' careers and the attendant reproduction of everyday patriarchal relations in the private lives of mining families.

Social ecological influences on preferences for care provided at the end of life amongst Taiwanese city-dwelling adults

Social and cultural elements are an essential part of the contexts within which people understand their word and make end-of-life decisions. A developmental social ecological model was used in this thesis to provide a comprehensive framework for examining influences on end-of-life preferences. The findings support claims made by social ecologists that individual's health-related choices can be influenced by cultural, social contextual and environmental factors over the course of life. The results of this study have implications for health professionals and the practices they can adopt to enhance end-of-life care.

ÉLET [LIFE]

Élet [pronounced air-let] is the Hungarian word for Life. The work is informed by the lyrics of six songs performed by French cover band Nouvelle Vague. Whilst Élet [Life] is created to be absorbed and interpreted openly by each individual, at the core of the choreography lies a desire to move forwards, to communicate – to be seen and heard. The work embraces aspects such as loneliness, joy and tension that we experience in our lives and relationships. As the movement opens out from these ideas, the physical shapes of our personal moments are infused with the elements of sound, colour and rhythm. A rich translation of personal movements through life.

Secure and safe water supplies in remote Australian and rural Sri Lankan regions : common issues and emerging responses

Most urban dwelling Australians take secure and safe water supplies for granted. That is, they have an adequate quantity of water at a quality that can be used by people without harm from human and animal wastes, salinity and hardness or pollutants from agriculture and manufacturing industries. Australia wide urban and peri-urban dwellers use safe water for all domestic as well as industrial purposes. However, this is not the situation remote regions in Australia where availability and poor quality water can be a development constraint. Nor is it the case in Sri Lanka where people in rural regions are struggling to obtain a secure supply of water, irrespective of it being safe because of the impact of faecal and other contaminants. The purposes of this paper are to overview: the population and environmental health challenges arising from the lack of safe water in rural and remote communities; response pathways to address water quality issues; and the status of and need for integrated catchment management (ICM) in selected remote regions of Australia and vulnerable and lagging rural regions in Sri Lanka. Conclusions are drawn that focus on the opportunity for inter-regional collaborations between Australia and Sri Lanka for the delivery of safe water through ICM.

Sweet sorghum : opportunities for a new, renewable fuel and food industry in Australia

Sweet sorghum is receiving significant global interest as an agro-industrial crop because of its capacity to co-produce energy, food, and feed products in integrated biorefineries. This report assesses the opportunities to develop a sweet sorghum industry in Australia, reports on research demonstrating the production of energy, food, and feed products, and assesses the potential economic and sustainability benefits of sweet sorghum biorefineries in the Australian context.