The stress process in palliative cancer care:A qualitative study on informal caregiving and its implication for the delivery of care

Objective: The primary objective of this study was to examine how the comprehensive nature of the Stress Process Model could elucidate on the stressors associated with caring for a palliative cancer patient. Method: A qualitative research strategy involving home-based face-to-face interviews with 12 bereaved family caregivers was used to examine the caregiving experience. Results: The primary stressors associated with caring for the palliative cancer care patients stemmed from care recipient symptoms and personal care needs. The absence of adequate support from the formal health care delivery system was a consistent message from all participants. There was evidence of financial stress primarily associated with the purchase of private home care to supplement formal care. In contrast, the resources that family caregivers relied on to moderate the stressful effects of caregiving included extended family, friends, and neighbors. While the stress of direct caregiving was high, the study revealed that formal care was also a significant source of stress for family caregivers. Conclusion: It was concluded that an appropriately financed, integrated system of care that followed a person-centered philosophy of care would best meet the needs of the patient and his or her family. © The Author(s) 2010.

Dignity and religion

This chapter, included in a book examining the relationship between Islam and English Law, considers the role that the idea of 'human dignity' plays in discussions of the relationship between the European Convention on Human Rights and freedom of religion, and the implications this has for future consideration of the place of Shari'a.

Science, Geography of

Interest in the geography of science has increased significantly over the past 20 years to create a highly interdisciplinary field of inquiry. Rejecting the spatial determinism of earlier work, geographers and many others have developed insights from the sociology and philosophy of science and from social and cultural theory to examine the spatiality of science in all of its diversity and complexity. Particular attention has been paid to the sites at which scientific knowledge has been produced, assessed, and consumed and to the transmission of science over physical, cultural, and cognitive terrain.

General practitioners’ management of the long-term sick role

In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees / patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons’s model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

Germany and the New Global History of Secularism: Questioning the Postcolonial Genealogy

Secularism has emerged as a central category of twenty-first century political thought that in many ways has replaced the theory of secularization. According to postcolonial scholars, neither the theory nor the practice of secularization was politically neutral. They define secularism as the set of discourses, policies, and constitutional arrangements whereby modern states and liberal elites have sought to unify nations and divide colonial populations. This definition is quite different from the original meaning of secularism, as an immanent scientific worldview linked to anticlericalism. Anthropologist Talal Asad has connected nineteenth-century worldview secularism to twenty-first century political secularism through a genealogical account that stresses continuities of liberal hegemony. This essay challenges this account. It argues that liberal elites did not merely subsume worldview secularism in their drive for state secularization. Using the tools of conceptual history, the essay shows that one reason that “secularization” only achieved its contemporary meaning in Germany after 1945 was that radical freethinkers and other anticlerical secularists had previously resisted liberal hegemony. The essay concludes by offering an agenda for research into the discontinuous history of these two types of secularism.

The impact of interventions to promote physical activity in urban green space: A systematic review and recommendations for future research

Evidence is mounting on the association between the built environment and physical activity (PA) with a call for intervention research. A broader approach which recognizes the role of supportive environments that can make healthy choices easier is required. A systematic review was undertaken to assess the effectiveness of interventions to encourage PA in urban green space. Five databases were searched independently by two reviewers using search terms relating to 'physical activity', 'urban green space' and 'intervention' in July 2014. Eligibility criteria included: (i) intervention to encourage PA in urban green space which involved either a physical change to the urban green space or a PA intervention to promote use of urban green space or a combination of both; and (ii) primary outcome of PA. Of the 2405 studies identified, 12 were included. There was some evidence (4/9 studies showed positive effect) to support built environment only interventions for encouraging use and increasing PA in urban green space. There was more promising evidence (3/3 studies showed positive effect) to support PAprograms or PA programs combined with a physical change to the built environment, for increasing urban green space use and PAof users. Recommendations for future research include the need for longer term follow-up post-intervention, adequate control groups, sufficiently powered studies, and consideration of the social environment, which was identified as a significantly under-utilized resource in this area. Interventions that involve the use of PA programs combined with a physical change to the built environment are likely to have a positive effect on PA. Robust evaluations of such interventions are urgently required. The findings provide a platform to inform the design, implementation and evaluation of future urban green space and PAintervention research.

The uncritical realism of realist evaluation

This article is a response to Ray Pawson’s critique of critical realism, the philosophy of science elaborated by Roy Bhaskar. I argue with Pawson’s interpretation of critical realism’s positions on both natural and social science and his charges concerning its totalizing ontology, its arrogant epistemology and its naive methodology. The differences between critical realism and realist evaluation are not as significant as Pawson contends. The main differences between the two realisms lie in their approaches to the relationship between social structures and human agency, and between facts and values. I argue that evaluation scientists need to clearly distinguish structure and agency. They should also make their values explicit. The uncritical approach of realist evaluation, combined with its underplaying of the importance of agency, leaves it open to implication in the abuses of bureaucratic instrumentalism.

Is the multiracial congregation an answer to the problem of race? Comparative perspectives from South Africa and the USAF

This paper uses a comparative perspective to analyze how multiracial congregations may contribute to racial reconciliation in South Africa. Drawing on the large-scale study of multiracial congregations in the USA by Emerson et al., it examines how they help transform antagonistic identities and make religious contributions to wider reconciliation processes. It compares the American research to an ethnographic study of a congregation in Cape Town, identifying cross-national patterns and South African distinctives, such as discourses about restitution, AIDS, inequality and women. The extent that multiracial congregations can contribute to reconciliation in South Africa is linked to the content of their worship and discourses, but especially to their ability to dismantle racially aligned power structures. © Koninklijke Brill NV, 2008.

The Intersection of Religious Autonomy and Religious Symbols: Setting the Stage

Two sets of issues in the area of law and religion have generated a large share of attention and controversy across a wide number of countries and jurisdictions in recent years. The first set of issues relates to the autonomy of churches and other religiously affiliated entities such as schools and social service organisations in their hiring and personnel decisions, involving the question of how far, if at all, such entities should be free from the influence and oversight of the state. The second set of issues involves the presence of religious symbols in the public sphere, such as in state schools or on public lands, involving the question of how far the state should be free from the influence of religion. Although these issues – freedom of religion from the state, and freedom of the state from religion – could be viewed as opposite sides of the same coin, they are almost always treated as separate lines of inquiry, and the implications of each for the other have not been the subject of much scrutiny. In this Introduction, we consider whether insights might be drawn from thinking about these issues both from a comparative law perspective and also from considering these two lines of cases together.

Northern Ireland: Religion and Transitional Justice

The right to practice religion is recognised as one of the universal liberties transitional justice interventions are designed to defend, and religion is often mentioned as one of the cultural factors that impact on local transitional justice practices from below. Many human rights cases of abuse, however, are motivated by religious extremism and the association of religion with conflict has largely a discouraged reflection on its positive contribution to transitional justice. This field is undeveloped and the little work that elaborates its positive role is descriptive. This paper theorises the relationship between religion and transitional justice and develops a model for understanding its potential role that better allows an assessment of its strengths and weaknesses. The model is applied to original research conducted on ex-combatants in Northern Ireland, and concludes that only in very limited circumstances can religious actors make a telling contribution to transitional justice.Understanding what these circumstances are is the purpose of the model developed here.

Bright Molecules for Sensing, Computing and Imaging: A Tale of Two Once-troubled Cities

The circumstances in Colombo, Sri Lanka, and in Belfast, Northern Ireland, which led to a) the generalization of luminescent PET (photoinduced electron transfer) sensing/switching as a design tool, b) the construction of a market-leading blood electrolyte analyzer and c) the invention of molecular logic-based computation as an experimental field, are delineated. Efforts to extend the philosophy of these approaches into issues of small object identification, nanometric mapping, animal visual perception and visual art are also outlined.

Christianity as a Vocation: The Rostrevor Benedictines and the Renewal of Faith in Ireland

This chapter explores how the Benedictine monks at Holy Cross Monastery in Rostrevor, Northern Ireland, have re-introduced the idea of vocation into the minds of a range of Christians on the island of Ireland. A picture of this new vision of the church in Ireland is painted through sections devoted to 'living ecumenism' and 'creating safe spaces'. The work of the Rostrevor Benedictines may seem limited because of the small scale of the changes among individuals. But Holy Cross is just one of multiple 'extra-institutional' spaces in Ireland's changing religious landscape. From their strategic positions on the margins, extra-institutional expressions of religion may prompt more significant changes in religious practice than initially seem possible.