2,097 research outputs found
Transitions at the end of life for older adults - patient, carer and professional perspectives
No full textBackgroundThe end of life may be a time of high service utilisation for older adults. Transitions between care settings occur frequently, but may produce little improvement in symptom control or quality of life for patients. Ensuring that patients experience co-ordinated care, and moves occur because of individual needs rather than system imperatives, is crucial to patients’ well-being and to containing health-care costs.ObjectiveThe aim of this study was to understand the experiences, influences and consequences of transitions between settings for older adults at the end of life. Three conditions were the focus of study, chosen to represent differing disease trajectories.SettingEngland.ParticipantsThirty patients aged over 75 years, in their last year of life, diagnosed with heart failure, lung cancer and stroke; 118 caregivers of decedents aged 66–98 years, who had died with heart failure, lung cancer, stroke, chronic obstructive pulmonary disease or selected other cancers; and 43 providers and commissioners of services in primary care, hospital, hospice, social care and ambulance services.Design and methodsThis was a mixed-methods study, composed of four parts: (1) in-depth interviews with older adults; (2) qualitative interviews and structured questionnaire with bereaved carers of older adult decedents; (3) telephone interviews with care commissioners and providers using case scenarios derived from the interviews with carers; and (4) analysis of linked Hospital Episode Statistics (HES) and mortality data relating to hospital admissions for heart failure and lung cancer in England 2001–10.ResultsTransitions between care settings in the last year of life were a common component of end-of-life care across all the data sets that made up this study, and many moves were made shortly before death. Patients’ and carers’ experiences of transitions were of a disjointed system in which organisational processes were prioritised over individual needs. In many cases, the family carer was the co-ordinator and provider of care at home, excluded from participation in institutional care but lacking the information and support to extend their role with confidence. The general practitioner (GP) was a valued, central figure in end-of-life care across settings, though other disciplines were critical of GPs’ expertise and adherence to guidelines. Out-of-hours services and care homes were identified by many as contributors to unnecessary transitions. Good relationships and communication between professionals in different settings and sectors was recognised by families as one of the most important influences on transitions but this was rarely acknowledged by staff.ConclusionsDevelopment of a shared understanding of professional and carer roles in end-of-life transitions may be one of the most effective ways of improving patients’ experiences. Patients and carers manage many aspects of end-of-life care for themselves. Identifying ways to extend their skills and strengthen their voices, particularly in hospital settings, would be welcomed and may reduce unnecessary end-of-life transitions. Why the experiences of carers appear to have changed little, despite the implementation of a range of relevant policies, is an important question that has not been answered. Recommendations for future research include the relationship between policy interventions and the experiences of end-of-life carers; identification of ways to harmonise understanding of the carers’ role and strengthen their voice, particularly in hospital settings; identification of ways to reduce the influence of interprofessional tensions in end-of-life care; and development of interventions to enhance patients’ experiences across transitions.FundingThe National Institute for Health Research Health Services and Delivery Research programme
Award winning author, journalist Daniel L. Coberly to Speak
No full textTollefson, Elizabeth. (2018). Award winning author, journalist Daniel L. Coberly to Speak. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/224033
The life of Elizabeth Prentiss, author of Stepping heavenward.
No full text"List of Mrs. Prentiss' writings" : v. 2, p. 342-351."Her letters ... with extracts from her journals, form the larger portion." cf. Prefatory note signed : G. L. P. [i. e. George L. Prentiss]Appeared (1882) under title : The life and letters of Elizabeth Prentiss.Mode of access: Internet
Tudor women writers fashioning masculinity
No full textThis thesis contributes to the growing interest in early modern masculinity and its literary representations by introducing texts by women writers into dialogue with their male-authored counterparts. It argues for a more nuanced approach that recognises that the concepts of masculinity and femininity can only be fully understood when studied in relation with each other.
The first chapter explores how, notwithstanding the wisdom of conduct books and marriage guides, the demands of the state may not always be commensurate with those of the domestic realm and shows that this conflict necessitates a rethinking of existing definitions of masculinity by focusing on selected writings of the Tudor sisters Mary and Elizabeth and Jane Fitzalan’s *Tragedie of Iphigeneia*. The second chapter identifies how Elizabeth’s unique discursive strategies were designed to elicit support from her male subjects and subdue the belligerence that simmered under polemic like John Stubbs’ *Gaping Gulf*. In her letters to Anjou, the chapter examines how Elizabeth manoeuvred around her position as a beloved and as a monarch to fashion a husband who would not only be sympathetic but also subordinate to her political authority. This chapter also shows how the fabulous world of John Lyly’s *Galatea* consummates the Queen’s desire for the ideal male subject. The final chapter investigates the construction of martial manhood. It juxtaposes Mary Sidney’s *The Tragedy of Antonie* with William Shakespeare’s *Antony and Cleopatra* to determine how the figure of Cleopatra, common to both plays, challenges and revises the martial code of masculinity as embodied by Antony. By examining the authorial position appropriated by Cleopatra in the plays and its impact on the narrative, this chapter also extends this thesis’ interest in the extent to which female characters within texts compete for diegetic control with male protagonists
Women's life writing 1760-1830 : spiritual selves, sexual characters, and revolutionary subjects
No full textPhDThis thesis uses print and manuscript sources to analyse and interpret women's life
writing at the end of the eighteenth and beginning of the nineteenth centuries. I
explore printed works by Catharine Phillips, Mary Dudley, Priscilla Hannah Gurney,
Ann Freeman, Elizabeth Steele, Mary Robinson, Helen Maria Williams, Mary
Wollstonecraft, Grace Dalrymple Elliott, and Charlotte West and discuss the
manuscripts of Mary Fletcher, Mary Tooth, Sarah Ryan, and Elizabeth Fox. Of these
sources, five have never been analysed in the critical literature and six have received
little attention. Considered as a group, this large corpus of texts offers new insights
into the personal and political implications of different models of female selfhood and
social being.
In chapter one, I compare the religious identities presented in the spiritual
autobiographies of Quakers and Methodists. For these women, religious identification
provides a powerful sense of social belonging and enables public participation.
However, it may also lead to a loss of self in the demand for religious conformity and
self-abnegation. In chapter two, I consider the life writing of late eighteenth-century
courtesans. These women adapt available models of femininity and female authorship
in order to establish themselves as socially connected subjects. However, their
narratives also reveal that dependence on the sexual and literary marketplace puts
female selfhood under pressure. In chapter three, I explore the eyewitness accounts of
British women in the French Revolution. I argue that, for these writers, connecting
personal identity to political history is an enabling source of self-definition but it also
exposes them to the risks of self-fragmentation.
In my focus on the social function of women's life writing, I present an alternative to
the traditional alignment of the eighteenth-century autobiographical subject with the
autonomous self of individualism. These narratives allow us to reconsider the
productive and problematic dialectic between personal expression and representative
selfhood, self-authorship and collective narratives, and individualism and social
being. They suggest that women's life writing has the potential to be both the self-expression
of a unique heroine and the self-inscription of a politicised subject
RoMEO Studies 2: How academics wish to protect their open-access research paper
No full textThis paper is the second in a series of studies (see Gadd, E., C. Oppenheim, and S. Probets. RoMEO Studies 1: The impact of copyright ownership on author-self-archiving. Journal of Documentation. 59(3) 243-277) emanating from the UK JISC-funded RoMEO Project (Rights Metadata for Open-archiving). It considers the protection for research papers afforded by UK copyright law, and by e-journal licences. It compares this with the protection required by academic authors for open-access research papers as discovered by the RoMEO academic author survey. The survey used the Open Digital Rights Language (ODRL) as a framework for collecting views from 542 academics as to the permissions, restrictions, and conditions they wanted to assert over their works. Responses from self-archivers and non-archivers are compared. Concludes that most academic authors are primarily interested in preserving their moral rights, and that the protection offered research papers by copyright law is way in excess of that required by most academics. It also raises concerns about the level of protection enforced by e-journal licence agreement
Bull trout conservation and recovery in the Odell Lake core area: distribution, behavior, ecology, and fisheries evaluations (2013-2014)
No full textMichael H. Meeuwig, Steve J. Starcevich, Elizabeth J. Bailey, Shaun P. Clements, and Joshua L. McCormick.This archived document is maintained by the State Library of Oregon as part of the Oregon Documents Depository Program. It is for informational purposes and may not be suitable for legal purposes.Includes bibliographical references (pages 63-68).Funding for this project was provided in part by USFWS (F14AF01131 and F13AF01080).Mode of access: Internet from the Oregon Government Publications Collection.Text in English
Correction to: Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol
No full textAfter publication of the original article [1] it was brought to our attention that author Elizabeth McGhee Hassrick was erroneously included as Elizabeth McGee Hassrick. The correct spelling of the author’s name is included in the author list of this erratum
Funding health and social services for older people: a qualitative study of the views of care recipients in the last year of life
No full textObjectives This study explores the views of older adults who are receiving health and social care at the end of their lives, on how services should be funded, and describes their health-related expenditure. Design Qualitative interview study Setting North West England Participants 30 people aged 69–93 years, diagnosed with lung cancer, heart failure or stroke and judged by health professionals to be in their last year of life. Sixteen participants lived in disadvantaged areas. Main outcome measures Views of older adults on funding of services. Results Participants expressed a belief in an earned entitlement to services funded from taxation, based on a broad sense of being a good citizen. Irrespective of social background, older people felt that those who could afford to pay for social care, should do so. Sale of assets and use of children's inheritance to fund care was widely perceived as an injustice. The costs of living with illness are a burden, and families are filling many of the gaps left by welfare provision. People who had worked in low-wage occupations were most concerned to justify their current acceptance of services, and distance themselves from what they described as welfare ‘spongers’ or ‘layabouts.’ Conclusions There is a gap between the health and social care system that older adults expect and what may be provided by a reformed welfare state at a time of financial stringencies. The values that underpinned the views expressed – mutuality, care for the most needy, and the importance of working to contribute to society – are an important contribution to the debate on welfare funding
Métricas de autor Laura Elizabeth Castro Jiménez
No full textInforme de las métricas de autor de la Dra. Laura Elizabeth Castro Jiménez de las publicaciones indexadas en Google Académico cuyo objetivo es entregar un insumo para el fortalecimiento de las capacidades y potencialidades de los autores de la Universidad Santo Tomás en el posicionamiento y visibilidad de sus publicacionesReport of the author metrics of Laura Elizabeth Castro Jiménez of the publications indexed in Google Scholar whose objective is to provide an input for the strengthening of the capacities and potentialities of the authors of the Santo Tomás University in the positioning and visibility of their publications.http://unidadinvestigacion.usta.edu.c
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