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Enhanced by recent survey, the authors define new kinds of rock art along the Lennard and Fitzroy rivers in Western Australia—black pigment and scratch-work images featuring anthropomorphic figures with elaborate head-dresses. These are shown to belong to the Contact period and represent the response of Indigenous artists to European land-taking by recalling and restating traditional themes from earlier times.
To understand the effects of Nurse Case Managers (NCMs) working in primary care in the English National Health Service (NHS) from multiple perspectives and how this new role impacts on social workers, this paper reports and discusses findings from a multi-level study of the role of NCMs working in primary care in the English NHS.
Case management as understood by the NHS is equivalent to key-worker type care management as understood by social workers. However, English health and social services are separately organised with different organisational principles; health services are free at the time of need, whereas social services are means-tested and access is restricted.
The study included reviews of evaluations and policy, a national survey of nurse case management in Primary Care Trusts (PCTs) and case studies in three purposively selected PCTs. The views and experiences of patients were collected through face-to-face and telephone interviews with 51 older people and their carers, and these experiences are illustrated. In this paper, we further draw on data reporting the views of NCMs and stakeholders from other disciplines and services.
The opinions of older people receiving nurse case management reveal the value of high intensity support to individuals with major health and social needs. The NCMs’ clinical expertise, the improved continuity of care they provided and the psychosocial support they offered, were all emphasised by older people or their carers. NCMs substituted for social workers in some cases, when the older person would not have been eligible for publicly funded social care or had declined it. In other cases, they supplemented social services by identifying unmet needs. In a third category of cases, they may have curtailed social services’ involvement by preventing hospital admission and social services’ involvement as a consequence. The implications of this from the viewpoint of other study participants are discussed.
Consumer organisations act as an important interface between the public and scientific developments and innovations. Our independent approach helps people to assess the implications of developments in a clear and simple way. Surveys have regularly put consumer organisations, along with other public interest organisations, among the most trusted sources of information and advice.
We therefore have an important role in communicating scientific issues and their implications to the public, as well as acting on their behalf in order to try and influence scientific and technological developments and the controls that oversee them in the consumer interest.
The phonetic characteristics of canonical babbling produced by Korean- and English-learning infants were compared with consonant and vowel frequencies observed in infant-directed speech produced by Korean- and English-speaking mothers. For infant output, babbling samples from six Korean-learning infants were compared with an existing English babbling database (Davis & MacNeilage, 1995). For ambient language comparisons, consonants and vowels in ten Korean and ten English infant-directed speech (IDS) samples were analyzed. The two infant groups demonstrated similar consonant patterns, but showed different vowel patterns from one another. For both languages, infant vowel patterns were related to those of ambient language IDS. Ambient language patterns were manifested in infant vowel output, perhaps because vowels are more perceptually and motorically available in the input and output capacities of babbling infants.
This study compared segmental distribution patterns for consonants and vowels in English infant-directed speech (IDS) and adult-directed speech (ADS). A previous study of Korean indicated that segmental patterns of IDS differed from ADS patterns (Lee, Davis & MacNeilage, 2008). The aim of the current study was to determine whether such differences in Korean are universal or language-specific. Results indicate that consonant distribution patterns of English IDS were significantly different from English ADS. Speakers who used IDS produced fewer fricatives, affricates, nasals and liquids, but more stops and glides, than speakers who used ADS. In terms of vowels, IDS speakers produced more high-back vowels /u Ʊ/ and /ɔI/ diphthongs than ADS speakers. These results indicate both general trends and language-specific segmental distribution patterns in IDS. When compared to previous findings on ADS and IDS in Korean, these results for English give support to a more general assertion that segmental distribution patterns in IDS seem to be mediated by linguistic and cultural factors across languages.
Personal relationships are an integral part of living, working and visiting in care homes, but little research has made relationships the main focus of enquiry, and there have been few studies of the perspectives of residents, staff and family members. The study reported here sought to redress this neglect. Using a constructivist approach, the nature and types of relationships between residents, staff and family members were explored in three care homes in England using combined methods including participant observation, interviews and focus groups. The data collection and analysis occurred iteratively over 21 months and three types of relationships were identified: ‘pragmatic relationships’ that primarily focus on the instrumental aspects of care; ‘personal and responsive relationships’ that engage more fully with the particular needs of individual residents; and ‘reciprocal relationships’ that recognise the roles of residents, staff and family members in creating a sense of community within the home. This paper explores the contributions made by staff, residents and family members in the development of these relationships. The findings enhance our understanding of the role of inter-personal relationships in care home settings and of the factors that condition them. The implications for developing improved practice in care homes are also considered.
Studies on reproduction in a colony of albino mice before and after length of daylight was made constant show no change in litter size. However, there was an increase in the number of post-partum pregnancies after light was made constant and, during the first month thereafter, females were older at first parturition than in previous months.
Elections are one of the major ways in which democratic governments maintain legitimacy. Do elections serve the same functions in transitioning, non-democratic, or semi-democratic systems? Perhaps the relationship between elections and legitimacy is different in systems that are not fully democratic? And what of the media? Is their role the same or is the role they play dependent upon the type of system in which they exist? The Republic of Georgia offers an interesting case in which to look at these relationships. I would posit that in transitioning, non-democratic, and semi-democratic systems, elections serve a different function than in a fully democratic society and the media are one tool that leaders in such systems can use to enhance their legitimacy. When non-democratic leaders enjoy popularity, there is no need to finesse the media since positive coverage is easy to come by when you are popular. But if your popularity is waning and democratic habits are not well ingrained, the temptation to overtly or covertly subvert the media can be quite intense. So instead of maintaining legitimacy, elections may serve to create legitimacy or at least the appearance of legitimacy when legitimacy is lacking. To that end, regimes and leaders cannot afford to lose, and moreover need to win, elections by large margins if their legitimacy is questionable. Therefore, control over the media is more important when this is the case. In fact, there may be an inverse relationship between media freedom and regime insecurity, as the insecurity of the regime goes up, the freedom of the media goes down. Couple this tendency with the fact that the media in these transitioning systems have not fully become a “fourth estate” that is strong, independent, and can hold the government and political leaders accountable and you have a climate in which the media are harassed, biased, and often co-opted. Georgia, through the 2000 presidential election, is such a political system.
Background: Late-life depression has been associated with vascular diseases and with increases in circulating cytokines and cell adhesion molecules in the prefrontal cortex. We hypothesized that soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) would be increased in late-life major depression.
Methods: Serum levels of sICAM-1 and sVCAM-1 were measured in subjects over 60 with major depression (N = 23), subsyndromal depression (N = 20) and controls (N = 25). Depression severity was assessed using the Montgomery-Åsberg (MDRS) and Geriatric Depression (GDS) rating scales.
Results: There was no significant increase in sICAM-1 (p = 0.240) or sVCAM-1 (p = 0.600) in depression nor was there any correlation of either molecule with depression severity. Adjusting for differences in cognitive impairment did not alter these findings. There was also no difference between subjects with an early onset of depression (before 60) and those with late-onset depression.
Conclusions: These findings do not provide evidence that previously reported increases in serum cytokines in depression are due to peripheral vascular disease. Although we assessed subjects for vascular diseases it is possible that subtle but important differences between groups may still have been present and may have contributed to our negative findings.
Our results suggest central nervous system mechanisms, such as related to HPA axis activation, may be responsible for the enhanced inflammatory response in depression.
The extent to which practice nurses use the best available evidence to inform their activities in cardiovascular disease (CVD) and stroke prevention is not known. This paper reports on a study designed to explore the extent to which practice nurses use the available evidence in the prevention of CVD and stroke, and to explore the associations between research utilization and other individual and organizational factors. A national survey of practice nurses employed in 11 health authorities was conducted. Self-completion questionnaires were returned by 1187 practice nurses (response rate 60.4%). In relation to the risk factors smoking, hypertension, raised plasma cholesterol and lack of exercise, the majority of practice nurses reported interventions which are supported by research evidence. However, only 66% of the respondents recommended nicotine patches for smoking cessation, 42% referred patients for hypertension at levels above those recommended by national guidelines, and only 3.9% followed the latest recommended guidelines for exercise prescription. Statistically significant associations were found between total research utilization scores and a number of individual and organizational characteristics. The study findings are discussed together with their implications for practice and education.
Despite the growing awareness of the significance of helping a relative to relocate to a care home as a key phase in the care-giving career, relatively few British studies have explored this experience in depth. Informed by a constructivist perspective, this study sought a better understanding of nursing home placements from the viewpoint of relatives. Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move into a nursing home. Analysis revealed three perceived phases to the transition: ‘making the best of it’, ‘making the move’ and ‘making it better’. The relatives' experiences through these phases had five perceived elements, all of which were continua, from absent to very strong, reflecting the extent to which they were felt. They were: operating ‘under pressure’ or not; ‘in the know’ or ‘working in the dark’; ‘working together’ or ‘working alone’; ‘in control of events’ or not, and ‘supported’ or ‘unsupported’ both practically and emotionally. This paper reports findings about the first phase of the transition, ‘making the best of it’, and documents the experiences of decision-making about nursing home placements. It is argued that health and social care practitioners have enormous potential to influence whether or not helping a relative to move into a nursing home is perceived as a positive choice.