The Last Gift: Advanced Healthcare Directives and the Family Members of Incapacitated Patients

Author(s):  
Eunice Collins

Abstract This article will provide an overview of the law related to the withdrawal of treatment from incapacitated adult patients in Ireland and the role of family members in such decisions. This overview will touch on the best interests test, how the wishes of an incapacitated patient may be assessed, and the tension that may arise between medical assessments and the views of the family of the patient. Cases arising in the UK and the USA will be discussed where relevant. It will be argued that family members should be provided with more information, particularly with respect to Do Not Attempt Resuscitation orders. The article calls for greater discussion about death and dying, and greater use of advance healthcare directives.

Author(s):  
Andrew Williams ◽  
Craig Paterson

Abstract The increase in calls for police reform following the death of George Floyd has led to renewed debate about social inequality and the role of policing in society. Modern bureaucratic police systems emerged from locally administered structures and Anglo-American policing models continue to be aligned, to varying degrees, with the political, socio-cultural, legal, and ideological aspects of contemporary liberal democratic society with its emphasis on democratic localism and decentralised accountability. However, at a time when society is reimagining itself and technology, government, and nations are radically re-shaping themselves, a critical question is whether there is a sufficiently common philosophical and conceptual understanding of policing to support its development rather than just a common understanding of police functions. This is profoundly important when considering the current calls for reform of policing in the USA and other western democratic states. The article argues that there is an urgent need to reconsider how we conceptualize policing and its relationship with social development.


2020 ◽  
pp. 1-7
Author(s):  
Tara Sims

BACKGROUND: The impact of paediatric upper limb difference may extend beyond the child themselves to their parents and other family members. Previous research has found that feelings of shock, numbness and loss are common amongst parents and that peer support can be a buffer against stress. OBJECTIVE: The current study aimed to explore the experiences of parents of children with limb difference, and the role of services and prosthetic devices in these experiences. METHODS: Nine parents of children with limb difference participated in either a group (n= 2) or individual (n= 7) interview. RESULTS: Analysis of the interview transcripts revealed four themes – ‘grief and guilt’, ‘prosthesis as a tool for parental adjustment’, ‘support’ and ‘fun and humour’. CONCLUSIONS: Parents may employ coping strategies to help them adjust to their child’s limb difference, including use of a prosthesis, accessing support from statutory services and peers, and use of fun and humour within the family.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047632
Author(s):  
Helen Humphreys ◽  
Laura Kilby ◽  
Nik Kudiersky ◽  
Robert Copeland

ObjectivesTo explore the lived experience of long COVID with particular focus on the role of physical activity.DesignQualitative study using semistructured interviews.Participants18 people living with long COVID (9 men, 9 women; aged between 18–74 years; 10 white British, 3 white Other, 3 Asian, 1 black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with long COVID.SettingTelephone interviews with 17 participants living in the UK and 1 participant living in the USA.ResultsFour themes were generated. Theme 1 describes how participants struggled with drastically reduced physical function, compounded by the cognitive and psychological effects of long COVID. Theme 2 highlights challenges associated with finding and interpreting advice about physical activity that was appropriately tailored. Theme 3 describes individual approaches to managing symptoms including fatigue and ‘brain fog’ while trying to resume and maintain activities of daily living and other forms of exercise. Theme 4 illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.ConclusionsThis study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with long COVID. Findings highlight the need for greater clarity and tailoring of physical activity-related advice for people with long COVID and improved support to resume activities important to individual well-being.


Author(s):  
Vasileva E.A. ◽  
Kuyarov A.A. ◽  
Kuyarov A.V.

The pathogenesis of atopic dermatitis (AD) is complex, and at present a unified concept of the development of the disease has not been formed. At the heart of pathogenesis, there is a complex interaction of numerous factors, such as genetic predisposition, dysfunction of the autonomic nervous system and the epidermal barrier. Previously, it has been proven that a high microbial contamination of the affected areas helps to maintain inflammation and aggravates skin dysfunction as a result of chronic inflammation, and favorable factors appear for the attachment of a secondary infection. However, little attention has been paid to dysfunctions of the epidermal barrier, the role of violations of the quantitative and qualitative composition of the microbiota in the development of AD, and this issue remains relevant at the present time. The aim of this study was to assess the effect of the carrier of bacteria on the mucous membranes of the upper respiratory tract in family members on the course of atopic dermatitis in a child. A bacteriological examination of the mucous membranes of the nose and throat was carried out in 34 children with AD and members of their families (74 people). When examining the mucous membranes of the nose and throat in family members of children with AD, it was found that the microflora isolated from family members in more than half of the cases has an increased potential for pathogenicity with a high degree of contamination (CFU lg 3), which forms an increased bacteriological load on the child. The tendency of bacterial carriage was revealed, contributing to the formation in the family of a permanent persistence of microflora with a high potential for pathogenicity. Asymptomatic carriage of bacteria forms an additional epidemiological load on the child, affects the severity of AD and is a risk factor in the development of secondary infection of the skin.


2019 ◽  
Vol 71 (2) ◽  
pp. 137-158
Author(s):  
Ognjen Pribicevic

Leaving the EU is one of the major political decisions made in the UK over the past half-century. Brexit brought about a virtual political earthquake not only in EU-UK relations but also in terms of UK future place and role on the international scene. Immediately after the decision of UK citizens to leave the EU at a referendum held on 23 June 2016, the question arose as to whether the UK will lose some of its international influence, whether Scotland will remain part of the Union, whether the UK will retain its privileged relations and special status with the USA, and what its future relations with the EU will be. The purpose of this article is to point to the basic priorities of the contemporary British foreign policy as well as to place and role of the UK on the contemporary international scene particularly in view of its decision to leave the EU. We shall first try to define the status of present-day Britain in international relations. Second, we shall address the traditional dilemma of the UK foreign policy - what should be given priority - relations with the USA, Europe or the Commonwealth? After that, we shall discuss in more detail the phases the UK foreign policy went through following the end of the cold war. In the third phase, we shall analyze the British contemporary foreign and economic policy towards Gulf countries and China. In the fourth part of the article, we shall discuss relations with the USA. It should be pointed out that the article does not seek to analyze all aspects of British foreign policy, even if we wanted to, due to a shortage of time. Of course, the topic of Brexit will be present in all chapters and especially in the last one and conclusion remarks. By its decision to leave the EU, the UK appears to have given priority to its relations with the USA, China, Gulf countries as well as Commonwealth countries instead of the EU which has been economically and politically dominant over the past few decades. This decision taken by UK citizens will no doubt have a great impact not only on their personal lives and standard of living but on the UK role in international relations. Despite its military, political, economic and cultural capacities, it is highly unlikely that the UK will manage to overcome the consequences of an exit from the single market, currently generating 18 trillion dollars on an annual basis as well as the loss of a privileged partner role with the USA within the Union. We are, therefore, more likely to believe that in the foreseeable future, the role of the UK on the international scene will continue to decline and be increasingly focused on its economic and financial interests. Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III 47010: Drustvene transformacije u procesu evropskih integracija - multidisciplinarni pristup]


Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 362
Author(s):  
Beti Kristinawati ◽  
Annisa Muryadewi ◽  
Ana Dwi Irianti

Introduction: Families have an important role in the successful treatment of people with pulmonary tuberculosis. The purpose of this study was to obtain an overview of the role of the family as a caregiver in caring for family members suffering from pulmonary tuberculosis.Methods: The phenomenological qualitative design was chosen to obtain in-depth information by interviewing thirteen family members who cared for pulmonary tuberculosis patients determined through a purposive technique. Results: The content of Collaizi's analysis produced five themes, namely: 1) Nonpharmacological therapy is given by the family to treat symptomatic pulmonary tuberculosis 2) Efforts to cut transmission was carried out by the family to prevent transmission of disease, 3) Nutrition support provided by families in treating patients, 4) Instrumental support given by families in caring for pulmonary tuberculosis patients, 5) Emotional support given by families in treating pulmonary tuberculosis sufferers.Conclusion: The family provides physical and psychological care to support the successful treatment of pulmonary tuberculosis. A program is recommended to increase family knowledge in caring for family members suffering from pulmonary tuberculosis. Words are sorted alphabetically.


2019 ◽  
Vol 23 (4) ◽  
Author(s):  
Rita de Cássia Melão de Morais ◽  
Tania Vignuda de Souza ◽  
Isabel Cristina dos Santos Oliveira ◽  
Juliana Rezende Montenegro Medeiros de Moraes ◽  
Elena Araújo Martinez ◽  
...  

ABSTRACT Objective: To analyze the role of the social network configured by the family/companion and their implications for their stay during the hospitalization of the child in the pediatric hospitalization unit. Method: Qualitative study with ten family members/companions of hospitalized children. Data collection was done through the technique of individual interview, which occurred in the period from February to December 2015. The analysis was thematic, in light of the theoretical reference of "Social Networks" described by Lia Sanicola. Results and discussion: The main role of the social network was emotional and material support, and the main components of this network were: companion, mother, aunt and daughter, as well as nursing team, physician and other family members/companions. Final considerations and implications for the practice: It was verified that the totality of the interviewees was female, however, the husband was the most important member of the social network for the family members involved, since they perform the material/financial and emotional function. In addition, the participants consider that they are responsible for all care to the family and, in the condition in that they are, they understand it as a favor provided by the other members of the network. Identifying the composition of the social networks of family members/companions provides a better targeting of care in order to strengthen the social support received.


2007 ◽  
Vol 7 (1) ◽  
Author(s):  
Helena Calvo Botella

Es un hecho ampliamente aceptado el hecho de que el abuso de drogas y las conductas adictivas tienen consecuencias negativas en diferentes áreas de la vida familiar. Muchos miembros de la familia pueden mostrar perturbaciones psicológicas, psicosomáticas, afectivas, económicas,… pero paralelamente, es igualmente cierto que las dinámicas familiares pueden infl uir sobre las conductas adictivas y su tratamiento. En este artículo se comentan dicha infl uencia recíproca y el papel de la familia en la integración social del paciente adicto. AbstractIt is widely accepted that drug misuse and addictive behaviours havenegative consequences in different areas of family life. Many family members can show psychological, psychosomatic, affective, economic disturbances…, but it is true as well that family dynamics can infl uence addictive behaviours and their treatment. In this paper this reciprocal infl uence and the role of family in social integration of addicted patients are discussed.


Author(s):  
Owen Barr ◽  
Bob Gates

This chapter builds on the information within Chapter 4 and gives more in-depth consideration to the practicalities of accurate nursing assessments and writing outcome-focused care plans. It provides detailed information on important considerations when planning nursing interventions with people with intellectual disabilities and their carer/carers, including the role of advocacy, life planning, client health records, consent process, making best interests decisions, vulnerability, and safeguarding children and adults. It adds to this practical information by providing information on the necessary wider considerations for effective nursing and collaborative interdisciplinary and inter-agency working across the UK and the Republic of Ireland, including care pathways, health action planning, health facilitation, case management, and direct care payments.


Author(s):  
David P. Stowell ◽  
Theron McLarty

Family members knew something was very wrong when Adolf Merckle, who had guided the family holding company, VEM Vermogensverwaltung GmbH, through dozens of successful investments, left the house one afternoon in January 2009 and failed to return. That night their fears were confirmed when a German railway worker located Merckle's body near a commuter train line near his hometown of Blaubeuren, about a hundred miles west of Munich. It was no secret that the recent financial crisis had taken a toll on Merckle's investments. He was known in Germany as a savvy investor, but had lost hundreds of millions of Euros after being caught on the wrong side of a short squeeze of epic proportions involving Volkswagen stock. This was not the only large bet against that company's stock. A number of hedge funds, including Greenlight Capital, SAC Capital, Glenview Capital, Tiger Asia, and Perry Capital, lost billions of Euros in a few hours based on their large short positions in Volkswagen's stock following the news on October 26, 2008, that Porsche AG had obtained a large long synthetic position in Volkswagen stock through cash-settled options. In the next two days, this short squeeze produced a fivefold increase in Volkswagen's share price, as demand for shares from hedge funds exceeded the supply of borrowable shares.This case focuses on the massive equity derivative positions entered into by Porsche in relation to Volkswagen stock and by TCI and 3G in relation to CSX stock. Students will learn how equity exposure can be created without buying stock and without prior disclosure. The role of regulators, courts, and investment banks that facilitate these transactions is also explored.


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