Title. A concept analysis of renal supportive care: the changing world of nephrology Aim. This paper is a report of a concept analysis of renal supportive care.Background. Approximately 1AE5 million people worldwide are kept alive by renal dialysis. As services are required to support patients who decide not to start or to withdraw from dialysis, the term renal supportive care is emerging. Being similar to the terms palliative care, end-of-life care, terminal care and conservative management, there is a need for conceptual clarity. Method. Rodgers' evolutionary method was used as the organizing framework for this concept analysis. Data were collected from a review of CINAHL, Medline, PsycINFO, British Nursing Index, International Bibliography of the Social Sciences and ASSIA (1806-2006) using, 'renal' and 'supportive care' as keywords. All articles with an abstract were considered. The World Wide Web was also searched in English utilizing the phrase 'renal supportive care'. Results. Five attributes of renal supportive care were identified: available from diagnosis to death with an emphasis on honesty regarding prognosis and impact of disease; interdisciplinary approach to care; restorative care; family and carer support and effective, lucid communication to ensure informed choice and clear lines of decision-making. Conclusion. Renal supportive care is a dynamic and emerging concept relevant, but not limited to, the end phase of life. It suggests a central philosophy underpinning renal service development that allows patients, carers and the multidisciplinary team time to work together to realize complex goals. It has relevance for the renal community and is likely to be integrated increasingly into everyday nephrology practice.

Following a structured educational experience student nurses' attitudes were more positive towards obese patients. The characteristics of the educational activity that appeared to influence student nurses' attitudes was related to the "lived experience" of wearing bariatric empathy suits.

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Female genital mutilation is widely practised in many cultures. It may be viewed as a rite of passage for girls or women, or it may be regarded as mutilation and a threat to health. This article considers the ethical issues surrounding the practice. The standpoints of cultural relativism and universal human rights are used to explore the debate surrounding the practice and to determine the response of health-care workers and society in general to the practice.

More than 130 million girls and women worldwide have undergone some form of female genital mutilation (FGM). In this article, the prevalence of FGM and the different types are outlined. Research related to the subject is reviewed along with the evidence of complications related to the practice. The meaning of the practice to the communities where it occurs and the perceived health-care needs of women are summarized and the implications for future research discussed