This is a descriptive case study employing a photographic survey of the numerous objects that patients and their social networks bring to a hospice setting. Photographs were taken of all objects kept by the bedside by 31 inpatients in a hospice in the UK county of Durham. These objects ranged from assorted food and drink, greetings cards and magazines, to more specific personal items such as family photos, children's drawings, and religious icons. A total of 176 objects were analysed. There were two principle findings. First, patients appeared to bring objects to a hospice setting that reflected their desire to partially recreate their home settings or functions, however modestly. Second, despite a major diversity of objects, and the fact that most objects underlined desires for distraction, entertainment and social contact, almost every individual patient harboured at least one personally unique object. These two observations--creating some semblance of 'home' and the existence of uniqueness amid a plethora of expected patient paraphernalia--suggest important reconsideration of both hospice settings and the possibility of new ways to engage patients about meaning, illness and loss.

Practice development is known for fostering innovation and change in creating a culture and working environment in which excellence can flourish. Excellence in practice through practice development is dependent on consulting, engaging and encouraging team members to buy into a shared vision and values. The challenge for some teams is in eliciting and sharing the team's vision and values. Hartlepool and District Hospice in the true spirit of practice development would like to share and disseminate their starting journey in the quest for excellence by developing and applying a creative transformational leadership approach using values clarification. Copyright © 2008 John Wiley & Sons, Ltd.

In Nigeria there is a consensus that in-country cancer services lack strategy, focus and coordination of care. This is magnified by poverty and by cultural and religious issues, resulting in the majority of patients presenting late and deemed palliative at the time of diagnosis. The Bricon Foundation, a Nigerian nongovernmental organization joined forces with Macmillan Cancer Support, a well-known established UK cancer charity to design an interactive teaching package for Nigerian health care professionals. The aim of the workshops was to share best practice in basic cancer, palliative and end of life care including bereavement support. The project concentrated on facilitating open discussions among Nigerian health care professionals about these topics including communication challenges and how to take care of themselves. The four two-day workshops were designed to identify challenges and obstacles health care professionals faced in delivering cancer and palliative care in Nigeria. They empowered participants to realize their own potential in improving the cancer experience for the patients and themselves. The cancer sessions were adapted from Macmillan cancer awareness materials that have been well evaluated in the UK. Additionally, the team developed a palliative, end of life and bereavement care study day as day two of the workshops to give participants a basic holistic overview. A team of Macmillan Alumni volunteers traveled to Nigeria to work with The Bricon Foundation team in delivering this training, which had sponsorship from NNPC, Total EPNL and partners. After each day participants completed an evaluation form. This enabled the team to adapt subsequent presentations to the Nigerian context using the feedback. The training was delivered to 91 participants from 26 government and private facilities with all 4 workshops evaluating positively. Attendees specifically valued the group work as it facilitated an exchange of ideas ensuring their voice was heard. Most expediently we were able to identify professionals drawn from different areas of healthcare who are interested in delivering future sessions on a regular basis keeping education at the forefront of cancer, palliative care and health care practice development. With further educational sessions anticipated in the near future, evaluation is on-going.