IntroductionAdvances in longevity and medicine mean that many more people in the UK survive life-threatening diseases but are instead susceptible to life-limiting diseases such as dementia. Within the next 10 years those affected by dementia in the UK is set to rise to over 1 million, making reliance on family care of people with dementia (PWD) essential. A central challenge is how to improve family carer support to offset the demands made by dementia care which can jeopardise carers’ own health. This review investigates ‘what works to support family carers of PWD’.MethodsRapid realist review of a comprehensive range of databases.ResultsFive key themes emerged: (1) extending social assets, (2) strengthening key psychological resources, (3) maintaining physical health status, (4) safeguarding quality of life and (5) ensuring timely availability of key external resources. It is hypothesized that these five factors combine and interact to provide critical biopsychosocial and service support that bolsters carer ‘resilience’ and supports the maintenance and sustenance of family care of PWD.Conclusions‘Resilience-building’ is central to ‘what works to support family carers of PWD’. The resulting model and Programme Theories respond to the burgeoning need for a coherent approach to carer support.

Qualitative research of this type may serve to illustrate the complexity of discrimination and the processes whereby stigma is internalised and may shape behaviour. Such an understanding may assist health practitioners reduce stigma, and identify and remediate the impact of discrimination.

Discusses the role of the HR specialist as we approach the new millennium. Observes the shift in the workplace from office to teleworking and cyber-management, along with the potential problems of remote working, and the role of video conferencing and the Internet. Finally contrasts the changing pattern of working life with the benefits of a more flexible workforce. In conclusion, emphasizes the changes in work style of workers themselves and of the HR function, with the personnel specialist being seen as the conductor of a work interface: that between the virtual world of information, and the real world of people.

PurposeDifferent pathways of frailty care to prevent or delay progression of frailty and enable people to live well with frailty are emerging in primary and community care in the UK. The purpose of the study is to understand effective frailty care pathways and their components to inform future service development and pathway evaluation in primary- and community-care services.Design/methodology/approachA rapid evidence review was conducted: 11 research publications met the inclusion criteria and were analysed using narrative thematic synthesis.FindingsThere is strong evidence that resistance-based exercise, self-management support, community geriatric services and hospital at home (HAH) improve patient health and function. In general, evaluation and comparison of frailty care pathways, components and pathway operations is challenging due to weaknesses, inconsistencies and differences in evaluation, but it is essential to include consideration of process, determinant and implementation of pathways in evaluations.Originality/valueTo achieve meaningful evaluations and facilitate comparisons of frailty pathways, a standardised evaluation toolkit that incorporates evaluation of how pathways are operated is required for evaluating the impact of frailty pathways of care.

Matrix stimulation of high-temperature sandstones using hydrochloric acid (HCl) is difficult to achieve due to its fast reaction, possible sand deconsolidation, clays destabilization, and tubular corrosion. These problems are common in stimulating wells completed across the Pinda formation in West Africa. This formation is a multilayered formation with a wide range of carbonate content (varying from 2% to nearly 100%) and bottomhole temperatures in the range of 300°F. In addition, most of the wells have up to 1,500 ft of perforated intervals producing together from different layers. Stimulation treatments in the area historically have been performed using 7.5% HCl pumped through coiled tubing and using foam diversion. In 2008 a different approach was taken to stimulate producing zones across this formation, using a low-pH chelant (pH 4) as the main stimulation fluid and straddle or inflatable packers for mechanical diversion, whenever applicable. Six wells were treated in a stimulation campaign using the chelant solution. Mechanical diversion was used in three of the six wells treated; two were treated with a mechanical straddle packer and one with an inflatable packer. Low bottomhole pressure (BHP) or wellbore configuration precluded the use of mechanical diversion for the other three wells; foam diversion was used instead. The results of these stimulations were encouraging, with the combined production of all six wells almost doubling. The good post-job results confirm the effectiveness of low-pH chelant in stimulating carbonate and carbonate-rich sandstones at high temperature, with the added value of low corrosion rates and reduced risk of sand deconsolidation and clays destabilization. This stimulation campaign also tested current technological limits of mechanical and inflatable packers. The combination of high expansion ratio, low BHP, and high temperature requirements precluded the stimulation of three of the six wells with mechanical diversion. With the increasing need to stimulate depleted high-temperature formations, these challenges must be addressed in the future.