BackgroundThe provision of institutional long-term care for older people varies across Europe reflecting different models of health care delivery. Care for dying residents requires integration of palliative care into current care work, but little is known internationally of the different ways in which palliative care is being implemented in the care home setting.ObjectivesTo identify and classify, using a new typology, the variety of different strategic, operational, and organizational activities related to palliative care implementation in care homes across Europe.Design and methodsWe undertook a mapping exercise in 29 European countries, using 2 methods of data collection: (1) a survey of country informants, and (2) a review of data from publically available secondary data sources and published research. Through a descriptive and thematic analysis of the survey data, we identified factors that contribute to the development and implementation of palliative care into care homes at different structural levels. From these data, a typology of palliative care implementation for the care home sector was developed and applied to the countries surveyed.ResultsWe identified 3 levels of palliative care implementation in care homes: macro (national/regional policy, legislation, financial and regulatory drivers), meso (implementation activities, such as education, tools/frameworks, service models, and research), and micro (palliative care service delivery). This typology was applied to data collected from 29 European countries and demonstrates the diversity of palliative care implementation activity across Europe with respect to the scope, type of development, and means of provision. We found that macro and meso factors at 2 levels shape palliative care implementation and provision in care homes at the micro organizational level.ConclusionsImplementation at the meso and micro levels is supported by macro-level engagement, but can happen with limited macro strategic drivers. Ensuring the delivery of consistent and high-quality palliative care in care homes is supported by implementation activity at these 3 levels. Understanding where each country is in terms of activity at these 3 levels (macro, meso, and micro) will allow strategic focus on future implementation work in each country.

Anti-interleukin-13 and anti-interleukin-4 agents versus placebo, anti-interleukin-5 or anti-immunoglobulin-E agents, for people with asthma (Review)

This work critiques the normative construction of ethical leadership and contributes to understanding the ethics of care in leadership from a lifestyle and embodied perspective. Drawing on feminist notions of ethics of care, we question the ethicality of the practices of a sporty and health-oriented leader who claims to transform his attempts at self-care into care for others through role-modelling lifestyle behaviours. We explore inherent moral dilemmas in connecting a seemingly creative self-care project with well-intentioned practices of caring for others. We highlight the need to question persistent masculine rationalisations in ethical leadership, and to engage in and encourage, organisational and relational interactions that take account of specific employee needs. We argue that the leaders’ claiming to care for others by insisting on particular lifestyle behaviours and role-modelling aesthetic bodily ideals introduce new managerial norms in the organisation. The Instrumental intentions come to hamper an ethical care for the well-being of employees, whilst demonstrating the power of the leader to influence employees both inside and outside the organisation.

This paper draws from our own experiences of sexism within Business Schools to bring attention to the effects of the operation of a highly masculinized, white, cis-gendered, and patriarchal culture, whether enacted by men or women, and to how we come to be silenced within it. Our work reflects on intersectional issues of race, health (mental and physical), and care-work, using faction built from six paired interviews to tell a truth we feel unable to tell individually. This piece highlights the real fear of repercussions that still persist for female academics, and uses the acts of collecting data and writing differently to offer the authors a safe space in which to resist both overt and structural sexism in Business Schools. It highlights the need to take seriously those subtleties of sexism that we are often expected to put up with, those difficult-to-name aspects of our working lives that leave us feeling it would be "silly" to complain and act as a form of micro-coercive control over our lives. We operationalize our collective voice as a form of activism in the academy that is situated within our individual silences.

Anti-interleukin-13 and anti-interleukin-4 agents versus placebo, anti-interleukin-5 or anti-immunoglobulin-E agents, for children and adults with asthma (Protocol)