The formula 'care = organisation -I-physical labour -Iemotional labour' identifies component parts of 'carework' as they were observed at a hospice. A comparison between women's domestic carework and that of the hospice nurses is made firstly to clarify the component elements of care and secondly to show how the interrelation and balance of the components differs in the two settings. It is argued that family care has been a model for hospice care but that division of labour in hospices, which replicates hospital labour-divisions, results in an inflexibility in hospice care which is incompatible with the 'family' model. In the final section it is suggested that emotional labour is likely to be increasingly recognised as part of health care but that the concept of 'total care' needs to be questioned.

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This paper presents an overview of current methods for determining nurse staffing requirements. A range of methods is described and the strengths and drawbacks of each are discussed. There follows an examination of some of the wider issues raised by the use of particular methods for determining nurse staffing. The paper concludes that since a perfect workload measurement system is unlikely ever to exist, such systems can be used to facilitate, but not to dictate, decisions about nurse staffing.

We report the case of a 9-year-old boy with a right optic disc pit and associated serous retinal detachment of the macula. This was treated by vitrectomy, endolaser, and gas tamponade as a primary procedure, which resulted in complete resolution. We review the literature and conclude that further reports of the management of this uncommon condition are required so that firmer guidelines on treatment can be established.A 9-year-old Caucasian boy presented to the eye casualty department in July 1989 with a sixmonth history of decreased visual acuity. A year previously an optician had recorded unaided visual acuities of 6/6 right eye and 6/6 left eye. There was no relevant past ocular or medical history of note.On examination his unaided visual acuities were 6/6 left and 1/60 right eye. There was no improvement with refraction. The anterior segment appeared normal, he had a right relative afferent pupil defect, and funduscopy revealed a serous retinal detachment of the macula clearly linked to an optic disc pit in the right eye. The detached retina had undergone cystic retinal degeneration, and the underlying pigment epithelium was irregularly pigmented (Fig 1). The left fundus was normal. The patient thought that there had been a recent improvement in the vision of the right eye, and treatment was therefore deferred and serial observations carried out. After nine months no further improvement had occurred. Various methods of treatment (see 'Discussion') were considered, and, though laser photocoagulation alone has met with some success, in view of the patient's age this would University Hospital, Nottingham M P Snead N James P M Jacobs have required a general anaesthetic. Vitrectomy and laser photocoagulation followed by fluid/gas exchange seemed to offer the highest chance of success with a single procedure (and anaesthetic), and it was agreed to proceed with surgery.On 10 April 1990 the patient underwent right pars plana vitrectomy, endolaser treatment, and 40% SF6 exchange. A standard 20 g three-port pars plana vitrectomy was performed, and during surgery the vitreous was noted to be still attached. Argon endolaser was applied temporal to the disc in a confluent double line of burns to seal off the link between pit and detachment and extended superiorly and inferiorly into attached retina. This was applied after the vitrectomy and before fluid-gas exchange in order to minimise any laser induced damage to the papillomacular bundle. A power setting was used which was just sufficient to produce a soft white burn in an area of attached retina and then applied in the distribution described above. This produced minimal or no reaction in the pigment epithelium underlying the detached retina at the time of application. There was no evident communication between the detachment and the vitreous cavity, and no attempt was made to drain subretinal fluid. The posterior segment was filled with 40% SF6 in air.Postoperatively the posterior retina was attached, but there was a collection of subretinal fluid inferiorly....

I define emotional labour as the labour involved in dealing with other peoples’feelings, a core component of which is the regulation of emotions. The aims of the paper are firstly to suggest that the expression of feelings is a central problem of capital and paid work and secondly to highlight the contradictions of emotions at work. To begin with I argue that ‘emotion’is a subject area fitting for inclusion in academic discussion, and that the expression of emotions is regulated by a form of labour. In the section ‘Emotion at home’I suggest that emotional labour is used to lay the foundations of a social expression of emotion in the privacy of the domestic domain. However the forms emotional labour takes and the skills it involves leave women subordinated as unskilled and stigmatised as emotional. In the section ‘Emotion at work’I argue that emotional labour is also a commodity. Though it may remain invisible or poorly paid, emotional labour facilitates and regulates the expression of emotion in the public domain. Studies of home and the workplace are used to begin the process of recording the work carried out in managing emotions and drawing attention to its significance in the social reproduction of labour power and social relations of production.