The authors argue that there is a tension between the concepts of caring and empowerment. This tension appears in political and managerial debates over how best to run a health service, and it reappears in the clinical situation in nursing dilemmas over the presentation of information to patients. The authors review the major contributions to theory from health care literature, and use case studies to explore some of the clinical implications of these theories for nursing practice.

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities This paper provides a discussion of some of the professional and policy outcomes associated with implementing clinical supervision within a community service for adults with learning disabilities. It is based upon a small qualitative study whose aim was to examine how clinical supervision was operating, its strengths, its weaknesses and where improvements might be made. The study followed the introduction of clinical supervision 9 months earlier for nurses and carers employed in three community homes and one community multiprofessional team. The method consisted of direct observation of individual and group supervision and staff completing critical incident questionnaires, followed by semi-structured, audio-taped interviews with seven registered nurses and four community team members, including a social worker, psychologist and physiotherapist. Outcomes were expressed in two ways: in terms of the benefits of clinical supervision or of its ambivalence. The range of matters brought for discussion, or resolution, in supervision reflected some of the difficulties or dilemmas staff faced working in this area, for example promoting empowerment and assisting clients to make choices, and dealing with clients' challenging and inappropriate behaviours. As for the role of supervisor there was some evidence of nurses expressing apprehension or unpreparedness, also a perceived general concern over the relatively low status of clinical supervision, thought to be due to absence of visible management approval or failure to articulate properly the objective of supervision. A limitation of the study was its small subject sample although considerable data were gathered in each of the units through relatively long-term contact.

Parental involvement and participation, partnership with parents, and community-focused development are important features of government initiatives such as the Sure Start project for children under four years of age and their families. A common feature of the rhetoric is empowerment' as a means of achieving this. This article describes the activity and development of the Parents Committee in one Sure Start programme and uses this to tease out different dimensions of empowerment. In particular, it highlights issues regarding developing empowerment and the dynamic tension between the growth of personal power and the changing symmetry of power relationships. A tentative model of the trajectory of developing empowerment is presented. This may raise challenges for professionals seeking to ful®ll their professional role in a complex context and questions as to whether, or how, it might be possible to better prepare professionals for this dimension of their work. Parental participation and partnershipWithin the ®elds of work with children and families, such as early childhood learning, health and social care, and parenting education and support there is an increasing expectation that professionals will work in partnership with parents. Indeed, it can be seen as a central plank of UK government policy, for example with reference to the Children Act (1989) and to more recent initiatives such as Sure Start, Early Excellence Centres and the Foundation Stage curriculum for children between the

In the context of increasing interest in how rurality affects health services and nursing practice in the UK, this paper reports and discusses data from a survey of older people living in three English villages. The survey found that village populations differed widely, that there were changes in the proportions of older people in the villages over time, and that close social networks existed for some but not all. The paper concludes that health care practitioners should avoid stereotypes of village life. In their increasing emphasis on health promotion and active ageing among older people, nurses may find data collected by the voluntary sector to be a useful resource. Working in partnership with groups to achieve a deep understanding of local contexts may assist nursing practitioners when building up pictures of older patients' health-related needs and views.