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In this article the authors present findings on professional carers' experience of providing pediatric palliative care to children with life-limiting conditions. For this qualitative study, part of a national pediatric palliative care needs analysis, the authors engaged in 15 focus group interviews and drew on the responses of open-ended questions to give voice to the experiences of professional carers and to situate the humanity of their caring reality. This humanity is articulated through three themes: clarity of definition and complexity of engagement, seeking to deliver a palliative care service, and the emotional cost of providing palliative care. Further analysis of these themes points to a work-life experience of skilled and emotional engagement with children, and their parents, in complex processes of caregiving and decision making. Pediatric palliative care occurs in an environment where parents shoulder a large burden of the care and professionals find themselves working in underresourced services.

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Part 1 of the study described the development of a Hazard Analysis and Critical Control Point (HACCP) based programme and accompanying handbook for the control of mastitis. This paper describes the implementation and evaluation of customised HACCP-based programmes, which were developed from the handbook and assessed on six Irish dairy farms. Both quantitative and qualitative (action research) research methodologies were used to measure the success of implementation and efficacy of control of sub-clinical mastitis as measured by Somatic Cell Counts (SCC) and the degree of compliance by farmers in adopting and maintaining recommendations throughout the course of the study period. No overall differences in SCC before and during the implementation of the study were found when all six farms were considered together. Three of the six study farms experienced a significant decrease in herd milk recorded SCC during the implementation of the control programme. An essential part of the study was achieving initial agreement on recommendations as well as ongoing monitoring of compliance during the study. This pilot study shows that HACCP can be implemented on farms as a means of working towards the control of mastitis and that farmer attitude, and understanding of mastitis are crucial in terms of motivation irrespective of practical approaches used to manage mastitis.

One Irish woman in 14 develops breast cancer. There are 1700 new cases each year. These rates compare poorly with EU figures. The government indicated in 1995 that it favoured rapid, comprehensive diagnostic facilities, using the triple assessment model of clinical care, to improve survival rates and to diminish the anxiety women experience about breast cancer. Implementation of this policy was delayed until 1999, when a plan for centres of excellence in breast care was conceived. To compliment this plan, the Department of Health and Children wanted consumer views on existing breast care services. The Women's Health Council was asked by the Department of Health and Children, through the National Cancer Forum, to conduct research on women's views and reactions as consumers of existing services for symptomatic breast disease. The research team was asked to document women's views on: diagnostic services; counselling; additional treatment services such as surgery and radiotherapy. The methodology consisted of four strands: questionnaires and focus groups with consumers of breast care services; postal questionnaires to clinic staff and a literature review. Striking aspects were the long delays women experienced before obtaining a completed diagnosis; often chaotic clinic settings which added greatly to women's shock and anxiety; the lack of support if they received a diagnosis of cancer; and problems relating to limited resources for cancer treatment, including radiotherapy. We explored women's coping mechanisms and their experiences, in the context of the model of quality of care. Finally, we argue that a centre of excellence must develop a multidimensional model of breast disease care that incorporates the full range of psycho-social dimensions for women, if it is to earn its claim to excellence. Correspondence