Family caregivers: a shadow workforce in the geriatric health care system?

Based on two years of fieldwork, conducted between March 2003 and March 2005 in the health care industry of the northeastern United States, this study shows that the work of family caregivers of elders goes far beyond previously recognized care in the home to acknowledge care inside health care facilities and in conjunction with community services. It reveals that family caregivers--untrained, undersupported, and unseen--constitute a "shadow workforce," acting as geriatric case managers, medical record keepers, paramedics, and patient advocates to fill dangerous gaps in a system that is uncoordinated, fragmented, bureaucratic, and often depersonalized. Detailed examination of what family caregivers actually do in traversing multiple domains reveals the extent of their contribution to and the weaknesses in the present geriatric health care system. It suggests that the experiences of family caregivers must be central to the creation of new policies and a more coordinated system that uses the complex work of family caregivers by providing the training and support that they need.     

Terrorism as Transnational Advocacy: An Organizational and Tactical Examination

This article attempts to shed light on the dynamics and machinations within terrorist organizations by incorporating a heretofore overlooked literature which is directly applicable, that of transnational advocacy networks (TANs). Terror networks have been described using every possible analogy, from multinational corporations to organized crime to the anthropomorphic classic “cut off the head, and the body will die.” In reality, terrorist organizations function in much the same way, and using many of the same techniques, as transnational advocacy networks concerned with issues like the environment or human rights. By describing these characteristics, and comparing TANs and Terror TANs (TTANs), this article aims to offer insight into the tactics and motivations that define modern, as well as the much heralded post-modern, terrorism.     

A Community Divided: Defense Attorneys and the Ethics of Death Row Volunteering

When death row inmates elect to waive appeals and proceed directly to execution a series of problematic legal and ethical questions are raised. This article examines the ethics of volunteering from the perspective of death row inmates'defense attorneys. Studying attorneys is important for two reasons: since they are charged with protecting their clients'interests they must resolve the difficult question of whether death is ever in someone's best interest; and perhaps more important, most death row defense attorneys are themselves against the death penalty and must thus negotiate between their clients'desire for execution and their own personal value systems. Interviews were conducted with 20 attorneys who have participated in representing would-be volunteers. Qualitative analysis suggests that most are faced with profound ethical dilemmas, both professional and personal, when a client elects to waive appeals. This article explores how attorneys interpret, experience, and resolve those dilemmas.     

Practical guidelines on incorporating “partnering” within IT agreements for public sector bodies

“Partnership” and “partnering” are two of the most frequently used terms in public sector procurement. They may be used by both customers and suppliers to justify their respective negotiating positions. A supplier may argue that, since the agreement is a “partnership agreement”, there should be no service credits or liquidated damages payable. The customer on the other hand, may argue, on similar grounds, that it wants to benchmark the supplier and have a broad right to audit every aspect of the supplier’s business.But despite being well used phrases, most guidance relating to these concepts does not define how “partnerships” or “partnering” is to work in practice. While most talk of the supplier and the customer working together “in partnership” with common aims, there is little information available as to how this will be incorporated into agreements, particularly in the context of large scale IT procurements.¹ The purpose of this article is to review the available guidance and detail some of the ways in which this guidance can be incorporated into legal agreements.     

Chemically sensitized erythrocytes for hemagglutination reactions.

The use of chemically modified indicator erythrocytes for hemagglutination reactions can result in increased sensitivity. Treatment of erythrocytes with polyvinylpyrrolidone (PVP) or dextran T40 (10% weight/volume) induces changes in the cell surface in the form of extensions and blebbing, thereby increasing the surface area. These sensitized cells can be used in forensic science when detection or quantitation of erythrocyte surface reacting antibodies is important. The effect of altering membrane lipid fluidity on erythrocyte surface antigens has also been investigated. Treatment of cells with a reagent that increases the membrane ratio of cholesterol to phospholipid results in enhanced hemagglutination capacity despite the lack of extensive spiculation.