This study set out to systematically review the research evidence about the impact of alternative models of specialist palliative care on the quality of life of patients. Eighty-six relevant papers were identified and reviewed, including 22 descriptive and 27 comparative studies. We found few comparative trials of reasonable quality. There was some evidence that in-patient palliative care provided better pain control than home care of conventional hospital care, but this research was dated and open to criticism. Research on palliative home care teams and co-ordinating nurses has demonstrated limited impact on quality of life over conventional care for patients dying at home. These negative findings may be due to the limitations of the assessment tools used. There is a need for larger studies to provide clear evidence as to whether specialist palliative care services provide improvements in patients' quality of life. This review does not exclude the possibility that models of care might be justifiable on other grounds such as patient preference or cost-effectiveness.

This systematic literature review examined the impact of specialist models of palliative care on consumer satisfaction, opinion and preference over the past 20 years. From the literature search, 83 relevant papers were identified. Research findings from North America did not reveal any reliable or consistent trends, and this was due primarily to methodological flaws in the research. In the UK, consumers are more satisfied with all types of palliative care, whether provided by inpatient units or in the community, than with palliative care provided by general hospitals. Even though research findings consistently indicate that consumers appreciate the psychosocial climate in hospices, this research was based on small-scale local studies which were mainly focused on a single hospice. The dearth of high quality, comprehensive research was notable on the impact on consumer preference, opinion or satisfaction of hospice home care services, and other forms of palliative care in the community. It was concluded that further research is needed into consumer priorities for patients dying of noncancer diseases, and into the possible impact of patient characteristics on consumer satisfaction, opinion and preference for specialist models of palliative care.

Aim: to report a literature study of leadership for learning in clinical practice in the United Kingdom (UK).Background: previous research in the UK showed that the ward sister was central to

2 Abstract:Respect for people with dementia and their involvement in service planning is explored, based on selected research publications and policy papers, mainly from the Department of Health and the Alzheimer's Society. This article supports the inclusion of people with dementia care in service planning as part of person-centred care. Necessary adjustments to research methods and ethics committee procedures for gaining informed consent are discussed, as is the importance of ethical policy formation and implementation, in order to achieve person-centred care. This will ensure a high degree of active involvement by people with dementia, enhancing self respect and responding to the needs of this often marginalised population. describe an inclusive approach to dementia care planning and delivery. In a joint study by Dementia North and Northumbria University, the research team produced a guide 'to explore how people with dementia can be involved in service planning and development' (p. 3). At an international level, the Dementia Advocacy and Support Network International (DASNI) has provided a forum for involving people with dementia in service planning and implementation, which will be discussed below (http://www.dasninertnational.org).Available evidence, suggesting ways of empowering users to participate in policy formation around services they access, selected research publications and reports from government and voluntary bodies will be examined in this article. The main focus is on the planning of broad systems of services. Personhood and dignity of people with dementia, and promotion of person-centred care.Personhood is central to demand for respect from society and the root of human dignity. Batson et. al.(1994) In the next section we discuss adjustments to research methods and the work of ethics committees, needed to achieve maximum involvement in service planning by clients as part of person-centred care. Adjustments of research methods and ethics committee proceduresBryan and Maxim (2006)  Promote respect and dignity for persons with dementia. Provide a forum for the exchange of information.

A historical overview of nurse leadership in the late 19th and late 20th centuries is presented, supported by relevant material from the literature. The 19th century material revealed the following main themes: emphasis on practical and domestic aspects of management; prominent input of religious ideals and social conscience and, autocratic and feminized style of leadership. The main themes in the contemporary literature examined were: role models in history, dysfunctional leadership styles, importance of knowledge, gender as an influencing factor on nurse leadership and threats to the autonomy of nurse leaders. It was concluded that formal nurse professionalization has progressed steadily during the past hundred years with associated evolution of nurse leaders to fit in with contemporary needs. It is hoped that future policies for nursing will encourage decision-making nearer the 'bed-side', more resource-driven care and value-based leadership.