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Spiritual care may be said to be universally recognized as an important aspect of palliative care and yet its effectiveness is notoriously difficult to evaluate. This article traces the experience of a group of three hospice services in East Kent. It describes the formulation of a multidisciplinary policy for spiritual care based on the best available evidence. Clinical and non-clinical staff were encouraged through training to adopt an approach to spiritual care for all patients recognizing that their spiritual needs are broader than religious needs, The outcome of the training was audited and showed that the principles of the policy had been understood and put into practice. Lessons learned through the audit were then used to update the policy, adapt practice and plan a fresh round of training.

Volumetric three-component velocimetry measurements have been taken of the flow field near a Rushton turbine in a stirred tank reactor. This particular flow field is highly unsteady and three-dimensional, and is characterized by a strong radial jet, large tank-scale ring vortices, and small-scale blade tip vortices. The experimental technique uses a single camera head with three apertures to obtain approximately 15,000 three-dimensional vectors in a cubic volume. These velocity data offer the most comprehensive view to date of this flow field, especially since they are acquired at three Reynolds numbers (15,000, 107,000, and 137,000). Mean velocity fields and turbulent kinetic energy quantities are calculated. The volumetric nature of the data enables tip vortex identification, vortex trajectory analysis, and calculation of vortex strength. Three identification methods for the vortices are compared based on: the calculation of circumferential vorticity; the calculation of local pressure minima via an eigenvalue approach; and the calculation of swirling strength again via an eigenvalue approach. The use of two-dimensional data and three-dimensional data is compared for vortex identification; a ‘swirl strength’ criterion is less sensitive to completeness of the velocity gradient tensor and overall provides clearer identification of the tip vortices. The principal components of the strain rate tensor are also calculated for one Reynolds number case as these measures of stretching and compression have recently been associated with tip vortex characterization. Vortex trajectories and strength compare favorably with those in the literature. No clear dependence of trajectory on Reynolds number is deduced. The visualization of tip vortices up to 140° past blade passage in the highest Reynolds number case is notable and has not previously been shown.

The idea of a ‘good death’ is one which has been central to the palliative care movement but which in fact predates it. A number of recent articles have grappled with the concept. It is a subject which is difficult to quantify scientifically and this article explores the territory using a number of philosophical, theological, historical and literary sources. The changing meaning of the concept is traced through the premodern, modern and postmodern periods. In particular the influence on Western ideals about death of the two paradigmatic stories of the deaths of Socrates and Jesus are examined. It is argued that the dualistic thinking of Plato, which often underlies our thinking about death, is no longer adequate and the author offers the thinking of the Spanish philosopher Miguel de Unamuno as an alternative way of approaching our attitudes to death. Although the article does not seek to give a definitive answer to the question it raises, it suggests that thinking about good death should be broadened to accept the struggle with which many people face their death.