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The significance of historic places often depends on their use by people. The Anderson Ferry, an historic river crossing in the Eastern United States, is an extreme example; arguably the on-going human use of the crossing is its only significant characteristic. The National Mall in Washington DC also exemplifies the importance of on-going human use. However, such places are often managed as though on-going human use were irrelevant and even damaging to their historic significance; again the National Mall offers a case in point. At least part of this disconnect may result from the documentation instruments used in recognising and designating such places as historic; these instruments tend to focus attention on architectural details and past events, at the expense of contemporary roles and values. We suggest that the forms and guidelines used in historic place designation should be rethought with an eye toward recognising that service as a living part of community life and development is an importan...

Background: The practice environment pivotal role in patients and nurses better outcomes is evident. Practice Environment Scale of Nursing Work Index (PES‑NWI) is widely utilized to assess nursing work environments. The present study was conducted to demonstrate the validity and reliability of the Persian version of PES‑NWI. Materials and Methods: The instrument was translated and its psychometrics were investigated by content, construct validity (factor analysis), and homogeneity (internal consistency and intraclass correlation) on a sample of 350 nurses at educational hospitals in East Azerbaijan, Iran. Results: The 30 items loaded onto 4 factors explained 34.95–50.06% of the variance. The items across the factors differed slightly from those reported by the original author of the PES‑NWI. Cronbach’s alpha and Pearson coefficient for the entire instrument and also for extracted factors was 0.70–0.96. Conclusions: The Persian version of PES‑NWI has an appropriate level of validity and reliability in the Iranian setting for nurses. The subscale of Nursing Foundations for quality care needs modification.

Sheri Fink draws the reader into Memorial Hospital and expresses the thoughts of those who struggled with the impossible during Hurricane Katrina. What was unknown is that health care providers, including nurses, were faced with the unthinkable: assisting critically ill patients to die. Fink is unflinching in telling the story, including investigation of the deaths, and clearly critiques disaster preparedness in health care settings. This book will help nurses prepare for ethical decision making in times of crisis.

Background/Aim: Information may inform and empower clients to engage in their health care. Information can be provided in written form, but it is only effective if it can be read and understood by clients. This study examined whether the knowledge acquisition of participants aged 65 years and older improved more after reading leaflets revised according to content and design principles compared to the leaflets in their original form. Methods: Seven participant pairs (mean age was 74 years, 79% were women), matched according to reading ability, read either the original or the revised versions of four leaflets used by occupational therapists with older clients. Knowledge before and after reading the leaflets was measured using true/false tests developed for each leaflet. Results: After adjusting for differences in baseline knowledge scores, participants who read the revised leaflets acquired 55.3% more knowledge than those who read the original leaflets. All but one participant preferred the revised versions of the leaflets. Conclusions: Simply written and clearly presented written education materials may improve clients' understanding of the content. Further research is needed to determine if one or a combination of the content and design principles used to revise the leaflets is effective in increasing clients' knowledge.

People who experience mental distress are no less capable than the rest of the community when it comes to starting a business. In this article Patience Seebohm talks to Sue Dixon from the Laughing Buddha Bubble Incubator project and Ann Holcroft from Inspire about their work with people with mental health problems to help them develop their entrepreneurial skills, and Judy Scott adds useful advice about Working Tax Credit for those starting a business.

UK policy seeks to shift commissioning of services ‘closer to the people’ with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. The participation of older people with mental health problems and their carers in the strategic planning process has been patchy, however. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.

Judy Scott warns that the new rules on Permitted Work may not be as helpful as we have been hoping — and that the literature being issued by the Department for Work and Pensions may mislead the unwary.

The Welfare Reform and Pensions Bill is passing through Parliament at the time of writing. Some minor amendments are anticipated before the Bill becomes law. This article attempts to summarise 9 of the 86 Clauses in the Bill ‐ those which are most relevant to people claiming benefits because of their incapacity to work and those who try to work when they can.

Judy Scott and Tamara Moreau report on an innovative way of reducing the stress of dealing with the Personal Capability Assessment for people with severe mental health problems who should be exempt.

The arguments about loosening up the benefits system to allow disabled people to work and retain more of their benefits need testing and evaluation in practice if they are ever to be resolved. The Government's encouragement of area based initiatives to help improve the health and wealth of deprived communities provide an opportunity to do just this. The scheme below is just one idea that is being put forward. A life in the day would welcome news of others.

Are people on the therapeutic earnings concession entitled to the minimum wage? Yes, says the legislation, they might be; or they might not; it depends. So how can an employment project which is subject to the Act offer realistic work opportunities? The £15 disregard limits paid work to a maximum of 4 hours and 10 minutes a week!The National Minimum Wage Team at the Department of Trade and Industry offer advice as to when and where the Act is likely to apply. They warn that where uncertainty exists tribunals and courts may decide.Self‐employed people are however exempt. If your project is risking falling foul of the Act, or is languishing in the past with a ‘patients’ attendance allowance, now may be the time to strike out and look for a new model. Three work projects have kindly provided some interesting examples for you to consider.

I invited service user representatives and mental health association leaders to comment on the benefit system in just 50 words. A torrent of criticism poured out of my fax machine. In this we are united. They are demanding a system free from fear which enables and rewards working as and when health allows.The Green Paper March 1998 failed to remove ‘serious barriers to work’. The modest improvements are described on p34.The Snakes & Ladders of the system remain as real life: shake the dice, move four steps forward and find you've landed on the wrong square. The DSS regulations snatch your security and toss you down. You are worse off than before you started.The Government invites our response to the Green Paper; we must ensure that they get it.

Elizabeth Bray has prepared a radical proposal to change the benefit system based on the brilliant idea produced by Alastair and David for the last issue of Life in the Day.Elizabeth has addressed each and every aspect of the problems created by the existing DSS regulations — her powerful arguments spell out the reasons for change.Tables of benefits, earnings and tax demonstrate with precision and clarity the bottom line takehome money. Anybody seeking change to our benefit system should get a copy of the 19‐page document without delay. To cover costs please send a cheque for £2.50 to E. Bray, at 21 Horn Lane, Linton, Cambridge CB1 6HT and an A4 SAE 39p postage.

Is the path back to work paved with incentives? Reflecting on the last five years, Judy, an editorial board member and the regular compiler of the journal's Benefits page, suggests that although improvements have been made, those returning to work after a period of ill health still have to follow a bumpy road.