Canada's Compassionate Care Benefit:Is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

Background: An increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically examine how Canada's Compassionate Care Benefit (CCB) - a contributory benefits social program aimed at informal P/EOL caregivers - operates as a public health response in sustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects of caregiver burden that are addressed within the population health promotion (PHP) model. Methods. As part of a national evaluation of Canada's Compassionate Care Benefit, 57 telephone interviews were conducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths and weaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software and emerging themes were identified by the research team, with such findings published elsewhere. The purpose of the present analysis was identified after comparing the findings to the literature specific to caregiver burden and public health, after which data was analyzed using the PHP model as a guiding framework. Results: Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants. Conclusions: This study, from the perspective of family caregivers, demonstrates that the CCB is not living up to its full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfill the potential it holds for serving as one public health response to caregiver burden that forms part of a healthy public policy that addresses the determinants of this burden. © 2011 Williams et al; licensee BioMed Central Ltd.

Educating families about end-of-life care in advanced dementia:Acceptability of a Canadian family booklet to nurses from Canada, France, and Japan

Background: The families of people with late-stage dementia need to be informed about the course of the dementia and the comfort/ palliative care option. A booklet was written for that purpose and can be provided to family members by physicians and nurses. Methods: The acceptability of the booklet for nurses was tested in Canada (French and English version), France (French Canadian version) and Japan (translated and adapted version). Results: Overall, 188 nurses completed a survey questionnaire. The booklet was accepted best in Canada and less so in France and Japan. Despite regional variation, the majority of the nurses perceived the booklet as useful for families. The French and Japanese nurses also reported a greater need for palliative care education in advanced dementia. Conclusion: The booklet may help nurses educate families about end-of-life issues in dementia palliative care, but local adaptation of the booklet content and physician engagement are necessary.

The Scottish Reformations and the Origin of Religious and Civil Liberty in Britain and Ireland: Presbyterian Interpretations, c.1800-60

This article examines Presbyterian interpretations in Scotland and Ireland of the Scottish Reformations of 1560 and 1638–43. It begins with a discussion of the work of two important Presbyterian historians of the early nineteenth century, the Scotsman, Thomas McCrie, and the Irishman, James Seaton Reid. In their various publications, both laid the template for the nineteenth-century Presbyterian understanding of the Scottish Reformations by emphasizing the historical links between the Scottish and Irish churches in the early-modern period and their common theology and commitment to civil and religious liberty against the ecclesiastical and political tyranny of the Stuarts. The article also examines the commemorations of the National Covenant in 1838, the Solemn League and Covenant in 1843, and the Scottish Reformation in 1860. By doing so, it uncovers important religious and ideological linkages across the North Channel, including Presbyterian evangelicalism, missionary activity, church–state relationships, religious reform and revival, and anti-Catholicism

Covenanter Politics: Evangelicalism, Political Liberalism and Ulster Presbyterians, 1798-1914

Historians of Ireland have devoted considerable attention to the Presbyterian origins of modern Irish republicanism in the 1790s and their overwhelming support for the Union with Great Britain in the 1880s. On the one hand, it has been argued that conservative politics came to dominate nineteenth-century Presbyterianism in the form of Henry Cooke who combined conservative evangelical religion with support for the established order. On the other hand, historians have long acknowledged the continued importance of liberal and radical impulses amongst Presbyterians. Few historians of the nineteenth century have attempted to bring these two stories together and to describe the relationship between the religion and politics of Presbyterians along the lines suggested by scholars of Presbyterian radicalism in the last quarter of the eighteenth century. This article argues that a distinctive form of Presbyterian evangelicalism developed in the nineteenth century that sought to bring the denomination back to the theological and spiritual priorities of seventeenth-century Scottish and Irish Presbyterianism. By doing so, it encouraged many Presbyterians to get involved in movements for reform and liberal politics. Supporters of ‘Covenanter Politics’ utilised their denominational principles and traditions as the basis for political involvement and as a rhetoric of opposition to Anglican privilege and Catholic tyranny. These could be the prime cause of Presbyterian opposition to the infringement of their rights, such as the marriage controversy and the Disruption of the Church of Scotland in the early 1840s, and they could also be employed as a language of opposition in response to broader social and political developments, such as the demands for land reform stimulated by the agricultural depression that accompanied the Famine. Despite their opposition to ascendancy, however, the Covenanter Politics of Presbyterian Liberals predisposed them towards pan-protestant unionism against the threat of ‘Rome Rule’.

Temporal distribution of porcine circovirus 2 genogroups recovered from postweaning multisystemic wasting syndrome-affected and -nonaffected farms in Ireland and Northern Ireland

Porcine circovirus type 2 (PCV2) is now recognized as the essential infectious component of porcine postweaning multisystemic wasting syndrome (PMWS). PMWS was first recognized in high-status, specific pathogen-free pigs in Canada in 1991 and is now an economically important disease that affects the swine industry around the world. Recently, reports of genomic studies on PCV2 viruses indicated that 2 distinctive genogroups of PCV2 exist.(4,10) This report involves the results of a study on the distribution of predominant PCV2 genogroups recovered from samples taken from PMWS-affected and PMWS-nonaffected farms on the island of Ireland over a 9-year period and the results of a study on PCV2 genogroup recovery from fecal samples taken from a farm in Northern Ireland from 2003 to 2005 that was first diagnosed as PMWS positive in August 2005. The results indicate that, although at least 2 distinct genogroups of PCV2 have been circulating on pig farms on the island of Ireland, there does not appear to be a direct relationship between infection with these different genogroups of PCV2 and the development of PMWS.