An exploration of nursing home managers' knowledge of and attitudes towards the management of pain in residents with dementia

Background The aims of this study were to explore the knowledge, attitudes and beliefs that nursing home managers hold with regard to the assessment and management of pain in residents with dementia and to determine how these may be affected by the demographic characteristics of the respondents.

Methods A questionnaire comprising six sections was mailed, on two occasions during March and April 2010, to 244 nursing home managers in Northern Ireland (representing 96% of the nursing homes in Northern Ireland).

Results The response rate was 39%. Nearly all respondents (96%) provided care to residents with dementia, yet only 60% of managers claimed to use pain treatment guidelines within their nursing home. Respondents demonstrated good knowledge about pain in residents with dementia and acknowledged the difficulties surrounding accurate pain assessment. Nursing home managers were uncertain about how to manage pain in residents with dementia, demonstrating similar concerns about the use of opioid analgesics to those reported in previous studies about pain in older people. Managers who had received recent training (p = 0.044) were less likely to have concerns about the use of opioid analgesia than those who had not received training. Respondents' beliefs about painkillers were largely ambivalent and were influenced by the country in which they had received their nursing education.

Conclusions The study has revealed that accurate pain assessment, training of nursing staff and a standardised approach to pain management (the use of pain management guidelines) within nursing homes all have a significant part to play in the successful management of pain in residents with dementia. Copyright (c) 2012 John Wiley & Sons, Ltd.

At Home in Care: Children living with birth parents on a Care Order

This study explored the processes, background information, and perceived reasons why children and young people returned home while remaining in care, in the five HSC Trusts in Northern Ireland. The research also focused on understanding the functions the Care Order had for social services, the birth parents, and young people involved.
It was found that on 31st March 2009, there were 193 children/young people living with their birth parents on a Care Order in Northern Ireland. This is eight per cent of the total population of Looked After children, and is lower than had been anticipated from governmental statistics. In total, the case files of 47 of these young people (24% of them) were reviewed, and interviews were conducted with ten of them and their birth parent/s.
The analysis revealed that the majority of them had in common a parental background history of alcohol abuse and domestic violence, and most return breakdowns in the study were related to continuing parental alcohol and/or drugs misuse. While some children had a planned return home after parents had engaged in supports and completed assessments, many young people had returns that were not planned, as they initiated the move themselves, or previous foster placements had broken down and there were no alternative placements identified for them. Many of these young people essentially ‘voted with their feet’, and social services were required to ensure that they remained safe in often less than optimal circumstances.
After returning home, for many, Care Orders remained for initially unintended lengthy periods because of the risks posed by parents’ intermittent alcohol abuse and their lifestyle, contact issues, and parents’ desire to ensure that their children were able to access the supports that they needed. Thus, Care Orders at home tended to serve two main functions: to either monitor and/or support the placement.

In and out of home care decisions: The influence of confirmation bias in developing decision supportive reasoning

The aims of this study were to identify the themes Social Workers regard as important in supporting decisions to remove children from, or return them to, the care of their parents. To further elicit underlying hypotheses that are discernible in interpretation of evidence. A case study, comprising a two-part vignette with a questionnaire, recorded demographic information, child welfare attitudes and risk assessments, using scales derived from standardised instruments, was completed by 202 Social Workers in Northern Ireland. There were two manipulated variables, mother’s attitude to removal and child’s attitude to reunification2 years later. In this paper we use data derived from respondents’ qualitative comments explaining their reasoning for in and out of home care decisions. Some 60.9% of respondent’s chose the parental care option at part one, with 94% choosing to have the child remain in foster care at part two. The manipulated variables were found to have no significant statistical effect. However, three underlying hypotheses were found to underpin decisions; (a)child rescue, (b) kinship defence and (c) a hedged position on calculation of risk subject to further assessment. Reasoning strategies utilised by social workers to support their decision making suggest that they tend to selectively interpret information either positively or negatively to support pre-existing underlying hypotheses. This finding is in keeping with the literature on ‘confirmation bias.’ The research further draws attention to the need to incorporate open questions in quantitative studies, to help guard against surface reading of data, which often does not ‘speak for itself.’

Handling the transfer of power: a note on the 1964 origins of the Douglas‐Home rules

Opposition is rarely a good preparation for government. The only post‐war government to enter office confident, well‐acquainted with the Civil Service and with a fund of administrative experience to draw on was the Attlee administration formed in 1945. The longer a party spends in opposition the more these assets disappear. Labour, by the end of the long period of Conservative rule in 1951–64, was largely unfamiliar with the burdens of office. This formed the background to the formulation of the Douglas‐Home rules, whereby informal contact is permitted between the Civil Service and the Opposition in advance of a general election. Since 1964 this arrangement has gradually become more extensive (especially after Neil Kinnock complained that the period for contact was too brief during the run‐up to the 1992 election) and more formalised. In late 1993 John Major agreed that contacts could be made from early 1996 in advance of the next election, rather than only during the last six months of a parliament, as had by then become the convention.’ The object of this short paper is, however, to explain how these rules originated.

John W. Fisher Fonds, 1937-1961, 1964-1989, 1993, n.d.

Norah and Fred Fisher welcomed John Fisher into the world on November 29, 1912, not knowing what an influential role he would play in shaping Canada's history. John Fisher grew up as the middle child of five brothers and sisters in Frosty Hollow, New Brunswick, close to today’s town of Sackville. Sackville’s main industry was the Enterprise Foundry which the Fisher family owned and operated; however, Fisher had no plans of going into the family business. He was more inspired by his maternal grandfather, Dr. Cecil Wiggins, who lived with the family after retiring from the Anglican ministry. Wiggins encouraged all his grandchildren to be well read and to take part in discussions on current events. There were often visitors in the Fisher household taking part in discussions about politics, religion, and daily life. Fisher forced himself to take part in these conversations to help overcome his shyness in social settings. These conversations did help with his shyness and also in forming many opinions and observations about Canada. It put Fisher on the road to becoming Mr. Canada and delivering the many eloquent speeches for which he was known. Fisher did not venture far from home to complete his first degree. In 1934 he graduated from Mount Allison University in Sackville, NB with an Arts degree. The same year Fisher enrolled in Dalhousie’s law school. During his time at Dalhousie, Fisher discovered radio through Hugh Mills. Mills or “Uncle Mel” was on CHNS, Halifax’s only radio station at the time. Fisher began by making appearences on the radio drama show. By 1941 he had begun writing and broadcasting his own works and joined the staff as an announcer and continuity writer. In 1936 the Canadian Broadcasting Corporation was formed, the first National radio station. Fisher joined the CBC shortly after it’s beginning and remained with them, as well as the Halifax Herald newspaper, even after his law school graduation in 1937. By 1943 Fisher’s talks became a part of the CBC’s programming for a group of maritime radio stations. Fisher once described his talks as follows “my talks weren’t meant to be objective. . . they were meant to be favourable. They were ‘pride builders’” He began his famed John Fisher Reports at CBC Toronto when he transfered there shortly after the war. This program brought emmence pride to the fellow Canadians he spoke about leading to approximately 3500 requests per year to speak at banquets and meeting throughout Canada and the United States. Fisher was a well travelled indivdual who would draw on personal experiences to connect with his audience. His stories were told in simple, straight forward language for anyone to enjoy. He became a smooth, dynamic and passionate speaker who sold Canada to Canadians. He became a renowned journalist, folk historian, writer and broadcaster. Fisher was able to reach a vast array of people through his radio work and build Canadian pride, but he did not stop there. Other ways Fisher has contributed to Canada and the Canadian people include: Honoured by five Canadian Universities. 1956, became the Director of the Canadian Tourist Association. 1961, was appointed Special Assistant to the Prime Minister of Canada. 1963, Commissioner of the Centennial Commission (the Federal Agency Responsible for Canada’s 100th birthday) 1968, received the Service Medal , a coveted Order of Canada. President of John Fisher Enterprises Ltd., private consultant work, specializing in Centennial planning, broadcasts, lectures and promotion. John Fisher continued recording radio broadcasts even after his diagnosis with cancer. He would record 3 or 4 at a time so he was free to travel across Canada, the U.S., Europe and Mexico in search of treatments. Fisher passed away from the disease on February 15, 1981 and he is buried at Mount Pleasant Cemetery in Toronto.

Lt. Col. John Clark Papers, 1838-1851 [photocopy]

Lt. Col. John Clark (1787-1862) was born in Kingston, Upper Canada. In 1801 Clark became a private in the 1st regiment of the Lincoln Militia, serving under Ralfe Clench. By June 1812 he was promoted to lieutenant by Maj. Gen. Sir Isaac Brock. During the War of 1812 he served as lieutenant and adjutant for the Lincoln Militia flank company on the Niagara frontier under Col. William Claus, and was present at the surrender of the enemy at the battle of Queenston Heights. By 1838 the Lincoln Militia was being re-organized and Lt. Col John Clark was requested to lead the 5th Regiment, made up of men from both Grantham and Louth townships in Lincoln County. He served in this capacity until his retirement in 1851?. Around this same time Clark bought from William May Jr. a house in Grantham Township. He was to call his home Walnut Dale Farm. John Clark also served as the customs collector for Port Dalhousie, and as a secretary in the Welland Canal Company. One hundred years later efforts by a local heritage group to save John Clark’s home failed, when the house was hit by arsonists. By this time the house had become known as the May-Clark-Seiler House. See RG 195 Anne Taylor Fonds for more information regarding the efforts of the heritage group to save this home. Clark died in 1862 at the age of 79 years and is buried in Victoria Lawn Cemetery. John Clark’s daughter Catherine (mentioned in the diary portion of the papers) was married to William Morgan Eccles.

Irish John Willson United Empire Loyalist Family Fonds

John Willson first came to Upper Canada along with his friend Nathaniel Pettit in the late 1700s. They both moved with their families from New Jersey where they had both been imprisioned for not siding with the rebels and maintaining Loyalist allegiences. Pettit arrived with his four daughters, leaving his son behind. Willson came with his wife and nine children. Willson received 1200 acres of land as well as 200 per child. He settled at the corner of Dorchester road and Thorold Stone Road, where he and his family did very well for themselves. Willson as well as his son Thomas ran ox-teams on the portage. His son John became the proprietor of the Exchange hotel at Niagara, and Charles operated at the Pavilion hotel at Falls View. Shortly after his arrival in Upper Canada John Willson changed his name to “Irish” John Willson, as there were 5 other “John Willsons” which appeared on the Loyalists lists. Irish John drowned in the Niagara River in 1798, and his family continued to thrive in Niagara after his death. His second son Thomas Willson, married Abigail Pettit, daughter of his Father’s friend Nathaniel. Thomas was awarded 250 acres of land as a Loyalist and 200 for Abigail, as she was the daughter of a loyalist. He became a blacksmith and also operated ox-teams along the portage. He was Assessor for Stamford Township for 1800, 1807, 1820 and 1829. During the years 1808, 1822, 1825, 1826 and 1831 he was a tax collector and overseer of Statute of Labour. Thomas and Abigail Willson had nine children together. Francis Bond Head Willson of Beaverdams (mentioned throughout the collection) was a great grandson of Thomas and Abigail. Thomas and his wife are both buried beside the Lundy’s Lane United Church. *for more information on the remaining Willson family please refer to box #1, folders 1-3. * Genealogical information from a paper prepared by Pearl Wilson and given before the Lundy’s Lane Historical Society, May 1945, by Hazel Culp Ferris. Box 1 Folder 1.

John Adams Smith letter, Jan. 14, 1813

Transcript: New York Jan. 14. 1813. My dear uncle, I had nearly concluded to have made my [jaunt?] earlier than I had mentioned in my last letter to you, for Swartout had intended to have written by me to Father & yourself; having [Louisa?] concluded not so soon to depart he sends me his letters which I forward in mail, I shall hope to have letters from home soon, it is a great pleasure to hear from any of you. I said last week in Hollands letter mentioning [bladeworth?] account, I have explained to him. It is a mistake about me agreeing to pay Mr. [Dening?] [their?] account. Caroline mentions to me your jaunt to [Sophia?], but I regret our friend there should be unpleasantly situated. I have not yet seen Col. Willett but will see him as mentioned. I have neglected to go there for some time which has been remiss in me. We have nothing new I believe unless it be that Armstrong & Jones of Philadelphia have been nominated as Secretarys of War & the Navy & [cer?] this in all probability may be appointed. There may be room for speculation, but perhaps it is not probable that Canada will be ceded to American Valor in the year 1813. There is a Bill before congress by which it may be made penal to enter on board American vessels, either British subjects or naturalized Americans, which it is presoomed by many will [spon?] the accommodation of Peace – may be yes may be no – the proof of the pudding is in the eating of it. I imagine pacification is not so near at hand although it is much to be desired. Whatever might be for the honor & prosperity of the Country I would strenuously advocate, aloof from partial & party considerations. We have not a word as yet what the Council at Albany may be thinking of as yet. I suppose these things will come in time, perhaps untimely to many. I desire for the present not to be found among the untimely. I am your sincerely, with love to all. John Adams Smith

Letter written by John Bentley, Sept. 26, 1813.

Transcript [original spelling and grammar retained]: Sacketts Harbour 26th Sept. 1813. Dear wife. From this you are informed that I am in health at this Date. When I last wrote to you I some expected to go upon and expedition but to us unknown we sat out and went up the Lake 3 Days Landed at Oswego The British Fleet appeared off, and we returned and saw our fleet upon our return, I think that our Regt. going was only a maneuver to get the Fleet out that our Fleet might come a threat[?] of them We expect to embark immediately into Canada as preparations are making to convey us over to them we are anxious to commence an action with them. Troops are daily coming in to the Harbour to take the Stand in our absence, we shall not be here 3 days before we try their[?] Powder. they are daily defecting[?] to us from Canada very fearful of the consequence of our Resisting[?] of them…our Fleet is now out and has been for 6 or 7 days. The Lake Erie fleet has done great things. I hope ours will be as successful. I think that our Generals are waiting to hear from them as every thing is ready[?] of to embark various opinions reflecting were we shall attack them some say at Kingston others at Montreal and others at Prescot—Mr. William Butler and D[?]…are well and in Spirits, Sergt Daniel White is very hearty for him, M. Samuel C[?] is well and in good health Benjm Thompson is well Charles Bryant is well [?] is well Eben[?] Smith is very much plagued with the Rheumatik Disease[?] he……… his limbs very often for being Crippled[?] he is at the Hospital I often visit it to see the sick Jacob Barnes is at the Hospital but recovering fast been very sick. Luther Gregory is at the Hospital and on the recovery, Sergt. L[?] & Smith are well, Henry ………[?] is well, very healthy have not more die here than 3…[?]to the best of my knowledge. I will make a few remarks upon the place it abounds in Lime Rock more than Thomaston and not every person to my knowledge burn it, and in the whole Town not but one Pump that supplies the Towns People and Soldiers and a ………[?] of such a Lake of water the Lake water is good for drinking but the water near the Shore is exposed to all kind of filth being thrown into it. The officers with whom I have been with have used me kindly and I get quietly by them. The Lieut. Downer who recruits at Thomaston tell me he has thots[?] of Leaving the army if so I must say I am greatly sorry as he was my ……[?] friend although he Left us and went in a northern Company it is a Company……………[?]worthy an officer as he proves to be, I cannot get any higher than a Sergeant or Quarter Master Sergeant which I may have without any friends at Thomaston assisting me. I am a Sergeant and Sergeant Daniel White is expecting[?] to be a Quarter Master Sergeant, and a number of his friends from Thomaston have went to their Major for him in the 9th Regt Major….[?] and he expects to obtain a Commission as I ……[?] expect to be promoted and it died away he will have the Laugh upon me, I wish that My Friend Dawes would[?] put the question to Col. Foot? to write to our Col. E.W. Ripley if he has …[?]in the …[?]taken by him and others of my …[?] friends[?]. I expect to come home this winter without fail. I remain your Loving Husband till Death. John Bentley for Betsey Bentley Thomaston P.S. The next Letter will be ……[?]to Mr. Dawes[?] and shall write as soon as our Fleet arrives or if we are ordered off tomorrow shall write before I leave this Place. I have understood that many letters have been ……[?]to me. I have received only 2 from Mary, one from Mr. Dawes, one from William Thompson and have answered them please to write……[?]to S. Harbour.

A Home at School: Building Stronger Indigenous People through Cultural Resurgence in an Urban Ontario Public School Context.

In this thesis, I work through the educational narratives of young Aboriginal women and men as I explore the relationship between cultural programming and student engagement. My analysis is structured through a collaborative Indigenous research project. My overarching task is to explore how a cultural support program, the Native Youth Advancement with Education Hamilton (NYA WEH) Program, offered at Sir John A. Macdonald Secondary School, located in Hamilton, Ontario, Canada, attempts to re-imagine Aboriginal education in ways that directly challenge the residential school legacy. In particular, I work to illuminate how particular forms of Aboriginal education are connected to the graduation rates of Aboriginal youth. I argue that the ways in which the NYA WEH Program navigates Native Studies curriculum, relationships, and notions of culture and tradition are significant to the engagement of Aboriginal youth. This research develops theoretical connections between the contemporary experience of Aboriginal social inequality and educational initiatives which attempt to reverse that legacy. By placing the NYA WEH Program narratives side-by-side with literature supporting Aboriginal education for Self-determination, I work to learn how to best support and encourage Aboriginal student engagement in secondary schools across Ontario.

Letter to S.D. Woodruff from John F. Day

Letter to S.D. Woodruff from John F. Day stating that his son will not be home until Saturday evening but he will lay his favour before him and reply by the first mail. This is accompanied by an envelope postmarked Bruce Mines, July 15, 1880.

L'evolution mentale chez l'home; origine des facultés humaines

UANL

Home in British working-class fiction

Offering new readings of working-class writing that focus on the home as a key emotional and material site in writing by working-class authors from the Edwardian period through to the mid-1990s. With close readings of The Ragged Trousered Philanthropists, works by D. H. Lawrence, Ethel Carnie Holdsworth, Ellen Wilkinson, Lewis Grassic Gibbon, Walter Brierley, Alan Sillitoe, John Braine, Nell Dunn, Sam Selvon, Sid Chaplin, Buchi Emecheta, Pat Barker, Jeanette Winterson, James Kelman and many others. The book demonstrates the importance of ideas of home and its narrative representation to the making and expression of class feeling and identity.