Managing pain medications in long-term care: nurses' views

The purpose of this study was to explore nurses' perceptions of their current practices related to administering pain medications to long-term care (LTC) residents. A cross-sectional survey design was used, including both quantitative and open-ended questions. Data were collected from 165 nurses (59% response rate) at nine LTC homes in southern Ontario, Canada. The majority (85%) felt that the medication administration system was adequate to help them manage residents' pain and 98% felt comfortable administering narcotics. In deciding to administer a narcotic, nurses were influenced by pain assessments, physician orders, diagnosis, past history, effectiveness of non-narcotics and fear of making dosage miscalculations or developing addictions. Finally, most nurses stated that they trusted the physicians and pharmacists to ensure orders were safe. These findings highlight nurses' perceptions of managing pain medications in LTC and related areas where continuing education initiatives for nurses are needed.

HRM and the employment of older workers: Germany and Britain compared

This study examines Human Resource Management (HRM) policies and practices towards older workers in Britain and Germany. While it is widely suggested that older workers have to be better integrated into the labour market, youth-centric HRM is still prevalent. However, HRM is shaped by multiple and contradictory pressures from the international and national institutional environments. We test this dynamic by analysing two national surveys, the German firm panel (IAB)1 and the British Workplace and Employment Relations Survey (WERS).2 Our findings suggest that the institutional environment shapes HR policies and practices distinctively in both countries. We find that age discrimination at the workplace is more prevalent in Germany than in Britain, which can be explained by divergent institutional patterns. As a result, we argue that although both countries will have to continue fostering an age-neutral HR approach, this has to take country-specific institutional peculiarities into account.

Fish product mislabelling: failings of traceability in the production chain and implications for illegal, unreported and unregulated (IUU) fishing

Increasing consumer demand for seafood, combined with concern over the health of our oceans, has led to many initiatives aimed at tackling destructive fishing practices and promoting the sustainability of fisheries. An important global threat to sustainable fisheries is Illegal, Unreported and Unregulated (IUU) fishing, and there is now an increased emphasis on the use of trade measures to prevent IUU-sourced fish and fish products from entering the international market. Initiatives encompass new legislation in the European Union requiring the inclusion of species names on catch labels throughout the distribution chain. Such certification measures do not, however, guarantee accuracy of species designation. Using two DNA-based methods to compare species descriptions with molecular ID, we examined 386 samples of white fish, or products labelled as primarily containing white fish, from major UK supermarket chains. Species specific real-time PCR probes were used for cod (Gadus morhua) and haddock (Melanogrammus aeglefinus) to provide a highly sensitive and species-specific test for the major species of white fish sold in the UK. Additionally, fish-specific primers were used to sequence the forensically validated barcoding gene, mitochondrial cytochrome oxidase I (COI). Overall levels of congruence between product label and genetic species identification were high, with 94.34% of samples correctly labelled, though a significant proportion in terms of potential volume, were mislabelled. Substitution was usually for a cheaper alternative and, in one case, extended to a tropical species. To our knowledge, this is the first published study encompassing a large-scale assessment of UK retailers, and if representative, indicates a potentially significant incidence of incorrect product designation.

Dedicated severe asthma services improve health-care use and quality of life

Background: Systematic assessment of severe asthma can be used to confirm the diagnosis, identify comorbidities, and address adherence to therapy. However, the prospective usefulness of this approach is yet to be established. The objective of this study was to determine whether the systematic assessment of severe asthma is associated with improved quality of life (QoL) and health-care use and, using prospective data collection, to compare relevant outcomes in patients referred with severe asthma to specialist centers across the United Kingdom. Methods: Data from the National Registry for dedicated UK Difficult Asthma Services were used to compare patient demographics, disease characteristics, and health-care use between initial assessment and a median follow-up of 286 days. Results: The study population consisted of 346 patients with severe asthma. At follow-up, there were significant reductions in health-care use in terms of primary care or ED visits (66.4% vs 87.8%, P < .0001) and hospital admissions (38% vs 48%, P = .0004). Although no difference was noted in terms of those requiring maintenance oral corticosteroids, there was a reduction in steroid dose (10 mg [8-20 mg] vs 15 mg [10-20 mg], P = .003), and fewer subjects required short-burst steroids (77.4% vs 90.8%, P = .01). Significant improvements were seen in QoL and control using the Asthma Quality of Life Questionnaire and the Asthma Control Questionnaire. Conclusions: To our knowledge, this is the first time that a prospective study has shown that a systematic assessment at a dedicated severe asthma center is associated with improved QoL and asthma control and a reduction in health-care use and oral steroid burden.

Clopidogrel use and cancer-specific mortality: a population-based cohort study of colorectal, breast and prostate cancer patients

PURPOSE: Concerns were raised about the safety of antiplatelet thienopyridine derivatives after a randomized control trial reported increased risks of cancer and cancer deaths in prasugrel users. We investigate whether clopidogrel, a widely used thienopyridine derivative, was associated with increased risk of cancer-specific or all-cause mortality in cancer patients.

METHODS: Colorectal, breast and prostate cancer patients, newly diagnosed from 1998 to 2009, were identified from the National Cancer Data Repository. Cohorts were linked to the UK Clinical Practice Research Datalink, providing prescription records, and to the Office of National Statistics mortality data (up to 2012). Unadjusted and adjusted hazard ratios (HRs) for cancer-specific and all-cause mortality in post-diagnostic clopidogrel users were calculated using time-dependent Cox regression models.

RESULTS: The analysis included 10 359 colorectal, 17 889 breast and 13 155 prostate cancer patients. There was no evidence of an increase in cancer-specific mortality in clopidogrel users with colorectal (HR = 0.98 95% confidence interval (CI) 0.77, 1.24) or prostate cancer (HR = 1.03 95%CI 0.82, 1.28). There was limited evidence of an increase in breast cancer patients (HR = 1.22 95%CI 0.90, 1.65); however, this was attenuated when removing prescriptions in the year prior to death.

CONCLUSIONS: This novel study of large population-based cohorts of colorectal, breast and prostate cancer patients found no evidence of an increased risk of cancer-specific mortality among colorectal, breast and prostate cancer patients using clopidogrel.

Seismic vulnerability and risk assessment of historic masonry buildings

Seismic risk evaluation of built-up areas involves analysis of the level of earthquake hazard of the region, building vulnerability and exposure. Within this approach that defines seismic risk, building vulnerability assessment assumes great importance, not only because of the obvious physical consequences in the eventual occurrence of a seismic event, but also because it is the one of the few potential aspects in which engineering research can intervene. In fact, rigorous vulnerability assessment of existing buildings and the implementation of appropriate retrofitting solutions can help to reduce the levels of physical damage, loss of life and the economic impact of future seismic events. Vulnerability studies of urban centresshould be developed with the aim of identifying building fragilities and reducing seismic risk. As part of the rehabilitation of the historic city centre of Coimbra, a complete identification and inspection survey of old masonry buildings has been carried out. The main purpose of this research is to discuss vulnerability assessment methodologies, particularly those of the first level, through the proposal and development of a method previously used to determine the level of vulnerability, in the assessment of physical damage and its relationship with seismic intensity.

The First Government of Northern Ireland, Education Reform, and the Failure of Anti-populist Unionism, 1921–1925

This article examines education reform under the first government of Northern Ireland (1921–5). This embryonic period offered the Ulster Unionist leadership a chance to construct a more inclusive society, one that might diminish sectarian animosities, and thereby secure the fledgling state through cooperation rather than coercion. Such aspirations were severely tested by the ruling party’s need to secure the state against insurgency, and, more lastingly, to assuage the concerns of its historic constituency. The former led to a draconian security policy, the latter to a dependency on populist strategies and rhetoric. It is argued here, however, that this dependency was not absolute until July 1925. Before that, the Belfast government withstood growing pressure from populist agitators to reverse controversial aspects of its education reforms, only relenting when Protestant disaffection threatened the unity of the governing party and the existence of the state.

'Incorrigibly Plural’: New Histories of Ulster and Northern Ireland’

Review article of Carson’s Army: The Ulster Volunteer Force, 1910–22. By Timothy Bowman. Manchester University Press, Manchester, 2007. 256 pp. ISBN 0719073715, £55. A History of the Northern Ireland Labour Party: Democratic Socialism and Sectarianism. By Aaron Edwards. Manchester University Press, Manchester, 2009. xiii + 240 pp. ISBN 0719078741, £60. Catholic Belfast and Nationalist Ireland in the Era of Joe Devlin 1871–1934. By A.C. Hepburn. Oxford University Press, Oxford, 2008. xix +307 pp. ISBN 019929884X, £55. The Big House in the North of Ireland: Land, Power and Social Elites, 1878–1960. By Olwen Purdue. University College Dublin Press, Dublin, 2009. xv + 297 pp. ISBN 978-1-906359-25-6, £24.

Cataloguing Kays: Body Image in the Catalogues of Kay & Co Ltd of Worcester, 1920 - 2000. JISC Final Report

Cataloguing Kays is a university-run project intended to create a community web-archive to celebrate the history and public memory of Kay & Co Ltd of Worcester, a noted mailorder catalogue company which was, until 2006, the largest employer in Worcester. The Kays Archive, housed at UoW, is one of the most comprehensive archive collections of 20th century mail-order catalogues in the UK and has a strong local elevance. The catalogues provide a window into over 100 years of body image, social history, consumable goods, fashion and design. The Project Team created www.WorldofKays.org, an online, fully-searchable archive containing 1500 digitised images from the catalogues, 1920-2000. The website is intended to form a seed bed for international research, focussing in particular on the representation of body image and the way the catalogues represent the developing tropes of consumer lifestyle and aspiration. The images are enhanced by blog postings from or film and audio interviews with local residents and former Kays staff members, who recall how the goods were selected and presented; as well as the impact the mail-order industry had on shaping 20th century lifestyle and consumption. These interviews and blogs have been sourced through the Cataloguing Kays team’s outreach activity in the local, academic and online communities. From the outset, we, the Cataloguing Kays team, engaged with online communities through social media sites, Facebook and Twitter, and through specialist blogs and online forums, inviting comment and contributions. Through events for the general public and a programme of targeted community outreach work with Kays Heritage Group and support groups for Worcestershire’s young and adult carers, we have also collected filmed and audio reminiscence material as well as community art and poetry content for the website. Our academic conference, the Catalogue of Dreams, showcased both the website and the physical archive to the wider academic, cultural and heritage sectors, provoking lively debateand much interest from international scholars.

Tackling the terrorists: the experience of internment without trial in Northern Ireland

In August 1971, the devolved Stormont administration in Northern Ireland introduced internment without trial of those suspected of involvement in IRA terrorism. Ever since, the policy has been regarded as an abject failure. This article will reassess many of the key questions about internment: why did the Northern Ireland government introduce it when it did? Why did the Westminster government agree to a measure without parallel in British peacetime history? Why did it fail, when it had worked before? Was internment always doomed, or only because it was badly implemented? What was the alternative? How does the liberal democratic state defend itself against violent subversion without itself resorting to brutality and violence? This article is based on archival research in Great Britain, Northern Ireland and the Republic of Ireland, and on interviews with former internees, politicians and civil servants, and former members of the security forces. It suggests that internment was a relatively humane and honest policy and might, in different circumstances, have spared Northern Ireland thirty years of murder and mayhem.

Chronique de Normandie, jusqu'en 1217.

Contient : « Cy ensuivent les croniques de Normandie. Pour ce que ceulx de bonne voulenté qui tendent venir à honneur selon Dieu par vaillance et par hardement... » ; « ... cel an s'esmeurent les Chrestiens de toutes terres de Chrestienté à eulx croisier pour aler en Jherusalem conquerre [la Sainte Terre] »

Office of the City Clerk, St. Catharines Records, 1928-1974, n.d.

The site of present-day St. Catharines was settled by 3000 United Empire Loyalists at the end of the 18th century. From 1790, the settlement (then known as "The Twelve") grew as an agricultural community. St. Catharines was once referred to Shipman's Corners after Paul Shipman, owner of a tavern that was an important stagecoach transfer point. In 1815, leading businessman William Hamilton Merritt abandoned his wharf at Queenston and set up another at Shipman's Corners. He became involved in the construction and operation of several lumber and gristmills along Twelve Mile Creek. Shipman's Corners soon became the principal milling site of the eastern Niagara Peninsula. At about the same time, Merritt began to develop the salt springs that were discovered along the river which subsequently gave the village a reputation as a health resort. By this time St. Catharines was the official name of the village; the origin of the name remains obscure, but is thought to be named after Catharine Askin Robertson Hamilton, wife of the Hon. Robert Hamilton, a prominent businessman. Merritt devised a canal scheme from Lake Erie to Lake Ontario that would provide a more reliable water supply for the mills while at the same time function as a canal. He formed the Welland Canal Company, and construction took place from 1824 to 1829. The canal and the mills made St. Catharines the most important industrial centre in Niagara. By 1845, St. Catharines was incorporated as a town, with the town limits extending in 1854. Administrative and political functions were added to St. Catharines in 1862 when it became the county seat of Lincoln. In 1871, construction began on the third Welland Canal, which attracted additional population to the town. As a consequence of continual growth, the town limits were again extended. St. Catharines attained city status in 1876 with its larger population and area. Manufacturing became increasingly important in St. Catharines in the early 1900s with the abundance of hydro-electric power, and its location on important land and water routes. The large increase in population after the 1900s was mainly due to the continued industrialization and urbanization of the northern part of the city and the related expansion of business activity. The fourth Welland Canal was opened in 1932 as the third canal could no longer accommodate the larger ships. The post war years and the automobile brought great change to the urban form of St. Catharines. St. Catharines began to spread its boundaries in all directions with land being added five times during the 1950s. The Town of Merritton, Village of Port Dalhousie and Grantham Township were all incorporated as part of St. Catharines in 1961. In 1970 the Province of Ontario implemented a regional approach to deal with such issues as planning, pollution, transportation and services. As a result, Louth Township on the west side of the city was amalgamated, extending the city's boundary to Fifteen Mile Creek. With its current population of 131,989, St. Catharines has become the dominant centre of the Niagara region. Source: City of St. Catharines website http://www.stcatharines.ca/en/governin/HistoryOfTheCity.asp (January 27, 2011)

William Van Every fonds, 1784, 1804-1806, 1815-1816, 1828, 1832, n.d.

William Van Every, son of McGregory and Mary Wilcox (Jaycocks) Van Every, was born in New York state in 1765. During the Revolutionary War he joined Butler’s Rangers and served under Captain John McDonnell. He was granted three lots of land in the Township of Niagara, with additional lands granted at later dates. William married Elizabeth, daughter of George Young. Elizabeth was the widow of Col. Frederick Dochstader and mother of Catherine Dochstader, b. 1781. William Van Every died in 1832, his wife Elizabeth in 1851. Both are buried in the Warner Cemetery, in present day Niagara Falls. The children of William Van Every and Elizabeth Young were Mary, Elizabeth, Phoebe, John, Peter, William, Rebecca, Samuel and Joseph. Source: Mary Blackadar Piersol, The Records of the Van Every Family, Toronto : Best Printing, 1947. And, Patricia M. Orr, Historic Woodend, sponsored by Niagara Peninsula Conservation Authority, 1980?

Manuscript of James Cummings- August 28, 1860

Transcript (spelling and grammar retained): Chippawa [Chippewa] 28th August 1860 My Dear Sir I duly received your very kind letter of the 24th [June] asking me to communicate such facts of general interest connected with my career during the War with the United States. I have no objection to afford you such information as came under my own observation; nevertheless I do so, with the understanding, I have no desire to be my own trumpeter. With respect to your circular wherein you state you have been for several years collecting materials for a History of the late War between the United States & Great Britain, for which you are now gathering further materials to add to your collection, concerning the Second War for Independence. I am rather at a loss to know, what is meant by the second war; If you allude to the petty Rebellion, it could not be called a War, Those that caused the outbreak were very soon put down, by the Loyal people of the Province without the aid of Regular Troops being satisfied with the Independence they enjoyed. With respect to the several questions names in your circular: To the 1st I would say, this locality is made memorable by the battle of Chippawa [Chippewa] which took place about a mile above the village on the ground I pointed out to you, when I had the pleasure of seeing you a few days ago, with Mr Porter of the Niagara Falls, of which I believe you took sketches at the time. 2nd I have no historical documents of any value; so many years having gone past, the most of my old papers have either been lost or destroyed, I however came across two letters, one dated Queenston 9th July 1812 from Lt. Col. Nicholl Quarter Master General of Militia, the other from Lt. Col Myers Deputy Quarter Master General of the Regular Army date Fort George 23rd same month, directed to me in the hand writing of each of those officers as Deputy Quarter Master General of Militia, which letters I shall be obliged you would return at as early a day possible, as I wish to place them with tome others in the case, I have had made to hold the cocked hat & feather I wore during that eventful period, which I am sorry I did not exhibit when you was at my house; with reference to it I now enclose a letter from Lt. Col. Clark, residing at Port Dalhousie he was Captain & Adjutant of Militia in the War of 1812__ I send the letter in proof of the cock’d hat it is a lengthy one, but you may find time to turn over it, as I shall also place it in the hat case__ 3rd Where are [but] [for] traditionary [sic] witnesses residing in this vicinity – Col Clark above named Mr Merritt of St. Catharines, & Mr Kerby of Brantford are the only ones I now recollect, who could offord [sic] you any statistical information. 4th I have no pictorial sketches of any Military Movements or fortifications. As regards my own career, which you appear [ ? ] of knowing__ I was first a Lieutenant in a volunteer flank company stationed on the river side opposite [Navy] Island not far from the battle ground of Chippawa [Chippewa], I got promotion as Lieutenant of Cavalry before I got my Cavalry dress completed in three days more, I was called by General Brock to Fort George, was appointed Deputy Quarter Master General of Militia with the rank of Captain s the accompanying letters will show. I was at the battle of Stony Creek, several skirmishes at the Cross Roads, when the American army [ ? ] Fort George, at the taking of Col. Boerstler at the Beaver Dam, & had the honor of receiving Colonel Chapens sword at the surrender, who commanded a company of volunteer Horse Men was at the taking of 15 regulars & two officers at Fort Schlosser—was with Col. Bishop at the taking of Black Rock, near him when he fell, three men of the 8th Reg. more killed in the Boat I was in – I was at Chippawa battle, and the last, not the least in Lundy’s lane battle, which the Americans call the battle of Bridge [Waters]. I had forgot; there was another small affair at Corks Mill where I was. I could write a little history of events, but have not the time to do so. If what I have stated will be of any service for the purpose you require I shall feel happy. The history of the late War was published at Toronto in the Anglo American Magazine. Did you ever see it, I have the Books, there were however several errors which came under my notice, which I could have corrected. If my time would permit I could give you a more detailed statement of events. I trust however you may succeed with your publication , and I shall be most happy to hear from you at all times—I related many little occurances verbally to you when here, which I thought not necessary to repeat again as you would have a perfect recollection of them. Be pleased to return the letters for the purpose I require them. I am My Dear Sir Your respectful friend James Cummings

Boston Patriot Vol. 8 No. 13- October 24, 1812

A semi-weekly paper that began in 1809 and ceased in 1816. Its succeeding title was the Boston Patriot and Morning Advertiser. Publishers included: Everett and Munroe, 1809-Mar. 7, 1810; Isaac Munroe, Mar. 10, 1810-May 1, 1811; Munroe and French, May 4, 1811-1813; D.C. Ballard, 1814-1816. Editor: David Everett, Mar. 10, 1810-Oct. 23, 1811. Topics of interest include: Page 1: announcement of war against Great Britain and the reasons for the war; Page 2: announcement of nomination of war supporter Francis Carr for Congress; Statement of the Senate of Massachusetts in support of the war; 3 accounts of the American attack on Queenston; Page 3: report of the movement of war ships in and out of the port of Boston; news of naval movements by American and British ships; Page 4: advertisement of American and British muskets and swords for sale;