British Monetary Sovereignty: A Cultural Analysis

In this thesis, I will document and analyze historical aspects of the British debate over adopting a common currency with the European Community primarily during the last half of the twentieth century until the present. More specifically, while on the surface such a decision would seem to turn on economic or political considerations, I will show that this historic British decision not to surrender their pound sterling in exchange for the euro was rooted in the nation's cultural identity. During this decades long British debate over the euro, two opposing, but strongly held, positions developed; one side believed that Britain had a compelling interest in bonding with the rest of Europe economically as well as politically, the other side believed that Britain's independent heritage was deeply rooted in many of its traditions including maintaining control of its own monetary matters, which included keeping its pound sterling. As part of this thesis, I have conducted interviews with business leaders, economists, and social scientists as well as researched public records in order to assess many of the arguments favoring and opposing Britain's adoption of the euro. Many Britons strongly believed that it was time to join other Europeans, who were willing to sacrifice their sovereign currency to a bold common currency experiment, while other Britons viewed the pound sterling as too integral a part of British heritage to abandon. Ultimately, British leaders and citizens had to determine whether such a currency tradeoff would be worth it to them as a nation. It was a gamble that twelve other nations (at the time of the euro's 2002 launch) were ready to take, optimistically calculating that easier credit and reduced exchange transaction costs would lead to greater economic prosperity. Many asserted that only with ! ! such a united European monetary coalition would Europe's nations be able to compete trade-wise with powerful economic nations like the United States and China. My conclusion is that Britain's refusal to join the euro was a decision that had less to do with economic opportunity or political motivations and much more to do with how the British people viewed themselves culturally and their identity as an independent nation.

Bloodstream infections in pediatric ECLS: usefulness of daily blood culture monitoring and predictive value of biological markers. The British Columbia experience

INTRODUCTION: The incidence of bloodstream infection (BSI) in extracorporeal life support (ECLS) is reported between 0.9 and 19.5%. In January 2006, the Extracorporeal Life Support Organization (ELSO) reported an overall incidence of 8.78% distributed as follows: respiratory: 6.5% (neonatal), 20.8% (pediatric); cardiac: 8.2% (neonatal) and 12.6% (pediatric). METHOD: At BC Children's Hospital (BCCH) daily surveillance blood cultures (BC) are performed and antibiotic prophylaxis is not routinely recommended. Positive BC (BC+) were reviewed, including resistance profiles, collection time of BC+, time to positivity and mortality. White blood cell count, absolute neutrophile count, immature/total ratio, platelet count, fibrinogen and lactate were analyzed 48, 24 and 0 h prior to BSI. A univariate linear regression analysis was performed. RESULTS: From 1999 to 2005, 89 patients underwent ECLS. After exclusion, 84 patients were reviewed. The attack rate was 22.6% (19 BSI) and 13.1% after exclusion of coagulase-negative staphylococci (n = 8). BSI patients were significantly longer on ECLS (157 h) compared to the no-BSI group (127 h, 95% CI: 106-148). Six BSI patients died on ECLS (35%; 4 congenital diaphragmatic hernias, 1 hypoplastic left heart syndrome and 1 after a tetralogy repair). BCCH survival on ECLS was 71 and 58% at discharge, which is comparable to previous reports. No patient died primarily because of BSI. No BSI predictor was identified, although lactate may show a decreasing trend before BSI (P = 0.102). CONCLUSION: Compared with ELSO, the studied BSI incidence was higher with a comparable mortality. We speculate that our BSI rate is explained by underreporting of "contaminants" in the literature, the use of broad-spectrum antibiotic prophylaxis and a higher yield with daily monitoring BC. We support daily surveillance blood cultures as an alternative to antibiotic prophylaxis in the management of patients on ECLS.

Promotion of health in older people: a randomised controlled trial of health risk appraisal in British general practice

BACKGROUND: there is inadequate evidence to support currently formulated NHS strategies to achieve health promotion and preventative care in older people through broad-based screening and assessment in primary care. The most extensively evaluated delivery instrument for this purpose is Health Risk Appraisal (HRA). This article describes a trial using HRA to evaluate the effect on health behaviour and preventative-care uptake in older people in NHS primary care. METHODS: a randomised controlled trial was undertaken in three London primary care group practices. Functionally independent community-dwelling patients older than 65 years (n = 2,503) received a self-administered Health Risk Appraisal for Older Persons (HRA-O) questionnaire leading to computer-generated individualised written feedback to participants and general practitioners (GPs), integrated into practice information-technology (IT) systems. All primary care staff received training in preventative health in older people. The main outcome measures were self-reported health behaviour and preventative care uptake at 1-year follow-up. RESULTS: of 2,503 individuals randomised, 2,006 respondents (80.1%) (intervention, n = 940, control n = 1,066) were available for analysis. Intervention group respondents reported slightly higher pneumococcal vaccination uptake and equivocal improvement in physical activity levels compared with controls. No significant differences were observed for any other categories of health behaviour or preventative care measures at 1-year follow-up. CONCLUSIONS: HRA-O implemented in this way resulted in minimal improvement of health behaviour or uptake of preventative care measures in older people. Supplementary reinforcement involving contact by health professionals with patients over and above routine clinical encounters may be a prerequisite to the effectiveness of IT-based delivery systems for health promotion in older people.

The Geology and Mineral Deposits of British Columbia

The province of British Columbia, with an area of 359,279 square miles, includes a large part of the Canadian Cordillera that is the western mountains of Canada. It is the leading province of Canada in the production of lead, zinc, and silver, and third among the provinces in the output of gold, copper, and coal.