28 research outputs found

    Enhancing diabetes care for the most vulnerable in the 21st century::Interim findings of the National Advisory Panel on Care Home Diabetes (NAPCHD)

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    Older adults with diabetes may carry a substantial health burden in Western ageing societies, occupy more than one in four beds in care homes, and are a highly vulnerable group who often require complex nursing and medical care. The global pandemic (COVID-19) had its epicentre in care homes and revealed many shortfalls in diabetes care resulting in hospital admissions and considerable mortality and comorbid illness. The purpose of this work was to develop a national Strategic Document of Diabetes Care for Care Homes which would bring about worthwhile, sustainable and effective quality diabetes care improvements, and address the shortfalls in care provided. A large diverse and multidisciplinary group of stakeholders (NAPCHD) defined 11 areas of interest where recommendations were needed and using a subgroup allocation approach were set tasks to produce a set of primary recommendations. Each subgroup was given 5 starter questions to begin their work and a format to provide responses. During the initial phase, 16 key findings were identified. Overall, after a period of 18 months, 49 primary recommendations were made, and 7 major conclusions were drawn from these. A model of community and integrated diabetes care for care home residents with diabetes was proposed, and a series of 5 ‘quick-wins’ were created to begin implementation of some of the recommendations that would not require significant funding. The work of the NAPCHD is ongoing but we hope that this current resource will help leaders to make these required changes happen

    A great and necessary measure : George Grenville and the genesis of the Stamp Act, 1763-1765

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    Includes bibliographical references (pages 290-309) and index.George Grenville could have upheld Parliament's sovereignty, raised a revenue, reduced smuggling, and asserted British control over the colonies by lowering the duty on foreign molasses imported into America from sixpence to one penny per gallon. But Grenville chose to set the duty at threepence instead, thereby irritating the mercantile community in the colonies. Would setting the molasses duty at one penny and collecting interest on paper currency have inspired Americans to resist parliamentary tyranny? Perhaps they would have; perhaps not. It does seem certain, though, that if resistance to these policies had occurred, it would have been a resistance shorn of substantial support from merchants, the agricultural elite of the northern colonies, and the planters of the South. In any crisis that might have arisen, Britain would have enjoyed far more support from these powerful groups in American society than she in fact did during the 1760s and 1770s. Thus, different decisions by Grenville might have totally prevented, considerably delayed, or essentially changed the American Revolution.5 How and why Grenville and his colleagues reached the fateful decisions are questions I examine in this book.The background of colonial taxation October 1760-February 1763 -- A cautious beginning: Bute's ministry and American taxation, January-March 1763 -- "The particular habits of his life": some implications of Grenville's political and administrative character -- "The first great object": obstructing the Clandestine trade to American, April-November 1763 -- Taxing molasses, July 1763-March 1764 -- The search for new sources of revenue July 1763-March 1764 -- The politics of postponing the Stamp Tax March-December 1764 -- Preparing and passing the Stamp Act December 1764-February 1765 -- Dispensing places "of emolument and of influence" December 1764-July 1765 -- Thoughts and hopes about future American Revenue March-July 1765 -- "The author of all the troubles in America" August-December 1765.Digitized at the University of Missouri--Columbia MU Libraries Digitization Lab in 2012. Digitized at 600 dpi with Zeutschel, OS 15000 scanner. Access copy, available in MOspace, is 400 dpi, grayscale
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