This book examines the daily details of slave work routines and plantation agriculture in the eighteenth-century British Atlantic, focusing on case studies of large plantations in Barbados, Jamaica and Virginia. Work was the most important factor in the slaves' experience of the institution. Slaves' day-to-day work routines were shaped by plantation management strategies that drew on broader pan-Atlantic intellectual and cultural principles. Although scholars often associate the late eighteenth-century Enlightenment with the rise of notions of liberty and human rights and the dismantling of slavery, this book explores the dark side of the Enlightenment for plantation slaves. Many planters increased their slaves' workloads and employed supervisory technologies to increase labor discipline in ways that were consistent with the process of industrialization in Europe. British planters offered alternative visions of progress by embracing restrictions on freedom and seeing increasing labor discipline as central to the project of moral and economic improvement.

Objectives The objective of this study was to assess the impact of an emergency department (ED) deprescribing intervention for geriatric adults. We hypothesized that pharmacist‐led medication reconciliation for at‐risk aging patients would increase the 60‐day case rate of primary care provider (PCP) deprescribing of potentially inappropriate medications (PIMs). Methods This was a retrospective, before‐and‐after intervention pilot study conducted at an urban Veterans Affairs ED. In November 2020, a protocol utilizing pharmacists to perform medication reconciliations for patients 75 years or older who screened positive using an Identification of Seniors at Risk tool at triage was implemented. Reconciliations focused on identifying PIMs and providing deprescribing recommendations to patients' PCPs. A preintervention group was collected between October 2019 and October 2020, and a postintervention group was collected between February 2021 to February 2022. The primary outcome compared case rates of PIM deprescribing in the preintervention group to the postintervention group. Secondary outcomes include per‐medication PIM deprescribing rate, 30‐day PCP follow‐up visits, 7‐ and 30‐day ED visits, 7‐ and 30‐day hospitalizations, and 60‐day mortality. Results A total of 149 patients were analyzed in each group. Both groups were similar in age and sex, with an average age of 82 years and 98% male. The case rate of PIM deprescribing at 60 days was 11.1% preintervention compared to 57.1% postintervention (p < 0.001). Preintervention, 91% of PIMs remained unchanged at 60 days compared to 49% (p < 0.05) postintervention. Regardless of PIM identification, the 30‐day primary care follow‐up rate increased postintervention: 31.5% and 55.7% (p < 0.0001), respectively. There was no improvement in 7‐ or 30‐day subsequent ED visits, hospitalization, or mortality. Conclusions Pharmacist‐led medication reconciliation in high‐risk geriatric patients was associated with an increase both in the rate of PIM deprescribing and in post‐ED primary care engagement.

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“Twenty and odd” Africans arrived in Virginia aboard a Dutch vessel in 1619 shortly after permanent colonization of the English Americas began. There has been significant academic debate about whether the enslavement of peoples of African descent in England’s early 17th-century colonies was an inevitable or “unthinking decision” and about the nature and degree of anti-black racism during the 17th century. The legal and social status of African peoples was more flexible at first in the English colonies than it later became. Some Africans managed to escape permanent enslavement and a few Africans, such as Anthony Johnson, even owned servants of their own. There was no legal basis for enslavement in the British Americas for the first several decades of settlement and slave and servant codes emerged only gradually. Labor systems operated by custom rather than through any legal mechanisms of coercion. Most workers in the Americas experienced degrees of coercion. In the earliest years of plantation production, peoples from Africa, Europe, and the Americas often toiled alongside each other in the fields. Large numbers of Native Americans were captured and forced to work on plantations in the English Americas and many whites worked in agricultural fields as indentured and convict laborers. There were a wide variety of different kinds of coerced labor beyond enslavement in the 17th century and ideas about racial difference had yet to become as determinative as they would later be. As the staple crop plantation system matured and became entrenched on the North American mainland in the late 17th and early 18th centuries and planters required a large and regular supply of slaves, African laborers became synonymous with large-scale plantation production. The permeable boundaries between slavery and freedom disappeared, dehumanizing racism became more entrenched and U.S.-based planters developed slave codes premised on racial distinctions and legal mechanisms of coercion that were modeled on Caribbean precedents.

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