Effectiveness of brief alcohol interventions in primary care populations.

Excessive drinking contributes significantly to social problems, physical and psychological illness, injury and death. Hidden effects include increased levels of violence, accidents and suicide. Most alcohol-related harm is caused by excessive drinkers whose consumption exceeds recommended drinking levels, not the drinkers with severe alcohol dependency problems. One way to reduce consumption levels in a community may be to provide a brief intervention in primary care over one to four sessions. This is provided by healthcare workers such as general physicians, nurses or psychologists. In general practice, patients are routinely asked about alcohol consumption during registration, general health checks and as part of health screening (using a questionnaire). They tend not to be seeking help for alcohol problems when presenting. The intervention they are offered includes feedback on alcohol use and harms, identification of high risk situations for drinking and coping strategies, increased motivation and the development of a personal plan to reduce drinking. It takes place within the time-frame of a standard consultation, 5 to 15 minutes for a general physician, longer for a nurse.A total of 29 controlled trials from various countries were identified, in general practice (24 trials) or an emergency setting (five trials). Participants drank an average of 306 grams of alcohol (over 30 standard drinks) per week on entry to the trial. Over 7000 participants with a mean age of 43 years were randomised to receive a brief intervention or a control intervention, including assessment only. After one year or more, people who received the brief intervention drank less alcohol than people in the control group (average difference 38 grams/week, range 23 to 54 grams). For men (some 70% of participants), the benefit of brief intervention was a difference of 57 grams/week, range 25 to 89 grams (six trials). The benefit was not clear for women. The benefits of brief intervention were similar in the normal clinical setting and in research settings with greater resources. Longer counselling had little additional benefit.This resource was contributed by The National Documentation Centre on Drug Use.

Mental health and growing up factsheet. Drugs and alcohol - what parents need to know.

Information about drugs and alcohol - what parents need to know: information for parents, carers and anyone who works with young people. About this leaflet This is one in a series of leaflets for parents, teachers and young people entitled Mental Health and Growing Up. These leaflets aim to provide practical, up-to-date information about mental health problems (emotional, behavioural and psychiatric disorders) that can affect children and young people. This leaflet offers practical advice for parents, teachers and carers who are worried that a young person is misusing drugs or alcohol. Why do I need to know about a young person using drugs or alcohol? Many young people smoke, drink alcohol and may try drugs. It is important you are aware of this and do not ignore it as a time when they are just having fun or experimenting. It doesnââ,‰"¢t take much for the young people to soon lose control and to need help to recover from this problem. How common is it? By the age of 16, up to half of young people have tried an illegal drug. Young people are trying drugs earlier and more are drinking alcohol. What are the different types of drugs which cause problems? The most commonly used, readily available and strongly addictive drugs are tobacco and alcohol. There are numerous others that can be addictive. Alcohol and cannabis are sometimes seen as ââ,¬Ëogatewayââ,‰"¢ drugs that lead to the world of other drugs like cocaine and heroin. Drugs are also classed as ââ,¬Ëolegalââ,‰"¢ andââ,¬Ëoillegalââ,‰"¢. The obviously illegal drugs include cannabis (hash), speed (amphetamines), ecstasy (E), cocaine and heroin. Using ââ,¬Ëolegalââ,‰"¢ drugs (like cigarettes, alcohol, petrol, glue) does not mean they are safe or allowed to be misused. It just means they may be bought or sold for specific purposes and are limited to use by specific age groups. There are clear laws regarding alcohol and young people. For more detailed information on various drugs, their side-effects and the law, see ââ,¬ËoFurther Informationââ,‰"¢ at the end of the factsheet. Why do young people use drugs or alcohol? Young people may try or use drugs or alcohol for various reasons. They may do it for fun, because they are curious, or to be like their friends. Some are experimenting with the feeling of intoxication. Sometimes they use it to cope with difficult situations or feelings of worry and low mood. A young person is more likely to try or use drugs or alcohol if they hang out or stay with friends or family who use them. What can be the problems related to using drugs or alcohol? Drugs and alcohol can have different effects on different people. In young people especially the effects can be unpredictable and potentially dangerous. Even medications for sleep or painkillers can be addictive and harmful if not used the way they are prescribed by a doctor. Drugs and alcohol can damage health. Sharing needles or equipment can cause serious infections, such as HIV and hepatitis. Accidents, arguments and fights are more likely after drinking and drug use. Young people are more likely to engage in unprotected sex when using drugs. Using drugs can lead to serious mental illnesses, such as psychosis and depression. When does it become addiction or problem? It is very difficult to know when exactly using drugs or alcohol is more than just ââ,¬Ëocasualââ,‰"¢. Addiction becomes more obvious when the young person spends most of their time thinking about, looking for or using drugs. Drugs or alcohol then become the focus of the young personââ,‰"¢s life. They ignore their usual work, such as not doing their schoolwork, or stop doing their usual hobbies/sports such as dancing or football. How do I know if there is a problem or addiction? Occasional use can be very difficult to detect. If the young person is using on a regular basis, their behaviour often changes. Look for signs such as: ïâ?s§ unexplained moodiness ïâ?s§ behaviour that is ââ,¬Ëoout of character' ïâ?s§ loss of interest in school or friends ïâ?s§ unexplained loss of clothes or money ïâ?s§ unusual smells and items like silver foil, needle covers. Remember, the above changes can also mean other problems, such as depression, rather than using drugs. What do I do if I am worried? If you suspect young person is using drugs, remember some general rules. ïâ?s§ Pay attention to what the child is doing, including schoolwork, friends and leisure time. ïâ?s§ Learn about the effects of alcohol and drugs (see websites listed below). ïâ?s§ Listen to what the child says about alcohol and drugs, and talk about it with them. ïâ?s§ Encourage the young person to be informed and responsible about drugs and alcohol. ïâ?s§ Talk to other parents, friends or teachers about drugs - the facts and your fears and seek help. If someone in the family or close friend is using drugs or alcohol, it is important that they seek help too. It may be hard to expect the young person to give up, especially if a parent or carer is using it too. My child is abusing drugs. What do I do? ïâ?s§ If your child is using drugs or alcohol, seek help. ïâ?s§ Do stay calm and make sure of facts. ïâ?s§ Don't give up on them, get into long debates or arguments when they are drunk, stoned or high. ïâ?s§ Donââ,‰"¢t be angry or blame themââ,‰?othey need your help and trust to make journey of recovery. Where can I get help? You can talk in confidence to a professional like your GP or practice nurse, a local drug project or your local child and adolescent mental health. They can refer your child to relevant services and they will be able to offer you advice and support. You may also be able to seek help through a school nurse, teacher or social worker. You can find this information from your local area telephone book or council website, or ask for the address from your health centre. [For the full factsheet, click on the link above]This resource was contributed by The National Documentation Centre on Drug Use.

A Cluster Randomised Controlled Trial to Evaluate a Policy of Making Hip Protectors Available to Residents of Nursing Homes

Objectives: to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes. Design: a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation. Setting: 127 nursing and residential homes in the greater Belfast area of Northern Ireland. Participants: 40 homes in the intervention group (representing 1,366 occupied beds) and 87 homes in the control group (representing 2,751 occupied beds). Interventions: a policy of making hip protectors available free of charge to residents of nursing homes and supporting the implementation process by employing a nurse facilitator to encourage staff in the homes to promote their use, over a 72-week period. Main outcome measures: the rate of hip fractures in intervention and control homes, and the level of adherence to use of hip protectors. Results: there were 85 hip fractures in the intervention homes and 163 in the control homes. The mean fracture rate per 100 residents was 6.22 in the intervention homes and 5.92 in the control homes, giving an adjusted rate ratio for the intervention group compared to the control group of 1.05 (95% CI 0.77, 1.43, P = 0.76). Initial acceptance of the hip protectors was 37.2% (508/1,366) with adherence falling to 19.9% (272/1,366) at 72 weeks.Conclusions: making hip protectors available to residents of nursing and residential homes did not reduce the rate of hip fracture. This research does not support the introduction of a policy of providing hip protectors to residents of nursing homes.

NHS Direct

NHS Direct operates a 24-hour nurse advice and health information service, providing confidential information on: What to do if you or your family are feeling ill; Particular health conditions; Local healthcare services, such as doctors, dentists or late night opening pharmacies. Self help and support organisations.If you need health information or advice at any time of the day or night, call NHS Direct on 0845 46 47.

Ethnicity Coding

The incidence, prevalence, and mortality of many diseases are known to vary by ethnic group.There are well documented inequities in access to prevention, treatment, and palliative health and social care services based on ethnic group. There are, too, reported differences in the quality of services received by different ethnic groups and of outcomes of treatment and care. Many of these inequities are amenable to change. However, in order to address them they must, first of all, be comprehensively defined and documented. Mainstreaming ethnic monitoring/data collection is a vital step in the process. The history of such data collection in the NHS is poor, whichever of the key datasets is examined: hospital episode statistics, general practitioner data, cancer registrations, and disease registers. While steps are now being taken to remedy some of these deficiencies, the continued non-availability of ethnic monitoring data and in some cases of compatible ethnically-coded denominator data remains a problem. In particular the lack of ethnic group in births and deaths data has been the subject of widespread comment by specialists in demography and public health and is probably the single action that could most improve the evidence based for addressing ethnic/racial inequalities in health and health care.

Employment and Health Briefing

The Employment and Health briefing is part of the South East Public Heath Group's Information Series of briefings. The Information Series is a set of briefings on a variety of public health topics. Their purpose is to inform partners about public health issues. In particular they can be used to inform the Local Area Agreement process. The series is evolving and comments and suggestions are welcome.

Developing a South East strategy for health

A strategy is being developed across the South East based on five major themes - inequalities, older adults, children, workforce, and sustainable communities. This presentation looks at the steps being taken to develop this strategy and gives more detail on the expected outcomes.

Learning Disabilities and Health

This factsheet on learning disability has been compiled by the Department of Health South East. It highlights the health inequalities experienced by those with learning disabilities and summarises the main health-related issues. It details key publications such as 'Valuing People Now', which was launched in Jan-09, and provides information about strategies, resources and national drivers including Local Area Agreements. It can serve as a useful tool for PCTs, commissioners, those involved in service development, and those with a public health remit in order to improve practice and health outcomes among those with learning disability at both local and regional levels. For further information contact: Jonathan Campion (jonathan.campion@dh.gsi.gov.uk) or Jo Nurse (jo.nurse@dh.gsi.gov.uk)

South East England public health factsheets

This collection contains a number of factsheets which have been produced by the Department of Health South East (the Department's presence in the region based in the Government Office for the South East) to promote understanding and awareness of key public health issues affecting the health of the population of the region. The factsheets are not policy documents, but are intended to promote good practice among the wider public health workforce in the NHS, Local Authorities and the voluntary and community sector. Each factsheet contains an overview of the extent and impact of the health issue, as well as a summary of the evidence-base regarding 'what works' to improve health. If you would like any further information on the factsheets, please contact Jo Nurse, Consultant in Public Health (jo.nurse@dh.gsi.gov.uk).

Regional guidelines for nurses when sharing information with NIGALA

Effective safeguarding children practice depends upon information sharing, collaboration and understanding between families, agencies and professionals. Nurses are required to work in partnership with other disciplines and agencies to safeguard and promote the health and wellbeing of children and young people. This includes working in partnership with the guardian ad litem (guardian) appointed by the court when making decisions regarding the best interests of a child or young person.This guidance replaces previous regional guidance. Regional implementation will ensure that information held by nurses is shared with the guardian in a consistent, timely and appropriate manner, so that informed decisions can be made in the best interests of children and young people.

Rotavirus factsheet for healthcare practitioners (Immunisation)

This factsheet provides information for healthcare practitioners on the rotavirus vaccine given to babies at two and three months old from July 2013.

Norovirus incident outbreak pack for nursing and residential homes

Norovirus Incidents and�Outbreaks Pack for Nursing and Residential Homes from PHA Duty Room October 2013.

Phase 1 Delivering care "A framework for nursing and Midwifery Workforce planning to support person centred care in Northern Ireland"

Delivering Care - Nurse staffing in Northern Ireland is the outcome of a commission undertaken by the PHA Director of Nursing from the DHSSPS Chief Nursing Officer and approved by the Minister of Health in 2014.� The aim of the Delivering Care project is to support the provision of quality care which is safe and effective in hospital and community settings.

Alcohol MOT part two

The Alcohol MOT is designed to support those working in primary care to carry out alcohol brief interventions. There is extensive evidence to show that primary care-based brief interventions are very effective at reducing drinking at both hazardous and harmful levels. MOT Part 1 enables patients to work out if they are drinking at hazardous or harmful levels. MOT Part 2 helps motivate and support patients to reduce their drinking. Both tools are designed so that a practitioner can work through them with a patient, or a patient can work through them alone.

Alcohol MOT part one

The Alcohol MOT is designed to support those working in primary care to carry out alcohol brief interventions. There is extensive evidence to show that primary care-based brief interventions are very effective at reducing drinking at both hazardous and harmful levels. MOT Part 1 enables patients to work out if they are drinking at hazardous or harmful levels. MOT Part 2 helps motivate and support patients to reduce their drinking. Both tools are designed so that a practitioner can work through them with a patient, or a patient can work through them alone.