Primary medical care in Irish prisons

An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review.   This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available.   There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available.   People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.This resource was contributed by The National Documentation Centre on Drug Use.

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.

The effectiveness of brief alcohol interventions in primary care settings: A systematic review

Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. Approach. A pre-specified search strategy was used to search all relevant electronic databases up to 2006. The authors also hand-searched the reference lists of key articles and reviews. They included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta-analyses, subgroup and sensitivity analyses and meta-regression were conducted.This resource was contributed by The National Documentation Centre on Drug Use.

Guidelines for the management of depression and anxiety disorders in primary care.

High risk groups for depression and anxiety disorders include those with co-occuring alcohol or other drug misuse.This resource was contributed by The National Documentation Centre on Drug Use.

Five year prognosis in patients with angina identified in primary care: incident cohort study

The objective of this study was to ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. This is an Incident cohort study of patients with primary care data linked to secondary care and mortality data. 40 primary care practices in Scotland participated. Participants 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease were monitored between1 January 1998 to 31 December 2001.

Briefing 21: Inequalities in Primary Care in the East of England

This report focuses on inequalities in primary care as indicated by the Quality and Outcomes Framework.

Health Equity Audit Made Simple: A briefing for Primary Care Trusts and Local Strategic Partnerships

A working/ consultation document outlining the key drivers and steps for undertaking health equity audit as required in the Performance and Planning Framework (PPF) 2003-2006

How to set and monitor goals for prevalence of child obesity: guidance for Primary Care Trusts (PCTs) and local authorities

This guidance follows on from the publication of the Government's obesity strategy Healthy Weight, Healthy Lives: A Cross-Government strategy for England. The guidance provides advice to PCTs and local authorities on how to set child obesity goals as part of the Vital Signs and the National Indicator Set. This will be followed shortly with full guidance on developing local plans.

Family centred, school based intervention for the prevention of obesity in primary school-aged children

The aim of this pilot study was to develop, deliver and monitor a programme aimed at the prevention of obesity in primary school children. Objectives1. To develop a school-based / family-orientated intervention programme to prevent obesity in children under 10 years of age. 2. To implement an intervention programme that is acceptable and appropriate for primary school-aged children. 3. To monitor and evaluate the programme and determine if there is an appropriateintervention(s) to prevent obesity in primary school-aged children. 4. If a successful programme(s) is identified, disseminate this at a national level.

Anti Bullying Procedures for Primary and Post Primary Schools

The role of the school is to provide an appropriate education for all its pupils. A stable, secure learning environment is an essential requirement to achieve this goal. Bullying behaviour, by its very nature, undermines and dilutes the quality of education. Research shows that bullying can have short and long-term effects on the physical and mental well-being of pupils, on engagement with school, on self-confidence and on the ability to pursue ambitions and interests. School-based bullying can be positively and firmly addressed through a range of school-based measures and strategies through which all members of the school community are enabled to act effectively in dealing with this behaviour. While it is recognised that home and societal factors play a substantial role both in the cause and in the prevention of bullying, the role of the school in preventative work is also crucial and should not be underestimated. School-based initiatives can either reinforce positive efforts or help counteract unsuccessful attempts of parents to change unacceptable behaviour. Parents and pupils have a particularly important role and responsibility in helping the school to prevent and address school-based bullying behaviour and to deal with any negative impact within school of bullying behaviour that occurs elsewhere. In this document, any reference(s) to parent(s) can be taken to refer also to guardian(s) where applicable.

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 1 Template anti-bullying policy

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 1 Template anti-bullying policy. Provided by the Department of Education and Skills, Ireland.

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 2 Practical tips for building a positive school culture and climate

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 2 Practical tips for building a positive school culture and climate. Provided by the Department of Education and Skills, Ireland.

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 3 Template for recording bullying behaviour

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 3 Template for recording bullying behaviour. Provided by the Department of Education and Skills, Ireland.

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 4 Checklist for annual review of the anti-bullying policy and its implementation

The Board of Management (the Board) must undertake an annual review of the school’s anti-bullying policy and its implementation. The following checklist must be used for this purpose. The checklist is an aid to conducting this review and is not intended as an exhaustive list. In order to complete the checklist, an examination and review involving both quantitative and qualitative analysis, as appropriate across the various elements of the implementation of the school’s anti-bullying policy will be required.

Males into Primary Teaching - Report of the Primary Education Committee (2006)

In Ireland and in most other developed countries there are significantly more female than male teachers working in both first and second level schools. While this was not always the case, since the 1970s there has been a significant and continuous decline in the number of males entering the teaching profession, particularly at primary level. In recognition of the feminisation of primary teaching, the Minister for Education and Science established the Primary Education Committee in 2003. The main task of the Committee is to make recommendations on strategies and initiatives to increase the number of males entering primary teaching.