Northern Ireland cervical screening programme: information for primary care and smear takers

From January 2011, the Northern Ireland cervical screening programme no longer invited women aged under 25 to attend for screening. In addition, the screening interval for women aged 25-49 was reduced to every three years. Thisbooklet describes the rationale for the change in policy so that primary care staff and smear takers can provide appropriate and accurate advice to patients.

Healthy child, healthy future - Information on the child health programme (0-4 years)

This booklet provides parents with information on the first four years of the child health programme for all families in Northern Ireland.

Fish pedicures: Information for the Public

Although the risk of catching an infection as a result of a fish spa pedicure is likely to be very low, it cannot be completely excluded. However, there are certain things you can do to further reduce your risk of catching or spreading an infection when having one of these treatments.Choosing a salonUse your personal judgment: as with all beauty salons, if it looks unsanitary, do not go there for your treatment. If you are very concerned about the cleanliness of a salon you visit, you can report this to your local Environmental Health department, who will be able to perform an inspection of the premises.When having a treatment, a trained member of staff should perform an inspection of your feet both beforehand, to check for any broken skin / infections, and afterwards, to check for signs of bleeding. They should also ask you to wash your feet with soap and water before putting them in the tank, to make sure that any products you have used that could be harmful to the fish are washed away, and to reduce the risk of spreading any infection.Ask your therapist what other procedures the salon has in place to minimise the risk of infection. The Health Protection Agency, England has produced a set of guidelines for salons which, if followed, will ensure any potential risk of infection is kept to an absolute minimum.Before having the treatment The HPA has identified a number of health conditions or prior treatments which may mean that you should not have a fish pedicure. These are:Leg waxing or shaving in last 24 hoursAny open cuts/wounds/abrasions/broken skin on the feet or lower legsInfection on the feet (including athlete's foot, verruca)Psoriasis, eczema or dermatitis affecting the feet or lower legsDiabetes (increased risk of infection)Infection with a blood borne virus such as Hepatitis B or Hepatitis C or HIVAny immune deficiency due to illness or medicationBleeding disorders or on anticoagulant medication (e.g. heparin or warfarinMore information and advice on fish spa pedicures and the full set of guidance can be found on the Health Protection website www.hpa.org.uk

A Step in the Right Direction: An Evaluation of the Fáiltiú Information and Advise Service

The Fáiltiú service provides information and advice on rights, entitlements and options to homeless people, or those at risk of homelessness. The objectives of this evaluation were to assess the information needs of users of the service, how effectively they were being met, and how they could be improved. Two focus groups of staff members and service users gave their views on the design and implementation of the research at the outset of the project. A screening questionnaire identified 78 people who used the Fáiltiú service in a specified time period, of whom 40 participated in the evaluation by giving their views on the service. The study reviewed the literature on homelessness, attempted to define the term, and examined the characteristics of homeless people and relevant Irish social policy. The conclusions reached were: users of the Fáiltiú service are marginalized in a number of ways and share characteristics related to poverty and social exclusion, such as poor educational qualifications, high levels of unemployment and experience of prison; their needs are multi-dimensional and include accommodation, financial, social and medical support, and access to employment and training services: the service needs to respond to these needs in a holistic way.This resource was contributed by The National Documentation Centre on Drug Use.

2004 National report to the EMCDDA by the Reitox National Focal Point: Norway: New developments, trends and in-depth information on selected issues.

This is the fourth annual report to the EMCDDA from the Norwegian Institute for Alcohol and Drug Research (SIRUS) on the drugs situation in Norway. The report has been drawn up in accordance with the new reporting guidelines introduced by the EMCDDA this year. We have endeavoured to follow these as consistently as possible, with the main focus on “new developments” and substantial changes in epidemiology, legislation and organisation. To allow readers to obtain more background information the report contains a number of references to the national report for 2003, and occasional references to the report for 2002.This resource was contributed by The National Documentation Centre on Drug Use.

2006 National report (2005 data) to the EMCDDA by the Reitox National Focal Point: Norway: New developments, trends and in-depth information on selected issues.

This is a 2006 national report to the EMCDDA, using 2005 data. It is compiled by the Reitox national focal point and covers epidemiology, policing, strategy, drugs markets, drug-related infectious diseases, drug-related death and problem drug use in Norway.This resource was contributed by The National Documentation Centre on Drug Use.

Cognitive behavioural therapy leaflet.

This leaflet is for anyone who wants to know more about Cognitive Behavioural Therapy (CBT).It discusses how it works, why it is used, its effects, its side-effects, and alternative treatments. If you can't find what you want here, there are sources of further information at the end of this leaflet. What is CBT? It is a way of talking about: ï,§ how you think about yourself, the world and other people ï,§ how what you do affects your thoughts and feelings. CBT can help you to change how you think ('Cognitive') and what you do ('Behaviour'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now. When does CBT help? CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue. How does it work? CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are: ï,§ A Situation - a problem, event or difficult situation. From this can follow: ï,§ Thoughts ï,§ Emotions ï,§ Physical feelings ï,§ Actions Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. All these areas of life can connect like this: {5 Areas - click related link below} What happens in one of these areas can affect all the others. There are helpful and unhelpful ways of reacting to most situations, depending on how you think about it. The way you think can be helpful - or unhelpful. An example: If you go home feeling depressed, you'll probably brood on what has happened and feel worse. If you get in touch with the other person, there's a good chance you'll feel better about yourself. If you avoid the other person, you won't be able to correct any misunderstandings about what they think of you - and you will probably feel worse. This 'vicious circle' can make you feel worse. It can even create new situations that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways. CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them - and so change the way you feel. CBT aims to get you to a point where you can 'do it yourself', and work out your own ways of tackling these problems. [For full factsheet â?" click on link above]This resource was contributed by the National Documentation Centre on Drug Use.

Mental health and growing up factsheet. Cannabis and mental health: information for 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 gives you some basic facts about cannabis and also how it might affect your mental health. Introduction Lots of young people want to know about drugs. Often, people around you are taking them, and you may wonder how it will make you feel. You may even feel under pressure to use drugs in order to fit in, or be â?~coolâ?T. You may have heard that cannabis is no worse than cigarettes, or that it is harmless. What is cannabis? The cannabis plant is a member of the nettle family that has grown wild throughout the world for centuries. People have used it for lots of reasons, other than the popular relaxing effect. It comes in two main forms: ï,§ resin, which is a brown black lump also known as bhang, ganja or hashish ï,§ herbal cannabis, which is made up of the dried leaves and flowering tops, and is known as grass, marijuana, spliff, weed, etc. Skunk cannabis is made from a cannabis plant that has more active chemicals in it (THC), and the effect on your brain is stronger. Because â?~streetâ?T cannabis varies so much in strength, you will not be able to tell exactly how it will make you feel at any particular time. What does it do to you? When you smoke cannabis, the active compounds reach your brain quickly through your bloodstream. It then binds/sticks to a special receptor in your brain. This causes your nerve cells to release different chemicals, and causes the effects that you feel. These effects can be enjoyable or unpleasant. Often the bad effects take longer to appear than the pleasant ones. ï,§ Good/pleasant effects: You may feel relaxed and talkative, and colours or music may seem more intense. ï,§ Unpleasant effects: Feeling sick/panicky, feeling paranoid or hearing voices, feeling depressed and unmotivated. Unfortunately, some people can find cannabis addictive and so have trouble stopping use even when they are not enjoying it. The effects on your mental health Using cannabis triggers mental health problems in people who seemed to be well before, or it can worsen any mental health problems you already have. Research has shown that people who are already at risk of developing mental health problems are more likely to start showing symptoms of mental illness if they use cannabis regularly. For example if someone in your family has depression or schizophrenia, you are at higher risk of getting these illness when you use cannabis. The younger you are when you start using it, the more you may be at risk. This is because your brain is still developing and can be more easily damaged by the active chemicals in cannabis. If you stop using cannabis once you have started to show symptoms of mental illness, such as depression, paranoia or hearing voices, these symptoms may go away. However, not everyone will get better just by stopping smoking. If you go on using cannabis, the symptoms can get worse. It can also make any treatment that your doctor might prescribe for you, work less well. Your illness may come back more quickly, and more often if you continue to use cannabis once you get well again. Some people with mental health problems find that using cannabis makes them feel a bit better for a while. Unfortunately this does not last, and it does nothing to treat the illness. In fact, it may delay you from getting help you need and the illness may get worse in the longer term. [For the full factsheet, click on the link above]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.

Caring for Seniors With Alzheimer's Disease: Canadian Institute for Health Information

Caring for Seniors In 2007-2008, one in five seniors (20%) in Canada receiving long-term home care had a diagnosis of Alzheimer's disease or other dementia. Nearly one in six (17%) of these clients with dementia were suffering from moderate to severe impairment in cognition and daily functioning yet still managed to remain at home.This study from the Canadian Institute for Health Information also found that one in six (17%) seniors with dementia living in residential care facilities (such as nursing or long-term care homes) in 2008-2009 had relatively low levels of impairment or could still perform basic functions quite well on their own. The odds of a senior with low impairment being placed in residential care were seven times more likely if the senior had a tendency to wander. Marital status was also a factor in determining whether a senior with low impairment was newly admitted to a care facility rather than at home with home care. 

The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes ILC-UK

The International Longevity Centre - UK��launched a new paper (Wednesday, 6th July 2011). The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes, provides care home workers and managers with information and practical advice on this complex, controversial and sensitive issue.The need for affection, intimacy and relationships for people with dementia in care homes has too often been ignored and side-lined in policy and practice. The onset of old age or a cognitive impairment does not erase the need for affection, intimacy and/or relationships. While the issues involved can be complex, controversial and sensitive and may challenge our own beliefs and value system, it is essential that we understand more about them to foster a more person-centred approach to dementia care. Care home residents with dementia often have complex care needs and trying to understand and respond to the more intimate and sexual aspects of a resident’s personality can be challenging.Aimed at care home workers and managers, the guide not only provides essential information on this aspect of dementia care but offers practical advice to support current work-based practices. Set out in an accessible and easy-to-read format, this guide includes case studies, questions, suggestions and a self assessment quiz to promote easy learning. It also provides a possible pathway for care home managers to develop a guiding policy on sexual expression in dementia.The guide for care staff is summarised in 10 key points:1. Some residents with dementia will have sexual or sensual needs.2. Affection and intimacy contribute to overall health and wellbeing for residents.3. Some residents with dementia will have the capacity to make decisions about their needs.4. If an individual in care is not competent to decide, the home has a duty of care towards the individual to ensure they are protected from harm.5. There are no hard and fast rules. Assess each situation on an individual basis6. Remember not everyone with dementia is heterosexual.7. Inappropriate sexual behaviour is not particularly common in dementia.8. Confront your own attitudes and behaviour towards older people and sex generally.9. Communicate – look at how you can improve communication with your colleagues, managers, residents and carers on this subject10. Look after yourself and remember your own needs as a care professional��The full paper is available: The Last Taboo

The Marmot Review: Updated data and information 2 years on

To mark the two year anniversary since The Marmot Review ('Fair Society, Healthy Lives') was published, on the 15th of February the UCL Institute of Health Equity published new data on key health inequalities indicators at local authority level in England.Main Findings:Life Expectancy – this has historically been one of the main indicators of health inequalities.The Marmot Indicators from this year’s charts show the average life expectancy for eachlocal authority and the level of inequality within each authority area (7):-While overall life expectancy at birth in England increased by 0.3 years for both menand women between 2007-9 and 2008-10, inequalities in life expectancy betweenneighbourhoods increased by 0.1 years for men and showed no change for women-Among the 150 upper tier local authorities in England, life expectancy improved inthe majority of cases (133 areas saw improvements for men and 125 sawimprovements for women). However inequalities also increased in the majority ofareas (104 for men and 92 for women).-The largest increase in inequality in life expectancy was in West Berkshire for men(2.0 years) and inMiddlesbrough for women (2 years). The largest decreases ininequality were in Kensington and Chelsea for both men and women (1.9 and 1.1years respectively. To find out more, please read: - The press release, including key figures and main findings. - A blog by Michael Marmot about the data and it's implications. - Press coverage of the data in national and local newspapers and websites. - A powerpoint presentation on the key findings.

Information sources on ethnicity and health and healthcare

This report provides a summary of work to date on a joint regional mapping project of ethnicity and health inequalities. It also covers equity of access to health care and initiatives (national and local) to address health inequalities between ethnic groups.

Information and Intelligence forum presentation 2007: Jon Cox

Presentation from Jon Cox (Norfolk PCT) at the May 2007 Public Health Information and Intelligence forum

Informing healthier choices: Information and intelligence for healthy populations

One of the commitments given in the Choosing Health white paper was to develop and implement a comprehensive public health information and intelligence strategy. This work was led by a specially constituted Task Force and informed by extensive public and professional consultation conducted in 2006. The resulting strategy sets out an approach that will strengthen health information and intelligence resources across England.This document reports on the results of consultation on the strategy.