PHA advises 'breast is best'!

The Public Health Agency is using National Breastfeeding Awareness Week (NBAW) to emphasise the message that breastfeeding is the healthiest option for both you and your baby and that by deciding to breastfeed, you will be giving your child the best possible start in life. NBAW runs from 19-25 June and highlights the fact that any period of breastfeeding, however short, will benefit your baby.Breast milk is different to formula milk as it contains antibodies that cannot be manufactured in formula. Antibodies help protect babies from infection and stimulate their immune system.Northern Ireland has the lowest breastfeeding rate in the UK, with an average of 63% of women breastfeeding their baby at birth. Janet Calvert, Regional Breastfeeding Coordinator at the PHA, said: "This is an issue that clearly needs addressed, as breastfeeding has many important health benefits for both mother and baby. These include a reduced risk of ear, chest, kidney and stomach infections and less risk of childhood diabetes and obesity."Breastfeeding can also significantly reduce the risk of hospital admission of children for gastroenteritis and chest infections. The health benefits for mothers who choose to breastfeed include a reduced risk of developing illnesses such as breast cancer, ovarian cancer and osteoporosis."There are other benefits as well as those to your health. Breastfeeding is free - you don't have to buy formula, bottles, teats, sterilising equipment etc. Breast milk is always available, with the right ingredients, at the right temperature, so it's easier to feed at night or on the go.The PHA recognises the importance of breastfeeding to health and the need to ensure that mothers get off to a good start with breastfeeding. It is vital that mothers get the right support and encouragement from their family and friends should they decide to breastfeed. Breastfeeding can be difficult at the start and mothers need reassurance while they learn."There are many local initiatives in the community to improve breastfeeding support. These include improving support in the health service and through Sure Start programmes, which work in areas of need to help ensure children get the best start in life," Janet added."Mother to mother peer support programmes are in place in many areas and are working with expectant and new mothers to help them breastfeed for longer. There are also 70 breastfeeding support groups, which provide ongoing support for breastfeeding mothers throughout Northern Ireland. "The PHA is also working to improve attitudes to breastfeeding in public through the Breastfeeding Welcome Here scheme, which began in 2005 and now has over 200 businesses and public facilities signed up to support and welcome breastfeeding families. All these initiatives, along with support from partners and family, are vital to help expectant and new mothers stay with breastfeeding."Health Minister Edwin Poots said: "There is clear evidence that breastfeeding offers health benefits for both babies and mothers. We know that breast milk gives baby the best start in life by providing all the nutrients and protection a baby needs for the first six months of life. That is why my Department is committed to promoting and supporting breastfeeding".For further information on breastfeeding visit www.breastfedbabies.org.uk

Maternal Obesity in the UK: Findings from a national project

In 2008, the Confidential Enquiry into Maternal and Child Health (CEMACH), now known as the Centre for Maternal and Child Enquiries (CMACE), commenced a 3-year UK-wide Obesity in Pregnancy project. The project was initiated in response to a number of factors. At the time, these included: i) growing evidence that obesity is associated with increased morbidity and mortality for both mother and baby, ii) evidence from the CEMACH 'Saving Mothers' Lives' report showed that women with obesity were over-represented among those who died of direct deaths compared to those who died of indirect deaths, 1 iii) unknown national and regional prevalence rates of maternal obesity, and iv) the need for a national clinical guideline for the care of women with obesity in pregnancy.

Craigavon & Banbridge Community HSS Trust - Primary Care Mental Health Services Triage Pilot Scheme (PDF 266 KB)

Craigavon & Banbridge Community HSS Trust's final report on Primary Care Mental Health Services Triage Pilot Scheme. Part of the Department's redesign of community nursing project.

National Health and Lifestyle Surveys

Results of the National Health and Lifestyle Surveys: SLaN [Survey of Lifestyle, Attitudes and Nutrition] and HBSC [Health Behaviour in School-Aged Children] Two baseline surveys of health related behaviours among adults and schoolgoing young people were carried out across the Republic of Ireland in 1998 and again in 2002. The main aims of these surveys are to: - Produce reliable data of a representative cross-section of the Irish population in order to inform the Department of Health and Children's policy and programme planning. - Maintain a survey protocol which will enable lifestyle factors to be remeasured so that trends can be identified and changes monitored to assist national and regional setting of priorities in health promotion activities. In keeping with the health and lifestyle surveillance system of many European countries a number of related factors were measured in both surveys. These include general health, smoking, use of alcohol and other substances, food and nutrition, exercise and accidents. This work was commissioned by the Health Promotion Unit, Department of Health and Children and carried out at the Centre for Health Promotion Studies, National University of Ireland, Galway.This resource was contributed by The National Documentation Centre on Drug Use.

National Health and Lifestyle Surveys. Regional Summary Report (2003)

Two baseline surveys of health related behaviours among adults and school-going young people were carried out across the Republic of Ireland in 1998 and again in 2002. The main aims of these surveys are to: - Produce reliable data of a nationally representative cross-section of the Irish population in order to inform the Department of health and Children's policy and programme planning. - Maintain a survey protocol which will enable lifestyle factors to be re-measured so that trends can be identified and changes monitored to assist national and regional setting of priorities in health promotion activities. This report focuses on these two cross-sectional studies, SLaN (Survey of Lifestyles, Attitudes and Nutrition) adults aged 18+ years and HBSC (health Behaviour in School-aged Children) school-going children aged 10-17 years. In keeping with the health and lifestyle surveillance system of many European countries a number of related factors were measured in both surveys. These include general health, smoking, use of alcohol and other substances, food and nutrition, exercise and accidents. This report presents the findings for the same topics at a regional level with some demographic analysis. It must be noted that the aim of the survey was to establish patterns in health and lifestyle at a national level. The significance therefore of findings at the regional level is to identify potential variations that may merit further investigation. This work was commissioned by the health Promotion Unit, Department of health and Children and carried out at the Centre for health Promotion Studies, national University of Ireland, Galway, and at the Department of Public health Medicine and Epidemiology, Woodview House, Belfield, national University of Ireland, Dublin.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 Drug Control Strategy launched in US

The Bush administration announced its 2006 National Drug Control Strategy in the first city to legalize marijuana, a decision that wasn't entirely coincidental. John P. Walters, director of the Office of National Drug Control Policy, who selected a youth drug treatment center here as the site for the announcement, said Denver represented 'a model of what we see and what we're trying to face'. The 2006 strategy calls for a continuation of the Bush administration's balance of reducing demand through, among other things, drug-prevention campaigns, and reducing supply by securing the Mexican border. Mr. Walters described the strategy, implemented in 2001, as a success, pointing to studies showing that overall teenage drug use has dropped since then by 19 per cent. Use of methamphetamine, LSD and steroids also have declined, he said.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.

A re-focused and re-energised National Drugs Strategy, Issue 14, Summer 2005

The Mid-Term Review1 of the National Drugs Strategy 2001–2008, published on 2 June 2005, recommends a number of additions and amendments to the existing Strategy, including making rehabilitation a new, ‘fifth’ pillar of the Strategy. The Steering Group that oversaw the Review, and the extensive consultation process on which it is based, found that the aims and objectives of the Strategy are fundamentally sound. While what has been achieved varies from action to action, progress has been made across the four pillars of supply reduction, prevention, treatment and research, and in the co-ordination of the institutional structures of the Strategy. The Review recommends the addition of eight new actions, the replacement of nine of the existing actions and amendments to a further eight. It also recommends revisions to the Strategy’s key performance indicators, reflecting new developments and data availability. The recommendations serve to ‘re-focus and re-energise’ the Strategy in the remaining period up to 2008.This resource was contributed by The National Documentation Centre on Drug Use.

A Study on the Feasibility of the Inclusion of General Practitioners and Prisons in the National Drug Treatment Reporting System: Plan for the Implementation of the NDTRS in Prison and GP Services

The Drug Misuse Research Division of the Health Research Board operates the National Drug Treatment Reporting System (NDTRS). The system is used to provide epidemiological information on treated problem drug misuse in Ireland and informs policy makers, researchers and the general public. The NDTRS collates data from participating treatment centres in all Health Board areas, however a gap in information exists in that drug misusers in treatment units within prisons and those treated by General Practitioners are not included. This study aims to determine the feasibility of including these two groups to increase coverage of the NDTRS and outlines preliminary steps for their inclusion.This resource was contributed by The National Documentation Centre on Drug Use.

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.

National Alcohol Policy Ireland

The National Alcohol Policy is directed at reducing the prevalence of alcohol-related problems through an emphasis on moderation in alcohol consumption. The importance of a comprehensive alcohol policy was highlighted when Ireland endorsed the European Charter on Alcohol in December 1995 along with 48 other Member States of the WHO European Region. The alcohol-related problems are multidimensional, therefore the solutions most be multi-sectoral. This means that commitment to the National Alcohol Policy must be on the agenda of policy makers in all sectors and at all levels. An Alcohol Policy requires both environmental and individual strategies. There is strong evidence that policies which influence access to alcohol, control pricing through taxation and other public health measures, can have a positive impact on curtailing the health and social burden resulting from drinking (Edwards et al. 1994). However, a key to the effectiveness of such strategies is public support, enforcement and maintenance of the policies. In examining the rationale for a National Alcohol Policy a number of elements have been identified. Research is urgently required to identify attitudes and patterns of alcohol consumption across the population and within sub-groups of the population. Based on sound research, a sensible drinking message of Less is Better should form an educational empowerment programme with regional and local initiatives as a required and integral part of such a campaign. A health education programme in all schools should be part of the core curriculum. The availability and effectiveness of treatment services need to be established. Action to contain the availability of alcohol could be achieved by reducing the number of special exemptions for longer opening hours and controlling access to underage drinking by ID schemes nation-wide. The enforcement of drink driving legislation including random breath testing needs to be continued to reduce alcohol-related traffic accidents. All levels of the Drinks Industry should recognise that people have the right to be safeguarded from pressures to drink. Finally, a National Alcohol Policy could be co-ordinated by a wider National Substance Use Surveillance Unit.This resource was contributed by The National Documentation Centre on Drug Use.

A framework for quality in long-term residential care for older people in Ireland / National Council on Ageing and Older People

In 1999 the National Council on Ageing and Older People commissioned a postal survey of all long-term residential care facilities in the country to determie: - whether facilities had quality initiatives in operation - providers' views and aspirations for future provision of long-term care - providers' views on the introduction of a national quality monitoring policy This report is the outcome of the programme of work conducted by the Council on the quality of long-term residential care provision for older people in Ireland. The aim of the report is to provide a framework for developing quality in long-term residential care settings with a focus on the well-being, dignity and autonomy of older residents.

National Audit of the Organisation of Services for Falls and Bone Health of Older People

This report presents the results of the second national audit which examines the organisation of services provided to older people for falls prevention and bone health. Falls and fractures are a common and serious problem affecting older people, with high levels of personal and financial cost. National guidelines, supported by the research evidence, require the provision of integrated services for falls and fracture prevention and treatment. Effective commissioning is needed to produce such high quality services.��This audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the second cycle of audits on services for the prevention of falls and fractures in older people. It follows the first organisational audit, performed in 2005, and the clinical audit of 2007. All were audited against specific standards from the National Service Framework for Older People (NSF) and guidance from the National Institute for Health and Clinical Excellence (NICE). Since the first audit, indicators have been added or updated in line with new guidance including that on falls prevention of inpatients following the National Patient Safety Agency (NPSA) report on slips, trips and falls in hospital (2007). For the first time, the audit also looks specifically at falls and fracture prevention in mental healthcare and a sample of care homes.

National Audit of Continence Care

The first National Audit of Continence Care for Older People, sponsored by the HealthcareCommission, was published in November 2005. The results from that audit generated muchinterest and harnessed an impetus for change. This report presents the results from the 3rdround of the organisational and clinical National Audit of Continence Care which examined thestructure and provision of care for people with lower urinary tract symptoms and incontinence,and faecal incontinence in primary care, secondary care and care homes in England, Walesand Northern Ireland, and compared this to current national guidelines.Well organised services,based upon national guidelines have been shown to deliver higher quality care to patients. Asjudged by the national guidelines however, this round of audit shows there is still considerablevariation in both the organisation of services and the way they deliver care to patients.