Rapid diagnostic tests for the home-based management of malaria, in a high-transmission area.

Rapid diagnostic tests (RDT) are sometimes recommended to improve the home-based management of malaria. The accuracy of an RDT for the detection of clinical malaria and the presence of malarial parasites has recently been evaluated in a high-transmission area of southern Mali. During the same study, the cost-effectiveness of a 'test-and-treat' strategy for the home-based management of malaria (based on an artemisinin-combination therapy) was compared with that of a 'treat-all' strategy. Overall, 301 patients, of all ages, each of whom had been considered a presumptive case of uncomplicated malaria by a village healthworker, were checked with a commercial RDT (Paracheck-Pf). The sensitivity, specificity, and positive and negative predictive values of this test, compared with the results of microscopy and two different definitions of clinical malaria, were then determined. The RDT was found to be 82.9% sensitive (with a 95% confidence interval of 78.0%-87.1%) and 78.9% (63.9%-89.7%) specific compared with the detection of parasites by microscopy. In the detection of clinical malaria, it was 95.2% (91.3%-97.6%) sensitive and 57.4% (48.2%-66.2%) specific compared with a general practitioner's diagnosis of the disease, and 100.0% (94.5%-100.0%) sensitive but only 30.2% (24.8%-36.2%) specific when compared against the fulfillment of the World Health Organization's (2003) research criteria for uncomplicated malaria. Among children aged 0-5 years, the cost of the 'test-and-treat' strategy, per episode, was about twice that of the 'treat-all' (U.S.$1.0. v. U.S.$0.5). In older subjects, however, the two strategies were equally costly (approximately U.S.$2/episode). In conclusion, for children aged 0-5 years in a high-transmission area of sub-Saharan Africa, use of the RDT was not cost-effective compared with the presumptive treatment of malaria with an ACT. In older patients, use of the RDT did not reduce costs. The question remains whether either of the strategies investigated can be made affordable for the affected population.

The Leas Cross Commission The Commission of Investigation (Leas Cross Nursing Home) Final Report June 2009

The Leas Cross CommissionThe Commission of Investigation (Leas Cross Nursing Home) Final Report June 2009 Click here to download PDF 1.2mb

Department of Health and Children Evaluation of Home Care Packages

Department of Health and Children Evaluation of Home Care Packages Click here to download PDF 1.6mb

La constitució de la naturalesa moral de l'home

En aquest treball filosòfic pretenem reflexionar sobre l'origen natural del fet moral, tot fent una comparació amb fets culturals, com ara, els Drets Humans o la mutilació genital femenina. La conclusió és que la moral es basa en el sentit dels comportaments més que no els comportaments en si mateixos.

Reducing unintentional injuries in and around the home among children under 5 Years

Public Health England today launches 2 new resources for local authorities on preventing accidents to children and young people in the home and on the road. The reports show whilst the number of children and young people killed or seriously injured continues to fall in England there are still significant numbers of deaths and emergency admissions from preventable causes. On average each year between 2008 to 2012, 525 children and young people under 25 died and there were more than 53,700 admissions to hospital. The reports highlight actions local partners can take to reduce accidents including improving safety for children travelling to and from school and using existing services like health visitors and children’s centres. The Reducing unintentional injuries in and around the home among children under 5 Years and the Reducing unintentional injuries on the roads among children and young people under 25 reports include an analysis of data between 2008 to 2012. Key findings from the reports include: home injuries (under 5 years of age): an average of 62 children died each year between 2008 and 2012 these injuries result in an estimated 40,000 emergency hospital admissions among children of this age each year 5 injury types should be prioritised for the under-fives: choking; suffocation and strangulation; falls; poisoning; burns and scalds; and drowning hospital admission rate for unintentional injuries among the under-fives is 45% higher for children from the most deprived areas compared with children from the least deprived Road traffic injuries (under 25 years of age) there were 2,316 deaths recorded by the police among road users under the age of 25 years, an average of 463 under 25s each year there were 68,657 admissions to hospital as a result of road traffic injuries, an average of 13,731 each year in total there were 322,613 casualties of all severities recorded by the police, an average of 64,523 each year the rate of fatal and serious injuries for 10to 14 year olds was significantly greater for children from the 20% most deprived areas (37 per 100,000) compared with those from the most affluent areas (10 per 100,000)

Consumer Focused Review of the Chicken Food Chain

safefood research into consumer concerns about the food chain has indicated that more than 40 per centof consumers are most concerned aboutchicken in terms of how it is produced, packaged, sold and handled at home. Our review of theindustry foundit was highly regulated while adhering to rigorous international standards. This review found that chicken is the main protein source for many consumers on the island of Ireland. It alsooutlined the need for consumers to ensure that chicken is cooked andhandled properly to avoid food borne illnesses.

Fuel Poverty and Cold Home-related Health Problems

Evidence Review 7 - Tackling fuel poverty and cold home-related health problems Briefing 7 - Fuel poverty and cold home-related health problems This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the health impacts of fuel poverty and cold homes. These documents provide an overview of fuel poverty, describing the evidence linking fuel poverty, cold homes, and poor health outcomes. They examine the scale of the problem across England and trends over time. Evidence shows that living in cold homes is associated with poor health outcomes and an increased risk of morbidity and mortality for all age groups. The documents also provide a brief overview of national policy and sets out the role of local authorities and potential interventions at local level. Fuel poverty is not just about poverty, but also about the quality of England’s housing stock and energy efficiency. The review discusses some of the interventions that have been implemented at the local level to help people on low incomes during cold weather and to address cold home-related health problems. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Good quality parenting programmes and the home to school transition

Evidence Review 1 - Good quality parenting programmes and the home to school transition Briefing 1a - Good Quality Parenting Programmes Briefing 1b - Improving the Home to School Transition This set of documents, commissioned by Public Health England (PHE£0, and written by the UCL Institute of Health Equity, address the effects of parenting and good transition on the health and wellbeing of children aged 0-5. They also provide case studies, and examples of good practice for local areas. Evaluations from the UK and other countries show a positive effect of parenting interventions on outcomes and behaviours that we know are linked to positive health and development outcomes for children. Home to school transition programmes can be effective in improving the outcomes for children from more disadvantaged socio-economic groups more than for children from more advantaged socio-economic groups, although longer term impact on health inequalities can only be inferred because the impact on health has not been studied. The full evidence review and two shorter summary briefings are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Limerick Seed to Plate

The aim of the project is to address an identified need in the community, promoting healthy eating and organic home-gardening practices. Building on the success of a pilot intergenerational project entitled "Through the Years", it became apparent that gardening related activities could be implemented and promoted on a larger scale, reaching the wider community, groups and classes. The project serves as a setting for community education and will be inclusive in helping reduce isolation by providing meeting places for all members of their local communities. Key people being targeted are older people, local families and residents, Limerick Youth Service, After School Clubs, the Garda Youth Diversion Project and the Family Resource Centre. The Limerick Seed to Plate works with gardeners whose primary focus is to develop the gardening projects further. There is a strong educational emphasis to the project and the learning is transferred to participants own homes and lifestyles. Southill has a community café and, where possible, food grown in their garden is showcased and cooked in the centre and café. The Community Food Initiative strengthens the existing healthy eating habits in the community and aims to result in increased long-term health benefits arising from a healthier lifestyle. Communities will benefit from the project which will create employment, build bridges between communities, promote social inclusion and provide a focus for the local areas. Part of theDemonstration Programme 2010-2012 Location Limerick Target Groups At risk youth Children ( 4-12 years) Children (0-4 years) Children (13-18 years) Families Lone parents Low income families Men Migrant, minority ethnic groups Older people Travellers Unemployed Women

Home Bitter Home? Gender, Living Arrangements, and the Exclusion from Home-Ownership among Older Europeans

A working paper published by the Families and Societies project shows that older women in non-traditional family arrangements are most disadvantaged with regard to home-ownership. This often appears to result from a lower socio-economic status. Home Bitter Home? Gender, Living Arrangements, and the Exclusion from Home-Ownership among Older EuropeansRead the report here.

Human thymus exports naive CD8 T cells that can home to nonlymphoid tissues.

Functionally naive CD8 T cells in peripheral blood from adult humans can be fully described by their CD45RA(bright)CCR7(+)CD62L(+) cell surface phenotype. Cord blood lymphocytes, from healthy newborns, are homogenously functionally naive. Accordingly, the majority of cord blood CD8 T cells express the same pattern of cell surface molecules. Unexpectedly, however, a significant fraction of cord blood CD8 T cells express neither CCR7 nor CD62L. Yet these cells remain functionally naive as they contain high levels of TCR excision circles, have long telomeres, display highly polyclonal TCRs, and do not exhibit immediate effector functions. In addition, these CD8 T cells already represent a significant fraction of the mature naive CD8 single-positive thymocyte repertoire and may selectively express the cutaneous lymphocyte Ag. We suggest that CD8 single-positive thymocytes comprise two pools of naive precursors that exhibit distinct homing properties. Once seeded in the periphery, naive CCR7(+)CD62L(+) CD8 T cells patrol secondary lymphoid organs, whereas naive CCR7(-)CD62L(-) CD8 T cells selectively migrate to peripheral tissues such as skin.

This one's got a phobia of doctors. Thankfully, you can do the bowel cancer test at home

This poster highlights the bowel cancer screening programme is being introduced for all 60 to 71 year olds. If you are in this age group a kit will be sent by post so you can do the test at home. You are encouraged to look out for the kit as it could save your life.

Preventing food poisoning in hospital and at home

Information for patients and visitors on preventing food poisoning.

Effectiveness of a nurse-led case management home care model in Primary Health Care. A quasi-experimental, controlled, multi-centre study

Background Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). Methods Quasi-experimental, controlled, non-randomised, multi-centre study on the population receiving home care services comparing the outcomes of the new model, which included nurse-led case management, versus the conventional one. Primary endpoints: functional status, satisfaction and use of healthcare resources. Secondary endpoints: recruitment and caregiver burden, mortality, institutionalisation, quality of life and family function. Analyses were performed at base-line, and at two, six and twelve months. A bivariate analysis was conducted with the Student's t-test, Mann-Whitney's U, and the chi squared test. Kaplan-Meier and log-rank tests were performed to compare survival and institutionalisation. A multivariate analysis was performed to pinpoint factors that impact on improvement of functional ability. Results Base-line differences in functional capacity – significantly lower in the intervention group (RR: 1.52 95%CI: 1.05–2.21; p = 0.0016) – disappeared at six months (RR: 1.31 95%CI: 0.87–1.98; p = 0.178). At six months, caregiver burden showed a slight reduction in the intervention group, whereas it increased notably in the control group (base-line Zarit Test: 57.06 95%CI: 54.77–59.34 vs. 60.50 95%CI: 53.63–67.37; p = 0.264), (Zarit Test at six months: 53.79 95%CI: 49.67–57.92 vs. 66.26 95%CI: 60.66–71.86 p = 0.002). Patients in the intervention group received more physiotherapy (7.92 CI95%: 5.22–10.62 vs. 3.24 95%CI: 1.37–5.310; p = 0.0001) and, on average, required fewer home care visits (9.40 95%CI: 7.89–10.92 vs.11.30 95%CI: 9.10–14.54). No differences were found in terms of frequency of visits to A&E or hospital re-admissions. Furthermore, patients in the control group perceived higher levels of satisfaction (16.88; 95%CI: 16.32–17.43; range: 0–21, vs. 14.65 95%CI: 13.61–15.68; p = 0,001). Conclusion A home care service model that includes nurse-led case management streamlines access to healthcare services and resources, while impacting positively on patients' functional ability and caregiver burden, with increased levels of satisfaction.