Dual diagnosis in mental health inpatient and day hospital settings.

Many mental health patients also have substance misuse problems, so mental health service staff need to be skilled to provide simple prevention and treatment interventions, assisted by drug and alcohol specialists. This guidance covers the assessment and clinical management of patients with mental illness being cared for in psychiatric inpatient or day care settings who also use or misuse alcohol and/or illicit or other drugs*. It also covers organisational and management issues to help mental health services manage these patients effectively. The key message is that the assessment and management of drug and alcohol use are core competences required by clinical staff in mental health services. The guidance aims to: â?¢ encourage integration of drug and alcohol expertise and related training into mental health service provision; â?¢ provide ideas and guidance to front-line staff and manages to help them provide the most effective therapeutic environments; â?¢ help mental health services plan action on dual diagnosisâ? .This resource was contributed by The National Documentation Centre on Drug Use.

Cairde le Cheile CFI

Potatoes, cabbage, onions, carrots, turnips and a range of herbs are grown for use in the Cairde le Cheile Meals on Wheels service. The core workers in the garden are Rural Social Scheme participants. The gardens are open weekly on Monday and Tuesday and many people visit. Local Agenda 21 Initiative Type Meals on Wheels Location Mayo Target Groups Older people Funding Local Agenda 21 Partner Agencies HSE Mayo County Council The Community Foundation for Ireland

Learning collaboration in General Internal Medicine: a pilot project for undergraduate students in nursing, physiotherapy and medicine

Background: A form of education called Interprofessional Education (IPE) occurs when two or more professions learn with, from and about each other. The purpose of IPE is to improve collaboration and the quality of care. Today, IPE is considered as a key educational approach for students in the health professions. IPE is highly effective when delivered in active patient care, such as in clinical placements. General internal medicine (GIM) is a core discipline where hospital-based clinical placements are mandatory for students in many health professions. However, few interprofessional (IP) clinical placements in GIM have been implemented. We designed such a placement. Placement design: The placement took place in the Department of Internal Medicine at the CHUV. It involved students from nursing, physiotherapy and medicine. The students were in their last year before graduation. Students formed teams consisting of one student from each profession. Each team worked in the same unit and had to take care of the same patient. The placement lasted three weeks. It included formal IP sessions, the most important being facilitated discussions or "briefings" (3x/w) during which the students discussed patient care and management. Four teams of students eventually took part in this project. Method: We performed a type of evaluation research called formative evaluation. This aimed at (1) understanding the educational experience and (2) assessing the impact of the placement on student learning. We collected quantitative data with pre-post clerkship questionnaires. We also collected qualitative data with two Focus Groups (FG) discussions at the end of the placement. The FG were audiotaped and transcribed. A thematic analysis was then performed. Results: We focused on the qualitative data, since the quantitative data lacked of statistical power due to the small numbers of students (N = 11). Five themes emerged from the FG analysis: (1) Learning of others' roles, (2) Learning collaborative competences, (3) Striking a balance between acquiring one's own professional competences and interprofessional competences, (4) Barriers to apply learnt IP competences in the future and (5) Advantages and disadvantages of IP briefings. Conclusions: Our IP clinical placement in GIM appeared to help students learn other professionals' roles and collaborative skills. Some challenges (e.g. finding the same patient for each team) were identified and will require adjustments.

Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders

Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders - NICE Guidance

Guide for World Class Commissioners Promoting Health and Well-being: Reducing Inequalities

One of the core missions of commissioners is to reduce health inequalities. Promoting health and well-being is necessary but not sufficient, and it is essential thatimprovements in commissioning and consequent improvements in service delivery, will not widen the gapbetween different groups in society. It is, of course,already difficult enough to decide how to commission services to promote health and well-being. There are practical, economic and ethical issues involved, but if in addition the commissioner wishes to ensure that the gap between the most healthy and the least healthy does not widen, they will have to think hard and commission carefully. It is also crystal clear that it would be wrong to let 152 Primary Care Trusts find out for themselves how to do this. Firstly, it would be a massive waste of resources, and secondly, many Primary Care Trusts would be unable to deliver. This Guide has been produced by knowledge harvesting; by gathering the knowledge that commissioners have created and accrued, about successes as well as failures; and blending it into a single readable Guide.

Standard Evaluation Framework for Weight Management Interventions - Core Criteria

The National Obesity Observatory was established to provide a single point of contact for wide-ranging authoritative information on data and evidence related to obesity, overweight, underweight and their determinants. The Standard Evaluation Framework is a list of data collection criteria and supporting guidance for collecting high quality information to support the evaluation of weight management interventions. This is a quick reference guide to the core criteria of the Standard Evaluation Framework. Essential criteria are presented as the minimum recommended data for evaluating a weight management intervention. Desirable criteria are additional data that would enhance the evaluation.refer to the resource

Hepatitis B virus screening in contacts of blood donors with antibodies against core protein (anti-HBc), but without surface antigen (HBsAg)

To increase blood safety Brazil introduced screening for anti-HBc among blood donors in 1993. There was a decrease in the hepatitis B virus (HBV) transmission, but this measure identified a great number of HBsAg-negative, anti-HBc-positive donors. Surveillance policy determines that contacts of HBV carriers should be screened to HBV markers, but there is no recommendation about how to guide contacts of HBsAg-negative, anti-HBc-positive donors. Aiming to evaluate whether the contacts of this group are at greater risk for HBV infection, a cross-sectional study was performed to compare prevalence of HBV infection between contacts of HBsAg-positive blood donors (group I) and contacts of HBsAg-negative, anti-HBc-positive donors (group II). Contacts were submitted to a questionnaire and blood tests for HBV markers. In group I (n = 143), 53 (37.1%) were anti-HBc-positive and 11 (7.7%) were HBsAg-positive. In group II (n = 111), there were 9 and 0.9%, respectively. HBV exposure was associated with group I, sexual activity, blood transfusion, being one of the donor's parents, and living for more than ten years with the donor. Regarding the families as sample units, it was more common to find at least one member with HBV markers (p < 0.05) among the families of group I compared to group II. Contacts of HBsAg-negative, anti-HBc-positive individuals presented a much lower risk of having already been exposed to HBV and there is no need to screen them for HBV in low to moderate prevalence populations.

Policy Options for New Student Contributions in Higher Education - Report to the Minister

The Government’s Framework for Sustainable Economic Renewal- Building Ireland’s Smart Economy, launched by the Taoiseach in late 2008, establishes Ireland’s ambition to become internationally renowned as an Innovation Island. At the core of achieving this ambition will be our capacity for producing highly skilled graduates and fostering a climate of creative thinking and advanced research and development. This relies on the quality of undergraduate provision right across the sciences, arts and humanities in our third level institutions. The development of a new national strategy for higher education is now underway. The strategy will aim to identify a vision and objectives for the development of the sector over the next twenty years. Leading higher education systems internationally are characterised by wide revenue sources that, in many cases, include a form of direct student contribution through a tuition fee or student loans system. If Ireland’s higher education system is to develop and meet future demands in an environment of increasingly tight public resources, then it is appropriate that the sector’s level of dependence on Exchequer funding should come under review.

Deep accidental hypothermia with core temperature below 24°c presenting with vital signs.

Abstract Pasquier, Mathieu, Noemi Zurron, Barbara Weith, Pierre Turini, Fabrice Dami, Pierre-Nicolas Carron, and Peter Paal. Deep accidental hypothermia with core temperature below 24°C presenting with vital signs. High Alt Med Biol. 15:58-63, 2014.-Background: According to the Swiss hypothermia clinical staging, patients with stage III are unconscious with preserved vital signs, with core temperature usually between 24° and 28°C. With stage IV, vital signs are absent with core temperature <24°C. Aims: To describe a patient presenting with HT stage III with vital signs but a core temperature of <24°C, and to search for similar patients in the medical literature. Materials and methods: MEDLINE was used to search for cases of deep accidental hypothermia (<24°C) and preserved vital signs. Results: We found 22 cases in addition to our case (n=23). Median age was 44 years (IQR 36; range 4-83) and median core temperature 22°C (IQR 1.7; 17-23.8). Vital signs were often minimal. Seven patients developed ventricular fibrillation (VF). Twenty patients survived with excellent neurological outcome. Conclusions: Vital signs can be present in hypothermic patients with core temperature <24°C. In deeply hypothermic patients, a careful check and prolonged check of vital functions should be made, as vital signs may be minimal. The clinical Swiss staging remains valuable in the prehospital evaluation of hypothermic patients; its correlation with core temperature should be better defined.

La visite médicale en pratique hospitalière: entre soins et apprentissage [Conducting ward rounds: a balance between care and teaching].

Every day, hospital doctors spend time at conducting ward rounds. Rounds are a core clinical activity during which doctors interact with patients, synthetise a whole set of informations and make many decisions. In addition, rounds can become a crucial teaching moment, when a trainee gets supervised by an attending physician. However, litterature on the topic of rounds is scarce. This paper summarizes the results of the few key studies focusing on ward rounds. The results are presented in four sections, each one being dedicated to one of the round stakeholders: the trainee or resident, the trainer, the patient and the nurse. An emphasis is put on ward rounds involving both a trainee and a trainer, since such rounds always mean striking a balance between care and teaching.

Director of Public Health annual report 2013 and additional core tables Recognising diversity in Public Health

The fifth Director of Public Health Annual Report for Northern Ireland, launched on 16 June 2014, celebrates diversity in our population.Diversity is about people and how we value and appreciate those who are not like us. People differ in all sorts of ways which may not always be obvious or visible. These differences might include race and ethnicity, culture and belief, gender and sexuality, age and social status, ability, and use of health and social care services

Director of Public Health Annual Report 2014 and core tables 2013

This is the sixth Director of Public Health (DPH) Annual Report, detailing the main public health challenges in Northern Ireland. It also provides information on the wide variety of work undertaken by the PHA and its partners during 2014 to improve the health and social wellbeing of the population.Each year, the report focuses on an overarching area, which this year is ��'Adults aged 18��-64 years��'.

Bibliotecas y centros de documentación en un entorno virtual

Les Biblioteques i Centres de Documentació han exercit sempre un paper important en el desenvolupament de l'aprenentatge, de la docència i de la investigació, però el canvi que s'ha experimentat i s'està experimentant en el camp docent en aquests últims anys, ha potenciat molt més la funció d'aquest tipus de centres, convertint-los en eixos bàsics del sistema educatiu, passant a formar part, en molts casos, del model dissenyat per exercir la funció educativa i investigadora a través d'un entorn virtual.

Application of compositional data analysis to geochemical data of marine sediments

In an earlier investigation (Burger et al., 2000) five sediment cores near the RodriguesTriple Junction in the Indian Ocean were studied applying classical statistical methods(fuzzy c-means clustering, linear mixing model, principal component analysis) for theextraction of endmembers and evaluating the spatial and temporal variation ofgeochemical signals. Three main factors of sedimentation were expected by the marinegeologists: a volcano-genetic, a hydro-hydrothermal and an ultra-basic factor. Thedisplay of fuzzy membership values and/or factor scores versus depth providedconsistent results for two factors only; the ultra-basic component could not beidentified. The reason for this may be that only traditional statistical methods wereapplied, i.e. the untransformed components were used and the cosine-theta coefficient assimilarity measure.During the last decade considerable progress in compositional data analysis was madeand many case studies were published using new tools for exploratory analysis of thesedata. Therefore it makes sense to check if the application of suitable data transformations,reduction of the D-part simplex to two or three factors and visualinterpretation of the factor scores would lead to a revision of earlier results and toanswers to open questions . In this paper we follow the lines of a paper of R. Tolosana-Delgado et al. (2005) starting with a problem-oriented interpretation of the biplotscattergram, extracting compositional factors, ilr-transformation of the components andvisualization of the factor scores in a spatial context: The compositional factors will beplotted versus depth (time) of the core samples in order to facilitate the identification ofthe expected sources of the sedimentary process.Kew words: compositional data analysis, biplot, deep sea sediments