Acute Hospital Portfolio Year 3 Regional Summary (PDF 1153 KB)

February 2006 - report providing an overview of the performance of the Northern Ireland Trusts

Dengue situation in Brazil by year 2000

Dengue virus types 1 and 2 have been isolated in Brazil by the Department of Virology, Instituto Oswaldo Cruz, in 1986 and 1990 respectively, after many decades of absence. A successful continental Aedes aegypti control program in the Americas, has been able to eradicate the vector in most countries in the 60's, but the program could not be sustained along the years. Dengue viruses were reintroduced in the American region and the infection became endemic in Brazil, like in most Central and SouthAmerican countries and in the Caribbean region, due to the weaning of the vector control programs in these countries. High demographic densities and poor housing conditions in large urban communities, made the ideal conditions for vector spreading. All four dengue types are circulating in the continent and there is a high risk of the introduction in the country of the other two dengue types in Brazil, with the development of large epidemics. After the Cuban episode in 1981, when by the first time a large epidemic of dengue hemorrhagic fever and dengue shock syndrome have been described in the Americas, both clinical presentations are observed, specially in the countries like Brazil, with circulation of more than one dengue virus type. A tetravalent potent vaccine seems to be the only possible way to control the disease in the future, besides rapid clinical and laboratory diagnosis, in order to offer supportive treatment to the more severe clinical infections.

Male vs Female Lupus. A comparison of ethnicity, clinical features, serology and outcome over a 30 year period

Un estudi observacional de pacients amb LES, atesos al University College de London Hospital entre 1976 i 2005, es va dur a terme per revisar les diferències entre homes i dones amb lupus pel que fa a les característiques clíniques, serologia i resultats. 439 dones i 45 homes van ser identificats. L'edat mitjana al diagnòstic va ser de 29,3 anys (12,6), sense diferències significatives entre homes i dones. El sexe femení es va associar significativament amb la presència d'úlceres orals i Ig M ACA. No hi va haver diferències significatives en la comparació de les altres variables. Durant aquest període de seguiment de trenta anys, relativament poques diferències han sorgit al comparar les freqüències de les característiques clíniques i serològiques en homes y dones amb lupus.

Does falls efficacy predict gait performance in high-functioning older people?

Introduction: Falls efficacy, defined as confidence in performing activities without falling, is a measure of fear of falling associated with gait impairment, falls and functional decline in frail older people. This relationship has not been well studied in high-functioning older people. Objective: To evaluate the relationship between falls efficacy and gait performance in a cohort of high-functioning older people. Methods: Subjects (N = 864) were a subsample of communitydwelling older people aged 65 to 70 years, enrolled in the "Lc65+" cohort, who completed gait assessment at baseline. Data were collected on demographics, functional, cognitive, affective, and health status. Falls efficacy was assessed using the Falls Efficacy Scale- International (FES-I) that measures confidence in performing 16 activities of daily life (ADL) without falling (score from 16 to 64, higher score indicates lower confidence). Gait parameters were measured over a 20 m walk at preferred gait speed using Physilog, an ambulatory gait monitoring system. Results: Participants (mean age 68.0 ± 1.4 years, 55.0% women) had excellent physical (92.2% independent in basic ADL, mean gait speed 1.13 ± 0.16 m/sec) and cognitive (98.0% with MMSE 024) performance. Nevertheless, 22.1% reported depressive symptoms and 16.1% one or more fall in the previous year. Mean FES-I score was 18.8 ± 4.1. Falls efficacy was associated with gait speed (Spearman rho -0.23, P <.001) and gait variability (Spearman rho 0.10, P = .006), measured by the coefficient of variation of stride velocity. These associations remained in multivariate analysis for both gait speed (adj [beta] coeff: -0.008, 95%CI -0.005 to -0.010, P <.001) and gait variability (adj [beta] coeff 0.024, 95%CI 0.003 to 0.045, P = .023) independent of gender, falls, functional, affective, cognitive, and frailty (Fried's criteria) status. On average, compared to subjects with poor confidence in performing one ADL without falling, those with full confidence had a 0.02 m/sec (2%) faster gait speed and a 2% decrease in gait variability. Conclusion: Even in high-functioning older people, poor falls efficacy is associated with reduced gait speed and stability, independent of health, functional, and frailty status. The direction of this relationship needs to be investigated prospectively to determine causality and design interventions to improve gait performance, reduce fall risk, and prevent functional decline.

A Healthier Future: A Twenty Year Vision for Health and Wellbeing in Northern Ireland 2005-2025

This Regional Strategy, A Healthier Future, aims to provide a vision of how our health and social services will develop and function over the next 20 years. In order to succeed, it must embrace the measures needed to promote health and wellbeing, support, protect and care for the most vulnerable and facilitate the delivery of services.

A Five Year Physical Activity Strategy and Action Plan

A Five Year Physical Activity Strategy and Action Plan

Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe: impact of maternal age and prenatal screening.

This study examines trends and geographical differences in total and live birth prevalence of trisomies 21, 18 and 13 with regard to increasing maternal age and prenatal diagnosis in Europe. Twenty-one population-based EUROCAT registries covering 6.1 million births between 1990 and 2009 participated. Trisomy cases included live births, fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly. We present correction to 20 weeks gestational age (ie, correcting early terminations for the probability of fetal survival to 20 weeks) to allow for artefactual screening-related differences in total prevalence. Poisson regression was used. The proportion of births in the population to mothers aged 35+ years in the participating registries increased from 13% in 1990 to 19% in 2009. Total prevalence per 10 000 births was 22.0 (95% CI 21.7-22.4) for trisomy 21, 5.0 (95% CI 4.8-5.1) for trisomy 18 and 2.0 (95% CI 1.9-2.2) for trisomy 13; live birth prevalence was 11.2 (95% CI 10.9-11.5) for trisomy 21, 1.04 (95% CI 0.96-1.12) for trisomy 18 and 0.48 (95% CI 0.43-0.54) for trisomy 13. There was an increase in total and total corrected prevalence of all three trisomies over time, mainly explained by increasing maternal age. Live birth prevalence remained stable over time. For trisomy 21, there was a three-fold variation in live birth prevalence between countries. The rise in maternal age has led to an increase in the number of trisomy-affected pregnancies in Europe. Live birth prevalence has remained stable overall. Differences in prenatal screening and termination between countries lead to wide variation in live birth prevalence.

A Five Year Tobacco Action Plan (PDF 109 KB)

Summary of Responses to the Consultation ‘A Five Year Tobacco Action Plan’ document was issued for public consultation in August 2002. The Plan, which was developed by an inter-sectoral Working Group, provides a framework for collaborative working across Government departments, the statutory and voluntary sectors, as well as with business and in local communities. It seeks to combine an overview of the background, scale and nature of the problem with a comprehensive programme of action to reduce the harm caused by tobacco use. åÊ

A Five Year Tobacco Action Plan (PDF 188KB)

Smoking claims between 2,700 and 3,000 lives here each year. It is the single greatest preventable cause of premature death and avoidable illness. It also harms people who do not smoke and babies in the womb. Smoking is a major risk factor for coronary heart disease, strokes and other diseases of the circulatory system, which kill two in every five men and women here. These diseases are also important causes of disability. A lifetime non-smoker is 60% less likely than a current smoker to have coronary heart disease and 30% less likely to suffer a stroke. åÊ

A Five Year Home Accident Prevention Strategy and Action Plan (PDF 124KB)

The Executive in its Programme for Government under the theme “Working for a Healthier People” gave a commitment to promoting public safety by reducing the number of injuries and deaths caused by accidents at home, at work and on the road. An overarching strategy for children and young people is also being developed, which will set out the vision, values and underlying principles, including general safety, for all children and young people and the long-term goals to make that vision a reality. Consultation Document

A Five Year Home Accident Prevention Strategy and Action Plan (Word 34KB)

Questionnaire