Whole-person care: from rhetoric to reality. Achieving parity between mental and physical health.

The report presents evidence on a range of factors affecting disparity between mental and physical health, and includes case studies and examples of good practice to illustrate some of the key issues and solutions. It should be seen as the first stage of an on-going process over the next 5"10 years that will deliver parity for mental health and make whole-person care a reality. It builds on the Implementation Framework for the Mental Health Strategy in providing further analysis of why parity does not currently exist, and the actions required to bring it about. A parity approach should enable NHS and local authority health and social care services to provide a holistic, whole person response to each individual, whatever their needs, and should ensure that all publicly funded services, including those provided by private organisations, give people's mental health equal status to their physical health needs. Central to this approach is the fact that there is a strong relationship between mental health and physical health, and that this influence works in both directions. Poor mental health is associated with a greater risk of physical health problems, and poor physical health is associated with a greater risk of mental health problems. Mental health affects physical health and vice versa. The report makes a series of key recommendations for the UK government, policy-makers and health professionals. Recommendations include: The government and the NHS Commissioning Board should work together to give people equivalent levels of access to treatment for mental health problems as for physical health problems, agreed standards for waiting times, and agreed standards for emergency/crisis mental healthcare. Action to promote good mental health and to address mental health problems needs to start at the earliest stage of a person's life and continue throughout the life course. Preventing premature mortality " there must be a major focus on improving the physical health of people with mental health problems. Public health programmes must include a focus on the mental health dimension of issues commonly considered as physical health concerns, such as smoking, obesity and substance misuse. Commissioners need to regard liaison doctors (who work across physical and mental healthcare) as an absolute necessity rather than an optional luxury. NHS and social care commissioners should commission liaison psychiatry and liaison physician services to drive a whole-person, integrated approach to healthcare in acute, secure, primary care and community settings, for all ages. Mental health services and mental health research must receive funding that reflects the prevalence of mental health problems and their cost to society. Mental illness is responsible for the largest proportion of the disease burden in the UK (22.8%), larger than that of cardiovascular disease (16.2%) or cancer (15.9%). However, only 11% of the NHS budget was spent on NHS services to treat mental health problems for all ages during 2010/11. Culture, attitudes and stigma " zero-tolerance policies in relation to discriminatory attitudes or behaviours should be introduced in all health settings to help combat the stigma that is still attached to mental illness within medicine. Political and managerial leadership is required at all levels. There should be a mechanism at national level for driving a parity approach to relevant policy areas across government; all local councils should have a lead councillor for mental health; all providers of specialist mental health services should have a board-level lead for physical health and all providers of physical healthcare services should have a board-level lead for mental health. The General Medical Council (GMC) and Nursing and Midwifery Council (NMC) should consider how medical and nursing study and training could give greater emphasis to mental health. Mental and physical health should be integrated within undergraduate medical education.This resource was contributed by The National Documentation Centre on Drug Use.

Steering Committee on Technical Education Report to the Minister for Education on Regional Technical Colleges

This Committee was established on 20 September 1966 to advise the Minister for Education generally on technical education in Ireland and, in particular, to provide the Department of Education Building Consortium with a brief for the technical colleges. This report from the Committee addresses the following aspects: the need/demand for technicians and skilled personnel; the role of the regional technical colleges; analysis of courses and student population; recruitment and training of teachers; organisation structure; accommodation needs (in the colleges, and residential requirements); growth and flexibility; and cost and time. Recommendations are made in relation to: the building program; the establishment of a Building Project Unit to be accountable for all school and college building work for the Department of Education; the establishment of Regional Education Councils with accountability for all education in each of the regions; and the establishment of a National Council for Educational Awards.

HSCB/PHA Draft Commissioning Plan 2011/2012

The draft Commissioning Plan was approved by the boards of the HSCB and PHA on Thursday 30 June 2011 for onward transmission to the DHSSPS for Ministerial consideration.Further refinement of the draft plan will take place in July and early August with a view to bringing a final draft plan to the August board meetings of the HSCB and PHA.

Substance Misuse Among People Over 55 - Perspectives from the Community and Voluntary sector in Belfast

The Belfast Health Development Unit (BHDU) was established as a Ministerial priority in March 2010, co-locating staff from The Public Health Agency (PHA), Belfast Health and Social Care Trust (BHSCT) and Belfast City Council (BCC). One of the strategic priorities for the BHDU is: an integrated approach to planning and delivery of services for older people in the city.The PHA and the BHDU had identified a need to examine the extent of substance misuse issues within the older population of the city of Belfast and to explore early intervention programmes targeting this population. It is envisioned that this piece of work will inform and support the Belfast Healthy Ageing Strategic Partnership on older people and its multi-sectoral action plan and will influence the work and priorities of the Belfast Strategic Partnership and its constituent stakeholders in taking drug and alcohol work forward in Belfast.The aim of this research was to review knowledge, awareness and evidence of the impact of substance misuse on the older population (aged 55+) and to review good practice in reducing substance related harm within this population which has been done by undertaking a review of available research, data and information sources. However, the main focus of the research involved consulting with a broad range of community and voluntary sector organisations working in the Belfast area to assess their views and perceptions of the prevalence and extent of substance misuse within the older population and the services currently in place to address this issue.�

'Active Travel' Maps: Derry/Londonderry, Enniskillen, Limavady, Omagh and Strabane

New 'Active Travel' Maps, funded by the Public Health Agency, for the cities and towns of Derry/ Londonderry, Enniskillen, Limavady, Omagh and Strabane have been launched to encourage local people and visitors to build physical activity into their day by walking, cycling, jogging, or using public transport.The Active Maps aim to promote health and wellbeing across the five district councils in the West and contain information on local cycle, walk and bus routes as well as useful contacts such as local cycle hire and sales outlets and walking groups, for example.

Veinte municipios trabajan en red para la acción local en salud

Boletín semanal para profesionales sanitarios de la Secretaría General de Salud Pública y Participación Social de la Consejería de Salud

Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition.

BACKGROUND Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. RESULTS As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality. CONCLUSIONS The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.

Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study.

BACKGROUND Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients.

Accesibilidad en los espacios públicos urbanizados

El libro, coordinado por el Director de ACCEPLAN, Fernando Alonso López, viene a ser un reflejo de los avances entorno a la búsqueda de accessibilidad universal en los espacios públicos urbanizados. Para aproximarse a la realidad normativa y técnica de la Orden Ministerial el libro se estructura en artículos referentes al contexto normativo, a los contenidos de la Orden, y a reflexiones y criterios en torno a la accesibilidad en la ciudad. Del conjunto de artículos, por su variedad y por su carácter multidiciplinar, se extrae un libro de referencia que ofrece la variedad de enfoques del tema y que ayuda a interpretar mejor la Orden Ministerial, su contribución a los objetivos de la Ley 51/2003 de Igualdad de Oportunidades No Discriminación y Accesibilidad Universal, LIONDAU, y su utilidad en la comformación de unas ciudades cada vez más abiertas a la diversidad funcional y a la convivencia.

Diagnostic yield of a PCR assay in focal complications of brucellosis.

In order to evaluate the diagnostic yield of a PCR assay for patients with focal complications of brucellosis, we studied by PCR and by conventional microbiological techniques 34 nonblood samples from 32 patients with different focal forms of brucellosis. The samples from patients with brucellosis were paired to an equal number of control samples from the same locations of patients whose illnesses had different etiologies. Thirty-three of the 34 nonblood samples (97%) from the brucellosis patients were positive by PCR, whereas Brucella spp. were isolated from only 29.4% of the conventional cultures. For 11.4% of the patients, the confirmatory serological tests were either negative or showed titers below the diagnostic range. Two patients (6.2%) from the control group, both with tuberculous vertebral osteomyelitis, had a positive PCR result. The brucella PCR of blood from these two patients was also positive, and the two strains of Mycobacterium tuberculosis isolated were analyzed by the brucella PCR, with no evidence of amplification. These results show that the PCR assay is far more sensitive than conventional cultures, and this, coupled with its speed and reduction in risk to laboratory workers, makes this technique a very useful tool for the diagnosis of focal complications of brucellosis.

Impact of Ownership Structure on the Performance of China’s Feed Mill Sector, April 2005

In the decade of the 1990s, China’s feed sector became increasingly privatized, more feed mills opened, and the scale of operation expanded. Capacity utilization remained low and multi-ministerial supervision was still prevalent, but the feed mill sector showed a positive performance overall, posting a growth rate of 11 percent per year. Profit margin over sales was within allowable rates set by the government of China at 3 to 5 percent. Financial efficiency improved, with a 20 percent quicker turnover of working capital. Average technical efficiency was 0.805, as more efficient feed mills increasingly gained production shares. This study finds evidence that the increasing privatization explains the improved performance of the commercial feed mill sector. The drivers that shaped the feed mill sector in the 1990s have changed with China’s accession to the World Trade Organization. With the new policy regime in place, the study foresees that, assuming an adequate supply of soy meal and an excess capacity in the feed mill sector, it is likely that China will allow corn imports up to the tariff rate quota (TRQ) of 7.2 mmt since the in-quota rate is very low at 1 percent. However, when the TRQ is exceeded, the import duty jumps to a prohibitive out-quota rate of 65 percent. With an import duty for meat of only 10 to 12 percent, China would have a strong incentive to import meat products directly rather than bringing in expensive corn to produce meat domestically. This would be further reinforced if structural transformation in the swine sector would narrow the cost differential between domestic and imported pork.

Long-Range Goals for Iowa's Criminal& Junvenile Justice Systems, 2005

The attached plan builds upon work done over the last decade. The first plan developed after the creation of the Division of Criminal and Juvenile Justice Planning in 1986 was issued in 1990 and annually updated through 1994. Since 1992, the CJJPAC has been required to coordinate their planning activities with those of the Iowa Juvenile Justice Advisory Council (JJAC). In 1995, these two councils developed a new plan consisting of a set of long-range justice system goals to assist policy makers and justice system practitioners as they plan and operate the justice system through the next twenty years. The statutory mandate for such long-range planning required the identification of goals specific enough to provide guidance, but broad enough to be of relevance over a long period of time. The long-range goals adopted by these councils in 1995 covered a wide variety of topics and offered a framework within which current practices could be defined and assessed. Collectively, these long-range goals were meant to provide a single source of direction to the complex assortment of practitioners and policymakers whose individual concerns and decisions collectively define the nature and effectiveness of Iowa’s justice system. The twenty-year goals established in 1995 were reviewed by the councils in 2000 to assess their current relevance. It was determined that, with a few revisions, the goals established in 1995 should be restated in 2000 with a renewed emphasis on their long-range status. This plan builds upon those issued in 1995 and 2000, continuing much of the emphasis of plans, with some new directions charted as appropriate.

Da luta de libertação nacional ao governo da República de Cabo Verde: as trajectórias dos membros de governo de 1975 a 1991

Nesta comunicação, procede-se a um estudo descritivo dos critérios de recrutamento ministerial e de secretários de Estado na República de Cabo Verde, de 1975, ano da independência, até 1991, ano que marca o fim do regime monopartidário, chegando à conclusão de que ainda durante a vigência deste regime, verificam-se algumas mudanças a nível dos critérios de recrutamento. Aprofundando a análise de dois momentos cruciais na trajectória destes dirigentes políticos, como foram a frequência de universidades portuguesas no período colonial e o engajamento no movimento de libertação dirigido pelo PAIGC, são levantadas algumas questões acerca da pertinência e das condições de realização de estudos que permitam desenvolver estas temáticas.

Customer Focus Newsleter, October, November 2004, Vol. 1, no. 1

With this newsletter, we begin a bi-monthly bulletin to keep the department/agency management teams of state government better informed. We hope to consolidate most of the service update messages we send throughout the month and keep you updated about the work of the Customer Councils. If yours is one of the many departments who participated in the second annual DAS customer satisfaction survey recently, we thank you for taking the time to give us this important feedback. We look forward to sharing survey results with you, and pledge to consider responses carefully as we work to determine benchmarks and set future priorities.

Customer Focus Newsleter, September-October, 2007, Vol. 4, no. 5

A bi-monthly bulletin to keep the department/agency management teams of state government better informed. We hope to consolidate most of the service update messages we send throughout the month and keep you updated about the work of the Customer Councils. If yours is one of the many departments who participated in the second annual DAS customer satisfaction survey recently, we thank you for taking the time to give us this important feedback. We look forward to sharing survey results with you, and pledge to consider responses carefully as we work to determine benchmarks and set future priorities.