981 resultados para Effective Attention Allocation


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  Report of the Expert Group on Resource Allocation and Financing in the Health Sector Download this document (PDF 4.77mb) Alternatively, there is a lower resolution version available (PDF 2.31mb) Related Documents Resource Allocation, Financing and Sustainability in Health Care Evidence for the Expert Group on Resource Allocation and Financing in the Health Sector (Volume I) – PDF, 4.25mbAlternatively, a Lower Resolution version is available – PDF, 2.23mb Resource Allocation, Financing and Sustainability in Health Care Evidence for the Expert Group on Resource Allocation and Financing in the Health Sector (Volume II) – PDF 4.87mbAlternatively, a Lower Resolution version is available – PDF, 2.65mb Presentation by Professor, Frances Ruane Director , ESRI and Chair of the Expert Group. PDF 235KB Presentation by Professor Charles Normand, a member of the Expert Group. PDF 32KB

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Department of Health and Children Consolidated Salary Scales effective from 1st Jan 2010 Click here to download PDF 224KB

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Revised Consolidated Salary Scales for New Entrants effective from 1 January 2011 Click here to download PDF 5.65MB

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Consolidated Salary Scales effective from 1st July 2013 Click here to download PDF 4.47MB

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This report is a Value for Money (VFM) evaluation, conducted by the National Hospitals Office (NHO) of the Health Service Executive (HSE) on the allocation and utilisation of funding for expenditure in the Southern Hospitals Group (SHG) in 2006. The SHG consists of nine hospitals in the HSE South region. The 2006 expenditure for the SHG covered by the evaluation was 590.1 million. Performance trends were studied over the period 2004 to 2006. Download document here Value for Money & Policy Review of Allocation & Utilisation of Funding in Acute Services in the Southern Hospitals Group (in 2006) – Department of Health and Children Response & Implementation Plan

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Rabies is a preventable disease, but it kills up to 55,000 people each year. Therefore on World Rabies Day, 28 September 2011, the Public Health Agency wants to raise awareness and understanding about the importance of seeking medical advice on whether the country or countries people are visiting require vaccination against this serious disease.Rabies is transmitted to humans mainly by the bite of an infected animal (commonly a dog, but can be spread by other mammals including cats and monkeys). It can also be spread through a scratch, or by the animal licking a cut or a wound and saliva from the infected animal getting into the eyes, mouth or nose. It is impossible to tell just by looking at an animal if they are infected, therefore while visiting other countries it is best to avoid touching animals, especially strays.Dr Michael Devine, Consultant in Health Protection, PHA, said: "Rabies is an acute viral infection which is almost certainly fatal. The infection causes inflammation of the brain and symptoms usually start 2-8 weeks after exposure. Early symptoms include headache, fever and anxiety; progressing to acute pain, violent uncontrolled movements, spasms of the swallowing muscles making it impossible to drink and respiratory failure."People may be used to thinking about rabies when they go to more exotic locations like Asia and Africa, but it can also be present closer to home, such as in some eastern European countries. So it is always best to play it safe and avoid animals, especially strays."Dr Devine continued: "If you are bitten by an animal while abroad it is important to clean the wound thoroughly with soap and water and seek medical attention immediately, even if you have been previously immunised, as treatment must be given to attempt to reduce the risk of developing the disease - treatment works best if initiated as soon as possible. Rabies vaccination is very effective - almost 100%. Booster doses may be required after one year and then every 2-5 years for those at continued risk."

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Whether a higher dose of a long-acting angiotensin II receptor blocker (ARB) can provide as much blockade of the renin-angiotensin system over a 24-hour period as the combination of an angiotensin-converting enzyme inhibitor and a lower dose of ARB has not been formally demonstrated so far. In this randomized double-blind study we investigated renin-angiotensin system blockade obtained with 3 doses of olmesartan medoxomil (20, 40, and 80 mg every day) in 30 normal subjects and compared it with that obtained with lisinopril alone (20 mg every day) or combined with olmesartan medoxomil (20 or 40 mg). Each subject received 2 dose regimens for 1 week according to a crossover design with a 1-week washout period between doses. The primary endpoint was the degree of blockade of the systolic blood pressure response to angiotensin I 24 hours after the last dose after 1 week of administration. At trough, the systolic blood pressure response to exogenous angiotensin I was 58% +/- 19% with 20 mg lisinopril (mean +/- SD), 58% +/- 11% with 20 mg olmesartan medoxomil, 62% +/- 16% with 40 mg olmesartan medoxomil, and 76% +/- 12% with the highest dose of olmesartan medoxomil (80 mg) (P = .016 versus 20 mg lisinopril and P = .0015 versus 20 mg olmesartan medoxomil). With the combinations, blockade was 80% +/- 22% with 20 mg lisinopril plus 20 mg olmesartan medoxomil and 83% +/- 9% with 20 mg lisinopril plus 40 mg olmesartan medoxomil (P = .3 versus 80 mg olmesartan medoxomil alone). These data demonstrate that a higher dose of the long-acting ARB olmesartan medoxomil can produce an almost complete 24-hour blockade of the blood pressure response to exogenous angiotensin in normal subjects. Hence, a higher dose of a long-acting ARB is as effective as a lower dose of the same compound combined with an angiotensin-converting enzyme inhibitor in terms of blockade of the vascular effects of angiotensin.

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Gifted children develop asynchronously, often advanced for their age cognitively, but at or between their chronological and mental ages socially and emotionally (Robinson, 2008). In order to help gifted children and adolescents develop and practice social and emotional self-regulation skills, we investigated the use of an Adlerian play therapy approach during pen-and-paper role-playing games. Additionally, we used Goffman's (1961, 1974) social role identification and distance to encourage participants to experiment with new identities. Herein, we propose a psychosocial model of interactions during role-playing games based on Goffman's theory and Adlerian play therapy techniques, and suggest that role-playing games are an effective way of intervening with gifted children and adolescents to improve their intra- and interpersonal skills. We specifically targeted intrapersonal skills of exercising creativity, becoming self-aware, and setting individual goals by raising participants' awareness of their privately logical reasons for making decisions and their levels of social interest. We also targeted their needs and means of seeking significance in the group to promote collaboration and interaction skills with other gifted peers through role analysis, embracement, and distancing. We report results from a case study and conclude that role-playing games deserve more attention, both from researchers and clinical practitioners, because they encourage change while improving young clients' social and emotional development.

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In androdioecious metapopulations, where males co-occur with hermaphrodites, the absence of males from certain populations or regions may be explained by locally high selfing rates, high hermaphrodite outcross siring success (e.g. due to high pollen production by hermaphrodites), or to stochastic processes (e.g. the failure of males to invade populations or regions following colonization or range expansion by hermaphrodites). In the Iberian Peninsula and Morocco, the presence of males with hermaphrodites in the wind-pollinated androdioecious plant Mercurialis annua (Euphorbiaceae) varies both among populations within relatively small regions and among regions, with some regions lacking males from all populations. The species is known to have expanded its range into the Iberian Peninsula from a southern refugium. To account for variation in male presence in M. annua, we test the following hypotheses: (1) that males are absent in areas where plant densities are lower, because selfing rates should be correspondingly higher; (2) that males are absent in areas where hermaphrodites produce more pollen; and (3) that males are absent in areas where there is an elevated proportion of populations in which plant density and hermaphrodite pollen production disfavour their invasion. We found support for predictions two and three in Morocco (the putative Pleistocene refugium for M. annua) but no support for any hypothesis in Iberia (the expanded range). Our results are partially consistent with a hypothesis of sex-allocation equilibrium for populations in Morocco; in Iberia, the absence of males from large geographical regions is more consistent with a model of sex-ratio evolution in a metapopulation with recurrent population turnover. Our study points to the role of both frequency-dependent selection and contingencies imposed by colonization during range expansions and in metapopulations.

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The prevalence of unhealthy drinking at all levels in Irish society poses serious issues in terms of the consequence to individuals concerned, as well as to society as a whole. The workplace offers a useful setting for early identification and intervention with new employees who may have pre-existing alcohol use disorder issues. This pilot study aimed to evaluate the effectiveness within the workplace of a brief Cognitive Behavioural Therapy (CBT) intervention in reducing participants binge and risky drinking behaviours. Twenty-six Irish Naval recruits volunteered to participate in this randomised controlled trial. The intervention was conducted over four consecutive one and a half hour weekly sessions. Participants completed four principle outcome measures at intake, termination of the intervention and at the two-month follow-up assessment. The Alcohol Use Disorders Identification Test (Babor, Higginis-Biddle, Saunders & Monterio, 2001) was used to measures participants’ consumption levels and frequency of binge or risky drinking. A Readiness Ruler (Miller, Zweben, Diclemente, & Rychtarik, 1992) was used to measure participants’ readiness to change drinking, while the Drinking Expectancy Questionnaire (Young & Oei, 1996) was used to measure participants’ beliefs pertaining to alcohol, and their ability to refuse alcohol in high-risk social surroundings. There were preliminary data in support of the intervention. There were interaction effects that approached statistical significance for both a reduction in participants’ binge drinking (p =. 064) and an increase in participants’ ability to refuse alcohol in high-risk social settings (p = .059). There was also a significant interaction effect (pThis resource was contributed by The National Documentation Centre on Drug Use.

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This thesis is concerned with alcohol problems and marital relationships. It is particularly interested in these dynamics from a treatment perspective. The study addresses theory, research and clinical practice in the field of alcohol problems. It specifically considers these areas as they relate to enhancing understanding of the dynamics between alcohol problems and marriage. The study examines three theoretical paradigms, the disease concept of addiction, behavioural/cognitive behavioural and systems based approaches to understanding alcohol addiction. This provides a multiple theory base from which research in the field and the clinical data collected in the current research is analysed and interpreted. The study reviews research findings that have contributed to the recognition of marital treatment interventions as significant in the alcohol field. It highlights the discrepancies between such research findings and developments in actual clinical practice. In doing so, the study illustrates the gap between theory, research and clinical practice. The need for a more effective framework of information exchange across these areas of activity is identified and a model for better exchange is presented and discussed. This model highlights the importance of including clients' experiences to influence policy, practice, theory and research. In the research, specific attention is focused on the experiences of couples in alcohol treatment. Clinical data is collected from a series of alcohol treatment couples group therapy sessions. The research analysis of the clinical data identifies and extracts concerns as expressed by couples in treatment. Interpretation of these identified concerns or themes is conducted by employing the theoretical constructs of the three selected theoretical paradigms in conjunction with group work theory. On the basis of the findings in this thesis a model for a maritally sensitive assessment framework is developed. The model identifies a number of factors that should be considered in order to enhance appreciation of the interaction between alcohol problems and marital dynamics. This has particular significance for treatment interventions.This resource was contributed by The National Documentation Centre on Drug Use.

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Attention Deficit Hyperactivity Disorder (ADHD) is a childhood onset psychiatric disorder that can persist into adulthood in up to 50% of patients. From a clinical point of view, ADHD is characterized by hyperactivity, mood instability, irritability, difficulties in maintaining attention, lack of organization and impulsive behaviours. The presence of other disorders occurring at the the same time is also common, especially mood disorders and substance abuse. It seems that amphetamines could reverse the underlying neurological problems that feature in ADHD, and so improve ADHD symptoms. We found seven studies, which enrolled 1091 patients. These studies compared amphetamines to placebo and three of them also compared amphetamines with other drugs: guanfacine, modafinil and paroxetine. Three amphetamine derivatives were investigated: dexamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS). Treatment length ranged from two to 20 weeks. All amphetamines improved ADHD symptoms but overall they did not make people more likely to stay in treatment and were associated with a higher risk of treatment ending early due to adverse events. One type of amphetamine, mixed amphetamine salts, did, however, increase retention in treatment. We found no evidence that higher doses worked better than lower ones. We did not find any difference in effectiveness between immediate-release and sustained-release formulations. Therefore, it appears that short-term treatment with amphetamines reduces ADHD symptoms, but studies assessing the effects of amphetamines for longer periods of time are needed.This resource was contributed by The National Documentation Centre on Drug Use.

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The Group makes 12 recommendations for actions covering the two key themes of strategic and organisational responses, and service design and delivery. It calls for: * A joint strategic response at national level to be developed * A joint strategic response at a local level to be developed (responsibility sitting with Alcohol and Drug Partnerships (ADPs) * Recognition of the importance of investing to save over the long term * A joint operational response at local level to be developed * More flexible approaches in rural and island areas * Service development and commissioning to be based on evidence of good practice * An individual’s priorities to be the starting point for the design and delivery of services and support * Ongoing evaluation of services in this field to be managed through the ADP planning and monitoring processes * Targeted service user participation and involvement to be supported * Training across homelessness, housing, alcohol and drug fields to be supported in statutory and commissioned services * The stigmatisation of these populations to be addressed at a local and national level.This resource was contributed by The National Documentation Centre on Drug Use.