The Swiss Systemic lupus erythematosus Cohort Study (SSCS) - cross-sectional analysis of clinical characteristics and treatments across different medical disciplines in Switzerland.

OBJECTIVES: To describe disease characteristics and treatment modalities in a multidisciplinary cohort of systemic lupus erythematosus (SLE) patients in Switzerland. METHODS: Cross-sectional analysis of 255 patients included in the Swiss SLE Cohort and coming from centres specialised in Clinical Immunology, Internal Medicine, Nephrology and Rheumatology. Clinical data were collected with a standardised form. Disease activity was assessed using the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI), an integer physician's global assessment score (PGA) ranging from 0 (inactive) to 3 (very active disease) and the erythrocyte sedimentation rate (ESR). The relationship between SLE treatment and activity was assessed by propensity score methods using a mixed-effect logistic regression with a random effect on the contributing centre. RESULTS: Of the 255 patients, 82% were women and 82% were of European ancestry. The mean age at enrolment was 44.8 years and the median SLE duration was 5.2 years. Patients from Rheumatology had a significantly later disease onset. Renal disease was reported in 44% of patients. PGA showed active disease in 49% of patients, median SLEDAI was 4 and median ESR was 14 millimetre/first hour. Prescription rates of anti-malarial drugs ranged from 3% by nephrologists to 76% by rheumatologists. Patients regularly using anti-malarial drugs had significantly lower SELENA-SLEDAI scores and ESR values. CONCLUSION: In our cohort, patients in Rheumatology had a significantly later SLE onset than those in Nephrology. Anti-malarial drugs were mostly prescribed by rheumatologists and internists and less frequently by nephrologists, and appeared to be associated with less active SLE.

Dental Treatment Services Scheme (DTSS) - Service Utilisation and Treatment Need (Lot 9)

Dental Treatment Services Scheme (DTSS) – Service Utilisation and Treatment Need (Lot 9) Since 2002, following agreement between the Department of Health and Children and the GMS Payments Board, data from the DTSS payments database has been transferred routinely to the Oral Health Services Research Centre (OHSRC), in University College, Cork for analysis. Queries have been developed in the OHSRC to provide individual level data on the treatments provided to patients, such as examinations, extractions, fillings, scale and polish, removal/amputation of roots, root treatment (upper and lower anterior teeth), radiographs, partial dentures and full dentures, and also data on the characteristics of the dentist providing services. Click here to download PDF 2.4mb

Lourdes Hospital Redress Scheme 2007

Lourdes Hospital Redress Scheme 2007 This Scheme arises from the findings and recommendations contained in the Report of The Lourdes Hospital Inquiry, January 2006, published by the Department of Health and Children on 28 February 2006. The object of this scheme is to provide compensation for patients of Dr. Michael Neary who underwent unnecessary obstetric hysterectomy and bilateral oophorectomy. Click here to download PDF 154kb

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

Review of the Nursing Homes Support Scheme - Summary of Submissions

When the Nursing Homes Support Scheme, A Fair Deal, was introduced in October 2009, a commitment was made that it would be reviewed after three years. The reason for allowing this period to elapse was to ensure that the Scheme had bedded in and that established and validated trends and statistics would be available in order to inform the work. Public consultation is a key component.   Click here to download PDF 743kb

CTL activation is induced by cross-linking of TCR/MHC-peptide-CD8/p56lck adducts in rafts.

To investigate the role of the coreceptor CD8 and lipid rafts in cytotoxic T lymphocyte (CTL) activation, we used soluble mono-and multimeric H-2Kd-peptide complexes and cloned S14 CTL specific for a photoreactive derivative of the Plasmodium berghei circumsporozoite (PbCS) peptide 252-260 [PbCS(ABA)]. We report that activation of CTL in suspension requires multimeric Kd-PbCS(ABA) complexes co-engaging TCR and CD8. Using TCR ligand photo-cross-linking, we find that monomeric Kd-PbCS(ABA) complexes promote association of TCR/CD3 with CD8/p56lck. Dimerization of these adducts results in activation of p56lck in lipid rafts, where phosphatases are excluded. Additional cross-linking further increases p56lck kinase activity, induces translocation of TCR/CD3 and other signaling molecules to lipid rafts and intracellular calcium mobilization. These events are prevented by blocking Src kinases or CD8 binding to TCR-associated Kd molecules, indicating that CTL activation is initiated by cross-linking of CD8-associated p56lck. They are also inhibited by methyl-beta-cyclodextrin, which disrupts rafts and by dipalmitoyl phosphatidylethanolamine, which interferes with TCR signaling. Because efficient association of CD8 and p56lck takes place in rafts, both reagents, though in different ways, impair coupling of p56lck to TCR, thereby inhibiting the initial and essential activation of p56lck induced by cross-linking of engaged TCR.

General Scheme of the Public Health (Standardised Packaging of Tobacco) Bill

The purposes of this Act are to : (a) reduce the appeal of tobacco and tobacco products, (b) increase the effectiveness of health warnings on tobacco products, and (c)reduce the ability of the packaging of tobacco and tobacco products to mislead consumers about the harmful effects of smoking in the public interest,by providing for the standardisation of the labelling and physical features of retailpackaging of tobacco products and the requirements for the appearance of cigarettes. Click here to download PDF 125KB Read the Reports of the Joint Committee on Health and Children – General Scheme of the Public Health (Standardised Packaging of Tobacco) Bill 2013 here  

Enterobiasis and strongyloidiasis and associated co-infections and morbidity markers in infants, preschool- and school-aged children from rural coastal Tanzania: a cross-sectional study.

Background. There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status, and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania.MethodsA total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional status determined in accordance with age.Results E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 ¿ 5.86).Conclusions E. vermicularis and S. stercoralis infections were moderately prevalent in children from rural coastal Tanzania. Our data can contribute to inform yet missing global burden of disease and prevalence estimates for strongyloidiasis and enterobiasis. The association between S stercoralis and asymptomatic Plasmodium parasitaemia found here warrants further comprehensive investigations.

Serological cross-reactivity between different Chlamydia-like organisms.

The serological cross-reactivity between different recently described Chlamydia-related organisms was determined. Mouse sera exhibited a strong reactivity against autologous antigen and closely related heterologous antigen but no cross-reactivity with distantly related species. These results are important to better interpret serological studies and assess the pathogenic role of these obligate intracellular bacteria.

The relationship between muscle strength and physiological age: a cross-sectional study in boys aged from 11 to 15.

OBJECTIVE: To investigate the relationships between isokinetic knee flexor and extensor muscle strength and physiological and chronological age in young soccer players. MATERIAL AND METHODS: Seventy-nine young, healthy, male soccer players (mean+/-standard deviation age: 12.78+/-2.88, range: 11 to 15) underwent a clinical examination (age, weight, height, body mass index and Tanner puberty stage) and an evaluation of bilateral knee flexor and extensor muscle strength on an isokinetic dynamometer. Participation in the study was voluntary. RESULTS: The peak torque increased progressively (by 50%) between the ages of 11 and 15 and most significantly between 12 to 14. The knee flexor/extensor ratios only decreased significantly between 14 and 15 years of age. Puberty stage was the most important determinant of the peak torque level (ahead of chronological age, weight and height) for all angular velocities (p<0.0001). Muscle strength increased significantly between Tanner stages 1 and 5, with the greatest increase between stages 2 and 4. CONCLUSION: The present study showed that isokinetic muscle strength increases most between 12 and 13 years of age and between Tanner stages 2 and 3. There was strong correlation between muscle strength and physiological age.

Cross-sectional study defines difference in malaria morbidity in two Yanomami communities on Amazonian boundary between Brazil and Venezuela

It is well established that immunity to malaria is short-lived and is maintained by the continuous contact with the parasite. We now show that the stable transmission of malaria in Yanomami Amerindian communities maintains a degree of immunity in the exposed population capable to reduce prevalence and morbidity of malaria. We examined 508 Yanomami Amerindians living along Orinoco (407) and Mucajaí (101) rivers, on the Venezuelan and Brazilian Amazon region, respectively. At Orinoco villages, malaria was hyperendemic and presented stable transmission, while at Mucajaí villages it was mesoendemic and showed unstable transmission. The frequency of Plasmodium vivax and P. falciparum was roughly comparable in Venezuelan and Brazilian communities. Malaria presented different profiles at Orinoco and Mucajaí villages. In the former communities, malaria showed a lower prevalence (16% x 40.6%), particularly among those over 10 years old (5.2% x 34.8%), a higher frequency of asymptomatic cases (38.5% x 4.9%), and a lower frequency of cases of severe malaria (9.2% x 36.5%). Orinoco villagers also showed a higher reactivity of the immune system, measured by the frequency of splenomegaly (72.4% x 29.7%) and by the splenic index (71.4% over level 1 x 28.6), and higher prevalence (91.1% x 72.1%) and mean titer (1243 x 62) of antiplasmodial IgG antibodies, as well as a higher prevalence (77.4% x 24.7%) and mean titer (120 x 35) of antiplasmodial IgM antibodies. Our findings show that in isolated Yanomami communities the stability of malaria transmission, and the consequent continuous activation of the immune system of the exposed population, leads to the reduction of malaria prevalence and morbidity.

Craigavon & Banbridge Community HSS Trust - Primary Care Mental Health Services Triage Pilot Scheme (PDF 266 KB)

Craigavon & Banbridge Community HSS Trust's final report on Primary Care Mental Health Services Triage Pilot Scheme. Part of the Department's redesign of community nursing project.

Sistema de transmissió encriptat J2EE : Crypto magatzem

El projecte consisteix en una aplicació web que actua com un magatzem central d'arxius, on els usuaris es poden connectar via https des de qualsevol localització, independentment del grau de seguretat que implementi la seva estació, i enviar arxius encriptats o sense encriptar amb les garanties màximes de seguretat i confidencialitat. Els fitxers restarien emmagatzemats a un BBDD on posteriorment, només usuaris acreditats amb una clau AES d'ecriptació/desencriptació els podrien recuperar, també via HTTPS, i procedir a desencriptar-los a nivell local.

Warm Front, Better Health: Health Impact Evaluation of the Warm Front Scheme

About 4 million households in the UK cannot adequately heat their homes in winter due to low income and poor quality housing, the two main causes of fuel poverty. The primary impact of fuel poverty is cold homes in winter which can lead to various health problems and even death among the vulnerable young and the elderly population. The government launched the Warm Front scheme in 2000 to tackle fuel poverty among the vulnerable households in England by providing energy efficiency measures in the forms insulation and modern heating system(??). By 2004, about 770,000 households had benefited from the Warm Front scheme and a total of 2 million households are still expected to benefit by 2010. Since 2001, the Bartlett has been investigating with London School of Hygiene & Tropical Medicine and Sheffield Hallam University, the health and the environmental impact of the Warm Front scheme. This investigative study is the most detailed to date on fuel poor dwellings based on detailed surveys of household and dwelling data, fuel consumption record and monitored temperature and relative humidity from 3,100 dwellings before and after the energy efficiency measures. The Warm Front investigation was expected to continue until the end of 2007. The findings from the investigation indicated that the Warm Front scheme was likely to have benefits in terms of improved thermal comfort and well-being as a result of mean temperature rise of 1.6C in the living room and 2.8C in the bedroom. Warm Front also lead to a decrease in indoor relative humidity mainly from the increased temperature since there appeared to be little impact on vapour pressure from changes in air tightness. Pressure test results indicated that the effects of air tightness measures such as draught stripping and cavity wall insulation were offset by the installation of a central heating system, particularly when the pipe work feeding radiators was installed below timber floors.