Best Practice - Best Care - Summary of Responses to the Consultation (PDF 318KB)

A Framework for Setting Standards, Delivering Services and Improving Monitoring and Regulation in the HPSS

Central nervous system stimulants and sport practice.

BACKGROUND AND OBJECTIVES: Central nervous system (CNS) stimulants may be used to reduce tiredness and increase alertness, competitiveness, and aggression. They are more likely to be used in competition but may be used during training to increase the intensity of the training session. There are several potential dangers involving their misuse in contact sports. This paper reviews the three main CNS stimulants, ephedrine, amfetamine, and cocaine, in relation to misuse in sport. METHODS: Description of the pharmacology, actions, and side effects of amfetamine, cocaine, and ephedrine. RESULTS: CNS stimulants have psychotropic effects that may be perceived to be ergogenic. Some are prescription drugs, such as Ephedra alkaloids, and there are issues regarding their appropriate therapeutic use. Recently attention has been given to their widespread use by athletes, despite the lack of evidence regarding any ergogenic or real performance benefit, and their potentially serious side effects. Recreational drugs, some of which are illegal (cocaine, amfetamines), are commonly used by athletes and cause potential ergolytic effects. Overall, these drugs are important for their frequent use and mention in anti-doping laboratories statistics and the media, and their potentially serious adverse effects. CONCLUSIONS: Doping with CNS stimulants is a real public health problem and all sports authorities should participate in its prevention. Dissemination of information is essential to prevent doping in sport and to provide alternatives. Adequate training and education in this domain should be introduced.

Best Practice Best Care

A framework for setting standards, delivering services and improving monitoring and regulation in the HPSS åÊ

Racial Equality in Health - Good Practice Guide - Consultation Document (PDF 261KB)

This good practice guide has been produced by the Equity Commission for Northern Ireland in partnership with the Department of Health, Social Services and Public Safety (DHSSPSNI).

A Strategy for Nursing Midwifery and Health Visiting in NI (PDF 180KB)

This study was designed to examine critically the impact of a government-led policy document upon community nursing, midwifery and health visiting practice in Northern Ireland (Strategy for Nursing, Midwifery and Health Visiting in Northern Ireland. Action Plan for Community Nurses, Midwives and Health Visitors, Working Together: A Focus on Health and Social Well-being, DHSS, 1996). The total number of participants was (n=409) and the eleven Health and Personal Social Services Trusts in NI were represented in the sample group which consisted of 93% females and 7% males. A questionnaire containing twenty items was designed and a pilot study was carried out with twenty-five community practitioners. Following the pilot study appropriate modifications were made to the questionnaire. åÊ

Focus on Fitness For Practice (PDF 1.28 Mb)

Pre-registration nursing and midwifery education

Benzodiazepines: Good Practice Guidelines for Clinicians

Benzodiazepines are one of the most widely used prescription medicinal products in the world. Benzodiazepines may be prescribed safely in the short-term and are a highly effective treatment for anxiety, insomnia and some forms of epilepsy and spasticity. Benzodiazepines are only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress. Dependence is now recognised as a significant risk in patients receiving treatment for longer than one month and the practitioner has to be conscious of this when evaluating the relative benefits and risks of continued prescription. Download document here

Our Duty to Care : the principles of good practice for the protection of children and young people

This document, which has been named Our Duty to Care, is aimed at community and voluntary organisations of any size or type that provide services for children. It offers guidance on the promotion of child welfare and the development of safe practices in work with children. It also gives information on how to recognise signs of child abuse and the correct steps to take within organisations if it is suspected, witnessed or disclosed. The process of reporting suspected or actual child abuse to the health board is described step by step, and guidance is given on how to handle sensitive areas. Download document here

Healthy Ageing in Ireland, Policies, Practice and Evaluation

Healthy Ageing in Ireland, Policies, Practice and Evaluation The National Council on Ageing and Older People (NCAOP) is pleased to present this report, which provides a comprehensive overview of current practice in the promotion of healthy ageing in Ireland. The Council considers â?~healthy ageingâ?T to be a positive concept relating to personal development and the exercise of personal choice. Healthy ageing therefore includes activities that influence social and environmental changes, which promote health, well-being and activities that prevent illness. Click here to download PDF 515kb

Le conseil génétique: aspects théoriques et pratique en prénatal [Genetic counselling: theoretical aspects and prenatal practice]

Le conseil génétique doit fournir aux individus une information médicale précise et un soutien psychologique. L'importance des principes d'autonomie et de confidentialité, dogmes du conseil génétique, est renforcée par la nouvelle loi suisse (LAGH). Dans certains pays, une grande partie du conseil génétique est assurée par des conseillers en génétique non médecins ayant une formation postgraduée spécifique. Le conseil génétique joue un rôle grandissant dans différents domaines de la médecine. En particulier, il est indispensable dans le contexte du prénatal où les couples reçoivent des informations complexes et doivent bénéficier d’un soutien pour prendre une décision. Genetic counselling provides families with accurate medical information and psychological support. Respect and concern for the emotional well-being should be taken into account while discussing genetics aspects and recurrence risks. The importance of autonomy and confidentiality, central to genetic counselling, is reinforced by the new Swiss law (LAGH). In many countries, most of the genetic counselling is provided by genetic counsellors who have a specialised post-graduate training. Genetic counselling plays an increasing role in different medical specialities. In particular, it is essential in the context of prenatal and pre-conceptual care, where couples are confronted to complex information and should have access to appropriate support during the decision-making process

Efficacy and safety of various combination therapies based on a calcium antagonist in essential hypertension: results of a placebo-controlled randomized trial

We tested the efficacy and safety of different combination therapies in hypertensive patients with uncontrolled blood pressure (BP) on a monotherapy with a calcium antagonist: 1,647 hypertensive patients were enrolled to receive placebo for 4 weeks followed by isradipine (ISR) 2.5 mg twice daily (b.i.d.) for 4 weeks. Nonresponders [diastolic BP (DBP) > 90 mm Hg] were randomly assigned to receive either the beta-blocker bopindolol 0.5 or 1 mg/day, the diuretic metolazone 1.25 or 2.5 mg/day, the angiotensin-converting enzyme (ACE) inhibitor enalapril 10 or 20 mg/day, ISR 5 mg b.i.d., or placebo. One hundred seventy-five receiving placebo dropped out; 93% (n = 1,376) of the 1,472 patients finished 4-week monotherapy with ISR. Sixty percent (n = 826) reached target BP, and 40% (n = 550) remained uncontrolled and were randomized. Regardless of dosage, all drugs led to a comparable reduction in BP except for the lower dosage of bopindolol and ISR 5 mg b.i.d., which were less effective in lowering systolic BP (SBP). The BP decrease achieved by combination therapy ranged from 10 to 15 mm Hg SBP and from 7 to 11 mm Hg DBP but remained unchanged with placebo. Side effects were minor, and only 2.4% of patients discontinued therapy because of side effects. The side-effect score for edema was lower with ISR plus diuretics than with other combinations, whereas the ACE inhibitor was associated with a higher score for cough. Monotherapy with a calcium antagonist normalizes BP in about two-thirds of patients when used in general practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Healthy Ageing in Ireland, Policies, Practice and Evaluation

Click here to download PDF This is a publication of The National Council on Ageing and Older People