More Equal Societies do Better

Greater income equality - the key to tackling health and social problems Everyone living in Ireland, North and South, could lead happier, healthier and longer lives if measures were put in place to achieve greater income equality according to the authors of 'The Spirit Level: Why more equal societies almost always do better'. Prof Richard Wilkinson and Dr. Kate Pickett will present their findings showing how greater income equality in rich countries is key to reducing social problems and improving health. 'The Spirit Level' highlights how more unequal societies are bad for almost everyone - rich as well as poor. It demonstrates that nearly every modern social and health problem - obesity, lack of community life, violence, drugs, mental illness and big prison populations - are more likely to occur in a less equal society. IPH Chief Executive, Dr. Jane Wilde said "The evidence shows the need to change from being focused on the pursuit of greater wealth to how existing wealth can be more evenly distributed. The current economic climate presents real opportunity to reflect on what we value in society, to learn from mistakes and make plans to move towards communities that are better for everyone."

Food poverty in rural Northern Ireland

“Decent Food for All” (DFfA) was a three-year integrated, partnership-based programme committed to reducing food poverty and addressing inequalities in physical and financial access to safe healthy food in the Armagh and Dungannon area of Northern Ireland. DFfA is led by the Armagh and Dungannon Health Action Zone (ADHAZ) and involves the delivery of a range of programmes and workshops which provide practical community based focused help and advice on food issues and nutrition. A comprehensive research and evaluation programme entitled ‘All-island learning from the Decent Food for All programme’ runs throughout the lifetime of the programme, which ensures effective evaluation, and the sharing of best practices and experiences. The research and evaluation program is coordinated by the Institute of Public Health in Ireland (IPH) with cooperation from ADHAZ. Funding for the research is provided by the Food Safety Promotion Board. To take into account background changes not directly attributable to the DFfA Programme a matched comparison area was selected in the Newry/Mourne area of Co. Down. An accurate measure of the changes that have occurred over the period of the DFfA programme is required. Valid estimates of change are based on measures before and after the programme. Pre-test and post-test community surveys provide a wide range of measures. This fact-book highlights the findings from the pre-test community survey.The aims of the pre-test survey were to:- Provide pre-test measures of the Key Performance Indicators underpinning the Key Expected Outcomes of the DFfA programme;- Identify factors influencing these pre-test measures; and- Contribute to the development of the programmes in DFfA.

Climate Change and Health: A platform for action

This paper provides an introduction to the links between climate change and health and aims to inform policy-makers, politicians and the public of the benefits for health from reducing greenhouse gas (GHG)* emissions from food production, transport, energy, and waste. It also highlights the importance of action by the health sector.It presents a platform for action which demonstrates that creating healthy sustainable places and communities can go hand in hand with reducing the negative impacts of climate change.

IPH response to Building an Active Travel Future for Northern Ireland

IPH responded to the Department for Regional Development consultation Building an Active Travel Future for Northern Ireland, March 2012 The draft Active Travel strategy seeks to set out how to increase active travel by demonstrating that walking and cycling are safe, healthy, flexible, inexpensive and social means of travel and by setting out ways in which opportunities for active travel can be significantly improved.IPH welcomes the new Active Travel Strategy and highlights the need for a truly integrated approach to the strategy which has the potential to positively influence health in areas such as obesity, mental health and cardiovascular health.  IPH suggest a health impact assessment is undertaken on each of the Active Travel Demonstration projects to fully maximise the potential health outcomes of developing the required infrastructure for active travel.

Response to the Health Information and Quality Authority on their Corporate Plan

The Institute of Public Health in Ireland is an all-island body which aims to improve health in Ireland, by working to combat health inequalities and influence public policies in favour of health. The Institute promotes co-operation in research, training, information and policy in order to contribute to policies which tackle inequalities in health. He Institute houses the all-Ireland population health observatory, INIsPHO. The Institute has enjoyed good working relations with HIQA and welcomes the opportunity to submit its views for inclusion in HIQA’s forthcoming Corporate Plan. Our response highlights the inter-relatedness of the four Functions of HIQA. The Institute believes that HIQA’s first Corporate Plan should aim to develop all four Functions in a co-ordinated manner that recognizes and takes advantage of their inter-dependence. For example; the Health Information Function should include a strong focus on, but not be limited to, information requirements to support the delivery of the other three Functions. As well as gathering relevant information in a complementary way, these other Functions can help define priorities for the Health Information Function. This approach will have implications for the organizational structures and processes within HIQA, and the way it conducts its business.

Composition of fingermark residue: a qualitative and quantitative review

This article describes the composition of fingermark residue as being a complex system with numerous compounds coming from different sources and evolving over time from the initial composition (corresponding to the composition right after deposition) to the aged composition (corresponding to the evolution of the initial composition over time). This complex system will additionally vary due to effects of numerous influence factors grouped in five different classes: the donor characteristics, the deposition conditions, the substrate nature, the environmental conditions and the applied enhancement techniques. The initial and aged compositions as well as the influence factors are thus considered in this article to provide a qualitative and quantitative review of all compounds identified in fingermark residue up to now. The analytical techniques used to obtain these data are also enumerated. This review highlights the fact that despite the numerous analytical processes that have already been proposed and tested to elucidate fingermark composition, advanced knowledge is still missing. Thus, there is a real need to conduct future research on the composition of fingermark residue, focusing particularly on quantitative measurements, aging kinetics and effects of influence factors. The results of future research are particularly important for advances in fingermark enhancement and dating technique developments.

Developmental and pathological lymphangiogenesis: from models to human disease.

The lymphatic vascular system, the body's second vascular system present in vertebrates, has emerged in recent years as a crucial player in normal and pathological processes. It participates in the maintenance of normal tissue fluid balance, the immune functions of cellular and antigen trafficking and absorption of fatty acids and lipid-soluble vitamins in the gut. Recent scientific discoveries have highlighted the role of lymphatic system in a number of pathologic conditions, including lymphedema, inflammatory diseases, and tumor metastasis. Development of genetically modified animal models, identification of lymphatic endothelial specific markers and regulators coupled with technological advances such as high-resolution imaging and genome-wide approaches have been instrumental in understanding the major steps controlling growth and remodeling of lymphatic vessels. This review highlights the recent insights and developments in the field of lymphatic vascular biology.

Atomic force and electron microscopic-based study of sarcolemmal surface of living cardiomyocytes unveils unexpected mitochondrial shift in heart failure.

Loss of T-tubules (TT), sarcolemmal invaginations of cardiomyocytes (CMs), was recently identified as a general heart failure (HF) hallmark. However, whether TT per se or the overall sarcolemma is altered during HF process is still unknown. In this study, we directly examined sarcolemmal surface topography and physical properties using Atomic Force Microscopy (AFM) in living CMs from healthy and failing mice hearts. We confirmed the presence of highly organized crests and hollows along myofilaments in isolated healthy CMs. Sarcolemma topography was tightly correlated with elasticity, with crests stiffer than hollows and related to the presence of few packed subsarcolemmal mitochondria (SSM) as evidenced by electron microscopy. Three days after myocardial infarction (MI), CMs already exhibit an overall sarcolemma disorganization with general loss of crests topography thus becoming smooth and correlating with a decreased elasticity while interfibrillar mitochondria (IFM), myofilaments alignment and TT network were unaltered. End-stage post-ischemic condition (15days post-MI) exacerbates overall sarcolemma disorganization with, in addition to general loss of crest/hollow periodicity, a significant increase of cell surface stiffness. Strikingly, electron microscopy revealed the total depletion of SSM while some IFM heaps could be visualized beneath the membrane. Accordingly, mitochondrial Ca(2+) studies showed a heterogeneous pattern between SSM and IFM in healthy CMs which disappeared in HF. In vitro, formamide-induced sarcolemmal stress on healthy CMs phenocopied post-ischemic kinetics abnormalities and revealed initial SSM death and crest/hollow disorganization followed by IFM later disarray which moved toward the cell surface and structured heaps correlating with TT loss. This study demonstrates that the loss of crest/hollow organization of CM surface in HF occurs early and precedes disruption of the TT network. It also highlights a general stiffness increased of the CM surface most likely related to atypical IFM heaps while SSM died during HF process. Overall, these results indicate that initial sarcolemmal stress leading to SSM death could underlie subsequent TT disarray and HF setting.

Estudi dels arbres i conjunts remarcables del municipi de Sitges

Aquest estudi s’ha realitzat amb l’objectiu d’aprofundir en el coneixement dels arbres i conjunts remarcables del municipi de Sitges, a la comarca del Garraf. S’ha fet un inventari dels arbres i conjunts estudiats, tot diferenciant els situats en la zona urbana (urbans) i els que es troben fora d’aquest àmbit (no urbans), i s’ha analitzat el seu estat de conservació i importància socioambiental. També se n’ha elaborat una base cartogràfica amb la seva localització. S’ha donat continuïtat a la metodologia aplicada en treballs anteriors sobre arbres monumentals, notables i singulars, amb algunes variants. S’han inventariat trenta-nou arbres i conjunts remarcables (pertanyents a vint-i-cinc espècies), dels quals trenta són urbans i nou són no urbans. Tots ells, excepte un exemplar considerat notable, s’han qualificat com a singulars. A banda, s’han inventariat tres conjunts remarcables sense contenir cap exemplar remarcable, els quals s’han treballat a part. Durant el treball de camp, realitzat a la tardor i al hivern de 2011 a Sitges, s’han pres dades de trenta-cinc variables sobre els arbres inventariats, les quals s’han sintetitzat en sis paràmetres qualitatius indicatius de l’estat de conservació i importància socioambiental dels arbres i conjunts inventariats. Aquesta simplificació ha permès fer un estudi comparatiu dels arbres, extreure conclusions i elaborar propostes de millora per a vetllar per a la seva conservació. El present estudi posa de manifest la necessitat de declarar els arbres inventariats d’interès local o comarcal d’acord amb les figures legislatives de protecció de l’administració competent, posant èmfasi en la incorporació a l’existent Catàleg d’Arbres Singulars de Sitges dels arbres no urbans inventariats i d’altres urbans que no hi són presents.

Partnerships in Caring - Standards for Service (PDF 96KB)

Health and Social Services are undergoing significant change and challenge as we move into a new millennium. The review of Regional Palliative Care Services, ‘Partnerships in Caring’ builds on the significant work already undertaken. The review highlights in particular the need for partnership with patients and their families – between the variety of care providers and with service planners and commissioners, as it is only in working together, in a co-ordinated way that we can hope to provide consistently high quality services. åÊ

Le mythe de la chute de Satan et la question du milieu d'origine de la Vie d'Adam et Ève

(Résumé de l'ouvrage) This collection of studies in honor of François Bovon highlights the rich diversity found within early expressions of Christianity as evidenced in ancient texts, traditions, symbols, and motifs. Old labels like 'apocrypha' or 'heresy' that for centuries have suppressed much of this evidence are removed, previous assumptions are questioned, and the old data are examined afresh along with the latest discoveries. The studies fall into six areas: ancient gospels, acts, early Christian movements, ancient interpretations, art, and manuscripts. Contributors include James Robinson, Helmut Koester, Harold Attridge, Karen King, and Jean-Daniel Kaestli.

Report of the Inspector of Mental Hospitals 1999

The report details some general matters affecting the psychiatric services at the time of inspection and highlights the main developments envisaged in the psychiatric services in each health board. The report then proceeds to deal with each individual service. Each health board is allocated a separate chapter, with a chapter also being devoted to registered psychiatric hospitals. Finally there is a presentation of the latest statistical information on the psychiatric services Download the Report here

Quand l'évêque Athanase se prend pour l'évangéliste Luc (Lettre festale XXXIX sur le canon des Ecritures)

(Résumé de l'ouvrage) This collection of studies in honor of François Bovon highlights the rich diversity found within early expressions of Christianity as evidenced in ancient texts, traditions, symbols, and motifs. Old labels like 'apocrypha' or 'heresy' that for centuries have suppressed much of this evidence are removed, previous assumptions are questioned, and the old data are examined afresh along with the latest discoveries. The studies fall into six areas: ancient gospels, acts, early Christian movements, ancient interpretations, art, and manuscripts. Contributors include James Robinson, Helmut Koester, Harold Attridge, Karen King, and Jean-Daniel Kaestli.

The interaction of human pathogenic arena viruses with the host cell

SummaryResearch projects presented in this thesis aimed to investigate two major aspects of the arenaviruses life cycle in the host cell: viral entry and the biosynthesis of the viral envelope glycoprotein.Old World arenaviruses (OWAV), such as Lassa virus (LASV) and lymphocytic choriomeningitis virus (LCMV), attach to the cell by binding to their receptor, alpha-dystroglycan. Virions are then internalized by a largely unknown pathway of endocytosis and delivered to the late endosome/lysosome where fusion occurs at low pH. In the major project of my thesis, we sought to identify cellular factors involved in OWAV cell entry. Our work indicates that OWAV cell entry requires microtubular transport and a functional multivesicular body (MVB) compartment. Infection indeed depends on phosphatidyl inositol 3-kinase (PI3K) activity and lysobisphosphatidic acid (LBPA), a lipid found in membranes of intraluminal vesicles (ILVs) of the MVB. We further found a requirement of factors that are part of the endosomal sorting complex required for transport (ESCRT), involved in the formation of ILVs. This suggests an ESCRT-mediated sorting of virus- receptor complex during the entry process.During viral replication, biosynthesis of viral glycoprotein takes place in the endoplasmic reticulum (ER) of the host cell. When protein load exceeds the folding capacity of the ER, the accumulation of unfolded proteins is sensed by three ER resident proteins, activating transcription factor 6 (ATF6), inositol-requiring enzyme 1 (IRE1) and PKR-like ER kinase (PERK), whose signaling induces the cellular unfolded protein response (UPR). Our results indicate that acute LCMV infection transiently induces the activation of the ATF6 branch of the UPR, whereas the PERK, and IRE1 axis of UPR are neither triggered nor blocked during infection. Our data also demonstrate that activation of ATF6 pathway is required for optimal viral replication during acute infection.The formation of the mature, fusion-active form of arenaviruses glycoproteins requires proteolytic cleavage mediated by the cellular protease subtilisin kexin isozyme-1 (SKI-l)/site-l protease (SIP). We show that targeting the SKI-1/S1P enzymatic activity with specific inhibitors is a powerful strategy to block arenaviruses productive infection. Moreover, characterization of protease function highlights differences in processing between cellular and viral substrates, opening new possibilities in term of drug development against human pathogenic arenaviruses.RésuméLes projets de recherche présentés dans cette thèse visaient à étudier deux aspects du cycle de vie des arenavirus: l'entrée du virus dans la cellule hôte et la biosynthèse de la glycoprotéine durant la réplication virale.Les arenavirus du vieux monde (OWAV), tels que le virus de Lassa (LASV) et le virus de la chorioméningite lymphocytaire (LCMV) s'attachent à la cellule hôte en se liant à leur récepteur, l'alpha-dystroglycane. Les virions sont ensuite intemalisés par une voie d'endocytose inconnue et livrés à l'endosome tardif/lysosome, où le pH acide permet la fusion entre l'enveloppe virale et la membrane du compartiment. Le projet principal de ma thèse consistait à identifier les facteurs cellulaires impliqués dans l'entrée des OWAV dans la cellule hôte. Nos résultats indiquent que l'entrée des OWAV nécessite le transport microtubulaire et la présence d'un corps multivésiculaire (MVB) fonctionnel. L'infection dépend en effet de l'activité de phosphatidyl inositol 3-kinase (PI3K) et de lysobisphosphatidic acid (LBPA), un lipide présent dans les membranes des vésicules intraluminales (ILVs) du MVB. Nous avons également trouvé l'implication de facteurs constituant l'endosomal sorting complex required for sorting (ESCRT) qui joue un rôle dans la formation des ILVs. Ces donnés suggèrent l'incorporation du complexe virus-récepteur dans des ILVs durant le processus d'entrée.Lors de la réplication virale, la biosynthèse de la glycoprotéine virale a lieu dans le réticulum endoplasmique (ER) de la cellule hôte. Lorsque la charge de protéines nouvellement synthétisées excède la capacité de pliage des protéines dans le ER, l'accumulation de protéines mal pliées est détectée par trois facteurs: activating transcription factor 6 (ATF6), inositol-requiring enzyme 1 (IRE1) et PKR-like ER kinase (PERK). Leur signalisation constitue la réponse cellulaire face aux protéines mal pliées (UPR). Nos résultats montrent que l'infection aiguë avec LCMV induit transitoirement l'activation de la voie de signalisation ATF6 alors que les axes PERK et IRE1 de l'UPR ne sont ni induits ni bloqués pendant l'infection. Nos données prouvent également que l'activation de la voie ATF6 est nécessaire à une réplication virale optimale lors de l'infection aiguë avec LCMV.La maturation des glycoprotéines des arenavirus nécessite un clivage protéolytique par la protéase cellulaire subtilisin kexin isozyme-1 (SKI-l)/site-l protease (SIP). Nous avons démontré que le ciblage de l'activité enzymatique de SKI-1/SIΡ avec des inhibiteurs spécifiques est une stratégie prometteuse pour bloquer l'infection par les arenavirus. La caractérisation du mécanisme d'action de la protéase a, par ailleurs, révélé des différences au niveau du clivage entre les substrats cellulaires et viraux, ce qui ouvre de nouvelles perspectives en terme de développement de médicaments contre les arenavirus pathogènes pour l'homme.

Eculizumab to treat antibody-mediated rejection in a 7-year-old kidney transplant recipient.

We report on successful early eculizumab administration to treat acute antibody-mediated rejection (ABMR) in a highly sensitized kidney transplant recipient. The recipient is a 7-year-old boy who received, 6 months after a desensitization protocol with monthly intravenous immunoglobulin infusion, a second kidney transplant in the presence of low donor-specific antibodies (DSAs). Both pretransplant lymphocytotoxic and flow cytometric crossmatch were negative. Allograft function recovered promptly, with excellent initial function. On postoperative day (POD) 4, the child developed significant proteinuria with an acute rise in serum creatinine. Allograft biopsy showed severe acute ABMR. Intravenous eculizumab (600 mg), preceded by a single session of plasmapheresis, was administered on POD 5 and 12 along with a 4-day thymoglobulin course. After the first dose of eculizumab, a strikingly rapid normalization of allograft function with a decrease in proteinuria occurred. However, because circulating DSA levels remained elevated, the child received 3 doses of intravenous immunoglobulin (POD 15, 16, and 17), with a significant subsequent decrease in DSA levels. At 9 months after transplant, the child continues to maintain excellent allograft function with undetectable circulating DSA levels. This unique case highlights the potential efficacy of using early eculizumab to rapidly reverse severe ABMR in pediatric transplantation, and therefore it suggests a novel therapeutic approach to treat acute ABMR.