Developing a Regional Strategy for the Health and Personal Social Services - Appendix 1 (PDF 35KB)

Summary of Relevant Policy Reviews

Developing a Regional Strategy for the Health and Personal Social Services - Appendix 2 (PDF 20KB)

Consultation Reply Form

Developing a Regional Strategy for the Health and Personal Social Services (PDF 73KB)

2002 - 2022

Regional Advisory Committee on Cancer - Second Report 2002 (PDF 132 KB)

Regional Advisory Committee on Cancer (RACC) was established in 1997 to carry forward the recommendations of the Campbell Report of 1996 and to provide advice to the Department of Health and Social Services on the future development of cancer services. The Committee meets twice a year and its membership (Appendix I) is an indication of the wide range of interests involved in Cancer Care across the community. This report records some of the key developments in cancer services over the last 3 years. åÊ Significant progress has been made toward developing a high quality and integrated cancer care network. All five Cancer Units are now operational with chemotherapy and outpatient services for the most common forms of cancer are delivered from these locations. Agreement to the start of the new Cancer Centre, at the Belfast City Hospital, currently estimated to cost å£58m, is expected shortly. As a temporary expedient two additional therapy machines will be installed in Belvoir Park Hospital to increase capacity while the building of the new Cancer Centre proceeds. åÊ To deliver high quality cancer care the workforce needs to continue to expand. This requires increasing investment in the training of professional staff in the context of an already difficult HPSS labour market. The development of the five Cancer Units has increased staff mobility in the short-term, drawing skilled staff away from the centre who have been difficult to replace. At the same time increasing numbers of patients are being offered effective therapies at both the Cancer Units and the Centre. åÊ This report contains a review of selected developments in cancer care. The first section introduces the Memorandum of Understanding and the Tripartite Agreement between the National Cancer Institute of the USA and the Health Departments both North and South. This is a unique international partnership, which promises to bring very significant advantages to both the service and research communities across the Island. åÊ åÊ åÊ

Construcción de un modelo Multi- Regional Input-Output (MRIO) medioambiental para Cataluña y el resto de España: Estudio del balance en CO2 incorporado en el comercio

El objetivo de este estudio es analizar el impacto, en emisiones de CO2, de la demanda final de Cataluña en relación a los vínculos comerciales interregionales con el resto de España y el resto del mundo. Este proceso implica el análisis del balance en CO2 incorporado para Cataluña, lo que permitirá evaluar la responsabilidad de la economía catalana respecto a estas emisiones. Para este propósito se construye, para esta determinada desagregación regional, un modelo Multi-Regional Input-Output (MRIO) extendido al medioambiente con sectores verticalmente integrados. La incorporación de la técnica de la integración vertical nos permite un enfoque alternativo para el Balance Neto y un análisis más detallado de los vínculos interregionales entre los diversos sectores productivos, centrado en la responsabilidad última de la demanda final de cada sector en cada región. Hasta el momento, los estudios previos sobre los impactos medioambientales incorporados al comercio español se han centrado principalmente en el ámbito nacional. No obstante, por un lado el comercio interregional con el resto de España en términos monetarios representa cerca de la mitad del comercio exterior catalán. Por otro lado, los distintos metabolismos energéticos de ambas economías tienen como consecuencia una importante diferencia en la intensidad de emisión en la producción de bienes y servicios. Esta situación genera para Cataluña un déficit en el Balance Neto estimado con el resto de España, aún teniendo un importante superávit monetario. De esto se desprende la importancia de integrar el nivel interregional en los estudios de los impactos medioambientales incorporados en el comercio y, en consecuencia, en la planificación y formalización de políticas económicas y ambientales a nivel nacional.

Regional Advisory Committee on Cancer - First Report 1999 (PDF 73 KB)

The Regional Advisory Committee on Cancer Services (RACC) was established in 1997. Its purpose is to advise the Department of Health and Social Services (DHSS) on the implementation of the recommendations contained in the Campbell Report Cancer Services: Investing for the Future and on the development and delivery of cancer services in Northern Ireland. The remit and functions of RACC are set out in Annex 1. The 28 members of RACC come from the Health and Social Services Councils (which represent the interests of the public), primary care, Trusts, Boards and the DHSS. The Chief Medical Officer attends as an observer. The full membership of the committee is listed in Annex 2. 1.3 RACC held its first meeting in June 1997 and has continued to meet twice a year since then. This is its first report. åÊ åÊ

Health Inequalities: NI Health % Social Care Inequalities Monitoring System - Regional 2014

Key Points: Health outcomes are generally worse in the most deprived areas in Northern Ireland when compared both with those witnessed in the region generally and in the least deprived areas. Large differences (health inequality gaps) continue to exist for a number of different health measures. åá Males in the 20% most deprived areas could expect, on average, to live 4.3 fewer years than the NI average and 7.3 fewer years than those in the 20% least deprived areas.åá Female life expectancy in the most deprived areas was 2.6 years less than the regional average and 4.3 years less than that in the least deprived areas.åá The overall death rate for males as measured by the All Age All Cause Mortality (AAACM) rate was a fifth higher in the most deprived areas (1,567 deaths per 100,000 population) than the NI average (1,304 deaths per 100,000 population), and 44% higher than in the least deprived areas (1,090 deaths per 100,000 population).åá The overall death rate for females (AAACM) in the most deprived areas (1,093 deaths per 100,000 population) was 17% higher than regionally (935 deaths per 100,000 population), and a third higher than in the least deprived areas (829 deaths per 100,000 population).åá The suicide rate in the most deprived areas (30.7 deaths per 100,000 population) was three times that in the least deprived areas (10.1 deaths per 100,000 population). All HSCIMS reports are published on the Departmental website at: http://www.dhsspsni.gov.uk/index/statistics/health-inequalities.htm

What about people in European Regional Science?

The 51st ERSA Conference held in Barcelona in 2011 was one of the largest ever. Here, by examining the characteristics of the conference, this paper identifies the main trends in Regional Science at a moment in which the discipline is renewing its efforts to provide responses in a complex, globalised world in which cities and regions are acquiring greater and greater importance. This paper follows in the tradition of a long list of studies that have examined the nature of the field of Regional Science and draws on a broad array of sources of information: the delegates’ demographic details, the conference program itself, a satisfaction survey conducted among delegates, a quality survey addressed to those chairing the sessions and, finally, a bibliometric database including each author signing a paper presented at the conference. With this information we describe the ERSA delegates: their relative youthfulness; the areas in which women are taking on a more important role; the countries and regions of the world that have the most dominant profile in Regional Science today; the thematic areas that are being driven by professionals as opposed to academics; the relevance of regional economic growth and innovation as trending topics in the field; the growing frequency of co-authorship and, consequently, of scientific collaboration; and, finally, and perhaps most importantly, the continuous enhancement of the quality of the work being undertaken in the discipline. Indeed, following on from this description, the results of the regression analysis conducted show that for ERSA delegates what matters most is quality, and this must be the direction that future conferences should move toward. Ultimately, therefore, ERSA conferences are comprehensive, all-embracing occasions, representing an ideal opportunity for regional scientists to present their work to each other and to network.

El nuevo sistema de financiación regional: Adenda

This note contains some addenda to a recent paper (de la Fuente, 2010) that analyzed the new Spanish system of regional financing and estimated its financial results for 2009. The note updates my previous estimates using the information contained in the recently published liquidation of the system for 2009. It also discusses some aspects of the new financing law that have to do with the future evolution of the system and collects some data that may be useful to project its results.

Standardization of Stroke Perfusion CT for Reperfusion Therapy

With the advances in terms of perfusion imaging, the "time is brain" approach used for acute reperfusion therapy in ischemic stroke patients is slowly being replaced by a "penumbra is brain" or "imaging is brain" approach. But the concept of penumbra-guided reperfusion therapy has not been validated. The lack of standardization in penumbral imaging is one of the main contributing factors for this absence of validation. This article reviews the issues underlying the lack of standardization of perfusion-CT for penumbra imaging, and offers avenues to remedy this situation

Perfusion ct based thrombolysis in acute ischaemic stroke

Background Despite use in clinical practice and trials of thrombolysis, a non-contrast CT is not sensitive for identifying penumbral tissue in acute stroke. This study evaluated how it compares with physiological imaging using CT perfusion.Methods 40 imaging datasets with non-contrast CT (NCCT) and perfusion CT (CTP) were retrospectively identified. 2 sets of observers (n¼6) and a neuroradiologist made a blind evaluation of the images. Inter-observer agreement was calculated for identifying ischaemic change on NCCT, and abnormalities on cerebral blood flow, time to peak and cerebral blood volume maps. A prospective cohort of 73 patients with anterior circulation cortical strokes were thrombolysed based on qualitative assessment of penumbral tissue on CTP within 3 h of stroke onset. Functional outcome was assessed at 3 months.Results Inter-rater agreement was moderate (k¼0.54) for early ischaemic change on NCCT. Perfusion maps improved this to substantial for deficit in cerebral blood volume (k¼0.67) and almost perfect for time to peak and cerebral blood flow (both k¼0.87). In the prospective arm, 58.9% of patients with cortical strokes were thrombolysed. There was no significant difference in attainment of complete recovery (p¼0.184) between the thrombolysed and nonthrombolysed group.Conclusions We demonstrate how perfusion CT aids clinical decision- making in acute stroke. Good functional outcomes from thrombolysis can be safely achieved using this physiologically informed approach.

Treatment of symphysitis pubis with one unique iv injection of Ibandronate: report of two cases

Objective: Osteitis pubis is a noninfectious painful inflammatorydisorder of the symphysis pubis. Etiologic factors are numerous, themost common are: osseous extension of adductor, enthesis due tosport overuse, irritation after urological and abdominal procedures,and systemic inflammatory disorders in particularspondylarthropathies. Many cases are idiopathic. The symptomsconsist of regional chronic mechanical and sometime nocturnal pain.Diagnosis is usually confirmed by either bone scintigraphy or by MRI.There are no standard treatments but conservative approachesincluding rest and NSAIDS are generally recommended. In 2001, agood clinical and radiological response of three refractory cases with3 to 6 monthly perfusions of pamidronate was reported [1].Ibandronate is a much more powerful and long-lasting bisphosphonatethan pamidronate, and has not yet been reported in literature to ourknowledge in this indication.Patients and Methods: We present two cases of idiopathic origin:one woman (63 years old) and one man (36 years old).The symptomswere present >3 months in the first patient and one year in the second.The diagnosis was confirmed by MRI which showed bone edemaon both sizes of symphysis and in the second case bony erosionsadjacent to the joint were seen. Both cases failed to respond toconservative measures. Both patients received one single direct ivInjection of 3 mg of Ibandronate.Results: The injections resulted in a rapid (within a few days)resolution of pain that lasted more than 6 months in both patients.No side effects were observed. In the first case, an isotope bone scanperformed 4 months after the injection showed no residual uptake. Thesecond patient had a repeated MRI after 6 months. It demonstrated anattenuation of bone edema compared to the first MRI.Conclusion: IV Ibandronate may constitute a safe and effectivetreatment option for patients with refractory osteitis pubis.References1 Maksymowych WP, Aaron SL, Russell AS. Treatment of refractorysymphysitis pubis with intravenous pamidronate. J Rheumatol.2001;28(12):2754, 2001.

Mechanisms of the pressor response to intravenous thyrotropin-releasing hormone in the rat.

1. The purpose of this study was to examine the contribution of the sympatho-adrenomedullary system to the blood pressure response to an intravenous bolus of thyrotropin-releasing hormone (TRH) in conscious medullectomized and sham-operated rats. 2. The peak pressor effect of 0.5 mg TRH was significantly increased in rats having no adrenal medulla (+24.2 +/- 1.6 mmHg, mean +/- s.e.m., P < 0.01) as compared to sham-operated animals (+12.2 +/- 3.0 mmHg). 3. Blockade of alpha-adrenergic receptors with phentolamine abolished the pressor effect of TRH in control rats (+2.1 +/- 1.9 mmHg) but did not attenuate the blood pressure response of medullectomized rats (+21.5 +/- 4.7 mmHg). In contrast, beta-blockade with propranolol blunted the blood pressure responsiveness of rats subjected to adrenal medullectomy (+12.4 +/- 2.6 mmHg) but did not modify the effect of TRH in sham-operated controls (+10.9 +/- 2.9 mmHg). 4. The direct in vitro effect of TRH on isolated mesenteric rat arteries was also evaluated. TRH did not induce contractions of isolated arteries. 5. These results suggest that in rats with intact adrenals, the pressor effect of intravenous TRH is mediated primarily by a stimulation of alpha-adrenergic receptors. Adrenal medullectomy appears to enhance the blood pressure response to intravenous TRH. Activation of cardiac beta-adrenoceptors seems to contribute to the blood pressure increasing effect of intravenous TRH in medullectomized animals.