Healthy child, healthy future - Speech and language therapy: Factsheet for parents 6. Tips for talking: children aged 4 to 5 years

This factsheet highlights simple ideas to encourage speech in children around 4 to 5 years old.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 3. Talk to your child in your own language

This factsheet encourages non-English speaking parents to talk to their children in their own language.

Healthy child, healthy future - Speech and language therapy aide memoire for health visitors

This card outlines the key skills, causes for concern and management options for children aged 24 months and 30 months.

Healthy child, healthy future - Information on the child health programme (0-4 years)

This booklet provides parents with information on the first four years of the child health programme for all families in Northern Ireland.

ASIST suicide prevention training - all-island evaluation report

The findings of a Public Health Agency evaluation report on a suicide prevention training programme were today presented at the North South Ministerial Council Health Sector meeting.ASIST, The Applied Suicide Intervention Skills Training programme, has to date been delivered to more than 20,000 people in the Republic of Ireland and more than 11,000 people in Northern Ireland. This two day course, delivered by a wide range of organisations including those from the voluntary/community sector, for professionals and the public helps individuals provide emergency help to people at risk of suicidal behaviour. It also develops a cooperative network among participants, since often many people have to work together to prevent suicide.Talking about the findings of this work, Dr Eddie Rooney, Chief Executive, PHA, said: "Both the PHA and the National Office for Suicide Prevention (NOSP), based in the Republic of Ireland, are concerned for any loss of life through suicide and we send our condolences to all families who have been bereaved. We know ASIST training brings a positive element to suicide prevention. Those who have been trained said that the two biggest advantages are that they know when, how and have the confidence to help people who are under pressure and that it helps to build positive links between community and voluntary organisations and the health service. I am pleased that this has been borne out in the evaluation and we hope ASIST will continue to be of enormous benefit and will contribute to a reduction in suicidal behaviour and the tragedy that this brings to our community".This evaluation found that within organisations where staff had participated in ASIST training, there were improvements in service development; staff attitudes, confidence and skills in relation to suicide and suicide intervention and in policies and procedures. At a community level, ASIST was found to have contributed to a sense of empowerment through an increased confidence in being able to deal with suicide and suicidal behaviour.The report also shows that the ASIST model offers a common language, helping communication between the community or voluntary organisations and those from a health background. In fact this training helped to cancel out any differences between those with mental health qualifications and those without, in terms of knowledge, skills, attitude and willingness to intervene. The study also confirmed that ASIST training was most relevant to those who were likely to be in contact with a person 'at risk'.In welcoming the publication of the report Geoff Day, Director of the NOSP, said: "This report is an independent evaluation of the ASIST programme, it has allowed us to demonstrate the effectiveness of the programme in increasing community participants confidence and ability to respond to individuals in suicidal crisis.He added: "The fact the evaluation was completed on an all-island basis allows the NOSP and the PHA to avoid duplication of resources, improve coordination of suicide prevention training programmes across both jurisdictions and allows us to learn from different approaches used in suicide prevention across the island of Ireland."He reiterated the Health Service Executive commitment to the continued implementation of quality assured training programmes as part of Reach out: the National Strategy for Action on Suicide Prevention.ASIST training is being rolled out in Northern Ireland as part of the implementation of the 'Protect Life' suicide prevention strategy, which was published by the Department of Health, Social Services and Public Safety in 2006.A copy of the evaluation report can be found below and in the publications section of this website, by clicking here

Consultation launched on Community Development Strategy - your views matter

Issued jointly by the Health and Social Care Board and Public Health AgencyThe Health and Social Care Board and the Public Health Agency have today launched, for public consultation, a new Community Development Strategy.The consultation period will run for 12 weeks from Friday 10 June until Friday 2 September 2011.The Board and Agency want to see strong, resilient communities where everyone has good health and wellbeing, places where people look out for each other and have community pride in where they live.Residents from deprived areas in Northern Ireland experience;lower life expectancy;higher rates of emergency admission to hospital;higher rates of lung cancer;higher rates of suicide; andhigher rates of smoking and alcohol related deaths.The kinds of health and social care issues which can be improved by community development approaches include depression; isolation; falls amongst elderly people; child protection; teenage pregnancy; childhood asthma; postnatal depression; drug and alcohol abuse; and ultimately also long term conditions such as obesity, diabetes and cancer.The Board and Agency seek a number of benefits from implementing this strategy such as; a reduction in health and wellbeing inequalities, which also means addressing the social factors that affect health; strengthening partnership working with service users, the community and voluntary sectors and other organisations; strengthening families and communities; supporting volunteering and making best use of our resources.John Compton, Chief Executive of the Health and Social Care Board said: "Community development is an important way to improving health and wellbeing - driving a message that 'prevention is better than cure' between different groups and communities, and helping to ensure the most effective use of the health and social care budget."Now more than ever we need to work in partnership with families and communities to achieve better health and wellbeing for those living in Northern Ireland.No one organisation can meet this challenge on its own and strong partnerships are needed. "Chief Executive of the Public Health Agency, Eddie Rooney added: "Every health and social care organisation should incorporate a community development approach into their programmes, and this strategy assists them to do so."The Board and Agency have jointly held pre-consultation workshops over the past few months across Northern Ireland on their Community Development Strategy and have engaged widely with the community and voluntary sectors. We are now keen to receive feedback from individuals, families and the wider community as your views are very important to us - they will help shape the future of community development across the province," he said.The draft Community Development Strategy, as well as information on how you can respond, can be found in the attachments below.

Quality Standards for Services Promoting Mental and Emotional Wellbeing and Suicide Prevention

These standards will apply to all organisations providing mental & emotional wellbeing and suicide prevention services which are funded by the PHA.

Loss to follow-up of HIV-infected women after delivery : The Swiss HIV Cohort Study and the Swiss Mother and Child HIV Cohort Study

INTRODUCTION: HIV-infected pregnant women are very likely to engage in HIV medical care to prevent transmission of HIV to their newborn. After delivery, however, childcare and competing commitments might lead to disengagement from HIV care. The aim of this study was to quantify loss to follow-up (LTFU) from HIV care after delivery and to identify risk factors for LTFU. METHODS: We used data on 719 pregnancies within the Swiss HIV Cohort Study from 1996 to 2012 and with information on follow-up visits available. Two LTFU events were defined: no clinical visit for >180 days and no visit for >360 days in the year after delivery. Logistic regression analysis was used to identify risk factors for a LTFU event after delivery. RESULTS: Median maternal age at delivery was 32 years (IQR 28-36), 357 (49%) women were black, 280 (39%) white, 56 (8%) Asian and 4% other ethnicities. One hundred and seven (15%) women reported any history of IDU. The majority (524, 73%) of women received their HIV diagnosis before pregnancy, most of those (413, 79%) had lived with diagnosed HIV longer than three years and two-thirds (342, 65%) were already on antiretroviral therapy (ART) at time of conception. Of the 181 women diagnosed during pregnancy by a screening test, 80 (44%) were diagnosed in the first trimester, 67 (37%) in the second and 34 (19%) in the third trimester. Of 357 (69%) women who had been seen in HIV medical care during three months before conception, 93% achieved an undetectable HIV viral load (VL) at delivery. Of 62 (12%) women with the last medical visit more than six months before conception, only 72% achieved an undetectable VL (p=0.001). Overall, 247 (34%) women were LTFU over 180 days in the year after delivery and 86 (12%) women were LTFU over 360 days with 43 (50%) of those women returning. Being LTFU for 180 days was significantly associated with history of intravenous drug use (aOR 1.73, 95% CI 1.09-2.77, p=0.021) and not achieving an undetectable VL at delivery (aOR 1.79, 95% CI 1.03-3.11, p=0.040) after adjusting for maternal age, ethnicity, time of HIV diagnosis and being on ART at conception. CONCLUSIONS: Women with a history of IDU and women with a detectable VL at delivery were more likely to be LTFU after delivery. This is of concern regarding their own health, as well as risk for sexual partners and subsequent pregnancies. Further strategies should be developed to enhance retention in medical care beyond pregnancy.

Your Child's Weight

As a parent, you can teach your children habits and skills to last them a lifetime. This booklet is full of practical advice for parents on how to make small changes to your children’s diet and physical activity habits. Small changes which could make a difference to their future health.

The cognitive errors and coping patterns of child molesters as assessed by external observers: a pilot study

Cognitive errors (CE) and coping strategies (CS) are the focus of most cognitive-behavioral treatments for incarcerated child molesters. Several studies have reported differences in CEs and CSs between child molesters and controls. However, the vast majority of these studies assessed cognitive errors and coping using questionnaires, which are known to present a number of important limitations. This pilot study aimed to compare the CEs and CSs of N = 17 incarcerated child abusers and N = 12 controls using observer-rated methods, namely the Cognitive Error Rating Scale (CERS; Drapeau et al., 2005) and the Coping Action Pattern Rating Scale (CAPRS; Perry, Drapeau, & Dunkley, 2005). Results showed that child molesters presented more cognitive errors, in particular positive selective abstraction, and lower coping functioning, such as escape strategies. Treatment and research implications, including the use of observer-rated methods, are discussed.

REACH - Rethinking Eating and Activity for Children's Health

The aims of the REACH programme were to: - Provide a quality whole-family healthy lifestyle programme that is accessible and equitable to support children aged 4-7 and 8-11years who are above the healthy weight range in maintaining or achieving a healthy weight; - Target areas of poor health and high prevalence of childhood obesity; Contribute towards the prevention and reduction of obesity prevalence in South Gloucestershire; - Be a resource for other health professionals and services in South Gloucestershire. As this was a pilot of a child weight management programme being developed from scratch the objectives of REACH were to: Provide a high quality service which meets the needs of the local health community; - Improve childrens diet and nutritional intake and promote a healthy weight; Encourage exercise and physical activity participation; - Develop a range of skills with participants in order to increase their confidence and self esteem; - Be participant centred but also use a whole family approach to deliver healthy lifestyle messages; - Develop appropriate referral protocols, resources and course plans; - Advertise and promote the programme locally liaising with communications and the Public Health Team in NHS South Gloucestershire, GPs and staff working in the community such as School Health Nurses (SHNs); - Successfully recruit families on to the programme; Enable eligible new participants referred to the service to take part; - Encourage participants to complete the programme; - Deliver a service that helps to address health inequalities; - Monitor participants weight and lifestyle changes as part of a follow up programme; - Provide continuous professional development of service staff; - Ensure individuals and families are signposted and supported to access other services such as after school clubs, local sports clubs and leisure centres; - Provide equitable access to the service and ensure equitable outcomes are achieved by the service; Ensure continuous quality improvement;

Dose reduction of epoetin-alpha in the prevention of chemotherapy-induced anaemia.

INTRODUCTION: Anaemia during chemotherapy is often left untreated. Erythropoiesis-stimulating agents are frequently used to treat overt anaemia. Their prophylactic use, however, remains controversial and raises concerns about cost-effectiveness. Therefore, we assessed the efficacy of a dose-reduction schedule in anaemia prophylaxis. MATERIALS AND METHODS: The study included patients with untreated solid tumours about to receive platinum-based chemotherapy and had haemoglobin (Hb) levels ≥11 g/dL. Epoetin-α was administered at a dose level of 3 × 10,000 U weekly as soon as Hb descended to < 13 g/dL. Dose reductions to 3 × 4,000 U and 3 × 2,000 U weekly were planned in 4-week intervals if Hb stabilised in the range of 11-13 g/dL. Upon ascending to ≥13 g/dL, epoetin was discontinued. Iron supplements of 100 mg intravenous doses were given weekly. Of 37 patients who enrolled, 33 could be evaluated. RESULTS AND DISCUSSION: Their median Hb level was 13.7 (10.9-16.2) g/dL at baseline and descended to 11.0 (7.4-13.8) g/dL by the end of chemotherapy. Anaemia (Hb < 10 g/dL) was prevented in 24 patients (73%). The mean dose requirement for epoetin-α was 3 × 5,866 U per week per patient, representing a dose reduction of 41%. Treatment failed in nine patients (27%), in part due to epoetin-α resistance in four (12%) and blood transfusion in three (9%) patients. CONCLUSION: Dose reduction was as effective as fixed doses in anaemia prophylaxis but reduced the amount of prescribed epoetin substantially.

A Brief Cognitive Behavioural Therapy Alcohol Intervention Programme is an Effective Secondary Prevention Approach for New Employees entering an Irish Workforce: A Pilot

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.

A Study of Drug Prevention Services for Young People

To investigate the range and utilisation of community based drug prevention services using the Belfast Youth Development Study data, along with in depth interviews and documentary analysis. It is hoped the research will inform local policy.This resource was contributed by The National Documentation Centre on Drug Use.