Framework Agreement between the Minister for Health and the Irish Medical Organisation in respect of a process for engagement concerning the GMS/GP Contract

Minister of State with responsibility for Primary Care, Alex White TD, today (4 June 2014) concluded a series of meetings with the Irish Medical Organisation (IMO) with the signing of the Framework Agreement between the Minister of Health, the HSE and the Irish Medical Organisation (IMO) setting out a process for engagement concerning the GMS/GP contract and other publicly funded contracts involving General Practitioners (GPs). Download document here

Department of Health and Children Consolidated Salary Scales - Clause 2.31 of the Haddington Road Agreement

CONSOLIDATED SALARY SCALES IN ACCORDANCE WITH CLAUSE 2.31 OF THE HADDINGTON ROAD AGREEMENT These scales must be read in conjunction with Department of Health Circular 3/2014 With reference to Clause 2.31 of the Haddington Road Agreement (HRA) which addresses the remuneration of new entrant grades who entered the Public Service on or after 1 January 2011 and were subject to Department of Health Circular 2/2011 dated 24 March 2011.   New entrants to health sector recruitment grades, who were subject to the 2011 reduced pay rates will be assimilated to the revised/merged incremental payscale as and from 1 November 2013. Download the document here

The Irish Study of Sexual Health and Relationships

This study was commissioned by the Department of Health and Children and the Crisis Pregnancy Agency (CPA) in response to a recommendation of the National AIDS Strategy Committee. The findings of this report will be considered by various organisations and will inform the future development and strategic direction of the Crisis Pregnancy Agency’s work in reducing the number of crisis pregnancies. Read the report (PDF, 2.2mb) View the summary report (PDF, 859KB) View the survey questionnaire (PDF, 235kb)

Report to the Minister for Health and Children on Risk Equalisation in the Irish Private Health Insurance Market

Provision for risk equalisation was first made in the Health Insurance Act, 1994, section 12 of which empowered the Minister to prescribe a scheme for risk equalisation. A Risk Equalsiation Scheme was introduced in 2003. In December 2005, the Minister decided, on the Authorityâ?Ts recommendation, which referred to risks now materialising, to commence risk equalisation payments under the Scheme as from 1 January 2006, but in the event the relevant legislation was overturned by the Courts in 2008. Download document here

Health and wellbeing project

This project will promote and introduce a healthier lifestyle for people over 50 through healthy eating, exercise and self-help in the Atticall and surrounding area. The project will focus on local produce and give participants an opportunity to cook and taste samples of their own 'healthy food'. The Pharmacist will attend these sessions to give diet realted talks and anwer any queries people may have.

Managing health and increasing well-being

The Building the Community-Pharmacy Partnership has worked to improve local health outcomes by encouraging members of the community to develop skills relating to managing their own health, and providing accessible information on the availability of services of which they can avail of. The aim is to facilitate local people to gain knowledge on various health issues through books, videos, leaflets and enable the most vulnerable and in need to access additional support through the pharmacy to complementary therapy. Outcome: A room in the pharmacy has been renovated and offers access to other support services. Funding has allowed the pharmacist to equip the room with videos, leaflets, books etc. There has been an increase in partnership working between the community group, pharmacist and more contact has been made with primary care. Further funding has allowed for the development of a subsidised support referral service for counselling and complementary therapies. As well as this, the pharmacist has worked with local groups to provide information sessions on lifestyle and on health issues identified by the local groups

Strategy for personal and public involvement in Health and Social Care research

This report outlines the strategic need for, and benefits of, personal and public involvement to all levels of Health and Social Care Research and Development Division activity.

The report of the Outbreak Control Team of the investigation of an outbreak of listeriosis in the Belfast Health and Social Care Trust during May to November 2008

This is the report of the interagency Outbreak Control Team (OCT) of an investigation of an outbreak of listeriosis which occurred during May to November 2008 in the Belfast Health and Social Care Trust. The report describes the chronology of the outbreak and the outcome of epidemiological, environmental health and microbiological investigations. The report concludes with recommendations for public health, Trusts, the Department of Health and Social Services and Public Safety, the Food Standards Agency, and those responsible for hospital food procurement.

Joint Commissioning Plan of the Health and Social Care Board and the Public Health Agency: 2010-2011

Legislation enacted on 1 April 2009 created a new Commissioning system with the establishment of a region-wide Health and Social Care Board, including 5 Local Commissioning Groups (LCGs), and a Public Health Agency. In line with Departmental direction and guidance the objectives of the new commissioning arrangements were to: - Approach the future delivery of Health and Social Care from a region-wide perspective focused on outcomes. - Ensure local sensitivity through the creation of five Local Commissioning Groups reflective of their areas. - Give appropriate weight to the public health agenda to ensure that commissioning reflects the drive to reduce health inequalities in our society and works in partnership with others to improve health and wellbeing. In this regard the legislation signalled a new way forward which would first be expressed in a Commissioning Plan for 2010/11 and beyond. This plan outlines how the Health and Social Care Board and the Public Health Agency are approaching that task. It is our aim that this plan is straightforward and written in a manner which will encourage public engagement and understanding. We wish to show clearly how the commissioning task is to be approached and to signal the decisions necessary to ensure the maintenance of a health and social care system in Northern Ireland which responds to the population it serves.

Second cranio-facial malignancies in hereditary retinoblastoma survivors previously treated with radiation therapy: clinic and radiologic characteristics and survival outcomes.

INTRODUCTION: Hereditary retinoblastoma survivors have an increased risk for cranio-facial second primary tumours (SPT), especially after treatment with external beam radiotherapy (EBRT). This multicentre study evaluates the clinical and imaging characteristics and outcomes of cranio-facial SPTs in irradiated retinoblastoma survivors. PATIENTS AND METHODS: Clinical and radiological data of 42 hereditary retinoblastoma patients with 44 second and third malignancies were reviewed. Radiological data included anatomic location and computed tomography (CT) and magnetic resonance (MR) characteristics. Cox regression and likelihood ratio chi-square test were used to evaluate differences in patients' survival rates. RESULTS: Cranio-facial SPTs were diagnosed at a median age of 13 years. Histological types included osteosarcomas (43%), rhabdomyosarcomas (20%) (57% embryonal, 43% alveolar) and a variety of other types of SPT (37%). Predilection sites were: temporal fossa (39%), ethmoid sinus (23%), orbit (18%), maxillary sinus (16%) and intracranial dura mater (4%). Most of the osteosarcomas (78%) and rhabdomyosarcomas (80%) occurred in patients treated with EBRT in the first year-of-life. Treatment of SPTs with a microscopically complete surgical resection led to a significantly better 5-year overall survival (OS) (P=0.017) and event-free survival (EFS) (P=0.012) compared to patients treated without surgery or incomplete resection (OS: 83% versus 52%; EFS: 80% versus 47%). CONCLUSIONS: Osteosarcomas and rhabdomyosarcomas are the most common cranio-facial SPTs in irradiated hereditary retinoblastoma survivors, which develop in specific locations and occur predominantly in patients irradiated in their first year-of-life. Microscopically complete surgical resection of SPTs is a major prognostic factor, suggesting the potential benefit of early detection by imaging.

Discovery of amino acid variants in the human glucose-dependent insulinotropic polypeptide (GIP) receptor: the impact on the pancreatic beta cell responses and functional expression studies in Chinese hamster fibroblast cells.

The two incretins, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), are insulinotropic factors released from the small intestine to the blood stream in response to oral glucose ingestion. The insulinotropic effect of GLP-1 is maintained in patients with Type II (non-insulin-dependent) diabetes mellitus, whereas, for unknown reasons, the effect of GIP is diminished or lacking. We defined the exon-intron boundaries of the human GIP receptor, made a mutational analysis of the gene and identified two amino acid substitutions, A207 V and E354Q. In an association study of 227 Caucasian Type II diabetic patients and 224 matched glucose tolerant control subjects, the allelic frequency of the A207 V polymorphism was 1.1% in Type II diabetic patients and 0.7% in control subjects (p = 0.48), whereas the allelic frequency of the codon 354 polymorphism was 24.9% in Type II diabetic patients versus 23.2% in control subjects. Interestingly, the glucose tolerant subjects (6% of the population) who were homozygous for the codon 354 variant had on average a 14% decrease in fasting serum C-peptide concentration (p = 0.01) and an 11% decrease in the same variable 30 min after an oral glucose load (p = 0.03) compared with subjects with the wild-type receptor. Investigation of the function of the two GIP receptor variants in Chinese hamster fibroblasts showed, however, that the GIP-induced cAMP formation and the binding of GIP to cells expressing the variant receptors were not different from the findings in cells expressing the wildtype GIP receptor. In conclusion, amino acid variants in the GIP receptor are not associated with random Type II diabetes in patients of Danish Caucasian origin or with altered GIP binding and GIP-induced cAMP production when stably transfected in Chinese hamster fibroblasts. The finding of an association between homozygosity for the codon 354 variant and reduced fasting and post oral glucose tolerance test (OGTT) serum C-peptide concentrations, however, calls for further investigations and could suggest that GIP even in the fasting state regulates the beta-cell secretory response.

Barriers to health - Migrant health and wellbeing in Belfast

Over the last decade Belfast has experienced significant political, economic and social change. As a consequence, the population of greater Belfast has increased substantially over the past decade. This has been as a result of both natural change and net migration gain. This report covers the following issues legislation on immigration, work, health & social services and social security entitlements; health issues; migrant health priorities identified at the Stakeholder Workshop held in April 2010.

Traveller Focus Week - improving health and wellbeing

Members of the Traveller community and their support organisations joined the Public Health Agency and the Health and Social Care Board at an event in Dungannon to mark Traveller Focus Week (5 - 11 December) by sharing the progress made, and celebrating good practice in meeting the health and wellbeing needs of Travellers.These needs were identified in the 'All Ireland Traveller Health Study' by University College Dublin in June 2010. It estimated that there are 3,905 Travellers living in 1,562 families in Northern Ireland, and the stark findings include that when compared with the life expectancy of the general population, male Travellers lose 15 years of life and females lose 11 years.The report made a number of recommendations, including:prioritising mother and children's health; enhanced preventative work for respiratory and cardiovascular disease, as well as better risk detection and management of the disease; development of primary care interventions which involve Travellers engaging with other Travellers in health improvement;engagement of men and young men in improving health and wellbeing and access to healthcare.Speaking at the event, Mary Black, Assistant Director of Public Health (Health and Social Wellbeing Improvement) PHA, said: "The Public Health Agency works in partnership to promote health and wellbeing and reduce health inequalities."This event with the Travellers Health and Wellbeing Forum was an important opportunity to look at progress against agreed priorities and share good practice across Northen Ireland and the successful work of the Forum. One such example is the recruitment of Travellers into employment as health workers developed by the Belfast Health and Social Care Trust and part-funded by the PHA. Other areas are also considering work placements and all of this developing practice will help inform future partnerships with employers and help break down the real prejudice that can be experienced by Travellers."We also heard about the progress Travellers have made in their own right, and their views about how the Travelling community is fully engaged and participates in the future development of the Forum and programmes that aim to improve health and wellbeing and contribute to a more equal society."Mark Donahue, Equality Officer, An Munia Tober (a Traveller support organisation), added "The event was a great success in terms of highlighting the main health issues for Travellers, which came out of the All Ireland Traveller Health Study. I was heartened to see a great turn out by the Traveller community from all over Northern Ireland and also by the interest and commitment of so many public agencies and other organisations to work together to improve Traveller health."The event, at 'Breakthru' in Dungannon, also brought together representatives from the five health and social care trusts, Cooperation and Working Together (CAWT), Housing and key voluntary sector organisations, all involved in delivering the recommendations from the 'All Ireland Traveller Health Study'.

Not in Education, Employment, or Training status among young Swiss men. Longitudinal associations with mental health and substance use.

PURPOSE: Not in Education, Employment, or Training (NEET) youth are youth disengaged from major social institutions and constitute a worrying concern. However, little is known about this subgroup of vulnerable youth. This study aimed to examine if NEET youth differ from other contemporaries in terms of personality, mental health, and substance use and to provide longitudinal examination of NEET status, testing its stability and prospective pathways with mental health and substance use. METHODS: As part of the Cohort Study on Substance Use Risk Factors, 4,758 young Swiss men in their early 20s answered questions concerning their current professional and educational status, personality, substance use, and symptomatology related to mental health. Descriptive statistics, generalized linear models for cross-sectional comparisons, and cross-lagged panel models for longitudinal associations were computed. RESULTS: NEET youth were 6.1% at baseline and 7.4% at follow-up with 1.4% being NEET at both time points. Comparisons between NEET and non-NEET youth showed significant differences in substance use and depressive symptoms only. Longitudinal associations showed that previous mental health, cannabis use, and daily smoking increased the likelihood of being NEET. Reverse causal paths were nonsignificant. CONCLUSIONS: NEET status seemed to be unlikely and transient among young Swiss men, associated with differences in mental health and substance use but not in personality. Causal paths presented NEET status as a consequence of mental health and substance use rather than a cause. Additionally, this study confirmed that cannabis use and daily smoking are public health problems. Prevention programs need to focus on these vulnerable youth to avoid them being disengaged.

Cardiovascular health and wellbeing profile for Northern Ireland

The PHA, supported by the Institute of Public Health in Ireland (IPH) and other agencies and individuals, has completed a health impact assessment (HIA) on the Cardiovascular Service Framework (CVSFW) for Northern Ireland.The CVSFW is the first in a series of service frameworks developed in Northern Ireland to guide HSC provision from prevention and health improvement over early intervention in communities and general practice into hospital and other institutional settings towards rehabilitation, palliative care and end of life.The CVSFW is relevant to everyone who has a part in HSC services for health improvement, hypertension, hyperlipidaemia, diabetes, heart disease, cerebrovascular disease (stroke), peripheral vascular disease and renal disease. This includes patients, carers, families, communities, voluntary and statutory service providers, policy makers and researchers.