Primary medical care in Irish prisons

An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review.   This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available.   There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available.   People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.This resource was contributed by The National Documentation Centre on Drug Use.

Hospital admission rates for alcoholic intoxication after policy changes in the canton of Geneva, Switzerland.

Background: In February, 2005, the canton of Geneva in Switzerland prohibited the off-premise sale of alcoholic beverages between 9pm and 7am, and banned their sale in gas stations and video stores. The aim of this study is to assess the impact of this policy change on hospital admission rates for alcoholic intoxication.Methods: An interrupted time series analysis of this natural experiment was performed with data on hospitalisations for acute alcoholic intoxication during the 2002-2007 period. The canton of Geneva was treated as the experimental group, while all other Swiss cantons were used as the control group.Results: In the experimental site, the policy change was found to have a significant effect on admission rates among adolescents and young adults. Depending on the age group, hospitalisation rates for alcoholic intoxication fell by an estimated 25-40% as the result of restricted alcohol availability.Conclusions: Modest restrictions on opening hours and the density of off-premise outlets were found to be of relevance for public health in the canton of Geneva. In light of this finding, policy makers should consider such action as a promising approach to alcohol prevention. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Prevalence of injuries among three-year-old children in the Republic of Ireland in 2011

The Institute of Public health in Ireland (IPH) produces population prevalence estimates and forecasts for a number of chronic conditions among adults. IPH has now applied the methodology to examine health conditions and injuries among young children across the island of Ireland.This short report is a supplement to a previous IPH report that examines health conditions among three-year-olds in the Republic of Ireland. It provides estimates of the prevalence of injuries that required hospital admission or treatment among three-year-olds in the Republic of Ireland in 2011. The analysis identifies risk factors associated with child injuries and provides estimates of the prevalence of these conditions for each of the 34 administrative cities and counties.

Health Trends within the East Midlands - 2008 Update

This is an analysis of health trends and inequalities in the East Midlands covering the period 1995 - 2006. Focusing on high-level health indicators, the report gives an overview of health in the East Midlands and evaluates regional trends in relation to national PSA targets. For the first time the report includes obesity prevalence data (adults and children) highlighting the growing importance of obesity within public health. The report also covers: - Life expectancy at birth - Mortality rate from circulatory disease in people aged under 75 - Mortality rate from cancer in people aged under 75 - Mortality rate from accidents in people of all ages - Suicide rate in people of all ages - Teenage pregnancy rate - Prevalence of cigarette smoking in people aged 16 and over (male/female)

Health Trends within the East Midlands - 2009 Update

This is an analysis of health trends and inequalities in the East Midlands covering the period 1995 - 2007. Focusing on high-level health indicators, the report gives an overview of health in the East Midlands and evaluates regional trends.

Delivering Choosing Health: Making healthier choices easier

This delivery plan outlines the key steps that will be taken over the next three years to deliver the Governnment White Paper Choosing Health: making healthier choices easier. This delivery plan highlights how the DH and the NHS, within the framework of government policies, will help more people make more healthy choices and reduce health inequalities. It outlines clearly the priorities for delivery at national, regional and local levels and what will be done by whom and when. It brings into one place all of the actions on the White Paper commitments, alongside related Public Service Agreements and local targets to improve health. It lists 45 'big wins' - key interventions which the evidence and expert advice suggest will make the greatest impact on health in the shortest period of time It explains how new policies and programmes will be developed and implemented. It describes how Government will drive forward delivery through Government targets to improve health new partnerships

East in Focus: Infants

An overview of infant health in the East of England. Includes: infant mortality - distribution by deprivation, geographical variation, inequality in social class; breastfeeding; perinatal mortality - effects of education ; causes of death in infancy; vital statistics - births and deaths in infancy.

Improving Health and Reducing Inequalities: A Practical Guide to Health Impact Assessment

(WHIASU) A basic guide to conducting a HIA. 1. Health impact assessment is a tool that can help organisations to assess the possible consequences of their decisions on people۪s health and well-being, thereby helping to develop more integrated policies and programmes. 2. This document has been developed as a practical guide to health impact assessment. It is designed to meet the needs of a variety of organisations by explaining the concept, the process and its flexibility, and by providing templates that can be adjusted to suit. 3. The Welsh Assembly Government is committed to developing the use of health impact assessment in Wales as a part of its strategy to improve health and wellbeing and to reduce health inequalities. This practical guide has been prepared by the Welsh Health Impact Assessment Support Unit, which was established by the Welsh Assembly Government to encourage and support organisations and groups in Wales to use the approach. 4. The development and use of health impact assessment will contribute to the ongoing development and implementation of local health, social care and wellbeing strategies, which is a joint statutory responsibility for Local Health Boards and local authorities. It can also contribute to Community Strategies which, given their overarching nature and breadth and depth, can address social, economic and environmental determinants of health, and to the implementation of Communities First, the Welsh Assembly Government۪s crosscutting regeneration programme. 5. The development of Health Challenge Wales as the national focus for improving health in Wales reinforces efforts to prevent ill health. Tools such as health impact assessment can help organisations and groups in all sectors to identify ways in which they can help people to improve their health.

Quality Standards for the Delivery of Specialist Stop Smoking Services in Northern Ireland September 2011

Cigarette smoking is the major cause of preventable ill health in Northern Ireland. It accounts for 2400 premature deaths every year. Fifty percent or one in every two smokers will die prematurely due to their addiction; many will suffer chronic ill health and poor quality of life before their death (DHSSPS, 2007; ASH, 2008). Approximately 340,000 people smoke in Northern Ireland or 24% of the population over 16yrs. The Public Health Agency (PHA) commissions specialist stop smoking services across Northern Ireland. It has enabled the establishment of specialist stop smoking services in a range of settings including GP practices, pharmacies, hospitals and community settings. Tobacco control activities are overseen locally by the PHA's Tobacco Control Groups. The multi-agency groups oversee and advise on tobacco control initiatives.All stop smoking services are required to comply with the requirements of 18 standards. This report highlights the standards.

Promoting positive mental health at work: a guide for employers

This booklet is one in a series aimed at promoting health in the workplace. It outlines to employers the importance of employees' mental health, good practice to support positive mental health at work, the legal requirements with regard to working environments and mental health, and key steps for action.�

Four decades of public health

Four decades of public health is a comprehensive history of public health in Northern Ireland�from 1973-2009. The project collected an oral history from public health professionals.

Phase 1 Delivering care "A framework for nursing and Midwifery Workforce planning to support person centred care in Northern Ireland"

Delivering Care - Nurse staffing in Northern Ireland is the outcome of a commission undertaken by the PHA Director of Nursing from the DHSSPS Chief Nursing Officer and approved by the Minister of Health in 2014.� The aim of the Delivering Care project is to support the provision of quality care which is safe and effective in hospital and community settings.

Smoke Free Spaces: Progress in reducing exposure to second-hand smoke in Northern Ireland incorporating the five year review of smoke-free legislation

This report provides an overview of progress in reducing Second Hand Smoke (SHS) exposure in Northern Ireland that incorporates the five year review of smoke-free legislation, but also extends to a consideration of SHS exposure in non-work environments.  The report considers aspects of inequalities in SHS exposure in particular according to social disadvantage and with a focus on vulnerable subgroups of the population.

Health Protection Inequalities on the island of Ireland: An introductory paper

Public health services in Ireland, North and South, are committed to addressing inequalities in health on the island of Ireland. This report, prepared by Dr Lorraine Doherty, Assistant Director of Public Health (Health Protection), Public Health Agency NI for the Institute of Public Health in Ireland (IPH), specifically highlights health inequalities in relation to infectious diseases and other areas of health protection such as chemical hazards and environmental disruption. Infectious diseases disproportionately affect the most vulnerable in society. These vulnerable groups bear the highest burden of disease in relation to infectious diseases. The report also highlights the impact of climate change on health protection and the impacts for water, food and vector borne diseases. The aim of this report is to enable a programme of work to begin to document health protection inequalities and develop action plans for addressing them on an all island basis.

The effect of a smoking ban introduction to environmental tobacco smoke exposure in Swiss hospitality workers : Abstracts of the 23rd Annual Conference of the International Society of Environmental Epidemiology (ISEE), September 13-16, 2011, Barcelona, Spain

Background and Aims: To protect the population from environmental tobacco smoke (ETS) Switzerland introduced a nationwide rather heterogeneous smoking ban in May 2010. The exposure situation of non-smoking hospitality workers before and after implementation of the new law is being assessed in a prospective cohort study. Methods: Exposure to ETS was measured using a novel method developed by the Institute for Work and Health in Lausanne. It is a passive sampler called MoNIC (Monitor of NICotine). The nicotine of the ETS is fixed onto a filter and transformed into salt of not volatile nicotine. Subsequently the number of passively smoked cigarettes is calculated. Badges were placed at the workplace as well as distributed to the participants for personal measuring. Additionally a salivary sample was taken to determine nicotine concentration. Results: At baseline Spearman's correlation between workplace and personal badge was 0.47. The average cigarette equivalents per day at the workplace obtained by badge significantly dropped from 5.1 (95%- CI: 2.4 to 7.9) at baseline to 0.3 (0.2 to 0.4) at first follow-up (n=29) three months later (p<0.001). For personal badges the number of passively smoked cigarettes declined from 1.5 (2.7 to 0.4) per day to 0.5 (0.3 to 0.8) (n=16).Salivary nicotine concentration in a subset of 13 participants who had worked on the day prior to the examination was 2.63 ng/ml before and 1.53 ng/ml after the ban (p=0.04). Spearman's correlation of salivary nicotine was 0.56 with workplace badge and 0.79 with personal badge concentrations. Conclusions: Workplace measurements clearly reflect the smoking regulation in a venue. The MoNIC badge proves to be a sensitive measuring device to determine personal ETS exposure and it is a demonstrative measure for communication with lay audiences and study participants as the number of passively smoked cigarettes is an easily conceivable result.