PHA urges parents to get 'at risk' children vaccinated against seasonal flu

The Public Health Agency is urging Northern Ireland parents to make sure children in 'at risk' groups get their flu vaccine early.The message has been issued to parents and carers of children as the PHA's seasonal flu vaccination programme gets underway for 2011/12.It is very important that children with any condition that puts them more at risk of the complications of flu get the vaccine.These 'at risk' conditions include:chronic lung conditions such as asthma;chest infections that have required hospital admission;chronic heart conditions;chronic liver disease;chronic kidney disease;diabetes;lowered immunity due to disease or treatment such as steroids or cancer therapy;chronic neurological conditions such as stroke, multiple sclerosis or a condition that affects the nervous system, such as cerebral palsy;hereditary and degenerative diseases of the central nervous system or muscles.Children who attend special schools for severe learning or physical disabilities are considered to be particularly at risk, as well as those with other complex health needs.The PHA has written to principals of local special schools, as well as parents of children at these schools, to raise awareness of the importance of getting vaccinated early.Dr Richard Smithson, PHA Flu Vaccination Lead, said: "For many people, flu is a short, unpleasant illness, but it does not usually cause any serious problems. However, for others, it can have very serious complications including, in rare cases, being fatal."We have been particularly reminded over the last two winters that children with chronic neurological problems and other complex health needs are very vulnerable to these complications. We have seen children become very seriously ill and, tragically, there have even been a few deaths in children who attend special schools."For this reason, we recommend that all children who attend special schools for severe learning disability, and special schools for physical disability, are offered the flu vaccine early in the autumn, before the flu viruses start circulating."The vaccine is now available from GP surgeries and the PHA recommends that parents check arrangements with their own GP's surgery so that their child can get the jab.The earlier you get vaccinated the better, as it takes the body about 10-14 days after the jab to develop antibodies. These will then protect you against the same or similar viruses if the body is exposed to them. The vaccine contains three strains of the flu virus, which are considered the most likely to be circulating this winter, including the H1N1 (swine flu) virus."Your child needs to get the flu jab every year - the protection it gives only lasts for one winter, so even if they got it last year, they still need to get it this year," added Dr Smithson."Also, if your child has been diagnosed with flu or swine flu in the past couple of years, they will still need the jab this year as there are different types of flu that the jab will protect against. Getting the flu jab is the best way to protect your child against flu and we would strongly recommend that you arrange for them to have it."Although the vaccine gives good protection, no vaccine gives total protection, so if your child develops flu-like symptoms (such as fever, cough, aches and pains, and sore throat) you should contact your GP for advice. If your child has any of these symptoms, they should be kept at home until they feel better."For more information on seasonal flu, go to www.fluawareni.info and follow us on Facebook and Twitter.

Maternal Obesity in the UK: Findings from a national project

In 2008, the Confidential Enquiry into Maternal and Child Health (CEMACH), now known as the Centre for Maternal and Child Enquiries (CMACE), commenced a 3-year UK-wide Obesity in Pregnancy project. The project was initiated in response to a number of factors. At the time, these included: i) growing evidence that obesity is associated with increased morbidity and mortality for both mother and baby, ii) evidence from the CEMACH 'Saving Mothers' Lives' report showed that women with obesity were over-represented among those who died of direct deaths compared to those who died of indirect deaths, 1 iii) unknown national and regional prevalence rates of maternal obesity, and iv) the need for a national clinical guideline for the care of women with obesity in pregnancy.

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.

Simple steps to a healthy heart

The number of deaths from coronary heart disease in Northern Ireland has dropped significantly, according to recent figures. However, the Public Health Agency is urging everyone to take steps to protect their heart and reduce their chances of developing the disease during National Heart Month (February).Despite the number of deaths dropping significantly in recent years, coronary heart disease is still the number one killer across the country. Over 2,200 people died in Northern Ireland from coronary heart disease in 2010 compared to just over 2,300 people in 2009 - an overall reduction of 100 province-wide. The latest figure reveals the positive downward trend is continuing - in 2008, there were 2,410 deaths, 2,493 in 2007 and 2,554 in 2006, while in 1979 there were nearly 5,000 deaths. Throughout National Heart Month in February, the PHA is calling for people to follow a number of steps in a bid to reduce their chances of developing the disease.Smoking is a major risk factor and, the more cigarettes you smoke, the higher the risk, according to Dr Christine McMaster, Consultant in Public Health Medicine, with responsibility for cardiovascular disease in the PHA."The reduction in smoking over the past number of years through public education, stop smoking programmes and smoke free legislation has had a major impact on reducing deaths from heart disease. However, 24% of the population in Northern Ireland still smoke, putting them at risk of developing the disease."People who suffer from high blood pressure also run an increased risk of developing coronary heart disease. High blood pressure is a silent, but treatable condition. In order to minimise the risk, I would urge everyone over the age of 45 to have their blood pressure measured every five years by their GP," said Dr McMaster.Simple lifestyle changes will also reduce the risk of heart disease, including eating at least five servings of fruit and vegetables a day, avoiding saturated fats, limiting alcohol intake and taking at least 30 minutes of exercise a day, five days a week.Dr McMaster described the reduction in deaths from coronary heart disease over the past few years as "a big success story". "It shows that people can take very positive steps to reduce their risk of heart disease by getting their blood pressure checked and adopting a healthier lifestyle; in particular by not smoking," he added. "The message is clear during National Heart Month - you only have one heart and you can take steps to keep it healthy."

Health Impact of Physical Inactivity (HIPI) Tool

Regular physical activity has substantial health benefits, yet only a minority (approximately 21%) of the population in England achieve the minimum levels as recommended by the four home countries’ Chief Medical Officers, in their Start Active, Stay Active report HIPI has been developed to estimate how many cases of certain diseases could be prevented in each local authority in England, if the population aged 40-79 were to engage in recommended amounts of physical activity. This first release (March 2013) includes the following health impacts: preventable cases of diabetes (only shown for Counties and Unitary Authorities) preventable emergency admissions to hospital with a coronary heart disease preventable new cases of breast and colon cancer total number of preventable deaths (all causes). Users can select geographical areas from a map or list. The data is also provided in a downloadable excel spreadsheet. HIPI uses estimates of local levels of physical activity from the Sport England Active People survey. It models the potential benefit from increased levels of physical activity for each local authority. This is pre-calculated to show the health impacts if 100%, 75%, 50% or 25% of the local population undertake the UK Chief Medical Officers’ recommended levels of physical activity. Other assumptions and sources of data are described in the technical document.

Reducing unintentional injuries in and around the home among children under 5 Years

Public Health England today launches 2 new resources for local authorities on preventing accidents to children and young people in the home and on the road. The reports show whilst the number of children and young people killed or seriously injured continues to fall in England there are still significant numbers of deaths and emergency admissions from preventable causes. On average each year between 2008 to 2012, 525 children and young people under 25 died and there were more than 53,700 admissions to hospital. The reports highlight actions local partners can take to reduce accidents including improving safety for children travelling to and from school and using existing services like health visitors and children’s centres. The Reducing unintentional injuries in and around the home among children under 5 Years and the Reducing unintentional injuries on the roads among children and young people under 25 reports include an analysis of data between 2008 to 2012. Key findings from the reports include: home injuries (under 5 years of age): an average of 62 children died each year between 2008 and 2012 these injuries result in an estimated 40,000 emergency hospital admissions among children of this age each year 5 injury types should be prioritised for the under-fives: choking; suffocation and strangulation; falls; poisoning; burns and scalds; and drowning hospital admission rate for unintentional injuries among the under-fives is 45% higher for children from the most deprived areas compared with children from the least deprived Road traffic injuries (under 25 years of age) there were 2,316 deaths recorded by the police among road users under the age of 25 years, an average of 463 under 25s each year there were 68,657 admissions to hospital as a result of road traffic injuries, an average of 13,731 each year in total there were 322,613 casualties of all severities recorded by the police, an average of 64,523 each year the rate of fatal and serious injuries for 10to 14 year olds was significantly greater for children from the 20% most deprived areas (37 per 100,000) compared with those from the most affluent areas (10 per 100,000)

Reducing unintentional injuries on the roads among children and young people under 25

Public Health England today launches 2 new resources for local authorities on preventing accidents to children and young people in the home and on the road. The reports show whilst the number of children and young people killed or seriously injured continues to fall in England there are still significant numbers of deaths and emergency admissions from preventable causes. On average each year between 2008 to 2012, 525 children and young people under 25 died and there were more than 53,700 admissions to hospital. The reports highlight actions local partners can take to reduce accidents including improving safety for children travelling to and from school and using existing services like health visitors and children’s centres. The Reducing unintentional injuries in and around the home among children under 5 Years and the Reducing unintentional injuries on the roads among children and young people under 25 reports include an analysis of data between 2008 to 2012. Key findings from the reports include: home injuries (under 5 years of age): an average of 62 children died each year between 2008 and 2012 these injuries result in an estimated 40,000 emergency hospital admissions among children of this age each year 5 injury types should be prioritised for the under-fives: choking; suffocation and strangulation; falls; poisoning; burns and scalds; and drowning hospital admission rate for unintentional injuries among the under-fives is 45% higher for children from the most deprived areas compared with children from the least deprived Road traffic injuries (under 25 years of age) there were 2,316 deaths recorded by the police among road users under the age of 25 years, an average of 463 under 25s each year there were 68,657 admissions to hospital as a result of road traffic injuries, an average of 13,731 each year in total there were 322,613 casualties of all severities recorded by the police, an average of 64,523 each year the rate of fatal and serious injuries for 10to 14 year olds was significantly greater for children from the 20% most deprived areas (37 per 100,000) compared with those from the most affluent areas (10 per 100,000)

Dépistage organisé du cancer colorectal: défis et enjeux pour un essai pilote en Suisse. [Organized screening for colorectal cancer: challenges and issues for a Swiss pilot study].

Colorectal cancer is among the three most common and lethal neoplasms in Switzerland (about 4,000 new cases and 1,600 deaths per year, respectively). Several screening modalities are available. The effectiveness of colorectal cancer screening on mortality is established. The implementation of a successful screening intervention shall follow specified phases and conditions, and abide with global principles: pooling and coordinating efforts from all partners, setting goals and priorities, and identifying action plans. A feasibility (pilot) study is needed to verify requirements for quality, effectiveness, efficiency and innocuousness. Endeavours towards implementing a pilot programme for colorectal cancer screening in the Vaud canton (Switzerland) are presented and discussed.

Immune response mechanisms and protection against "Plasmodium falciparum" and "Plasmodium berghei"

Malaria is one of the most important tropical and infectious diseases causing many deaths and enormous social and economic consequences, particularly in the developing countries. Despite of widely use of anti-malaria drugs and insecticide, the development of successful vaccines constitutes one of the main strategies to control malaria transmission. Several proteins expressed from blood stage such as merozoite surface proteins (MSP] or liver stage as circumsporozoite protein (CSP) are shown to be the targets of immune responses in humans and in animals. Thus, several studies have illustrated that natural infection and laboratory immunizations of humans and animals with Plasmodium sporozoite (SPZ) and its derivate-proteins (peptides) can elicit protection and control of parasite infection. However, a clear understanding of immune response against defined Plasmodium proteins should be the prerequisite conditions before any development of appropriate vaccines. In this order, our study focused on the immune responses to MSP2 (dimorphic and C-terminal fragments) in human and mice; and the mechanisms by which mouse infected hepatocytes present Plasmodium antigens to CD8+ T-cells to induce protective immunity in mice.¦The first part of this work shows that infected hepatocytes can present Plasmodium antigens to PbCSP-specific CD8+ T-cells and induce a protective immunity in mice. Here, this was addressed in vivo and showed that the infected hepatocytes were able of stimulating of primed-and naive-CD8+ T-cell clones and induced fully protective immunity against SPZ challenge. The role of infected hepatocytes in antigen presentation was illustrated here by their graft into immuno-deficient mice and depletion of cosspresenting dentritic cells (DCs) that are known to have key role in the activation of CD8+ T-cells during the liver cycle stage of Plasmodium.¦The second part of this project concerned the fine specificity of Ab responses regarding D and C regions of the two allelic families of MSP2 (3D7 and FC27). Covering of the two regions by overlapping-20 mers led to delineate the epitopes in the different endemic areas and different age groups of donors. The major epitopes characterizing D or C regions were conserved in different endemic areas (P12/P13 and P15/P16 for the 3D7-D, P23/24 and P25/26 for the FC27-D; P29/P30 for the C region). This offers thus, the possibility of a multi-epitope vaccine design including the major epitopes from the two domains of the two allelic MSP2 families. On the other, the 20 mers, particularly some major epitopes of the 3D7-Dregion (P12, P13 and P16) belonged to the epitopes that presented a high probability to be associated with protection in the children group [1 to 5 year-old). In addition, D and C LSP purified Abs (pAbs) recognized merozoite derived polypeptides and native proteins. A crossreactivity activity of homologous pAbs against the heterologous was also illustrated between the two allelic MSP2 parasites. Finally, the functional analysis of D regions pAbs showed an inhibition of Plasmodium falciparum growth suggesting the functional biological activity of the D region pAbs in the control of malaria.¦The last part of this project aimed the evaluation of the immunogenicity of the D and C region LSPs of the two allelic MSP2 families in the presence of adjuvants for the possible use in clinical trial study in humans. The MSP2 LSP mixture showed that D and C were immunogenic and defined limited epitopes (whose intensity of immune responses) depending on the adjuvants and mouse strain for the D regions. The major epitopes characterizing the C region were usually conserved in different strains of mouse and adjuvants used. Furthermore, the single region (either with D or C) immunization of mice confirmed the immunogenicity and the presence of their limited epitopes. We concluded that the possibility to finely delineate in animals the immune responses to antigens might help to select optimal antigen/adjuvant combinations to be tested later in clinical trials. Thus, formulation of glucopyranosyl-lipid A stable emulsion, GLA-SE (toll like receptor (TLR) 4 agonist) and its different combination (CpG: TLR9 agonist and GDQ: LR7 agonist) with MSP2 LSP was better than with alum, montanide ISA 720 (Mt) and virosome. Immunization of mice with allelic LSP did not show a crossreactivity between the two allelic MSP2 parasites unlike as humans, suggesting that the crossreactivity could be acquired during natural infection of the population who are usually exposed to both allelic parasite forms (3D7 and FC27).¦Nevertheless, similar epitope of D (P12, P13 and P25) and C (P29) regions have been found both in mice and human. This offers an opportunity to compare their epitopes in naïve immunized donors with LSPs and naturally infected populations in the endemic areas.

Accidents and Safety - Ageing in Ireland Fact File No. 14

Accidents and SafetyAlthough the number of deaths caused by accidents has fallen by 37% across all age groups in Ireland over the past twenty years, accidents and falls continue to be relatively common causes of death and injury among older people, often resulting in serious longterm difficulties and even premature death. Consequently, the reduction of accidents in the older population is considered to be an important factor in promoting the general well-being of older people. The 1998 Health Promotion Strategy for Older People, Adding years to life, life to years, which was formulated by the National Council on Ageing and OlderPeople in co-operation with the Department of Health and Children, set a target to reduce the death rate from all accidents and their adverse effects in people aged 65 and over by at least 17% in the year 2005. It also set a target of reducing hospital admissions due to falls in people aged 65 and over by at least 17% in the same year.����

Changes in the NI life expectancy gap 1999/01 to 2004/06

In Northern Ireland between 1999-01 and 2004-06 male life expectancy at birth increased from 74.8 to 76.2 years (an increase of 1.4 years) and female life expectancy increased from 79.8 to 81.0 years (an increase of 1.3 years). Declining mortality rates due to Coronary Heart Disease, strokes and other circulatory causes, as well as cancer and respiratory disease caused life expectancy to increase.However, these increases were partially offset by increasing mortality rates over time due to accidental deaths, suicides and chronic liver disease and other causes of death (not separately identified).

Cardiovascular disease mortality: trends at different ages

Despite a dramatic reduction since the late 1960s, cardiovascular disease remains the largest cause of death in Australia.Cardiovascular disease mortality: trends at different ages examines recent data to determine if the observed decrease in cardiovascular disease deaths since the 1960s is shared across disease sub-types and among different population groups.This report includes information on the past and recent trends of key cardiovascular diseases such as coronary heart disease and stroke, and describes how trends vary on the basis of age group and sex. International trends are also presented for comparison.The analyses presented in this report help to better understand what is driving the observed decrease in cardiovascular disease deaths, and are a useful resource for policy makers, researchers and health professionals interested in cardiovascular diseases.

New Alzheimer's Association report reveals 1 in 3 seniors dies with Alzheimer's or another dementia

2.3 Million Americans are “Long-Distance Caregivers” for people with Alzheimer’s; Costs for Long-Distance Caregivers are Almost Twice as High.According to the Alzheimer's Association 2013 Alzheimer's Disease Facts and Figures report released today, one in three seniors dies with Alzheimer’s or another dementia in the United States. The new report shows that while deaths from other major diseases, such as heart disease, HIV/AIDS and stroke, continue to experience significant declines, Alzheimer’s deaths continue to rise — increasing 68 percent from 2000-2010.��“Unfortunately, today there are no Alzheimer’s survivors. If you have Alzheimer's disease, you either die from it or diewith it,” said Harry Johns, president and CEO of the Alzheimer’s Association. “Now we know that 1 in 3 seniors dies with Alzheimer’s disease or another dementia. Urgent, meaningful��action is necessary, particularly as more and more people age into greater risk for developing a disease��that today has no cure and no way to slow or stop its progression.”Read more here.����������

Briefing 02: Mortality in children and young people in the East of England

The current trend in infant mortality in the East compared with the UK as a whole, the contribution of different causes to the total number of deaths, and PCT-specific information on 8 years of combined data.

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment.

BACKGROUND: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. METHODS: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. FINDINGS: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. INTERPRETATION: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. FUNDING: UK Medical Research Council, US National Institutes of Health.