MoreLife Adult Clinical Obesity Service (ACOS)

The aim of this intervention is to educate, inform and empower patients to safely lose and manage their weight. It strives for Patients to lose an agreed amount of weight, with the help and support of the MoreLife team.

Direct in vivo measurement of glycine and the neurochemical profile in the rat medulla oblongata.

The medulla oblongata (MO) contains a high density of glycinergic synapses and a particularly high concentration of glycine. The aims of this study were to measure directly in vivo the neurochemical profile, including glycine, in MO using a spin-echo-based (1)H MRS sequence at TE?=?2.8 ms and to compare it with three other brain regions (cortex, striatum and hippocampus) in the rat. Glycine was quantified in MO at TE?=?2.8 ms with a Cramér-Rao lower bound (CRLB) of approximately 5%. As a result of the relatively low level of glycine in the other three regions, the measurement of glycine was performed at TE?=?20 ms, which provides a favorable J-modulation of overlapping myo-inositol resonance. The other 14 metabolites composing the neurochemical profile were quantified in vivo in MO with CRLBs below 25%. Absolute concentrations of metabolites in MO, such as glutamate, glutamine, ?-aminobutyrate, taurine and glycine, were in the range of previous in vitro quantifications in tissue extracts. Compared with the other regions, MO had a three-fold higher glycine concentration, and was characterised by reduced (p?<?0.001) concentrations of glutamate (-50?±?4%), glutamine (-54?±?3%) and taurine (-78?±?3%). This study suggests that the functional specialisation of distinct brain regions is reflected in the neurochemical profile.

Fakenham Weight Management Service

Tier 3 weight management service for clients with BMI>40, or >30 plus co-morbidities. The service aims for 5% weight loss in 6 months, and to increase fruit and vegetable intake and activity levels. It also aims to set up hub and spoke model with 3 satellite sites to deliver local services in a rural area, and to develop a North Norfolk Obesity Pathway and to make only appropriate bariatric surgery referrals as per East of England guidelines.

MoreLife Specialist Obesity Service (ASOS)

The aims of this intervention are: - To prevent or defer patients from requiring surgical interventions. - To ready patients for surgical procedures (indirectly related to weight status), such as orthapaedic ops etc. - To educate, inform and empower patients to safely lose and manage their weight - To improve the patient's clinical risk and quality of life.

Health Trainers weight management service

The aim of the intervention is to offer tailored advice, motivation, and practical support to individuals who want to adopt a healthier lifestyle. The objectives are to support clients in setting goals and planning behaviour change

Weigh2go: A Peripatetic Level 1 Weight Management Service

The aim of this intervention is to increase the accessibility of appropriate evidence based support to people who are clinically obese to enable them to make lifestyle changes that will lead to weight loss. Objectives1. Identify patients whose lifestyle put them at risk of obesity and poor health outcomes and provide them with advice and support along with signposting to specific services and activities. 2. Identify patients who are overweight or obese and offer them a structured multi-component programme of support for them to loose weight. 3. Through the use of software collect data to monitor outcomes at individual and practice levels.

Weight Reduction Service

The aim of this intervention is to offer support to overweight and obese patients, particularly those with co-morbidities to make changes to lifestyle in food habits and physical activity.

Kirklees Adult Specialist Weight Management Service

The aims and objectives of this intervention are: Multidisciplinary approach to help: 1. Weight loss 2. Improve exercise tolerance 3. Quality of life 4. Adverse weight related medical conditi

A Process Analysis of Males and Females who Attended a Community Based Addiction Treatment Service: Towards an Expanded Paradigm

A process analysis was conducted in a community - based treatment programme for alcohol abuse. The aims of the study were: to evaluate assessment instruments and measures; to measure change following treatment; to monitor gender differences; to assess the importance of early and current relationships; and to evaluate the effects of therapists. Subjects (n=145, males 83/females 62) completed a semi-structured interview schedule, Severity of Alcohol Dependency Questionnaire (SADQ), Short Alcohol Dependence Data Questionnaire (SADD); General Health Questionnaire (GHQ 12), and Alcohol Problems Questionnaire (APQ). A further three non-standardised self-rated measures were devised by the author. Included was the opportunity to obtain qualitative data. Follow up data was collected at 3, 9 and 15 months following first assessment. The SADD, APQ and consumption measures using detailed drink diaries proved the most relevant assessment measures. Following treatment, there was significant reduction in clients' dependency levels at 3 months, maintained through 9 and 15 months. Key client-rated changes were progress in reducing consumption and alcohol problems leading to a better quality of life and health. Qualitative data augmented these quantitative results. Psychological and acquired cognitive behavioural skills emerged as the main reasons for positive change and the treatment programme was found to have played a significant role in their acquisition. It appears that addressing marital problems can lead to a reduction in alcohol dependency levels. Gender analysis showed that males and females were similar in demographic characteristics, alcohol history details and dependence levels. It was concluded that the differences found did not necessitate different treatment programmes for women. Early family relationships were more problematic for females. Therapist performance varied and that variance was reflected in their clients' outcomes.This resource was contributed by The National Documentation Centre on Drug Use.

A Step in the Right Direction: An Evaluation of the Fáiltiú Information and Advise Service

The Fáiltiú service provides information and advice on rights, entitlements and options to homeless people, or those at risk of homelessness. The objectives of this evaluation were to assess the information needs of users of the service, how effectively they were being met, and how they could be improved. Two focus groups of staff members and service users gave their views on the design and implementation of the research at the outset of the project. A screening questionnaire identified 78 people who used the Fáiltiú service in a specified time period, of whom 40 participated in the evaluation by giving their views on the service. The study reviewed the literature on homelessness, attempted to define the term, and examined the characteristics of homeless people and relevant Irish social policy. The conclusions reached were: users of the Fáiltiú service are marginalized in a number of ways and share characteristics related to poverty and social exclusion, such as poor educational qualifications, high levels of unemployment and experience of prison; their needs are multi-dimensional and include accommodation, financial, social and medical support, and access to employment and training services: the service needs to respond to these needs in a holistic way.This resource was contributed by The National Documentation Centre on Drug Use.

In vitro measurement of enzymatic markers as a tool to detect mouse cardiomyocytes injury

Primary cultures of cardiomyocytes represent a useful model for analyzing cardiac cell biology as well as pathogenesis of several cardiovascular disorders. Our aim was to standardize protocols for determining the damage of cardiac cells cultured in vitro by measuring the creatine kinase and its cardiac isotype and lactate dehydrogenase activities in the supernatants of mice cardiomyocytes submitted to different protocols of cell lysis. Our data showed that due to its higher specificity, the cardiac isotype creatine kinase was the most sensitive as compared to the others studied enzymatic markers, and can be used to monitor and evaluate cardiac damage in in vitro assays.

Instrumental leadership: Measurement and extension of transformational-transactional leadership theory.

Leaders must scan the internal and external environment, chart strategic and task objectives, and provide performance feedback. These instrumental leadership (IL) functions go beyond the motivational and quid-pro quo leader behaviors that comprise the full-range-transformational, transactional, and laissez faire-leadership model. In four studies we examined the construct validity of IL. We found evidence for a four-factor IL model that was highly prototypical of good leadership. IL predicted top-level leader emergence controlling for the full-range factors, initiating structure, and consideration. It also explained unique variance in outcomes beyond the full-range factors; the effects of transformational leadership were vastly overstated when IL was omitted from the model. We discuss the importance of a "fuller full-range" leadership theory for theory and practice. We also showcase our methodological contributions regarding corrections for common method variance (i.e., endogeneity) bias using two-stage least squares (2SLS) regression and Monte Carlo split-sample designs.

A Survey of Health Service Utilisation and Health Needs of a Population of Patient with HIV/ AIDS

This study described the demographic and medical characteristics of a population of patients with HIV/AIDS attending the department of Genito-Urinary Medicine (GUM) at a major Dublin hospital. The study population's utilisation of statutory and voluntary medical and social services at primary care level, satisfaction with services received and perceived need for services examined. The information obtained was used to make recommendations concerning the provision of care to patients with HIV/AIDS. The study was carried out between February and November 1994. Data was collected from a consecutive sample of eighty inpatients using n interviewer-administered questionnaire which contained both closed and open questions. The first forty patients interviewed were reviewed six months following the initial interview to document changes in physical condition and uptake of medical services over that time period. Data for the second part of the study was obtained by review of the patients' medical case notes and interview with the individual hospital medical social worker assigned to each patient. Over ninety percent of respondents were from the Greater Dublin Area. Almost three quarters were intravenous drug users (IVDUs), and the majority of these patients came from south inner city Dublin. The methodology was biased towards sampling patients with advanced disease and 73% had CDC Stage 4 disease. Twenty percent required some assistance with the activities of daily living when first interviewed. Most were reliant on informal carers. Social and physical dependency increased substantially over the six month period of the follow-up study of forty patients. Financial difficulties were identified as a particular area of need. Only ten percent of those interviewed were in current employment and over 80% were dependent on statutory payments. There is a need for greater co-ordination between the providers of services to patients HIV/AIDS and an improved system of data collection regarding patients' uptake of services and unmet needs is required to assist in future service planning.This resource was contributed by The National Documentation Centre on Drug Use.

Implementing A vision for change: moving towards a modern, quality and responsive mental health service. Carlow / Kilkenny / South Tipperary.

The key element of the HSE South’s Programme is to enhance and develop community mental health services in Carlow, Kilkenny and South Tipperary, to enable the service user to remain in the community to the greatest extent possible. HSE South has prioritised the implementation of the change programme and has allocated more than €20m capital funding and over €1.75m revenue funding to support this comprehensive development programme. Speaking at the briefings Mr. Pat Healy, Regional Director of Operations, HSE South said, “When this plan is delivered, clients will have access to the highest standards of services in all three counties, which should significantly improve these clients’ treatment programmes and quality of life. The National Service Users Executive are supporting the change programme, which is of immense importance to HSE South. The programme heralds the enhancement and development of community mental health services, the closure of old long stay institutions, the separation of North and South Tipperary acute inpatient mental health services and development of appropriate acute inpatient services, for the extended catchment area, in line with the national strategy for mental health “A Vision for Change”. The programme also acts on recommendations of the Mental Health Commission.”This resource was contributed by The National Documentation Centre on Drug Use.

Cognitive behavioural skills for practice a model for delivery in the Irish mental health service.

This publication outlines a model of delivery for introductory level Cognitive Behavioural Therapy (CBT) training in the Mental Health Service, HSE South (Carlow, Kilkenny, South Tipperary, Waterford, Wexford). This model has proved useful in guiding the development of four introductory programmes during 2009 and 2010. As a result of this experience, we have amended and updated our programme delivery strategies. We see this process as organic and ever changing, thus these reflections are a snap shot of our current thinking which we have no doubt will evolve as we proceed with future programmes. This booklet will act as a guide for our upcoming programmes in 2010 and 2011 and we believe it may also offer guidance to others who will be involved in the delivery of CBT training within the Irish Mental Health Service.This resource was contributed by The National Documentation Centre on Drug Use.