Family doctors' consultations with people suffering from chronic pain without objective findings: Which protective practices might they develop in these challenging medical encounters?

Introduction: Consultations with patients suffering from chronic pain without objective findings represent a challenge fo r family doctors (FDs). A mutual lack of understanding may arise, which threatens the doctor-patient relationship and may lead to dissatisfaction of both patient and doctor and to a breakdown of the therapeutic alliance. Objectives: This study aims to investigate FDs' potential protective practices to preserve the doctor-patient relationship during this type of consultation. Method: In the first step of this qualitative research, I carried out a range of 10 se- mi-structured interviews with FDs to explore their reported practices and repre- sentations during consultations with people suffering from chronic pain without objective findings. The interviews' transcripts were integrally analysed with computer-assisted thematic content analysis (QSR NVivo ® ) to highlight the main themes related to the topic in the participants' talk. Results: At this point of the research, two types of FDs' protective practices can be identified: first the use of complementary sources of knowledge in addition to the medical model to provide explanations to patients, second the collaboration with multidisciplinary teams or support gr oups that allow them to share profes- sional expertise and emotional experiences. Conclusion: The findings could be useful to develop ways to improve the follow- up of patients suffering from chronic pain without objective findings and conse- quently the FDs' work satisfaction.

Nutrition for substance users - a step by step workbook for people using alcohol and other drugs

This workbook aims to help people who use alcohol or drugs to think about the importance of eating well and find ways to achieve a more balanced diet.

What is the most relevant standard of success in assisted reproduction?: The cumulated singleton/twin delivery rates per oocyte pick-up: the CUSIDERA and CUTWIDERA.

National and international registries are essential tools for establishing new standards and comparing success rates, but they do not take into account the total pregnancy/delivery rate per oocyte recovery. In Switzerland and Germany, because of legal constraints, a maximum of three two-pronuclear zygotes are allocated for transfer whereas all the supernumerary pronuclear zygotes are immediately cryopreserved, preventing selection of the transferred embryos. We report on a 10 years' experience (1993-2002) of our centre which performs transfers of unselected embryos and cryopreservation at the two-pronuclear zygote stage. As approximately 30% of all deliveries are from cryo cycles, it is essential to take into account the contribution of the cryo transfers, and we propose therefore to evaluate, as a measure of IVF performance, the cumulated delivery rate per oocyte pick-up. This delivery rate is broken down further into the cumulated singleton delivery rate (CUSIDERA) and the cumulated twin delivery rate (CUTWIDERA). The sum (S) of these two rates is a measure of efficacy while the ratio CUTWIDERA/S as a percentage is a measure of safety of IVF treatments. Using these new indexes, the average 10 year efficacy and safety of our IVF programme were 26 and 19%, respectively. Both CUSIDERA and CUTWIDERA can be calculated easily in any clinical situation and yield useful parameters for patient counselling and internal/external benchmarking purposes.

Immunisation for babies up to a year old (Translations)

This booklet provides information on the routine immunisations that are given to babies up to year old to protect them from serious childhood diseases.Please note, the following translations are based on last year's leaflet and do not yet include the new information. Translations of the latest leaflet will follow.

ASIST training helping to tackle suicide

Work to help communities prevent suicide has taken a further step forward with over 50 ASIST Trainers from across Northern Ireland completing the new ASIST 11 upgrader trainer course.The Applied Suicide Intervention Skills Training (ASIST) enables people in a position of trust to recognise risk and learn how to intervene to prevent the immediate risk of suicide.The Public Health Agency (PHA) funded the upgrading training as part of their ongoing commitment to supporting quality training for a range of individuals, communities and organisations.Madeline Heaney, the PHA's strategic lead for Suicide Prevention, explained: "This programme enables people who have been trained to become more willing, ready and able to help those at risk of suicide, which can be vital in a crisis situation.�"We want to empower people who are in position of responsibility and care to know what to do if they find themselves in a situation where someone is at risk of taking their own lives."�ASIST has been delivered in Northern Ireland since 2003 and the course is designed for all caregivers or any person in a position of trust, making it useful for a range of people. The training is suitable for mental health professionals, nurses, doctors, pharmacists, teachers, counsellors, youth workers, police and prison staff, school support staff, clergy, community volunteers and the general public.This most recent training, which ASIST Trainers must complete, builds on previous editions and offers advances that help meet current challenges and provides new opportunities in helping to reduce suicides within communities.The intensive Trainer Upgrade was held in Derry/ Londonderry.More information on looking after your mental health and the support which is available across Northern Ireland can be found at www.mindingyourhead.info��You can also talk to your GP for advice.If you or someone you know is in distress or despair, call Lifeline on 0808 808 8000. This is a confidential service, where trained counsellors will listen and help immediately on the phone and follow up with other support if necessary. The helpline is available 24 hours a day, seven days a week. You can also access the Lifeline website at www.lifelinehelpline.info

Assessment of a two-step nucleic acid amplification assay for detection of Neisseria meningitidis followed by capsular genogrouping

Immediate prevention of meningococcal disease relies in part on the prompt treatment with antibiotics of household and other close contacts of cases; however intervention with effective vaccination relies on identification of serogroup-causing strains. Parenteral antibiotic for patient with suspected meningococcal disease before hospital admission is currently recommended. Laboratory standard methods are hindered by failure to detect bacteria by this medical approach to improve patient prognosis. We assessed two polymerase chain reaction (PCR) assays to detect (crgA) and define the serogroups (siaD, orf-2, and ctrA) of Neisseria meningitidis in 120 cerebrospinal fluid (CSF) samples from positive cases (culture or antigen detection or direct smear). The PCR sensitivity for the identification of N. meningitidis was 100% (95% confidence interval, CI, 96-100%) compared to a sensitivity of 46% for culture (95% CI 37-55%), 61% for latex agglutination test (95% CI 52-70%), and 68% for Gram stain (95% CI 59-76%); PCR specificity was 97% (95% CI 82-100%). PCR correctly identified the serogroups A, B, C, W135, Y, and X in CSF samples with a sensitivity of 88% (95% CI 80-93%); the primer sets were 100% specific. The introduction of PCR-based assays shall increase laboratory confirmed cases, consequently enhancing surveillance of meningococcal disease.

"I'll look it up on the Web first": barriers and overcoming barriers to consult for sexual dysfunction among young men.

QUESTIONS UNDER STUDY: Our aim was to identify the barriers young men face to consult a health professional when they encounter sexual dysfunctions and where they turn to, if so, for answers. METHODS: We conducted an exploratory qualitative research including 12 young men aged 16-20 years old seen in two focus groups. Discussions were triggered through vignettes about sexual dysfunction. RESULTS: Young men preferred not to talk about sexual dysfunction problems with anyone and to solve them alone as it is considered an intimate and embarrassing subject which can negatively impact their masculinity. Confidentiality appeared to be the most important criterion in disclosing an intimate subject to a health professional. Participants raised the problem of males' accessibility to services and lack of reason to consult. Two criteria to address the problem were if it was long-lasting or considered as physical. The Internet was unanimously considered as an initial solution to solve a problem, which could guide them to a face-to-face consultation if necessary. CONCLUSIONS: Results suggest that Internet-based tools should be developed to become an easy access door to sexual health services for young men. Wherever they consult and for whatever problem, sexual health must be on the agenda.

Construcció i explotació d'un magatzem de dades per a l'anàlisi estadístic dels resultats del Campionat de Fórmula 1

En els darrers anys les organitzacions han anat agafant consciència de la importància de la gestió de la seva informació. D'aquesta necessitat d'organitzar les pròpies dades d'una forma coherent i eficient per al seu anàlisi sorgeixen els magatzems de dades. El projecte "Construcció i explotació d'un magatzem de dades per a l'anàlisi estadístic dels resultats del Campionat de Fórmula 1" s'emmarca dins aquest context i te com a objectiu el disseny d'un magatzem de dades per a cobrir les necessitats del Institut Català d'Esports de Motor (ICEM) en la gestió de les seves dades referents a la Fórmula 1. En aquest projecte s'han executat les diferents fases necessàries per a la creació d'un nou magatzem. En primer lloc s'ha fet l'anàlisi de requeriments i de les dades disponibles. A continuació s'ha fet el disseny i la implementació física del magatzem de dades. Seguidament s'ha procedit amb l'extracció, transformació i càrrega de dades originals (ETL) i per finalitzar s'han creat els informes. Com a resultat s'han obtingut una sèrie d'informes per a ser consumits de manera immediata pels usuaris del ICEM. Aquests informes han de permetre l'anàlisi de les dades d'una forma senzilla i àgil. A més s'ha implementat un sistema d'actualització automàtic de les dades que per al manteniment de la informació del magatzem.La implementació del magatzem de dades s'ha fet sobre una base de dades Oracle 10g Express Edition i els informes s'ha dissenyat amb l'eina Oracle Discoverer. Per a l'automatització de les dades s'ha fet servir a més visual basic script i l'eina de càrrega SQL*Loader.

Is your waistline creeping up on you? poster (female)

This poster was produced to support the choose to live better campaign aimed at raising awareness of the health risks associated with overweight and obesity in women Northern Ireland.�

Is your waistline creeping up on you?

If you think you could be inching towards bad health then this leaflet is packed with tips and advice to help you keep your weight and waistline healthy.Now includes food and physical activity diaries to complete, and a pull-out section for a weekly meal planner and shopping list.

Immunisation for babies up to a year old (English and translations)

This booklet provides information on the routine immunisations that are given to babies up to year old to protect them from serious childhood diseases. It describes the DtaP/IPV/Hib, pneumococcal and MenC vaccines and now includes information on the rotavirus vaccine given to babies at two and three months old from July 2013.(A new version will be available from summer 2015)

Is your waistline creeping up on you? poster (male)

This poster was produced to support the choosetolivebetter campaign aimed at raising awareness of the health risks associated with overweight and obesity in men Northern Ireland.