Hand cleaning technique

This reversible poster is part of an extension of the cleanyourhands campaign, aimed at preventing the spread of healthcare associated infections (HCAIs) in community healthcare settings including primary care and dental services, residential and nursing homes (including independent sector homes), hospices and independent clinics/hospitals. It is designed for pump dispenser or handwashing areas to heighten awareness of protecting patients from avoidable infections by cleaning of hands using proper techniques.

Hand hygiene: a guide for all healthcare staff

This leaflet is part of an extension of the cleanyourhands campaign, aimed at preventing the spread of healthcare associated infections (HCAIs) in community healthcare settings including primary care and dental services, residential and nursing homes (including independent sector homes), hospices and independent clinics/hospitals. It is designed to remind staff of their power to help protect patients from avoidable infections by cleaning their hands using proper techniques. Due to licensing restrictions, this leaflet is not available for download. Limited numbers are available from local HSC Trusts (Belfast HSCT and South Eastern HSCT on 028 9056 5862; Southern HSCT on 028 3741 2887; Northern HSCT on 028 2563 5575; Western HSCT on 028 7186 5127).

Help us to prevent infections spreading

This leaflet is part of an extension of the cleanyourhands campaign, aimed at preventing the spread of healthcare associated infections (HCAIs) in community healthcare settings including primary care and dental services, residential and nursing homes (including independent sector homes), hospices and independent clinics/hospitals. It is designed to heighten awareness in patient/relative waiting areas of how healthcare staff can help protect patients from avoidable infections by cleaning their hands using proper techniques. Due to licensing restrictions, this leaflet is not available for download. Limited numbers are available from local HSC Trusts (Belfast HSCT and South Eastern HSCT on 028 9056 5862; Southern HSCT on 028 3741 2887; Northern HSCT on 028 2563 5575; Western HSCT on 028 7186 5127).

Clean your hands: hand hygiene in the community - guidance

This leaflet is part of an extension of the cleanyourhands campaign, aimed at preventing the spread of healthcare associated infections (HCAIs) in community healthcare settings including primary care and dental services, residential and nursing homes (including independent sector homes), hospices and independent clinics/hospitals. It describes the campaign and outlines the campaign resources. Due to licensing restrictions, this folder is not available for download. Limited numbers are available from local HSC Trusts (Belfast HSCT and South Eastern HSCT on 028 9056 5862; Southern HSCT on 028 3741 2887; Northern HSCT on 028 2563 5575; Western HSCT on 028 7186 5127).

Putting a health inequalities focus on Northern Ireland cardiovascular service framework - Summary report

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.

Putting a health inequalities focus on the Northern Ireland cardiovascular service framework

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. There are many determinants which impact on cardiovascular disease. Individual lifestyles are major contributors and smoking remains one of the biggest risk factors for the disease alongside sedentary lifestyles and alcohol consumption. Circumstances experienced during the early years influence health and wellbeing into adulthood. Breastfeeding can help protect against obesity, while physical activity and eating habits developed from a young age often form lifelong patterns of behaviour. Living and working conditions also impact on health. Type of job, level of control and employment conditions are major factors. Educational achievement and income are also powerful influences on health. The environment where we live can provide access to open and green space, which plays an important part in physical activity patterns alongside available transport infrastructure. As well as physical health impacts, all of these factors also influence mental health and emotional wellbeing.

PHA supports World Hospice and Palliative Care Day

Saturday 8 October 2011 marks World Hospice and Palliative Care Day. The Public Health Agency would like to celebrate and support hospice and palliative care around the world by raising awareness and understanding of the needs - medical, social, practical and spiritual - of people living with a life-limiting illness, and their families.This year's World Hospice and Palliative Care Day theme is 'Many diseases, manylives, many voices - palliative care fornon-communicableconditions'.The theme will focus on how people living with conditions thatare notinfectious can benefit from palliative care.Non-communicable diseases (NCDs), which include cardiovascular diseases, cancers, chronic respiratory conditions and diabetes, make up60% of deaths worldwide. The majority of thesedeaths occur in low and middle income countries, where palliative care is often not available. To get involved in World Hospice and Palliative Care Day, log on to www.worldday.org/get-involved/ which gives you ideas and suggestions on what you can do on the day to support people living with life-limiting illnesses, and their families.Mary Hinds, Director of Nursing and Allied Health Professions, PHA, and Chair of the Implementation Process for End of Life Care in Northern Ireland, said: "Good quality palliative and end of life care will be important for us all. 'Living Matters, Dying Matters' is a five year strategy for palliative and end of life care in Northern Ireland, established to ensure that any person living with a life-threatening illness lives well and dies well, irrespective of their condition or care setting. "It has been encouraging to see the plans being taken forward by the Health and Social Care Trusts in partnership with local hospices and other providers, and involving local people."We aim to ensure that people receiving palliative care, their families and carers, are provided with high quality care across all settings and conditions, and are supported to enjoy a good quality of life, maximising their potential through the course of their illness."There is still some progress to be made within the context of the review of health and social services. We are looking for statutory and voluntary services to work together to make a significant difference in improving access to high quality services for those with life-limiting conditions, and to develop innovative approaches to care."

Smoking causes mouth cancer, PHA warns

Mouth cancer awareness week begins on the 13 - 20 November. With this in mind the Public Health Agency is urging everyone to be aware of the signs and symptoms of mouth cancer and is encouraging all smokers thinking about stopping smoking to make the decision to stop today.In Northern Ireland 195 people were diagnosed with mouth cancer in 2009. The disease causes one death every five hours in the UK and yet it is one of the least well-known cancers. Smoking and excess alcohol consumption is associated with an increased risk of developing mouth cancer, which can occur in or on any part of the mouth, tongue, lips, neck and throat. In its very early stages, mouth cancer can be easy to ignore. Most people with mouth cancer have no early symptoms at all, but others may have:an ulcer in the mouth or on the lip that won't heal; constant pain or soreness; red or white patches in the mouth;a lump on the lip, tongue or in the neck; bad breath; unexplained bleeding in the mouth; numbness in the mouth; loose teeth.The earlier the disease is caught, the better. Survival rates rise to 90 per cent if the cancer is treated before it has spread. Gerry Bleakney, Head of Health and Social Wellbeing Improvement, PHA, said: "Certain lifestyle choices can increase an individual's risk of developing mouth cancer. Tobacco is considered to be the main cause of mouth cancer, with three in four cases being linked to smoking. Excess alcohol consumption is also a known factor, with those who both smoke and drink excessively being up 30 times more likely to be at risk. "Mouth cancer and the treatment required can be traumatic for the patient as this may affect functions such as speech, chewing and swallowing. The positive news is that stopping smoking is associated with a rapid reduction in the risk of oral cancers. Regular trips to the dentist are also a must because half of all mouth cancer cases are detected by dentists."I would encourage everyone who is thinking about quitting to log on to our Want 2 Stop website www.want2stop.info and order a 'Quit Kit' free of charge. Alternatively contact the Smokers' Helpline on 0808 812 8008. "Health Minister Edwin Poots said: "Smoking is the single greatest cause of preventable illness and premature death in Northern Ireland.It is a major risk factor for oral cancer, as well as coronary heart disease, strokes and other diseases of the circulatory system. Approximately 2,300 people die each year in Northern Ireland from smoking related illnesses. Quitting smoking is the single most effective step people can take to improve their long term health."A key objective of the Department's new ten-year tobacco control strategy, due to be published next month,is to prevent people from starting to smoke. Funding provided by the Department for smoking cessation services has resulted in around 650 such services being made available in Northern Ireland in a range of settings, including pharmacies, GP surgeries and community centres. These services have helped almost 80,000 smokers to set a quit date between 2008/09 and 2010/11."The Minister added: "It is also important for people to look after their oral health by regularly attending the dentist for check-ups, as any problems can be picked up and treated at an early stage."

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.

Cardiovascular health and wellbeing in Northern Ireland - Literature review

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.

Healthy breaks: tasty tips for the under fives

Today the Public Health Agency is launching a new resource pack designed to assist nursery schools and playgroups deliver a healthy breaks scheme.All nursery schools and playgroups in Northern Ireland will receive the pack - 'Healthy breaks for pre-school children' - which includes a poster and information leaflets for parents explaining why a healthy break is so important for pre-school children and some tips and ideas for healthy nutritious breaks.Judith Hanvey, Regional Food in Schools Co-ordinator, appointed jointly by the PHA and the Department of Education, said: "Break-time snacking schemes currently operate in many pre-school settings across Northern Ireland, however they are implemented in different ways. The PHA has developed this new guidance so that any existing or future schemes have the information that they need to deliver a healthy break programme."Judith explained why a healthy break is so important for pre-school pupils."Young children have small stomachs but high requirements for energy (calories) and nutrients. This means that healthy snacks between meals are very important to make sure that they get all the nourishment they need."Childhood is also an important time to establish good eating and drinking habits for later life."Healthy eating schemes give children the knowledge and opportunity to make healthier choices."The Department of Education and Department of Health, Social Services and Public Safety recently launched 'Healthy Food for Healthy Outcomes: Food in Schools Policy', which builds on the nutritional standards which were introduced in 2007 by the Department of Education.The policy encourages a 'whole school approach' to all food and drink provided and consumed in schools. This ensures that children have the opportunity to benefit from a healthy balanced diet, which can aid learning, leading to improved educational outcomes. It also requires that every school should have their own whole-school food policy in place by September 2014. Nursery schools that receive funding from the Department of Education must follow this policy.This is also in line with the position taken by the Department of Health, Social Services and Public Safety's 10 year obesity prevention strategy, A Fitter Future for All, which aims to take a consistent approach to healthy food within early years settings.

Effects of immunosuppressive drugs on T helper cells subsets and potential to promote tolerance in a stringent experimental transplantation model.

To achieve the goal of sustained donor-specifi c transplantation (Tx) tolerance, research efforts are now focusing on therapies based on specifi c cell subsets with regulatory properties. We and others have previously highlighted the therapeutic potential of naturally occurring CD4+CD25+Foxp3+ regulatory T cells (nTreg) in promoting long-term graft acceptance. Using more stringent experimental Tx models, we were however confronted to limitations. Indeed, while the transfer of antigenspecifi c nTreg promoted long-term MHC-mismatched skin allograft acceptance in lymphopenic mice in the absence of any immunosuppressive drug, allograft survival was only slightly prolonged when nTreg were transferred alone into non-lymphopenic mice. This suggested that in more stringent conditions, adjuvant therapies may be needed to effectively control alloreactive T cells (Teff). Whether and how the expansion of the Treg pool could be best combined with current immunosuppressive regimens in clinical settings remains to be defi ned. In this study, we have used in vitro assays and an in vivo skin Tx model to investigate the effects of various immunosuppressive drugs on the survival, proliferation and effector function of Teff and nTreg in response to alloantigens. Teff proliferation was inhibited in a dose-dependent manner by rapamycin and cyclosporine A, while anti-CD154 mAb only marginally affected Teff survival, proliferation and effector fucntion in vitro. Rapamycin promoted apoptosis of Teff as compared to nTreg that were more resistant in the presence of IL-2. In vivo, the transfer and/or expansion of Treg could be advantageously combined with rapamycin and anti-CD154 mAb treatment to signifi cantly prolong MHC-mismatched skin allografts survival in non-lymphopenic recipients. Taken together our data indicate that immunosuppressive drugs differentially target T-cell subsets and that some regimens could promote Treg expansion while controlling the Teff pool in response to alloantigens.

Food on a Low Income: Four households tell their story

The aim of this research was to investigate the everyday experiences of food on a low income among people in four household types on the island of Ireland (IOI). This research will inform safefood and other stakeholders targeting vulnerable groups. It should influence both policy and practical programmes such as community food initiatives and awareness campaigns. Why do low-income groups suffer more from diet-related ill health than other groups? Is it because a healthy diet is too expensive? Or what other forces are there at work? safefood commissioned this qualitative research for four different low-income household types to gain a deeper understanding of the dynamics behind food poverty. The research involved a qualitative approach to enable an exploration of the ‘why’ behind the statistics of food poverty. In total, thirteen focus groups were conducted amongst four household types: two parent household with children, single males, single older people and lone parents with children, on IOI in both rural and urban settings.

Association of urinary calcium excretion with serum calcium and vitamin D levels.

BACKGROUND AND OBJECTIVES: Population-based data on urinary calcium excretion are scarce. The association of serum calcium and circulating levels of vitamin D [25(OH)D2 or D3] with urinary calcium excretion in men and women from a population-based study was explored. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Multivariable linear regression was used to explore factors associated with square root-transformed 24-hour urinary calcium excretion (milligrams per 24 hours) taken as the dependent variable with a focus on month-specific vitamin D tertiles and serum calcium in the Swiss Survey on Salt Study. RESULTS: In total, 624 men and 669 women were studied with mean ages of 49.2 and 47.0 years, respectively (age range=15-95 years). Mean urinary calcium excretion was higher in men than in women (183.05 versus 144.60 mg/24 h; P<0.001). In adjusted models, the association (95% confidence interval) of square root urinary calcium excretion with protein-corrected serum calcium was 1.78 (95% confidence interval, 1.21 to 2.34) mg/24 h per milligram per deciliter in women and 0.59 (95% confidence interval, -0.11 to 1.29) mg/24 h per milligram per deciliter in men. Men in the third 25(OH)D3 tertile had higher square root urinary calcium excretion than men in the first tertile (0.99; 95% confidence interval, 0.36 to 1.63 mg/24 h per nanogram per milliliter), and the corresponding association was 0.32 (95% confidence interval, -0.22 to 0.85) mg/24 h per nanogram per milliliter in women. These sex differences were more marked under conditions of high urinary sodium or urea excretions. CONCLUSIONS: There was a positive association of serum calcium with urinary calcium excretion in women but not men. Vitamin 25(OH)D3 was associated with urinary calcium excretion in men but not women. These results suggest important sex differences in the hormonal and dietary control of urinary calcium excretion.

Monte Carlo simulations of metasomatic enrichment in the lithosphere and implications for the source of alkaline basalts

One hypothesis for the origin of alkaline lavas erupted on oceanic islands and in intracontinental settings is that they represent the melts of amphibole-rich veins in the lithosphere (or melts of their dehydrated equivalents if metasomatized lithosphere is recycled into the convecting mantle). Amphibole-rich veins are interpreted as cumulates produced by crystallization of low-degree melts of the underlying asthenosphere as they ascend through the lithosphere. We present the results of trace-element modelling of the formation and melting of veins formed in this way with the goal of testing this hypothesis and for predicting how variability in the formation and subsequent melting of such cumulates (and adjacent cryptically and modally metasomatized lithospheric peridotite) would be manifested in magmas generated by such a process. Because the high-pressure phase equilibria of hydrous near-solidus melts of garnet lherzolite are poorly constrained and given the likely high variability of the hypothesized accumulation and remelting processes, we used Monte Carlo techniques to estimate how uncertainties in the model parameters (e.g. the compositions of the asthenospheric sources, their trace-element contents, and their degree of melting; the modal proportions of crystallizing phases, including accessory phases, as the asthenospheric partial melts ascend and crystallize in the lithosphere; the amount of metasomatism of the peridotitic country rock; the degree of melting of the cumulates and the amount of melt derived from the metasomatized country rock) propagate through the process and manifest themselves as variability in the trace-element contents and radiogenic isotopic ratios of model vein compositions and erupted alkaline magma compositions. We then compare the results of the models with amphibole observed in lithospheric veins and with oceanic and continental alkaline magmas. While the trace-element patterns of the near-solidus peridotite melts, the initial anhydrous cumulate assemblage (clinopyroxene +/- garnet +/- olivine +/- orthopyroxene), and the modelled coexisting liquids do not match the patterns observed in alkaline lavas, our calculations show that with further crystallization and the appearance of amphibole (and accessory minerals such as rutile, ilmenite, apatite, etc.) the calculated cumulate assemblages have trace-element patterns that closely match those observed in the veins and lavas. These calculated hydrous cumulate assemblages are highly enriched in incompatible trace elements and share many similarities with the trace-element patterns of alkaline basalts observed in oceanic or continental setting such as positive Nb/La, negative Ce/Pb, and similiar slopes of the rare earth elements. By varying the proportions of trapped liquid and thus simulating the cryptic and modal metasomatism observed in peridotite that surrounds these veins, we can model the variations in Ba/Nb, Ce/Pb, and Nb/U ratios that are observed in alkaline basalts. If the isotopic compositions of the initial low-degree peridotite melts are similar to the range observed in mid-ocean ridge basalt, our model calculations produce cumulates that would have isotopic compositions similar to those observed in most alkaline ocean island basalt (OIB) and continental magmas after similar to 0 center dot 15 Gyr. However, to produce alkaline basalts with HIMU isotopic compositions requires much longer residence times (i.e. 1-2 Gyr), consistent with subduction and recycling of metasomatized lithosphere through the mantle. such as a heterogeneous asthenosphere. These modelling results support the interpretation proposed by various researchers that amphibole-bearing veins represent cumulates formed during the differentiation of a volatile-bearing low-degree peridotite melt and that these cumulates are significant components of the sources of alkaline OIB and continental magmas. The results of the forward models provide the potential for detailed tests of this class of hypotheses for the origin of alkaline magmas worldwide and for interpreting major and minor aspects of the geochemical variability of these magmas.