Poverty and social exclusion in Northern Ireland

Northern Ireland’s labour market and poverty rates have deteriorated in the last five years, in addition to longstanding issues of mental health and community divisions – and welfare reforms are likely to exacerbate these problems.��New research��by the New Policy Institute for JRF brings together the latest data to show the extent and nature of poverty in Northern Ireland (NI), focusing on the links between poverty, work, disability and age. It finds that:��•��between 2006/07 and 2011/12 the average (median) income in NI fell by almost 10 per cent compared with 7 per cent for the UK as a whole;��•��the proportion of unemployed working-age people in NI almost doubled between 2007/08 and 2012/13 to reach 5.8 per cent. Growth in the proportion working part-time and wanting full-time work has been greater – up from 1.7 per cent, the same as in Great Britain (GB), to 4.4 per cent (compared with 3.5 per cent in GB);��•��the proportion of pensioners in poverty in NI fell from 19 per cent to 16 per cent in the five years to 2011/12. The poverty rate rose over this period for working-age adults and children;��•��in the five years to 2011/12, the poverty rate among adults aged 16 to 29 rose by 8 percentage points to reach 26 per cent. Poverty has also increased among those aged 30 to 59, solely among those in working families.��For more information about this research and forthcoming work, please contact Aleks Collingwood, programme manager:��Aleks.Collingwood@jrf.org.uk

Effects of exaggerated amino acid and protein supply in man.

A general update review of the dynamic aspect of protein metabolism is presented. The effect of excess protein level on protein metabolism has been the object of a limited number of studies in man. From the information available, it appears that the primary regulatory pathway for body protein homeostasis is the process of amino acid (protein) oxidation.

Cleaning up neighbourhoods - Environmental Problems and Service Provision in Deprived areas

There has been growing concern that the quality of public services can be affected by the nature and scale of problems in deprived neighbourhoods and that poor services can contribute to a widening gap۪ between deprived and non-deprived neighbourhoods. There is also an increased emphasis within national policy on the quality of neighbourhood environments the so-called liveability۪ agenda. This report explores the challenges of delivering street scene۪ environmental services such as street sweeping and refuse collection in deprived and less deprived areas and examines the gap in environmental amenity between these different neighbourhoods. It also contributes to our understanding of the interplay between poor services and neighbourhood decline. The research involved a telephone survey of chief officers in local authority environmental service departments across the UK and detailed case studies of policy and practice in environmental service provision in four local authorities with significant levels of deprivation. Each case study involved work in three neighbourhoods within the authority two deprived and one less deprived as well as focus groups with residents and frontline environmental operatives, interviews with senior council staff and observation on the ground

National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants.

BACKGROUND: Data for trends in glycaemia and diabetes prevalence are needed to understand the effects of diet and lifestyle within populations, assess the performance of interventions, and plan health services. No consistent and comparable global analysis of trends has been done. We estimated trends and their uncertainties in mean fasting plasma glucose (FPG) and diabetes prevalence for adults aged 25 years and older in 199 countries and territories. METHODS: We obtained data from health examination surveys and epidemiological studies (370 country-years and 2·7 million participants). We converted systematically between different glycaemic metrics. For each sex, we used a Bayesian hierarchical model to estimate mean FPG and its uncertainty by age, country, and year, accounting for whether a study was nationally, subnationally, or community representative. FINDINGS: In 2008, global age-standardised mean FPG was 5·50 mmol/L (95% uncertainty interval 5·37-5·63) for men and 5·42 mmol/L (5·29-5·54) for women, having risen by 0·07 mmol/L and 0·09 mmol/L per decade, respectively. Age-standardised adult diabetes prevalence was 9·8% (8·6-11·2) in men and 9·2% (8·0-10·5) in women in 2008, up from 8·3% (6·5-10·4) and 7·5% (5·8-9·6) in 1980. The number of people with diabetes increased from 153 (127-182) million in 1980, to 347 (314-382) million in 2008. We recorded almost no change in mean FPG in east and southeast Asia and central and eastern Europe. Oceania had the largest rise, and the highest mean FPG (6·09 mmol/L, 5·73-6·49 for men; 6·08 mmol/L, 5·72-6·46 for women) and diabetes prevalence (15·5%, 11·6-20·1 for men; and 15·9%, 12·1-20·5 for women) in 2008. Mean FPG and diabetes prevalence in 2008 were also high in south Asia, Latin America and the Caribbean, and central Asia, north Africa, and the Middle East. Mean FPG in 2008 was lowest in sub-Saharan Africa, east and southeast Asia, and high-income Asia-Pacific. In high-income subregions, western Europe had the smallest rise, 0·07 mmol/L per decade for men and 0·03 mmol/L per decade for women; North America had the largest rise, 0·18 mmol/L per decade for men and 0·14 mmol/L per decade for women. INTERPRETATION: Glycaemia and diabetes are rising globally, driven both by population growth and ageing and by increasing age-specific prevalences. Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequelae. FUNDING: Bill & Melinda Gates Foundation and WHO.

OECD Review of Early Childhood Education and Care Policy in Ireland - Information Note

Thematic reviews of early childhood policy originated in response to a significant change in Western societies in the latter part of the 20th century. In effect, the care and education of young children in the industrialised world had shifted from the private to the public sphere, to become a shared responsibility of families and the state. Not only was the provision of equal access to women to the labour market an important goal in this development, but also the issue of giving every child a fair start in life and at school.

Automated systems in the identification and determination of methicillin resistance among coagulase negative staphylococci

Coagulase-negative staphylococci (CoNS) are an important cause of nosocomial bacteremia, specially in patients with indwelling devices or those submitted to invasive medical procedures. The identification of species and the accurate and rapid detection of methicillin resistance are directly dependent on the quality of the identification and susceptibility tests used, either manual or automated. The objective of this study was to evaluate the accuracy of two automated systems MicroScan and Vitek - in the identification of CoNS species and determination of susceptibility to methicillin, considering as gold standard the biochemical tests and the characterization of the mecA gene by polymerase chain reaction, respectively. MicroScan presented better results in the identification of CoNS species (accuracy of 96.8 vs 78.8%, respectively); isolates from the following species had no precise identification: Staphylococcus haemolyticus, S. simulans, and S. capitis. Both systems were similar in the characterization of methicillin resistance. The higher discrepancies for gene mec detection were observed among species other than S. epidermidis (S. hominis, S. saprophyticus, S. sciuri, S. haemolyticus, S. warneri, S. cohnii), and those with borderline MICs.

Analysis of need in relation to 'one stop shop' services for young people in Northern Ireland

An analysis of need for 'one stop shop' drop-in support services in relation to alcohol and drug misuse, undertaken by the PHA for the Health Development Policy Branch of the DHSSPS Additional information:

Prevention and Early Intervention in Children and Young People’s Services- Child Health and Development

IPH developed this report for the Centre for Effective Services (CES). The report explores learning from evaluations of 10 programmes operated as part of the Prevention and Early Intervention Initative funded by Atlantic Philanthropies and others. The report provides insights into the outcomes of prevention and early intervention initiatives relevant to early child development, school-based programmes and the integration of child services. A briefing paper is also available.

Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland.

BACKGROUND: The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey. METHODS: Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected. RESULTS: Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker. CONCLUSIONS: The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.

E-Governance and Citizen Information : The Generalitat of Catalonia in the International Context. Research report (synthesis document)

Aquest estudi té com a objectiu principal analitzar les transformacions que s'esdevenen al voltant de la incorporació d'innovacions tecnològiques de l'entorn de les TIC en els processos d'atenció al ciutadà per part de les administracions públiques. Les transformacions que hem analitzat tenen a veure amb tres dimensions que hem considerat bàsiques. D'una banda, ens hem centrat en els canvis que es produeixen en la forma en què els ciutadans (com a principals, tot i que no únics, usuaris) i l'administració es relacionen entre sí. De l'altra hem analitzat les transformacions que s'esdevenen en el funcionament intern i en la pròpia organització de l'administració arran de les transformacions dels canals de comunicació amb els usuaris. Per últim, hem considerat els canvis en la forma de gestionar (dissenyar, planificar, organitzar i dur a terme) el canvi i la innovació, tenint en compte especialment els rols dels diferents actors (no només públics) que hi participen. La recerca es recolza en un ampli estudi empíric sobre la Generalitat de Catalunya i en un estudi compartiu internacional sobre el Quebec, Emillia-Romagna i Escòcia.

Mitochondrial dysfunction and mitophagy activation in blood mononuclear cells of fibromyalgia patients: implications in the pathogenesis of the disease.

Introduction. Fibromyalgia is a chronic pain syndrome with unknown etiology. Recent studies have shown some evidence demonstrating that oxidative stress may have a role in the pathophysiology of fibromyalgia. However, it is still not clear whether oxidative stress is the cause or the effect of the abnormalities documented in fibromyalgia. Furthermore, the role of mitochondria in the redox imbalance reported in fibromyalgia also is controversial. We undertook this study to investigate the role of mitochondrial dysfunction, oxidative stress, and mitophagy in fibromyalgia. Methods. We studied 20 patients (2 male, 18 female patients) from the database of the Sevillian Fibromyalgia Association and 10 healthy controls. We evaluated mitochondrial function in blood mononuclear cells from fibromyalgia patients measuring, coenzyme Q10 levels with high-performance liquid chromatography (HPLC), and mitochondrial membrane potential with flow cytometry. Oxidative stress was determined by measuring mitochondrial superoxide production with MitoSOX™ and lipid peroxidation in blood mononuclear cells and plasma from fibromyalgia patients. Autophagy activation was evaluated by quantifying the fluorescence intensity of LysoTracker™ Red staining of blood mononuclear cells. Mitophagy was confirmed by measuring citrate synthase activity and electron microscopy examination of blood mononuclear cells. Results. We found reduced levels of coenzyme Q10, decreased mitochondrial membrane potential, increased levels of mitochondrial superoxide in blood mononuclear cells, and increased levels of lipid peroxidation in both blood mononuclear cells and plasma from fibromyalgia patients. Mitochondrial dysfunction was also associated with increased expression of autophagic genes and the elimination of dysfunctional mitochondria with mitophagy. Conclusions. These findings may support the role of oxidative stress and mitophagy in the pathophysiology of fibromyalgia.

Nanoparticle usage and protection measures in the manufacturing industry : a representative survey

Addressing the risks of nanoparticles requires knowledge about release into the environment and occupational exposure. However, such information currently is not systematically collected; therefore, this risk assessment lacks quantitative data. The goal was to evaluate the current level of nanoparticle usage in Swiss industry as well as health, safety, and environmental measures, and the number of potentially exposed workers. A representative, stratified mail survey was conducted among 1626 clients of the Swiss National Accident Insurance Fund (SUVA), which insures 80,000 manufacturing firms, representing 84% of all Swiss manufacturing companies (947 companies answered the survey for a 58.3% response rate). The extrapolation to all Swiss manufacturing companies results in 1309 workers (95% confidence interval [CI]: 1073 to 1545) potentially exposed to nanoparticles in 586 companies (95% CI: 145 to 1027). This corresponds to 0.08% of workers (95% CI: 0.06% to 0.09%) and to 0.6% of companies (95% CI: 0.2% to 1.1%). The industrial chemistry sector showed the highest percentage of companies using nanoparticles (21.2%). Other important sectors also reported nanoparticles. Personal protection equipment was the predominant protection strategy. Only a few applied specific environmental protection measures. This is the first nationwide representative study on nanoparticle use in the manufacturing sector. The information gained can be used for quantitative risk assessment. It can also help policymakers design strategies to support companies developing a safer use of nanomaterial. Notingthe current low use of nanoparticles, there is still time to proactively introduce protective methods. If the predicted "nano-revolution" comes true, now is the time to take action. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of occupational and Environmental Hygiene for the following free supplemental resource: a pdf file containing a detailed description of the approach to statistical analyses, English translation of the questionnaire, additional information for Figure 1, and additional information for the SUVA-code.] [Authors]

Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy

Chagas disease, named after Carlos Chagas, who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine bugs and via blood transfusion. Chagas disease has two successive phases: acute and chronic. The acute phase lasts six-eight weeks. Several years after entering the chronic phase, 20-35% of infected individuals, depending on the geographical area, will develop irreversible lesions of the autonomous nervous system in the heart, oesophagus and colon, and of the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980s as a result of the demographically representative cross-sectional studies in countries where accurate information was not previously available. A group of experts met in Brasilia in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country programme in the Southern Cone countries, the transmission of Chagas disease by vectors and via blood transfusion was interrupted in Uruguay in 1997, in Chile in 1999 and in Brazil in 2006; thus, the incidence of new infections by T. cruzi across the South American continent has decreased by 70%. Similar multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been reported towards the goal of interrupting the transmission of Chagas disease, as requested by a 1998 Resolution of the World Health Assembly. The cost-benefit analysis of investment in the vector control programme in Brazil indicates that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the programme is a health investment with very high return. Many well-known research institutions in Latin America were key elements of a worldwide network of laboratories that carried out basic and applied research supporting the planning and evaluation of national Chagas disease control programmes. The present article reviews the current epidemiological trends for Chagas disease in Latin America and the future challenges in terms of epidemiology, surveillance and health policy.