973 resultados para CONSULTATION
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A report on the potential to transform disadvantaged communities in Lisburn through early intervention.This feasibility study and consultation was commissioned from Barnardo's with funding from the Public Health Agency, by Resurgam Development Trust representing community and youth organisations in disadvantaged communities in the City of Lisburn, including Old Warren, Hilden, Hillhall, Tonagh, Knockmore and Lagan Valley. It involved consultations with a very wide range of community organisations, schools and professional agencies working in Lisburn. It also included research into: the needs of the target areas; the desired outcomes for children and young people; the evidence and arguments for taking an early intervention approach to the issues; the public policy context and the extent that it might support an early intervention approach; and the evidence of the potential impact of delivering particular proven programmes in the target areas of Lisburn. Researched and written by Dr Roger Courtney.
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The Community Development Strategy for Health and Wellbeing has been developed jointly by the Health and Social Care Board and the Public Health Agency.�The main purpose of the strategy is to recognise and support the important and pivotal role that community development plays in improving health and wellbeing.�The HSCB and PHA 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.�We seek to narrow the gap in health inequalities and improve the health and wellbeing of the population.�This means working to address the determinants of ill health and reducing risk factors, including those associated with poverty and social exclusion, and this can only be achieved in partnership with the community.The strategy was influenced by a widespread consultation in 2011 - details available here - during which over 300 individuals and organisations attended workshops and 60 written responses were received.�The following documents are attached below:Community Development Strategy - Consultation ResponsesCommunity Development Strategy - Executive SummaryCommunity Development Action PlanCommunity Development Strategy Community Development Strategy - Performance Management Framework
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The influenza season started later than normal, clinical indices began to increase marginally in mid-February, much later than previous seasons, and activity remained very low throughout, with community syndromic indicators not reaching the baseline warning threshold during the season. The peak GP influenza-like illness consultation rates in 2011/12 were the lowest since surveillance began in Northern Ireland in 2000. No one age-group appeared predominantly affected, with low levels of activity in all age groups, however, GP consultation rates increased in both children and adults.Influenza A (H3) was the predominant strain of the virus circulating, with small numbers of the influenza B strain circulating later in the season. Unlike the 2010/11 season when Influenza A (H1N1)2009 strain dominated in Northern Ireland, there were no detections of this subtype in 2011/12; virological activity generally corresponded to clinical activity.There were however, patients with confirmed influenza admitted to Intensive care units, across Northern Ireland during the season. Numbers were low, the average age of these patients increased compared with the previous season and one fatality was reported in this group.The proportion of over 65 year olds who received the 2011/12 seasonal influenza vaccine was 77.0%, and in those in a clinical risk group aged under 65 years was 81.7%, both of these vaccination uptake figures were a slight increase on the previous year. Influenza vaccine uptake in frontline healthcare workers also increased marginally this season to 20.8%, as did the proportion of pregnant women vaccinated during the season.
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The 2012/13 influenza season started earlier than in 2011/12; however it lasted longer, with GP consultation rates being elevated for approximately four months. Clinical indices began to increase in late December and peaked in early January, with the only two instances of community syndromic indicators exceeding the baseline threshold occurring in this month. GP influenza-like illness consultation rates in 2012/13 were higher than those in the 2011/12 season for the majority of the season but remained low overall.Overall no one age-group appeared predominantly affected; however, older adults predominated during the peak period, with rates increasing in children during February. Rates for those aged 65 and over increased late in the season, and this was associated with influenza outbreaks in care homes for the elderly.
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BACKGROUND: Major depression, although frequent in primary care, is commonly hidden behind multiple physical complaints that are often the first and only reason for patient consultation. Major depression can be screened by two validated questions that are easier to use in primary care than the full DSM-IV criteria. A third question, called the "help" question, improves the specificity without apparently decreasing the sensitivity of this screening procedure. We validated the abbreviated screening procedure for major depression with and without the "help" question in primary care patients managed for a physical complaint. METHODS: This diagnostic accuracy study used data from a cohort study called SODA (for SOmatisation Depression Anxiety ) conducted by 24 general practitioners (GPs) in western Switzerland that included patients over 18 years of age with at least one physical complaint at index consultation. Major depression was identified with the full Patient Health Questionnaire. GPs were asked to screen patients for major depression with the three screening questions one year after inclusion. RESULTS: Out of 937 patients with at least one physical complaint, 751 were eligible one year after index consultation. Major depression was diagnosed in 69/724 (9.5%) patients. The sensitivity and specificity of the two-question method alone were 91.3% (95% confidence interval 81.4-96.4%) and 65.0% (95% confidence interval 61.2-68.6%), respectively. Adding the "help" question decreased the sensitivity (59.4% ; 95% confidence interval 47.0-70.9%) but improved the specificity (88.2% ; 95% confidence interval 85.4-90.5%) of the three-question method. CONCLUSIONS: The use of two screening questions for major depression was associated with high sensitivity and low specificity in primary care patients presenting a physical complaint. Adding the "help" question improved the specificity but clearly decreased the sensitivity; when using the "help" question; four out of ten patients with depression will be missed, compared to only one out of ten with the two-question method. Therefore, the "help" question is not useful as a screening question, but may help discussing management strategies.
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�The 2013/14 influenza season started later than in 2012/13, it did not last as long and was noted at generally lower levels throughout than the previous season. Clinical indices began to increase in early January and peaked in mid-March, with community syndromic indicators not exceeding the baseline threshold at any time during the season. GP influenza-like illness consultation rates in 2013/14 were lower than those in the 2012/13 season for the majority of the season and remained low overall.Overall no one age group appeared predominantly affected with rates fluctuating throughout the season. The highest rate overall however was noted among the youngest age group during the peak period.
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Aquest projecte es centra en la Web Semàntica, concretament en els llenguatges de consulta per a documents RDF. Es fà un estudi dels llenguatges de consulta existents en l'actualitat.
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En aquest projecte de final de carrera s'ha dissenyat, implementat i provat un sistema que utilitzant criptografia de clau pública, garanteix la correcta utilització de les dades en un procés de consulta i complimentació d'una història clínica informatitzada consultada a distància.
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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.
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The 2014/15 influenza season was characterised by moderate levels of influenza activity.� Primary care consultation rates were higher than in 2013/14 for the majority of the season, although still low overall.� Activity seen in other surveillance was also higher than in 2013/14 year, and showed that the severity and impact of influenza was greater in 2014/15 and affected older age groups most frequently, with more reported respiratory outbreaks, patients with confirmed influenza admitted to Intensive Care Units/High Dependency Units and excess mortality in those over 65 years of a
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En aquesta memòria desenvolupem els conceptes associats al RSS i Atom: què és la web semàntica i la sindicació web, quines són les particularitats del XML i del seu llenguatge de consulta, el XQuery, les característiques dels formats RSS i Atom, i les bases de dades XML natives.
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Construcción de un web con OpenLayers, GeoServer y PostGIS para la visualización y consulta integrada de diferentes fuentes relacionadas con la biodiversidad.
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During the past twenty years, various instruments have been developed for the assessment of substance use in adolescents, mainly in the United States. However, few of them have been adapted to, and validated in, French-speaking populations. Consequently, although increasing alcohol and drug use among teenagers has become a major concern, the various health and social programs developed in response to this specific problem have received little attention with regard to follow-up and outcome assessment. A standardized multidimensional assessment instrument adapted for adolescents is needed to assess the individual needs of adolescents and assign them to the most appropriate treatment setting, to provide a single measurement within and across health and social systems, and to conduct treatment outcome evaluations. Moreover, having an available instrument makes it possible to develop longitudinal and trans-cultural research studies. For this reason, a French version of the Adolescent Drug Abuse Diagnosis (ADAD) was developed and validated at the University Child and Adolescent Psychiatric Clinic in Lausanne, Switzerland. This paper aims to discuss the methodological issues that we faced when using the ADAD instrument in a 4-year longitudinal study including adolescent substance users. Methodological aspects relating to the content and format of the instrument, the assessment administration and the statistical analyses are discussed.
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To assess the effectiveness of a multidisciplinary evaluation and referral process in a prospective cohort of general hospital patients with alcohol dependence. Alcohol-dependent patients were identified in the wards of the general hospital and its primary care center. They were evaluated and then referred to treatment by a multidisciplinary team; those patients who accepted to participate in this cohort study were consecutively included and followed for 6 months. Not included patients were lost for follow-up, whereas all included patients were assessed at time of inclusion, 2 and 6 months later by a research psychologist in order to collect standardized baseline patients' characteristics, process salient features and patients outcomes (defined as treatment adherence and abstinence). Multidisciplinary evaluation and therapeutic referral was feasible and effective, with a success rate of 43%for treatment adherence and 28%for abstinence at 6 months. Among patients' characteristics, predictors of success were an age over 45, not living alone, being employed and being motivated to treatment (RAATE-A score < 18), whereas successful process characteristics included detoxification of the patient at time of referral and a full multidisciplinary referral meeting. This multidisciplinary model of evaluation and referral of alcohol dependent patients of a general hospital had a satisfactory level of effectiveness. Predictors of success and failure allow to identify subsets of patients for whom new strategies of motivation and treatment referral should be designed.