14 principles of best practice for Service Delivery: An Interculturally Competent Approach to Meeting the Needs of Victims/Survivors of Gender-based Violence

14 principles of best practice for Service Delivery: An Interculturally Competent Approach to Meeting the Needs of Victims/Survivors of Gender-based Violence Click here to download PDF 390kb This is a publication of the Womens Health Council

Changing Cardiovascular Health: National Cardiovascular Health Policy 2010 - 2019

This new cardiovascular policy, Changing Cardiovascular Health covering the period 2010-2019, comes a decade after the first national cardiovascular health strategy, entitled Building Healthier Hearts, was published by the Department of Health in 1999. The new policy is timely given the pace of scientific discovery and related changes in medical practice, changes in health service structures, and patterns and influences on population health behaviours in Ireland over the decade. Cardiovascular health and its maintenance is a microcosm of health more generally. A policy that can improve cardiovascular health and cardiovascular disease management will have beneficial effects for the whole healthcare system and population.Download this document

A Review Of Practice Development In Nursing And Midwifery In The Republic Of Ireland And The Development Of A Strategic Framework

A Review Of Practice Development In Nursing And Midwifery In The Republic Of Ireland And The Development Of A Strategic Framework Click here to download PDF 1.52MB

Foreign ant queens are accepted but produce fewer offspring.

Understanding social evolution requires us to understand the processes regulating the number of breeders within social groups and how they partition reproduction. Queens in polygynous (multiple queens per colony) ants often seek adoption in established colonies instead of founding a new colony independently. This mode of dispersal leads to potential conflicts, as kin selection theory predicts that resident workers should favour nestmate queens over foreign queens. Here we compared the survival of foreign and resident queens as well as their relative reproductive share. We used the ant Formica exsecta to construct colonies consisting of one queen with workers related to this resident queen and introduced a foreign queen. We found that the survival of foreign queens did not differ from that of resident queens over a period of 136 days. However, the genetic analyses revealed that resident queens produced a 1.5-fold higher number of offspring than introduced queens, and had an equal or higher share in 80% of the colonies. These data indicate that some discrimination can occur against dispersing individuals and that dispersal can thus have costs in terms of direct reproduction for dispersing queens.

Good Practice Guides

This series of Good Practice Guides is designed to share important information about health inequalities and some of the evidence-based measures that can be taken to reduce the stark differences in health and wellbeing within populations. It is recognised that leadership and coordinated, effective action at a number of levels can reduce this gap. Ensuring concerted, evidence-based action on health and wellbeing inequalities demands the efforts of government, statutory organisations and the community, voluntary and private sectors. The Good Practice Guides were developed to inform and support joined-up working across these sectors. It is known that health inequalities are closely linked with degrees of social disadvantage and with the unequal distribution of power, income, goods and services. According to the World Health Organization, there are also powerful social and psychological factors and life circumstances that can serve to compound health and wellbeing inequalities. The topics included in the Good Practice Guide series reflect the wider determinants of health and the range of approaches necessary to reduce health inequalities. This first set of three guides is designed, in part, to test their usefulness. There are many other issues and areas where evidence of what works may be needed. It is envisaged that further guides will follow on other issues. All of the guides will be kept under review and amended in light of experience.

Shaping the future: applying therapy research to practice

In these challenging financial times the use of research as a basis for effective health and social care cannot be overstated. 'Shaping the Future', a joint Public Health Agency and University of Ulster workshop (27 January) takes a fresh look at research within the Allied Health Professions (AHPs) to improve the care and experiences of people across Northern Ireland.The AHPs provide a wide range of services including physiotherapy, occupational therapy, radiography, podiatry, speech and language therapy and orthoptics.The nature of their work enables AHPs to carry out research that can rapidly benefit patient care and experience. 'Shaping the Future' will look at priorities for new AHP research and consider how existing research can be more effectively shared and used in health and social care development, rather than perhaps being limited to the academic world.Speaking at the event, Professor Bernie Hannigan, Director of Health and Social Care Research and Development (HSC R&D), aDivision of the PHA, said: "A sound base of evidence from research is vital for effective health and social care practice. I welcome this study as an important resource that will help generate new evidence and highlight the potential for existing evidence to be applied in practice. The evidence base points to beneficial innovations that use the most up-to-date knowledge and keep the service user at the centre of care practices. At this event, health and social care policy makers, commissioners, academics and researchers will be able to consider how they can do and use research to ensure our AHP services deliver the best outcomes for patients and are sufficiently cost-effective to be sustained."A recent study funded by HSC R&D was carried out by the University of Ulster working closely with leading AHPs, key stakeholders and service users* from throughout Northern Irealnd. Presenting the results of this study at the 'Shaping the Future' event will help to identify ways to gather evidence and contribute to innovative projects and programmes.Professor Suzanne McDonough, of the Health and Rehabilitation Sciences Research Centre at the University of Ulster, said: "In our study we used the Delphi technique, which is a structured process using a series of questionnaires, to gather information and gain consensus from AHP groups, stakeholders and service users."The results identified seven major priority areas for research. These ranged from: the need for more practice evaluation particularly in the areas of mental health, cancer, obesity; diabetes; chronic disease management (especially stroke and brain injury); the role of AHPs in health promotion; service delivery issues such as access to services and waiting times. This study provides an important road map for AHP research priorities. It is the first step in the process of identifying what research still needs to be undertaken, what research already exists but needs to be translated, and some of the processes that need to be in place to ensure that research is an integral part of the day-to-day practice of AHPs and of service delivery."

Planning Practice Guidance

The Department for Communities and Local Government has published National Planning Practice Guidance which recognises the importance of local infrastructure planning in the development of healthy communities. The guidance supports the National Planning Policy Framework and now includes a section on health and wellbeing. This guidance sets out the government’s planning policies for England and how these are expected to be applied by local authorities. A significant development in the guidance is the recognition of the important role the planning system can play in facilitating social interaction and creating healthy, inclusive communities. Local planning authorities should ensure that health and wellbeing, and health infrastructure are considered in local and neighbourhood plans and in planning decision making.

A good practice guide for school food initiatives

This Guide was developed through extensive consultation with schools, community groups, health professionals and suppliers who are currently involved in providing food in school. Research was also conducted on approaches in Northern Ireland and in other countries. Finally, we consulted with Government and social partner stakeholders at national level to get their views as to the main issues to be addressed.

A good practice guide for community food initiatives

Food and nutrition are key determinants of health. What people eat, and how much they eat, influences how healthy they are, and even how long they live. Food poverty arises when people lack the money or other resources needed to eat a healthy diet. The overarching objective of Healthy Food for All is to end food poverty on the island of Ireland.

Médecine sociale en 2013 : quand la précarité précède la pauvreté [Social medicine : does it still make sense in 2013?]

Social medicine is a medicine that seeks to understand the impact of socio-economic conditions on human health and diseases in order to improve the health of a society and its individuals. In this field of medicine, determining the socio-economic status of individuals is generally not sufficient to explain and/or understand the underlying mechanisms leading to social inequalities in health. Other factors must be considered such as environmental, psychosocial, behavioral and biological factors that, together, can lead to more or less permanent damages to the health of the individuals in a society. In a time where considerable progresses have been made in the field of the biomedicine, does the practice of social medicine in a primary care setting still make sense? La médecine sociale est une médecine qui cherche à comprendre l'impact des conditions socio-économiques sur la santé humaine et les maladies, dans la perspective d'améliorer l'état de santé d'une société et de ses individus. Dans ce domaine, la détermination du statut socio-économique des individus ne suffit généralement pas à elle seule pour expliquer et comprendre les mécanismes qui sous-tendent les inégalités sociales de santé. D'autres facteurs doivent être pris en considération, tels que les facteurs environnementaux, psychosociaux, comportementaux et biologiques, facteurs qui peuvent conduire de manière synergique à des atteintes plus ou moins durables de l'état de santé des individus d'une société. A une époque où les connaissances, les compétences et les moyens à disposition en biomédecine ont fait des progrès considérables, la pratique de la médecine sociale en cabinet a-t-elle encore sa place en 2013?

Rôle des paramètres sociopolitiques et des connaissances dans la gestion des risques hydrologiques

Résumé Rôle des paramètres sociopolitiques et des connaissances dans la gestion des risques hydrologiques¦La recherche analyse (1) la mise en oeuvre de la gestion des risques hydrologiques et (2) les connaissances dont disposent les acteurs sur ces derniers, ainsi que (3) les interdépendances entre ces deux volets. Au total, trois études de cas ont été réalisées dont deux études régionales (ville de Berne, commune de Saillon) et une étude sur un acteur spécifique (les corporations de digues dans le canton de Berne). Les données empiriques ont été obtenues par des entretiens oraux semi-directifs et des enquêtes écrites.¦La gestion des risques hydrologiques est fortement influencée par des paramètres sociopolitiques, c'est-à-dire par les intérêts et les objectifs des acteurs, par les rapports de force entre ceux-ci ainsi que par les processus de négociation et de décision. Dans la pratique, les démarches de gestion se restreignent toutefois majoritairement aux aspects physiques, techniques et administratifs des risques hydrologiques. La dimension sociopolitique est ainsi négligée, ce qui est source de conflits qui ralentissent considérablement la planification de la protection contre les crues, voire la bloquent même complètement. La gestion des risques hydrologiques est en outre largement focalisée sur la réduction des aléas. Lés débats sur la vulnérabilité sont nettement plus rares bien qu'ils soient indispensables lorsqu'il s'agit de traiter les risques de façon holistique.¦Etant donné l'importance de la dimension sociopolitique et de la vulnérabilité, il est nécessaire que les démarches prévues dans la gestion des risques hydrologiques soient reconsidérées et adaptées. De plus, une meilleure intégration de tous les acteurs concernés est primordiale afin de trouver des solutions qui soient acceptables pour une majorité. Pour l'instant, le recours à des instruments de négociation est insuffisant.¦Les connaissances des risques hydrologiques et de leur gestion peuvent être classées en quatre répertoires (connaissances du système, de l'événement, de l'intervention et connaissances sociopolitiques) qui influent tous sur la réduction des risques. Parmi les facteurs les plus importants susceptibles de déclencher des transformations se trouvent l'occurrence de crues, la réalisation d'études (portant sur les aléas, la vulnérabilité, les mesures, etc.), l'échange de connaissances entre les acteurs, ainsi que la recherche de solutions lors de la gestion.¦Les caractéristiques des connaissances varient considérablement selon les acteurs. L'appartenance à un groupe donné ne permet toutefois pas à elle seule de déterminer l'état des connaissances : tous les acteurs peuvent avoir des connaissances pertinentes pour la gestion des risques. Les différences entre les acteurs rendent pourtant la communication compliquée. Ce problème pourrait être atténué par des médiateurs qui assureraient un travail de traduction. Dans la pratique, de telles instances manquent généralement.¦La gestion et les connaissances des risques hydrologiques sont fortement interdépendantes. L'état et les caractéristiques des connaissances déterminent directement la qualité de la protection contre les crues. Des lacunes ou des imprécisions peuvent donc entraîner une gestion non adaptée aux risques présents. Afin d'éviter une telle situation, il est important que les connaissances sur les risques hydrologiques et sur les possibilités d'y faire face soient régulièrement remises à jour. Ne devant pas se restreindre à l'expérience de crues passées, il est impératif qu'elles contiennent aussi des réflexions prospectives et des scénarios novateurs.¦La gestion n'est pas seulement demandeuse en connaissances, elle est également susceptible d'en générer de nouvelles et d'élargir les connaissances existantes. Il convient donc de considérer la création et le transfert de connaissances comme une tâche centrale de la gestion des risques.¦Zusammenfassung Die Rolle der soziopolitischen Parameter und des Wissens im Umgang mit hydrologischen Risiken¦Die Arbeit untersucht drei Themenbereiche: (1) den soziopolitischen Umgang mit hydrologischen Risiken, (2) das Wissen, über das die Akteure bezüglich der Hochwasserrisiken verfügen sowie (3) die Wechselwirkungen zwischen diesen beiden Themenfeldern. Insgesamt wurden drei Fallstudien durchgeführt, darunter zwei regionale Studien (Stadt Bern, Gemeinde Saillon) und eine Untersuchung eines spezifischen Akteurs (Schwellenkorporationen im Kanton Bern). Die empirischen Daten wurden anhand von halbstandardisierten Interviews und schriftlichen Umfragen erhoben.¦Das Management hydrologischer Risiken ist stark von soziopolitischen Parametern beeinflusst, d.h. von Interessen und Zielvorstellungen der Akteure, von Machtverhältnissen und von Verhandlungs- und Entscheidungsprozessen. Die in der Praxis vorgesehenen Schritte zur Reduktion der Hochwasserrisiken beschränken sich jedoch meist auf die physischen, administrativen und technischen Aspekte der Risiken. Die Vernachlässigung ihrer soziopolitischen Dimension führt zu Konflikten, welche die Planung von Hochwasserschutzprojekten deutlich verlangsamen oder gar blockieren. Des Weiteren konzentriert sich das Risikomanagement im Wesentlichen auf die Reduktion der Gefahren. Gesellschaftliche Debatten zur Vulnerabilität sind deutlich seltener, obschon sie für einen umfassenden Umgang mit Risiken unabdingbar sind.¦Angesichts der Bedeutung der soziopolitischen Dimension und der Vulnerabilität ist es notwendig, dass die Vorgehensweise im Risikomanagement überdacht und angepasst wird. Zudem ist eine bessere Integration aller betroffener Akteure unablässig, um mehrheitsfähige Lösungen zu finden. Zur Zeit ist der Rückgriff auf entsprechende Instrumente ungenügend.¦Das Wissen über hydrologische Risiken und deren Management kann in vier Repertoires eingeteilt werden (Systemwissen, Ereigniswissen, Interventionswissen, soziopolitisches Wissen), die alle bei der Reduktion von Risiken bedeutsam sind. Zu den wichtigsten Faktoren, die Wissenstransformationen auslösen, gehören Hochwasserereignisse, die Durchführung von Studien (zu Gefahren, zur Vulnerabilität, zu Massnahmen usw.), der Wissensaustausch zwischen Akteuren und die Suche nach Lösungen während des Risikomanagements.¦Die Merkmale der Wissensformen unterschieden sich stark zwischen den verschiedenen Akteuren. Die Zugehörigkeit eines Akteurs zu einer bestimmten Gruppe ist jedoch kein ausreichendes Kriterium, um dessen Wissensstand zu bestimmen: Alle Akteure können über Wissen verfügen, das für den Umgang mit Risiken relevant ist. Die Unterschiede zwischen den Akteuren gestalten die Kommunikation allerdings schwierig. Das Problem liesse sich entschärfen, indem Mediatoren eingesetzt würden, die als Übersetzer und Vermittler agierten. In der Praxis fehlen solche Instanzen weitgehend.¦Zwischen dem Umgang mit hydrologischen Risken und dem Wissen bestehen enge Wechselwirkungen. Der Zustand und die Eigenschaften der Wissensformen bestimmen direkt die Qualität des Hochwasserschutzes. Lückenhaftes und unpräzises Wissen kann demnach zu einem Risikomanagement führen, das den tatsächlichen Gegebenheiten nicht angepasst ist. Um eine solche Situation zu verhindern, muss das Wissen über Risiken und Hochwasserschutz regelmässig aktualisiert werden. Dabei darf es sich nicht auf die Erfahrung vergangener Hochwasser beschränken, sondern hat auch vorausschauende Überlegungen und neuartige Szenarien einzubeziehen.¦Das Risikomanagement benötigt nicht nur Wissen, es trägt auch dazu bei, neues Wissen zu t generieren und bestehendes zu erweitern. Die Erarbeitung und der Transfer von Wissen sind deshalb als zentrale Aufgaben des Risikomanagements zu betrachten.¦Abstract¦The role of socio-political parameters and of knowledge in the management of hydrological risks¦The purpose of the thesis is to analyse (1) the socio-political management of hydrological risks, (2) the knowledge about hydrological risks, and (3) the interaction between risk management and knowledge. Three case studies were carried out, two at a regional level (city of Berne, village of Saillon) and one about a specific stakeholder (the dyke corporations in the canton of Berne). Empirical data were collected by the means of semi-structured interviews and surveys.¦The management of hydrological risks is highly influenced by socio-political issues, i.e. by interests and goals of stakeholders, by the balance of power between stakeholders, as well as by negotiations and decision-making processes. In practice, however, risk management is mainly constrained by physical, technical, and administrative aspects. The neglect of the socio-political dimension may thus be the source of conflicts which significantly delay the planning and implementation of flood protection measures, or even stop them. Furthermore, risk management mostly concentrates on hazard reduction. Discussions on vulnerability issues are less frequent although they are fundamental for treating risks in a holistic manner.¦Because of the importance of the social-political dimension and of vulnerability issues, it is necessary that the common approach of managing hydrological risks is reconsidered and adapted. Moreover, the integration of all stakeholders that are concerned with hydrological risks is essential for finding solutions which are supported by a majority. For instance, the application of appropriate negotiation instruments is insufficient.¦Knowledge about hydrological risks and their management can be classified into four categories (system knowledge, event knowledge, intervention knowledge, socio-political knowledge) which are all influencing the reduction of risks. Among the most important factors that are likely to trigger knowledge transformations, one can point out flood events, studies about risk parameters (hazards, vulnerability, protection measures, etc.), knowledge exchange between stakeholders, and the search for solutions during risk management.¦The characteristics of knowledge vary considerably between stakeholders. The affiliation to a specific group is thus not a sufficient criterion to determine the quality of a stakeholder's knowledge: every stakeholder may have knowledge that is relevant for risk management. However, differences between stakeholders complicate the communication. This problem could be attenuated by mediators which ensure the translation between stakeholders. In practice, such instances are generally lacking.¦The management and knowledge of hydrological risks are highly interdependent. The state and the characteristics of the four categories of knowledge determine directly the quality of flood protection. Gaps and imprecison may thus lead to forms of management which are not adapted to the actual risks. This kind of situation can be avoided by updating regularly the knowledge about hydrological risks and about protection measures. However, knowledge must not be restricted to the experience of past floods. On the contrary, it is indispensable also to involve prospective reflections and new scenarios.¦Risk management does not only require knowledge, it may also generate new knowledge and enlarge existing knowledge. The creation and the transfer of knowledge has thus to be seen as a central task in risk management.

Accident & Emergency Nursing Assessment of Deliberate Self Harm. Exploring the Impact of Introducing a Suicide Education Programme and a Suicide Intent Scale into A&E/MAU Nursing Practice: A Pilot Study

A proposal to pilot nursing assessment of self harm in Accident and Emergency Departments (A&E) was developed by key stakeholders in nurse education and suicide prevention in the South East and submitted to the National Council for the Professional Development of Nursing and Midwifery in April 2002.The proposal included the introduction of a suicide intent scale. Following an initial training programme, a suicide intent scale was utilised by nursing staff in A&E and the Medical Assessment Unit (MAU),Wexford General Hospital and evaluated over a period of nine months. Four months into the study the National Suicide Research Foundation (NSRF) was invited to collaboratively prepare a successful submission to the Health Research Board (HRB) as part of ‘Building Partnerships for a Healthier Future Research Awards 2004’. The NSRF undertook independent scientific evaluation of the outcomes of the suicide awareness programme. The study is in line with priorities determined by Reach Out, the National Strategy for Action on Suicide Prevention 2005-2014 (HSE, 2005) and the HSE-South East Suicide Prevention Programme through raising nursing staff awareness of the public health issue of suicide/deliberate self harm and by improving the efficiency and quality of nursing services offered to persons who present to acute hospitals with deliberate self harm. The study findings indicate evidence to positively support nursing assessment of DSH using a suicide intent scale in terms of assessing behavioural characteristics of individual clients and their suicide risk. Enhanced confidence levels of nursing personnel in caring for suicidal clients was demonstrated by staff who participated in an education programme related to risk assessment and specifically the use of a suicide intent scale.This resource was contributed by The National Documentation Centre on Drug Use.

Primary medical care in Irish prisons

An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review.   This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available.   There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available.   People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.This resource was contributed by The National Documentation Centre on Drug Use.