Symposium on Dementia and Caregiving 23 May - Presentations

This Symposium, hosted by Dementia Services Information and Development Centre, opened up debate on formal and informal care for people with dementia living in the community and in residential care. ��It also discussed recent research findings on dementia care in Ireland and the United States.Click the link to view the following presentation slides:Professor Steve Zarit - Caregiving at a Cross-Roads; Bridging the Gap between Science and PracticeProfessor Eamon O'Shea - Costing Care for People with Dementia in IrelandDr Caroline O'Nolan - Longterm Residential Care for People with Dementia in Ireland: New Findings from a National SurveyDr Ana Diaz - "I Have a Good Life, I just want to Keep it"; Subjective Understandings and Objective Evaluations of Quality of Life after Diagnosis of DementiaProfessor Charles Normand - Burdens and Paradoxes in Caregiving

Profile of CAMHS service users in the East Midlands

This section uses the Children and Adolescent Mental Health Services mapping exercise set up in 2002, currently data is being collected for the 2005 exercise. This mapping is carried out on an annual basis collecting data on the specialist CAMH tier 2-4 services. Tier 1 is cover by professionals such as GPs and school nurses whereas tier 4 are highly specialised tertiary level services, tiers 2 and 3 cover the spectrum in between. The purpose of the mapping is to contribute towards the improvement of mental health services for children and adolescents by informing and supporting the implementation of the Children's Nation Service Framework.

Attracting, Developing and Training Effective Teachers - OECD Country Background Report for Ireland

This Country Background Report (CBR) on the teaching career in Ireland forms part of the major OECD study “Attracting, Developing and Retaining Effective Teachers.” Similar reports are being submitted from twenty six other countries. Nine of these countries are also engaged on ‘thematic’ studies of the teaching career, involving site visits by external reviewers appointed by the OECD. The format of the CBRs follows a common pattern, set out by the OECD in its Design and Implementation Plan. This is to facilitate comparative analysis of sub-themes of the reports. Thus, each CBR involves six chapters. The first two – “the national context” and “school system and the teaching force”– are intended to provide succinct overviews of these themes in line with queries posed in the OECD documentation. Each of the other four chapters is designed on a common format – identification of policy concerns; data, trends and factors; policy initiatives and their impact. Specific questions are posed regarding data, trends and factors. The same questions may be posed in relation to more than one sub-theme which gives rise to some repetition in the report, but is important for the comparative analysis.

OECD Review of Migrant Education - Country Report for Ireland

Immigration is a relatively new phenomenon in Ireland. Between 8 and 10% of students in Irish schools have an immigrant background representing many countries, cultures and languages. Their education outcomes are, on average, similar to their Irish-born peers. Irish schools experienced a rapid increase in the inflow of immigrant students only in recent years, and the main focus of migrant education is first-generation immigrants. Currently about 10% of students in primary schools and about 8% of students in post-primary schools have immigrant backgrounds. Unlike most other OECD countries, first-generation immigrant students in Ireland, on average, achieve education outcomes similar to their Irish-born peers, possibly because the socio-economic backgrounds of these students are similar to or higher than those of their Irish-born peers.

A one-year monitoring of nicotine use in sport: frontier between potential performance enhancement and addiction issues

Tobacco consumption is a global epidemic responsible for a vast burden of disease. With pharmacological properties sought-after by consumers and responsible for addiction issues, nicotine is the main reason of this phenomenon. Accordingly, smokeless tobacco products are of growing popularity in sport owing to potential performance enhancing properties and absence of adverse effects on the respiratory system. Nevertheless, nicotine does not appear on the 2011 World Anti-Doping Agency (WADA) Prohibited List or Monitoring Program by lack of a comprehensive large-scale prevalence survey. Thus, this work describes a one-year monitoring study on urine specimens from professional athletes of different disciplines covering 2010 and 2011. A method for the detection and quantification of nicotine, its major metabolites (cotinine, trans-3-hydroxycotinine, nicotine-N′-oxide and cotinine-N-oxide) and minor tobacco alkaloids (anabasine, anatabine and nornicotine) was developed, relying on ultra-high pressure liquid chromatography coupled to triple quadrupole mass spectrometry (UHPLC-TQ-MS/MS). A simple and fast dilute-and-shoot sample treatment was performed, followed by hydrophilic interaction chromatography-tandem mass spectrometry (HILIC-MS/MS) operated in positive electrospray ionization (ESI) mode with multiple reaction monitoring (MRM) data acquisition. After method validation, assessing the prevalence of nicotine consumption in sport involved analysis of 2185 urine samples, accounting for 43 different sports. Concentrations distribution of major nicotine metabolites, minor nicotine metabolites and tobacco alkaloids ranged from 10 (LLOQ) to 32,223, 6670 and 538 ng/mL, respectively. Compounds of interest were detected in trace levels in 23.0% of urine specimens, with concentration levels corresponding to an exposure within the last three days for 18.3% of samples. Likewise, hypothesizing conservative concentration limits for active nicotine consumption prior and/or during sport practice (50 ng/mL for nicotine, cotinine and trans-3-hydroxycotinine and 25 ng/mL for nicotine-N′-oxide, cotinine-N-oxide, anabasine, anatabine and nornicotine) revealed a prevalence of 15.3% amongst athletes. While this number may appear lower than the worldwide smoking prevalence of around 25%, focusing the study on selected sports highlighted more alarming findings. Indeed, active nicotine consumption in ice hockey, skiing, biathlon, bobsleigh, skating, football, basketball, volleyball, rugby, American football, wrestling and gymnastics was found to range between 19.0 and 55.6%. Therefore, considering the adverse effects of smoking on the respiratory tract and numerous health threats detrimental to sport practice at top level, likelihood of smokeless tobacco consumption for performance enhancement is greatly supported.

Ready to Learn White Paper on Early Childhood Education

The purpose of this White Paper is to set out Government policy on all issues relating to early childhood education. An essential starting point is to define what we mean by early childhood education. The Department of Education and Science�s mission is to support the development of a high quality education system which will enable individuals to develop to their full potential as persons and to participate fully as citizens in Ireland�s social and economic development. For many years, it was considered that education began when children went to school and ended when students left the formal education system at the end of first, second or third level. There is growing recognition of the importance of lifelong learning and the idea that children learn from the earliest moment and continue to learn throughout their lives. Education is concerned with all the phases of life, including the very early childhood phase.

The Forum on Patronage and Pluralism in the Primary Sector - Report of the Forum's Advisory Group

The fact that 96 percent of primary schools in Ireland are under denominational patronage is unique among developed countries. The reasons for this are deeply rooted in history and in the belief system of the population. With the establishment of the National (Primary) School system in 1831 the State provided financial support to local patrons for primary school provision, on the condition that patrons observed the regulations of the newly established Commissioners of National Education. While the State favoured applications from patrons of mixed denominations, what evolved, in practice, was that the great majority of schools came under the patronage of individual clergymen of different denominations.

Treatment of chronic hepatitis c in 3 patients with hcv-induced severe thrombocytopenia

BACKGROUND: Thrombocytopenia has been described in HCV infection even in the absence of cirrhosis and splenomegaly. Different mechanisms have been proposed, including immunemediated platelet (plt) destruction. Here, we report on the treatment of 3 patients with HCV-HIV coinfection and HCVinduced severe thrombocytopenia. PATIENTS AND TREATMENT: All patients had an infection with HCV genotype 3, an intermediate fibrosis stage (Metavir F2 or F3), HIV infection controlled by antiretroviral combination therapy, and severe, steroid-refractory thrombocytopenia. Pegylated interferon-α2a (PEG-IFN-α2a) was started at 45 or 90 μg per week and doses were rapidly increased in the following, while ribavirin (RBV) was prescribed at standard doses. Treatment was pursued for 48 weeks. Two patients received intravenous immunoglobulins (IVIG) during the first weeks of PEG-IFN-α2a and RBV combination therapy. RESULTS: A significant increase in plt counts (from 17, 39 and 37 G/l, respectively, to > 100 G/l) was observed in the 3 patients while they experienced a virological response. Thrombocytopenia relapsed in one patient together with a relapse of chronic hepatitis C. The other 2 patients achieved a sustained virological response (SVR), with normal plt counts at follow-up in one and persistent mild thrombocytopenia in the other. CONCLUSIONS: Carefully titrated PEG-IFN-α2a and RBV combination therapy may be performed safely in this difficult-totreat patient population, with close monitoring and eventually concomitant IVIG during the first weeks. SVR can lead to normalization or significant improvement of plt counts, suggesting a causative role of HCV in this condition.

Enjoy healthy eating

�What we eat every day has a big impact on our health - from the amount of energy we have when we get up in the morning to our risk of developing conditions like heart disease and cancer in the future. A healthy diet doesn��'t have to be boring or restrictive ��- we can still eat a wide range of delicious foods, while keeping an eye on our intake of sugar, fat and salt.

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.

Loneliness and ageing: Ireland, North and South

Loneliness can have a significant impact on the physical and mental health of older people and is of increasing concern for public health says a new report from the Institute of Public Health in Ireland (IPH). The research suggests that approximately 10% of older people are affected by chronic or persistent loneliness. It also finds that loneliness amongst older people may be linked to depression, increased nursing home admission, decreased quality of life and cognitive decline. The report compiled by Brian Harvey and Kathy Walsh for the Ageing Research and Development Division at IPH examines loneliness in particular amongst older people and the policy and service interventions to tackle the issue. It argues that loneliness may be tackled by health and social policies and therefore needs to be addressed in a cross cutting manner to maximise the impact of interventions and services.

Health Protection Inequalities on the island of Ireland: An introductory paper

Public health services in Ireland, North and South, are committed to addressing inequalities in health on the island of Ireland. This report, prepared by Dr Lorraine Doherty, Assistant Director of Public Health (Health Protection), Public Health Agency NI for the Institute of Public Health in Ireland (IPH), specifically highlights health inequalities in relation to infectious diseases and other areas of health protection such as chemical hazards and environmental disruption. Infectious diseases disproportionately affect the most vulnerable in society. These vulnerable groups bear the highest burden of disease in relation to infectious diseases. The report also highlights the impact of climate change on health protection and the impacts for water, food and vector borne diseases. The aim of this report is to enable a programme of work to begin to document health protection inequalities and develop action plans for addressing them on an all island basis.

Report of the Consultation for a National Rare Disease Plan for Ireland

This IPH report (2013) (prepared for the ROI Department of Health) presents findings from the National Consultation on Rare Disease overseen by the Institute of Public Health in Ireland on behalf of the Department of Health to inform the development of Ireland’s first National Rare Disease Plan. In 2009, the Council of the European Union recommended that all member countries develop a national plan for rare diseases with the framework of their health and social systems by the end of 2013. The aim is to ensure that all patients with rare disease in Europe have access to high quality care, including diagnostics, treatments and rehabilitation.

Ageing Prisoners' Disease Burden: Is Being Old a Better Predictor than Time Served in Prison?

Background: The number of older prisoners entering and ageing in prison has increased in the last few decades. Ageing prisoners pose unique challenges to the prison administration as they have differentiated social, custodial and healthcare needs than prisoners who are younger and relatively healthier. Objective: The goal of this study was to explore and compare the somatic disease burden of old and young prisoners, and to examine whether it can be explained by age group and/or time served in prison. Methods: Access to prisoner medical records was granted to extract disease and demographic information of older (>50 years) and younger (≤49 years) prisoners in different Swiss prisons. Predictor variables included the age group and the time spent in prison. The dependent variable was the total number of somatic diseases as reported in the medical records. Results were analysed using descriptive statistics and a negative binomial model. Results: Data of 380 male prisoners from 13 different prisons in Switzerland reveal that the mean ages of older and younger prisoners were 58.78 and 34.26 years, respectively. On average, older prisoners have lived in prison for 5.17 years and younger prisoners for 2.49 years. The average total number of somatic diseases reported by older prisoners was 2.26 times higher than that of prisoners below 50 years of age (95% CI 1.77-2.87, p < 0.001). Conclusion: This study is the first of its kind to capture national disease data of prisoners with a goal of comparing the disease burden of older and younger prisoners. Study findings indicate that older inmates suffer from more somatic diseases and that the number of diseases increases with age group. Results clearly illustrate the poorer health conditions of those who are older, their higher healthcare burden, and raises questions related to the provision of healthcare for inmates growing old in prison. © 2014 S. Karger AG, Basel.

Efficacy of benznidazol treatment for asymptomatic chagasic patients from state of Rio Grande do Sul evaluated during a three years follow-up

The efficacy of benznidazol on the treatment of chagasic patients from the state of Rio Grande do Sul was evaluated during a three-year follow-up. A cohort of 80 asymptomatic chronic chagasic patients or blood bank donors (49 male and 31 female) was studied. Their ages varied from 17-42 years, with a mean and a median of 30 and 35 years, respectively. The 80 patients presented positive serology, hemoculture and polymerase chain reaction (PCR). They were treated with 5 mg/Kg benznidazol twice a day for 60 days. Serological, parasitological and PCR methods were used to evaluate response. Serology was performed using commercial ELISA and indirect immunofluorescence (IFI) tests, parasitemia was monitored by hemoculture in LIT medium and PCR with primers S35/S36 was used to amplify a Trypanosoma cruzi 330 bp kDNA repetitive sequence. PCR positivity of 240 seropositive individuals was compared using DNA preparations from whole blood/guanidine EDTA (GE), buffy-coat/GE and frozen buffy-coat. Fifty non-chagasic individuals were used as negative controls. PCR positivity was 86.7% for the frozen buffy-coat, 71.7% for the GE/buffy-coat and 69.2% for the GE/whole blood. The hemocultures became negative just after treatment and remained negative during the three years of follow-up. In the third year after treatment, 9/80 (11.3%) patients presented negative PCR and, from those, four also presented negative serological tests. Furthermore, a reduction in three serological titers was observed in 27/80 (33.8%) of the patients treated. Taken together, the results show that four of the 80 (5.0%) chronic chagasic patients from the state of Rio Grande do Sul were cured after treatment with benznidazol.