OECD Thematic Review of Early Childhood Education and Care Policy in Ireland

Ireland is one of the smallest countries in Europe and occupies the most westerly, peripheral position. Geographically, the entire island is comprised of 32 counties, 26 of which make up the Republic of Ireland, (commonly referred to as the South), and 6 of which go to make up Northern Ireland (usually called the North), which forms part of the United Kingdom. This report is concerned with the Republic of Ireland only, which will be referred to as Ireland in the remainder of this report for ease of reading.

Alcoolisme et violence: dangerosité et relation médecin-malade [Alcohol and violence: reflection on care and responsibility].

Violence and aggression in human drinking society, either physical, psychological, sexual or resulting from neglect are not only debilitating both for the victim and the offender but extremely prevalent and pervasive. While being on the frontline to identify and rate auto- and hetero aggressive behaviour risk, the general health practitioner remains keen to protect his special relationship. When a history of violent behaviour becomes apparent, discernment must be thoroughly assessed and a critical exploration of its larger impact on family, children, co-workers and everyday fellow citizen should become compulsory.

Implications of Objective vs Subjective Delirium Assessment in Surgical Intensive Care Patients.

Background Delirium is an independent predictor of increased length of stay, mortality, and treatment costs in critical care patients. Its incidence may be underestimated or overestimated if delirium is assessed by using subjective clinical impression alone rather than an objective instrument. Objectives To determine frequency of discrepancies between subjective and objective delirium monitoring. Methods An observational cohort study was performed in a surgical-cardiosurgical 31-bed intensive care unit of a university hospital. Patients' delirium status was rated daily by bedside nurses on the basis of subjective individual clinical impressions and by medical students on the basis of scores on the objective Confusion Assessment Method for the Intensive Care Unit. Results Of 160 patients suitable for analysis, 38.8% (n = 62) had delirium according to objective criteria at some time during their stay in the intensive care unit. A total of 436 paired observations were analyzed. Delirium was diagnosed in 26.1% of observations (n = 114) with the objective method. This percentage included 6.4% (n = 28) in whom delirium was not recognized via subjective criteria. According to subjective criteria, delirium was present in 29.4% of paired observations (n = 128), including 9.6% (n = 42) with no objective indications of delirium. A total of 8 patients with no evidence of delirium according to the objective criteria were prescribed haloperidol and lorazepam because the subjective method indicated they had delirium. Conclusions Use of objective criteria helped detect delirium in more patients and also identified patients mistakenly thought to have delirium who actually did not meet objective criteria for diagnosis of the condition.

La visite médicale en pratique hospitalière: entre soins et apprentissage [Conducting ward rounds: a balance between care and teaching].

Every day, hospital doctors spend time at conducting ward rounds. Rounds are a core clinical activity during which doctors interact with patients, synthetise a whole set of informations and make many decisions. In addition, rounds can become a crucial teaching moment, when a trainee gets supervised by an attending physician. However, litterature on the topic of rounds is scarce. This paper summarizes the results of the few key studies focusing on ward rounds. The results are presented in four sections, each one being dedicated to one of the round stakeholders: the trainee or resident, the trainer, the patient and the nurse. An emphasis is put on ward rounds involving both a trainee and a trainer, since such rounds always mean striking a balance between care and teaching.

Early infection and asymptomatic spread of hepatitis A virus in a public child care center in Rio de Janeiro, Brazil: should attending children under two years of age be vaccinated?

A cross-sectional study was conducted in order to identify hepatitis A virus (HAV) serological markers in 418 individuals (mean age, 16.4 years; range, 1 month-80 years) at a public child care center in Rio de Janeiro, Brazil, as well as to analyze risk factors and determine circulating genotypes. Serum samples were tested using an enzyme immunoassay. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect and characterize HAV RNA, and sequencing was performed. Anti-HAV antibodies and IgM anti-HAV antibodies were detected, respectively, in 89.5% (374/418) and 10.5% (44/418) of the individuals tested. Acute HAV infection in children was independently correlated with crawling (p < 0.05). In 56.8% (25/44) of the IgM anti-HAV-positive individuals and in 33.3% (5/15) of the IgM anti-HAV-negative individuals presenting clinical symptoms, HAV RNA was detected. Phylogenetic analysis revealed co-circulation of subgenotypes IA and IB in 93.3% (28/30) of the amplified samples. In present study, we verify that 79% (30/38) of children IgM anti-HAV-positive were asymptomatic. In child care centers, this asymptomatic spread is a more serious problem, promoting the infection of young children, who rarely show signs of infection. Therefore, vaccinating children below the age of two might prevent the asymptomatic spread of hepatitis A.

Diabetes in pregnancy: are we providing the best care?

This third and final report of the CEMACH national diabetes programme comes at an important time in the national drive to improve services for women with diabetes in pregnancy. The National Service Framework (NSF) for Diabetes requires the NHS to develop, implement and monitor policies that seek to empower and support women with diabetes to optimise the outcomes of their pregnancy. The CEMACH report shows that, whilst progress has been made in improving services for women with diabetes and their babies, there is much still to be done to meet the standards recommended by the NSF. Too many women continue to be poorly prepared for pregnancy in the critical areas of glycaemic control and folic acid supplementation. The report underlines the need for an increased focus on diabetes preconception care services and the development of strategies to educate women with diabetes of childbearing age. The growing proportion of women with type 2 diabetes during pregnancy, many of whom are from minority ethnic groups, presents an additional challenge for health services in developing responsive and accessible services.This CEMACH report has identifi ed several areas of good clinical practice during pregnancy in women with pre-existing diabetes. However, there continue to be areas where there is room for improvement, including antenatal fetal surveillance, glycaemic control during labour and delivery and postnatal diabetes care. The National Institute for Health and Clinical Excellence (NICE) is currently in the fi nal stages of development of its new guideline for the management of diabetes in pregnancy. This guideline, when taken together with the CEMACH report, will provide local health services with an unprecedented wealth of material on which to base their development of improved services for women with diabetes in pregnancy.��

Consultation on Personal and Public Involvement strategy

Personal and Public Involvement (PPI) is an integral element of effective commissioning and is underpinned by a core set of values and principles - involving and listening to people in order to help us make services better.It brings about a number of recognised benefits if fully embraced into our culture and practice, these include:Use of service user knowledge and expertise;Better priority setting and decision making;More responsive, appropriate, efficient and tailored services;Transformation and reduction of complaints;Increased levels of service satisfaction;Increased dignity and self worth.The Public Health Agency (PHA) and Health and Social Care Board (HSCB) have now developed a joint Personal and Public Involvement (PPI) Strategy after extensive engagement and discussion. The Strategy has been approved by both organisations and is now being formally consulted on during the period 23rd June 2011 to 15th September 2011.The Strategy is now available for your consideration. We have developed the following documents (please see attachments below):Valuing People, Valuing Their Participation. Involving You and Listening to You Consultation Document.Valuing People, Valuing Their Participation, Involving You and Listening to You. [An Easy Read version of the Personal and Public Involvement Strategy].Valuing People, Valuing Their Participation. [An Equality and Human Rights Screening of the Strategy].Key Questions to guide consideration of the Personal and Public Involvement Strategy.People are encouraged to read the Strategy and to let us have your views.� There is a set of Key Questions, but any comments, ideas and or suggestions that you may have, that could support us in our efforts to embed Personal and Public Involvement into our culture and practice, would be most welcome.Responses should be returned by 4.00pm on Thursday 15th September 2011 to:By post:Martin QuinnRegional PPI LeadPublic Health AgencyGransha Park House15 Gransha ParkLondonderryBT47 6FNBy email: siobhan.carlin@hscni.net By telephone: (028) 7186 0086A more detailed version of the consultation document is avalable by clicking here or contacting Siobhan Carlin, email: siobhan.carlin@hscni.net, Tel: (028) 7186 0086.If you require any of these documents in an alternative format such as Braille, larger print or in another language if you are not fluent in English, please do not hesitate to contact us.A report of feedback received as part of this consultation can be made available upon request.Please be aware that the PHA and HSCB are also currently consulting on the Community Development Strategy.You are invited to consider responding to this consultation as well if appropriate.

Regional Health and Social Care Personal and Public Involvement Forum: Annual update report

This is the first annual report of the Regional Health and Social Care Personal and Public Involvement (PPI) Forum. It gives a brief introduction into the concept of PPI, which seeks to involve service users and the public in the planning, delivery and commissioning of services across healthcare in Northern Ireland. The report also provides a background to the development of PPI in Northern Ireland and details on the establishment of the forum.The bulk of the report centres on how PPI is being implemented across all the partner organisations within the healthcare system. Each organisation is introduced and each provides a summary of PPI work it has delivered and planned for the near future. A list of relevant contacts is also included.

Providing meaningful care: using the experiences of young suicidal men to inform mental health care services

A short report using the experiences of young suicidal men to inform mental health care services.�

Valuing People, Valuing Their Participation - A Strategy for Personal and Public Involvement for the Public Health Agency and Health and Social Care Board

Personal and Public Involvement (PPI) is about involving those who use Health and Social Care (HSC) services, or care for those who use services, with those who plan and deliver services. This involvement can sometimes relate to individuals (personal), or groups, or the wider community (public).This Strategy shows the direction that both the PHA and the HSCB are committed to, in their development of PPI.

Care pathway and model for community forensic teams in Northern Ireland

Care pathway and model for community forensic teams in Northern Ireland, October, 2011.

Perinatal Mental Health Care Pathway

�This regional care pathway provides�guidance for all Health and Social Care (HSC) professionals who come into contact with pregnant women. In addition, each Trust has developed a local adaptation of this pathway for their population.�

Northern Ireland Primary and Secondary Care Opioid Substitute Treatment Guidelines (2013)

The guidelines are intended for all those involved in providing support for drug misusers, especially those providing pharmacological interventions as a component of drug misuse treatment.

Personal and Public Involvement (PPI) - Consultation Scheme

The Chief Executive is accountable to the Minister for Health, Social Services and Public Safety for the performance of the Public Health Agency and its staff.The Chief Executive is required to appoint a senior professional at Board level to provide leadership in relation to Personal Public Involvement.� In the Public Health Agency this role is undertaken by the Director of Nursing and Allied Health Professions supported by the Assistant Director for Allied Health Professions and Personal Public Involvement. The Public Health Agency has also appointed a Regional Lead Officer for PPI.This document sets out the PHA's commitment to PPI and�recognises the importance of proper and timely consultation as an integral part of fulfilling its statutory obligation to make arrangements with a view to securing involvement and consultation with service users, their carers, the public and the Patient Client Council on decisions on planning and proposals for change affecting the provision of the health and social care services for which the PHA is responsible the�PHA will endeavour to conduct consultations in a timely, open and inclusive way.

Regional Guidelines for the Search of Patients, their Belongings and the Environment of Care within Adult Mental Health and Learning Disability Inpatient Settings

The overarching purpose of these guidelines is to ensure the safety and promote the protection of patients, staff and visitors by ensuring that dangerous items or hazardous substances are not brought into the in-patient setting, including illicit substances, prescribed / over the counter medications, dangerous items and alcohol or any other hazardous or potentially hazardous item or substance.