Bilateral uveal pigmented alterations with remarkable evolution: long term follow-up in a case of possible bilateral diffuse uveal melanocytic proliferation

Purpose: to describe a case of probable bilateral diffuse uveal melanocytic proliferation (BDUMP) with scleral involvement, free from systemic malignancies and cataract. Methods: fifty months of follow up with recurrent complete ophthalmological examinations, including fundus photography, fluorescein/indocyanine green angiography (FA) and optical coherence tomography (OCT). Investigations also included an electroretinography (ERG) and histological examination of scleral biopsy. Extraocular malignancies were repeatedly searched. Results: the patient was a 61 year-old Italian man with chronic hepatitis type C. At first visit his best corrected visual acuity (BCVA) was 20/32 in OS and 20/25 in OD. Funduscopy showed multiple patch-shaped pigmented alterations involving macular region and mid retinal periphery. FA showed corresponding areas of late-phase hyperfluorescent pinpoints (figure 1a, OS) and intemediate-phase hypocyanescence (figure 1b, OS), with subtle serous neurosensory retinal detachment confirmed by OCT. Photopic and scotopic ERG tested normal. Systemic prednisone was administered for one month without any improvement. After ten months round pigmentary lesions appeared also in superior scleral surface of both eyes. Biopsy allowed to disclose slightly pigmented spindle cells. BCVA worsened for further 10 months, with enlargement of FA alteration areas but lenses still clear. After 30 months spontaneous coalescence and atrophy of retinal lesions started, paralleled by progressive visual recovery. At the end of our follow up BCVA was 20/25 in OU while scleral pigmentary lesions remained unchanged. Conclusions: we report the case of a patient with main features of BDUMP and some unusual findings. Although not all classical diagnostic criteria were fulfilled, the presence of scleral pigmented lesions and spontaneous visual recovery may enlarge clinical spectrum of the disease.

Pilot HIA of European Employment Strategy in Ireland

This pilot Health Impact Assessment (HIA) exercise was conducted as part of the ‘Policy Health Impact Assessment for the European Union’, commissioned by the European Commission ’s Directorate Generale Health and Consumer Protection (DG Sanco). The project is coordinated by Liverpool University and the research partners are from Ireland, Germany and the Netherlands. The aim of the European project is to develop a HIA methodology for assessing the health impacts of EU policies and activities. The purpose of the pilot HIA in Ireland was to test the methodology produced in the first phase of the project in 2002. The policy chosen for assessment was the European Employment Strategy. The Irish pilot used a range of methods suggested in the draft methodology but concentrated particularly on the participatory aspects of HIA. A key stakeholder group with knowledge of employment (including decision makers in labour market policy) was established to provide expert advice and support. Other methods used included policy analysis, information gathering from key informants, community profiling (including demographic and labour force data), data analysis, literature review, the production of a report and the development of recommendations.

Review of Health Impact Assessment for the Institute of Public Health in Ireland

IPH commissioned a review of HIA work in 2009 to detail progress and achievements of HIA from 2001. This included an assessment of current levels of HIA awareness and activity and suggestions for the direction of future work.

Facing the challenge: The impact of the recession and unemployment on men's health in Ireland

The economic recession with its accompanying rise in unemployment rates is linked to extremely adverse effects for men’s mental health. This research report Facing the Challenge – The Impact of the Recession and Unemployment on Men’s Health in Ireland identifies a strong expectation of increased mental health problems for men given the very strong correlation between unemployment and male mental ill health. The report is the result of a research and consultation process carried out, in Northern Ireland and the Republic of Ireland, by Nexus Research Co-operative on behalf of IPH. 93% of frontline organisations, North and South, in contact with unemployed men linked health challenges to unemployment and recession and all organisations surveyed noted adverse health challenges for men they work with. In addition to health challenges being higher for unemployed men, they were also very high for men who saw themselves as being threatened with unemployment. The organisations surveyed and the men who were interviewed identified the challenges to health as:•    High levels of stress or anxiety•    Dependency on or over-use of alcohol/other drugs•    Deterioration in physical health•    Development of conflict in family or close personal relationships•    Isolation (including sharing or communicating problems)•    A reluctance to approach services or seek help

IPH response to the HIQA consultation on the National Demographic Dataset and Guidance for use in health and social care settings in Ireland

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland. IPH have previously responded to consultations to the Department of Health’s Discussion Paper on the Proposed Health Information Bill (June 2008), the Health Information and Quality Authority on their Corporate Plan (Oct 2007), and the Road Safety Authority of Ireland Road Safety Strategy (Jul 2012). IPH supports the development of a national standard demographic dataset for use within the health and social care services. Provided necessary safeguards are put in place (such as ethics and data protection) and the purpose of collecting the information is fully explained to subjects, mandatory provision of a minimum demographic dataset is usually the best way to achieve the necessary coverage and data quality. Demographic information is needed in several forms to support the public health function: Detailed aggregated information for comparison to population counts in order to assess equity of access to healthcare as well as examining population patterns and trends in morbidity and mortality Accurate demographic information for the surveillance of infectious disease outbreaks, monitoring vaccination programmes, setting priorities for public health interventions Linked to other data outside of health and social care such as population data, survey data, and longitudinal studies for research and analysis purposes.   Identify and address public health issues to tackle health inequalities, and to monitor the success of such efforts to tackle them.

Institute of Public Health in Ireland's (IPH) Open Access Statement

This document states the Institute of Public Health in Ireland’s (IPH) commitment to an Open Access policy and outlines how it implements that policy. "Open Access is the immediate, online, free availability of research outputs without restrictions on use commonly imposed by publisher copyright agreements. Open Access includes the outputs that scholars normally give away for free for publication; it includes peer-reviewed journal articles, conference papers and data of various kinds."1 The Open Access (OA) movement aims to: Provide access to scientific outputs in publications that are freely available Foster the adoption of open access publication models

A strategy for cancer control in Ireland / National Cancer Forum

To address the rapidly rising burden of cancer, this second National Cancer Strategy A Strategy for Cancer Control in Ireland 2006 advocates a comprehensive cancer control policy programme. Cancer control is a whole population, integrated and cohesive approach to cancer that involves prevention, screening, diagnosis, treatment, and supportive and palliative care. It places a major emphasis on measurement of need and on addressing inequalities and implies that we must focus on ensuring that all elements of cancer policy and service are delivered to the maximum possible extent. This Strategy also focuses substantially on reform and reorganisation of the way we deliver cancer services, in order to ensure that future services are consistent and are associated with a high-quality experience for patients and their carers. There is evidence of considerable variation in cancer survival between regions and also significant fragmentation of services for cancer patients. These interrelated factors are of major concern to the National Cancer Forum.

A management development strategy for the health and personal social services in Ireland

The integration of personal and organisational objectives is a notoriously difficult task but a systematic approach to training and development provides a powerful source of integration. A model illustrating how management development can occupy the 'middle ground' where organisational and individual development overlap is included in this report. Management development must be just one part of a continum, starting with workforce planning and recruitment and selection, and leading to training and development, succession planning and career development.

Care and Case Management for Older People in Ireland

This study provides, for the first time, a systematic review of how health and social services are currently being delivered to older people with the purpose of identifying models of best practice within a Care Management framework. The research allows the voices of a wide range of health and social service providers to comment individually about how care is currently delivered in Ireland. In addition, the research provides them with an opportunity to express how they feel about Care and Case Management as a model for the planning, co-ordination and delivery of services and its feasibility in an Irish context Download the Report here

Report on the Regulation of Practitioners of Complementary and Alternative Medicine in Ireland

This report has been written in the context of this interest and in response to a request from the Department of Health and Children. It follows a Forum on regulatory issues that was held at the IPA in June 2001 and attended by many CAM practitioners. The Minister for Health and Children asked the Institute to build on the discussions at the Forum by preparing a report on possible options in the regulation of CAM practitioners in Ireland. The focus of the report is on regulatory and policy issues in general. It is not within the Instituteâ?Ts competence or brief to comment on more specific clinical or technical issues. Download the document here

Information leaflet concerning Working Visas / Work Authorisations for employment in Ireland

The growth of the Irish economy in recent years is resulting in shortages of skilled employees in some sectors such as information and computing technologies, construction professionals and across a broad range of medical, health and social care professions (including Medical Practitioners, nurses, speech and language therapists, occupational therapists, radiographers, physiotherapists, social workers) Download document here

An Evaluation of Cancer Services in Ireland: A National Strategy 1996

An Evaluation of “Cancer Services in Ireland: A National Strategy 1996″ This report presents the outcome of a comprehensive study that evaluated the extent to which the objectives and actions of the 1996 National Cancer Strategy were achieved. The evaluation was commissioned by the Department of Health and Children on behalf of the National Cancer Forum. The field work was carried out by Deloitte and Touche Management Consultants between October 2002 and February 2003. Click here to download PDF 360kb

Healthy Ageing in Ireland, Policies, Practice and Evaluation

Healthy Ageing in Ireland, Policies, Practice and Evaluation The National Council on Ageing and Older People (NCAOP) is pleased to present this report, which provides a comprehensive overview of current practice in the promotion of healthy ageing in Ireland. The Council considers â?~healthy ageingâ?T to be a positive concept relating to personal development and the exercise of personal choice. Healthy ageing therefore includes activities that influence social and environmental changes, which promote health, well-being and activities that prevent illness. Click here to download PDF 515kb

Nurses' and Midwives' - Understanding and Experiences of Empowerment in Ireland

Nurses’ and Midwives’ Understanding and Experiences of Empowerment in Ireland With the recently launched national health strategy (Department of Health and Children, 2001) and a tightening fiscal policy there is a requirement for a more innovative use of existing resources dedicated to healthcare in Ireland. Nurses and midwives, one of the largest professional groups within the health service, will play a critical role in developing this â?onewâ?Âù health service. Click here to download PDF 745kb