Improving Patients' Access to Medicines: A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the HPSS in Northern Ireland (PDF 704 KB)

A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the HPSS in Northern Ireland

Consent (Consent to Examination Treatment or Care)

Consent (Consent to Examination Treatment or Care)

Report: Access to the New Social Work Degree for Relevant Graduate in Northern Ireland (PDF 36 KB)

Report: Access to the New Social Work Degree for Relevant Graduate in Northern Ireland

Asylum Seekers And Refugees Policy Guidance On Access To Health And Social Services (PDF 136 KB)

This policy guidance is intended for staff working within the Health and Personal Social Services sector in Northern Ireland, and aims to provide advice and information on the provision of health and social care services to asylum seekers and refugees. The purpose of the policy is to ensure that asylum seekers and refugees are given equitable access to health and social care services under the terms of the current legislation, with the overall aim of providing a culturally competent health and social care services. åÊ

Detection of pathogenic bacteria in skin lesions of patients with chiclero's ulcer: reluctant response to antimonial treatment

We investigated the bacterial flora present in skin lesions of patients with chiclero's ulcer from the Yucatan peninsula of Mexico using conventional culture methods (11 patients), and an immunocolorimetric detection of pathogenic Streptococcus pyogenes (15 patients). Prevalence of bacteria isolated by culture methods was 90.9% (10/11). We cultured, from chiclero's ulcers (60%), pathogenic bacterial such as Staphylococcus aureus (20%), S. pyogenes (1.6%), Pseudomonas aeruginosa (1.6%), Morganella morganii (1.6%), and opportunist pathogenic bacteria such as Klebsiella spp. (20.0%), Enterobacter spp. (20%), and Enterococcus spp. (20%). We also cultured coagulase-negative staphylococci in 40% (4/10) of the remaining patients. Micrococcus spp. and coagulase-negative staphylococci constituted the bacterial genuses more frequently isolated in the normal skin of patients with chiclero's ulcer and healthy individuals used as controls. We also undertook another study to find out the presence of S. pyogenes by an immunocolorimetric assay. This study indicated that 60% (9/15) of the ulcerated lesions, but not normal controls, were contaminated with S. pyogenes. Importantly, individuals with purulent secretion and holding concomitant infections with S. pyogenes, S. aureus, P. aeruginosa, M. morganii, and E. durans took longer to heal Leishmania (L.) mexicana infections treated with antimonial drugs. Our results suggest the need to eliminate bacterial purulent infections, by antibiotic treatment, before starting antimonial administration to patients with chiclero's ulcer.

Improving Access to Green Spaces

Evidence Review 8 - Improving access to green spaces Briefing 8 - Improving access to green spaces This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the role of green space in improving health locally. The first part of the evidence review defines ‘accessible’ green space and provides an overview of the evidence linking access to green spaces with health benefits, setting out the potential for reducing health inequalities. The second part provides an overview of interventions implemented at the local level to increase equitable access and use of good quality green spaces. Local authorities and local organisations have taken action on these issues through the implementation of interventions to: 1. Create new areas of green space and improve the quality of existing green spaces 2. Increase accessibility, engagement and use of green spaces The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

The transventricular-transseptal access to the aortic root: a new route for extrapleural trans-catheter aortic stent-valve implantation.

Objective: The aim of this study was to investigate the feasibility of transventricular-transseptal approach (TVSA) for extrapleural transcatheter aortic valved stent implantation via a subxyphoidian access. Methods: In five porcine experiments (52.3 +/- 10.9 kg) the right ventricle was exposed via subxyphoidian access. Under the guidance of intracardiac echocardiography (ICE) and fluoroscopy, the transseptal access from right ventricle to left ventricle was created progressively by puncture and dilation with dilators (8F-26F). Valved stents built in-house from commercial tanned pericardium and self-expandable Nitinol stents were loaded into a cartridge. A delivery sheath was then introduced from the right ventricle into the left ventricle and then into the ascending aorta. The cartridge was connected and the valved stent was deployed in the aortic position. Then, the ventricular septal access was sealed with an Amplatzer septal occluder device and the right ventricular access was closed by tying prepared purse-string suture directly. Thirty minutes after the whole procedure, the animals were sacrificed for macroscopic evaluation of the position of valved stent and septal closure device. Result: Procedural success of TVSA was 100% at the first attempt. Mean procedure time was 49 +/- 4 min. Progressive dilatation of the transseptal access resulted in a measurable ventricular septal defect (VSD) after dilator sizes 18F and more. All valved stents were delivered at the target site over the native aortic valve with good acute valve function and no paravalvular leaks. During the procedure, premature beats (5/5) and supraventriclar tachycardias (5/5) were observed, but no atrial-ventricular block (0/5) occurred. Heart rate before (after) was 90 +/- 3 beats min(-1) (100 +/- 2 beats min(-1): p < 0.05), whereas blood pressure was 60 + 1 mm Hg (55 + 2 mm Hg (p < 0.05)). Total blood loss was 280 + 10 ml. The Amplatzer septal occluder devices were fully deployed and the ventricular septal accesses were sealed successfully, without detectable residual shunt. Conclusion: Trans-catheter implantation of aortic valved stent via extrapleural transventricular-transseptal access is technically feasible and has the potential for a simplified procedure under local anaesthesia. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B. V. All rights reserved.

Commissioning for equity. A briefing on inequalities in access to revascularisation in the NHS and in the independent sector among London residents

This briefing describes inequalities in access to revascularisation using data from both the NHS and the independent sector.

Commissioning for equity. Inequalities in access to revascularisation in the NHS and in the independent sector. A technical report

This document describes the methodology for examining inequalities in access to revascularisation in the NHS and in the independent sector. It is a technical report.

Commissioning for equity. Stop gaps: equity of access to London's stop smoking services

This briefing looks at who is making use of NHS stop smoking services in the London area.

Report of the Action Group on Access to Third Level Education

In line with a commitment under the Programme for Prosperity and Fairness the Minister for Education and Science, Dr Michael Woods, established the Action Group on Access to Third Level Education, in September 2000, to advise the Minister on the development of a co-ordinated framework to promote access by mature and disadvantaged students and students with disabilities to third level education.

Vers un accès a des soins de qualité pour les personnes lesbiennes, gays, bisexuelles et transgenres [Access to quality primary care for LGBT people].

This article offers a comprehensive approach to the health of lesbian, gay, bisexual and transgender (LGBT) people, where respect for diversity and non judgemental care play a central role. It calls for a health and medical vision that goes beyond HIV risk. For those who never had to question their own sexual orientation or gender identity, it is certainly difficult to understand how the discovery of one's identity trait in childhood or early adolescence can be transformed under social pressure into a burden which often remains invisible but is associated with considerable emotional and medical morbidity. This article raises the following question: How many LGBT patients go unnoticed every week, leaving the physician's office without an opportunity to receive appropriate listening, support and care?

Audio as medium for content distribution (providing access to knowledge)

Reaching and educating the masses to the benefit of all of mankind is the ultimate goal and through the use of this technology facility/tool many can be reached in their own language, in their own community, in their own time and at their own pace. Making this content available to those who will benefit from the information, is vital. These people who want to consume the content are not necessarily that interested in the qualification, they need the information. Making the content available in an auditory format may also help those who may not be as literate as others. The uses of audio/ recorded lessons have a number of uses and should not just be seen as a medium for content distribution to distant communities. Recording lectures makes it possible for a lecturer to present lectures to a vast number of students, while just presenting the lecture once.