Report of the Forum on Medical Manpower

The proposals for change which emerged from the debate were put in context with the announcement by the Minister for Health and Children on 7th May 1998 of the establishment of the Forum on Medical Manpower to develop a programme of action to deliver changes necessary in this area. The purpose of the Forum was to: ofacilitate the development and implementation of a comprehensive Manpower policy relating to training, career structure, and service delivery, designed to address the problems that have been identified.â?Âù Download the Report here

Report of the Forum on Fluoridation

The recommendations of the Forum on water fluoridation are intended to assist health care providers, public health officials, policy makers and the public in achieving maximum protection against dental decay and to minimise the occurrence of dental fluorosis. Download the Executive Summary Download the Full Report

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.

Meta-analysis of gene-level associations for rare variants based on single-variant statistics.

Meta-analysis of genome-wide association studies (GWASs) has led to the discoveries of many common variants associated with complex human diseases. There is a growing recognition that identifying "causal" rare variants also requires large-scale meta-analysis. The fact that association tests with rare variants are performed at the gene level rather than at the variant level poses unprecedented challenges in the meta-analysis. First, different studies may adopt different gene-level tests, so the results are not compatible. Second, gene-level tests require multivariate statistics (i.e., components of the test statistic and their covariance matrix), which are difficult to obtain. To overcome these challenges, we propose to perform gene-level tests for rare variants by combining the results of single-variant analysis (i.e., p values of association tests and effect estimates) from participating studies. This simple strategy is possible because of an insight that multivariate statistics can be recovered from single-variant statistics, together with the correlation matrix of the single-variant test statistics, which can be estimated from one of the participating studies or from a publicly available database. We show both theoretically and numerically that the proposed meta-analysis approach provides accurate control of the type I error and is as powerful as joint analysis of individual participant data. This approach accommodates any disease phenotype and any study design and produces all commonly used gene-level tests. An application to the GWAS summary results of the Genetic Investigation of ANthropometric Traits (GIANT) consortium reveals rare and low-frequency variants associated with human height. The relevant software is freely available.

The discourse of health managers on aspects related to the delay in tuberculosis diagnosis

The aim of this study was to analyze the discourse of health managers on aspects related to delay in tuberculosis diagnosis. This was a qualitative research study, conducted with 16 Family Health Unit managers. The empirical data were obtained through semi-structured interviews. The analysis was based on the theoretical framework of the French school of discourse analysis. According to the managers’ statements, the delay in tuberculosis diagnosis is related to patient and health service aspects. As for patient aspects, managers report fear, prejudice and lack of information as factors that may promote a delayed diagnosis. Regarding health service aspects, structural problems and lack of professional skills were reported. The discourse of managers should be considered to qualify tuberculosis control actions and to prevent delays in diagnosis.

Informe sobre el segon DLM-Forum on electronic records

El DLM-Forum on Electronic Records és un fòrum internacional multidisciplinari, organitzat per la Comissió Europea, que té per objectiu impulsar els projectes per a la millora de la gestió dels documents electrònics en les organitzacions i per a la conservació d'aquests a llarg termini. Al mateix temps, el DLM-Forum esdevé un punt de referència bàsic per a la coordinació de les polítiques de gestió dels documents electrònics que es porten a terme als estats membres de la Unió Europea, per a l'establiment d'estàndards de gestió i de conservació a escala comunitària, i per a la implicació dels agents del sector privat en la recerca de solucions a la problemàtica dels documents electrònics. El present informe exposa l'origen d'aquesta iniciativa, en descriu les dues edicions celebrades fins ara i les perspectives de futur del fòrum.

Report on Aging Resources of Central Iowa for the period July 1, 2005 through June 30, 2009

Report on Aging Resources of Central Iowa for the period July 1, 2005 through June 30, 2009

Informe sobre el tercer DLM-Forum on Electronic Records (Barcelona, 6¿8 de maig de 2002)

Del 6 al 8 de maig de 2002 es va celebrar a Barcelona la tercera edició del DLM-Forum on Electronic Records, el fòrum internacional multidisciplinari que té per objectiu la millora de la gestió dels documents electrònics a les organitzacions i conservació a llarg termini. Aquesta edició ha estat marcada per una participació més activa de la indústria de les tecnologies de la informació i de les comunicacions, i per la presentació dels resultats d'iniciatives del DLM-Forum 1996. El present informe descriu la gènesi i el desenvolupament del DLM-Forum de Barcelona, i n'indica els assoliments més remarcables.

Report on the Iowa Department on Aging for the year ended June 30, 2009

Report on the Iowa Department on Aging for the year ended June 30, 2009

Report on the Iowa Department on Aging for the year ended June 30, 2010

Report on the Iowa Department on Aging for the year ended June 30, 2010

Report on the Iowa Department on Aging for the year ended June 30, 2011

Report on the Iowa Department on Aging for the year ended June 30, 2011

Impact of chlorhexidine-impregnated sponges on catheter-related infections rate

INTRODUCTION. Multimodal strategy targeted at prevention of catheter-related infection combine education to general measures of hygiene with specific guidelines for catheter insertion and dressing (1). OBJECTIVES. In this context, we tested the introduction of chlorhexidine(CHX)-impregnated sponges (2). METHODS. In our 32-beds mixed ICU, prospective surveillance of primary bacteremia and of microbiologically documented catheter-related bloodstream infections (CRBSI) is performed according to standardized definitions. New guidelines for central venous catheter (CVC) dressing combined a CHX-impregnated sponge (BioPatch_) with a transparent occlusive dressing (Tegaderm _) and planning for refection every 7 days. To contain costs, Biopatch_ was used only for internal jugular and femoral sites. Other elements of the prevention were not modified (overall compliance to hand hygiene 65-68%; non coated catheters except for burned patients [173 out of 9,542 patients];maximal sterile barriers for insertion; alcoholic solution ofCHXfor skin disinfection). RESULTS. Median monthly CVC-days increased from 710, to 749, 855 and 965 in 2006, 2007, 2008 and 2009, respectively (p\0.01). Following introduction of the new guidelines (4Q2007), the average monthly rate of infections decreased from 3.7 (95% CI: 2.6-4.8) episodes/1000 CVC-days over the 24 preceding months to 2.2 (95% CI: 1.5-2.8) over the 24 following months (p = 0.031). Dressings needed to be changed every 3-4 days. The decrease of catheter-related infections we observed in all consecutive admitted patients is comparable to that recently showed in a placeborandomized trial2. Further generalization to all CVC and arterial catheters access may be justified. CONCLUSIONS. Our data strongly suggest that combined with occlusive dressings, CHXimpregnated sponges for dressing of all CVC catheters inserted in internal jugular and/or femoral sites, significantly reduces the rate of primary bacteremia and CRBSI. REFERENCES. (1) Eggimann P, Harbarth S, Constantin MN, Touveneau S, Chevrolet JC, Pittet D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000; 355:1864-1868. (2) Timsit JF, Schwebel C, Bouadma L, Geffroy A, Garrouste-Org, Pease S et al. Chlorhexidine- impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA 2009; 301(12):1231-1241.

Effects of bioaerosol exposure on work-related symptoms among Swiss sawmill workers

Objective Exposure to bioaerosols in the occupational environment of sawmills could be associated with a wide range of health effects, in particular respiratory impairment, allergy and organic dust toxic syndrome. The objective of the study was to assess the frequency of medical respiratory and general symptoms and their relation to bioaerosol exposure. Method Twelve sawmills in the French part of Switzerland were investigated and the relationship between levels of bioaerosols (wood dust, airborne bacteria, airborne fungi and endotoxins), medical symptoms and impaired lung function was explored. A health questionnaire was distributed to 111 sawmill workers. Results The concentration of airborne fungi exceeded the limit recommended by the Swiss National Insurance (SUVA) in the twelve sawmills. This elevated fungi level significantly influenced the occurrence of bronchial syndrome (defined by cough and expectorations). No other health effects (irritations or respiratory effects) could be associated to the measured exposures. We observed that junior workers showed significantly more irritation syndrome (defined by itching/running nose, snoring and itching/red eyes) than senior workers. Lung function tests were not influenced by bioaerosol levels nor dust exposure levels. Conclusion Results suggest that occupational exposure to wood dust in a Swiss sawmill does not promote a clinically relevant decline in lung function. However, the occurrence of bronchial syndrome is strongly influenced by airborne fungi levels. [Authors]