Improvements in readiness to change and drinking in primary care patients with unhealthy alcohol use: a prospective study.

BACKGROUND: The course of alcohol consumption and cognitive dimensions of behavior change (readiness to change, importance of changing and confidence in ability to change) in primary care patients are not well described. The objective of the study was to determine changes in readiness, importance and confidence after a primary care visit, and 6-month improvements in both drinking and cognitive dimensions of behavior change, in patients with unhealthy alcohol use. METHODS: Prospective cohort study of patients with unhealthy alcohol use visiting primary care physicians, with repeated assessments of readiness, importance, and confidence (visual analogue scale (VAS), score range 1-10 points). Improvements 6 months later were defined as no unhealthy alcohol use or any increase in readiness, importance, or confidence. Regression models accounted for clustering by physician and adjusted for demographics, alcohol consumption and related problems, and discussion with the physician about alcohol. RESULTS: From before to immediately after the primary care physician visit, patients (n = 173) had increases in readiness (mean +1.0 point), importance (+0.2), and confidence (+0.5) (all p < 0.002). In adjusted models, discussion with the physician about alcohol was associated with increased readiness (+0.8, p = 0.04). At 6 months, many participants had improvements in drinking or readiness (62%), drinking or importance (58%), or drinking or confidence (56%). CONCLUSION: Readiness, importance and confidence improve in many patients with unhealthy alcohol use immediately after a primary care visit. Six months after a visit, most patients have improvements in either drinking or these cognitive dimensions of behavior change.

Obtenció de jerarquies d'estats cel·lulars via web

Hi ha diversos mètodes d'anàlisi que duen a terme una agrupació global de la sèries de mostres de microarrays, com SelfOrganizing Maps, o que realitzen agrupaments locals tenint en compte només un subconjunt de gens coexpressats, com Biclustering, entre d'altres. En aquest projecte s'ha desenvolupat una aplicació web: el PCOPSamplecl, és una eina que pertany als mètodes d'agrupació (clustering) local, que no busca subconjunts de gens coexpresats (anàlisi de relacions linials), si no parelles de gens que davant canvis fenotípics, la seva relació d'expressió pateix fluctuacions. El resultats del PCOPSamplecl seràn les diferents distribucions finals de clusters i les parelles de gens involucrades en aquests canvis fenotípics. Aquestes parelles de gens podràn ser estudiades per trobar la causa i efecte del canvi fenotípic. A més, l'eina facilita l'estudi de les dependències entre les diferents distribucions de clusters que proporciona l'aplicació per poder estudiar la intersecció entre clusters o l'aparició de subclusters (2 clusters d'una mateixa agrupació de clusters poden ser subclusters d'altres clusters de diferents distribucions de clusters). L'eina és disponible al servidor: http://revolutionresearch.uab.es/

DETERMINE Working document #4 'Economic arguments for addressing social determinants of health inequalities'

The Institute of Public Health in Ireland (IPH) is a partner in the European project DETERMINE, building on its previous involvement in the Closing the Gap project in 2004-2006. In Year 2 the DETERMINE project  focused on identifying and exploring economic arguments to support action on social determinants of health inequalities.  Working document #4 'Economic arguments for addressing social determinants of health inequalities' presents the findings.

DETERMINE Working Document #1 'Policies and actions addressing the social determinants of health inequalities: examples of activity at EU member state level in Europe'

The Institute of Public Health in Ireland (IPH) is a partner in the European project DETERMINE, building on its previous involvement in the Closing the Gap project in 2004-2006. In the first year of the project (2007-2008) 15 DETERMINE partners identified policies and actions that have taken place within countries, and at the EU level, to address Social Determinants of Health Inequalities. These policies and actions were identified via a questionnaire, which also identified structures and tools/mechanisms being used in the country to support a 'health in all policy' approach.

Comparing Multilevel Clustering Methods on Weighted Graphs : The Case of Worldwide Air Passenger Traffic 2000-2004

Specific properties emerge from the structure of large networks, such as that of worldwide air traffic, including a highly hierarchical node structure and multi-level small world sub-groups that strongly influence future dynamics. We have developed clustering methods to understand the form of these structures, to identify structural properties, and to evaluate the effects of these properties. Graph clustering methods are often constructed from different components: a metric, a clustering index, and a modularity measure to assess the quality of a clustering method. To understand the impact of each of these components on the clustering method, we explore and compare different combinations. These different combinations are used to compare multilevel clustering methods to delineate the effects of geographical distance, hubs, network densities, and bridges on worldwide air passenger traffic. The ultimate goal of this methodological research is to demonstrate evidence of combined effects in the development of an air traffic network. In fact, the network can be divided into different levels of âeurooecohesionâeuro, which can be qualified and measured by comparative studies (Newman, 2002; Guimera et al., 2005; Sales-Pardo et al., 2007).

A Fitter Future for All: Consultation Document

The prevalence of people who are overweight and obese has been steadily rising in Northern Ireland, and in the western world, over the last few decades. It has been described as an “obesity time-bomb”, given the impact that obesity can have on physical and mental health and wellbeing.Evidence has shown that, while weight gain is the result of a relatively simple energy imbalance, the causes that underpin changes to energy intake and expenditure are very complex and cover issues such as social and individual psychology, physiology, food production and consumption, individual activity, and the built environment.This Framework aims to “empower the population of Northern Ireland to make healthy choices, and reduce the level of harm related to overweight and obesity, by creating an environment that supports and promotes a physically active lifestyle and a healthy diet”.In addition, the following overarching target has been set: to reduce the level of obesity in Northern Ireland to the 2005-06 level by 2021.

Adopting the Future Consultation response document (MS Word 290 KB)

While for most children the best place to grow up is with their birth parents, others are unable to do so. Under the Children (Northern Ireland) Order 1995, the first duty of Health and Social Services Trusts, where children cannot live with their birth parents, is to seek a home for them with their extended famly. Finding a safe and caring new home for children with their wider family or friends allows them to keep important attachments and connections in their lives, and is therefore the preferred choice where it is possible. Where this is not possible, society has a clear responsibility to provide children with stability and permanence in their lives. Some children are placed in alternative forms of care. Adoption is traditionally a means of providing a permanent family for a small, but significant number of children who are unable to return to their birth parents. Adoption is, however, much wider than just the service provided to children. Adoption affects birth parents, prospective adopters, adoptive parents, siblings, grandparents and other relatives. The Department of Health Social Services and Public Safety believes that more can and should be done to reflect the complex needs of those affected by adoption. åÊ

Primary Dental Care Strategy Consultation Document December 2005 (PDF 223 KB)

Primary Dental Care Strategy Consultation Document December 2005

Racial Equality in Health - Good Practice Guide - Consultation Document (PDF 261KB)

This good practice guide has been produced by the Equity Commission for Northern Ireland in partnership with the Department of Health, Social Services and Public Safety (DHSSPSNI).

Myths & Reality - Summary Document (PDF 142KB)

Report of the Working Group on Teenage Pregnancy & Parenthood