The Mental Health Bill 2006: Briefing sheets on key policy areas

Includes: supervised community treatment, professional roles, nearest relatives, definition of mental disorder, cirteria for detention, mental health review tribuneral, general information, implementing government policy, Bournewood safteguards

Alpha- and gamma-melanocyte stimulating hormones in obesity. A study of the key central areas of metabolic regulation

The melanocortin system is an important regulator of feeding, energy metabolism,and cardiovascular function and it consists of the pro-opiomelanocortin (POMC) derived melanocyte stimulating hormones (α-, β- and γ-MSH) and their endogenous melanocortin receptors, MC1R to MC5R. In the hypothalamus, α-MSH reduces food intake, and increases energy expenditure and sympathetic tone by binding to MC4R. Mutations affecting the MC4R gene lead to obesity in mammals. On the other hand, the metabolic effects of MC3R stimulation using agonists such as the endogenously expressed γ-MSH have been less extensively explored. The main objective of this study was to investigate the long-term effects of increased melanocortin tone in key areas of metabolic regulation in the central nervous system (CNS) in order to investigate the sitespecific roles of both α-MSH and γ-MSH. The aim was to stereotaxically induce local overexpression of single melanocortin peptides using lentiviral vectors expressing α-MSH (LVi-α-MSH-EGFP) and γ-MSH (LVi-γ-MSH-EGFP). The lentiviral vectors were shown to produce a long-term overexpression and biologically active peptides in cell-based assays. The LVi-α-MSHEGFP was targeted to the arcuate nucleus in the hypothalamus of diet induced obese mice where it reduced weight gain and adiposity independently of food intake. When the nucleus tractus solitarus in the brainstem was targeted, the LVi-α-MSH-EGFP treatment was shown to cause a small decrease in adiposity, which did not impact weight development. However, the α-MSH treatment increased heart rate, which was attenuated by adrenergic receptor blockade indicative of increased sympathetic activity. The LVi-γ-MSH-EGFP was targeted to the hypothalamus where it decreased fat mass in mice eating the standard diet, but the effect was abated if animals consumed a high-fat Western type diet. When the diet induced obese mice were subjected again to the standard diet, the LVi-γ-MSH-EGFP treated animals displayed increased weight loss and reduced adiposity. These results indicate that the long-term central anti-obesity effects of α-MSH are independent of food intake. In addition, overexpression of α-MSH in the brain stem efficiently blocked the development of adiposity, but increased sympathetic tone. The evidence presented in this thesis also indicates that selective MC3R agonists such as γ-MSH could be potential therapeutics in combination with low fat diets.

Caracterização e composição florística de uma comunidade savânica no Rio Grande do Norte, Brasil : subsídios para a conservação

Studies on Brazilian biodiversity are still very few and can observe the difference of knowledge between the different regions of the country. This affirmation can be verified in the investigation to identify the rare species in Brazil and the key biodiversity areas (ACBs). In that study were identified for Brasil 2.256 rare species and 752 ACBs. The Rio Grande do Norte (RN) was the only Brazilian state that has not been identified any rare species and no ACBs, possibly due to the lack of floristic studies in this state. A particular area was selected for this study: an area of ecological tension with savanna physiognomy in Rio do Fogo, RN. This savanna community is represented in RN in a fragment and immersed in restinga and caatinga and was identified and described only through of radar imagens there are no studies to date in loco . We have prepared the following questions about this community savanna: 1) The region delimited and described by through of radar images by the RADAMBRASIL, 1976, can be associated of the Cerrado, in terms of floristic ?; 2) What is the floristic composition of this area? This area includes rare species, endemic or endangered? 3) What is the geographical and phytogeographical distribution of plant species registered in this area? 4) Those plant species registered are endemic or have affinity with other areas phytoecological Brazilian? To answer these questions we performed a floristic inventory of the August 2007 to September/2009. The results are presented in two chapters (manuscripts). The first chapter, titled "The Savannah Rio Grande do Norte: floristic links with other plant formations in the Northeast and Center-West Brazil" was submitted to the Revista Brasileira de Botância. Chapter 1 discusses the phytogeographical distribution of the species, by comparing floristic studies conducted in the Cerrado, Caatinga and Restinga in the Northeast and Cerrado of the Central Brazil. The analysis of data of this study and compilation with other studies indicated that: i) the record of 94 plant species; ii) of total species, about 64% are associated with the Cerrado, the second specialized bibliography, and about 78% as the List of Species of Flora of Brazil. However, about 73% of total species (94) are also distributed in the Caatinga, the Atlantic forest 64%, the Amazon forest 64%, the Pantanal 15% and the Pampa 12%. Floristically the data show that the community studied is influenced by other floras, has a structure where grasses dominate and also because of his appearance the same savanna then be classified as a Savana gramíneo-lenhosa do tabuleiro . Chapter 2, titled "Considerations on the flora of a savanna community in Rio Grande do Norte, northeastern Brazil: Subsidy key area for conservation" was submitted to the Revista Natureza e Conservação. This has the objective of improve the knowledge of flora of Rio Grande do Norte and to identify possible rare species and consequently increase the key areas of biodiversity in Brazil. The data indicated that: i) of 94 species registered in the study area, 40 were new records for the Rio Grande do Norte state; ii) These citations to unpublished state, Stylosanthes montevidensis Vogel (Fabaceae) and Aristida laevis (Nees) Kunth (Poaceae) are indicated for the first time to the Northeast of Brazil; iii) are registered in the area 24 species endemic to Brazil and 63 non-endemic; iv) Aspilia procumbens Baker (Asteraceae) registered in the area is considered a restricted species and micro endemic Rio Grande do Norte, ie rare species; v) Aspilia procumbens is also cited in the category of critically endangered species and Stilpnopappus cearensis Hubber (Asteraceae) a species vulnerable to extinction. This study shows a new area phytoecological in Rio Grande do Norte and indicates the area's potential to contribute with the sites of global significance for biodiversity conservation, either locally, regionally and nationally. This will certainly contribute to respond some targets set by the Global Strategy for Plant Conservation and the Convention on Biological Diversity such as the inventory of vegetal diversity in a region with little collection, which will provide data that contributes to questions and themes related to biodiversity.

Economic and climate change pressures on biodiversity in southern Mediterranean coastal areas. MEDPRO Technical Report No. 24/February 2013

This paper establishes and measures key biodiversity and ecosystem health indicators and the number of world heritage sites in coastal areas at global level. It then estimates – econometrically – the indicators’ influence on the provision of tourism values through the marine ecosystem function as a harbour of biodiversity, and as a provider of amenity values and marine cultural identity. The report then focuses on the MEDPRO region, providing some estimates of the potential impact of climate change on these services for a given temperature increase scenario. Finally, the effect on ecosystemrelated tourism is computed for the four MEDPRO social economic scenarios. The analysis is enriched by some quantification of the potential costs of adaptation.

Letting the managers manage: analyzing capacity to conserve biodiversity in a cross-border protected area network

Biodiversity loss is one of the most significant drivers of ecosystem change and is projected to continue at a rapid rate. While protected areas, such as national parks, are seen as important refuges for biodiversity, their effectiveness in stemming biodiversity decline has been questioned. Public agencies have a critical role in the governance of many such areas, but there are tensions between the need for these agencies to be more “adaptive” and their current operating environment. Our aim is to analyze how institutions enable or constrain capacity to conserve biodiversity in a globally significant cross-border network of protected areas, the Australian Alps. Using a novel conceptual framework for diagnosing biodiversity institutions, our research examined institutional adaptive capacity and more general capacity for conserving biodiversity. Several intertwined issues limit public agencies’ capacity to fulfill their conservation responsibilities. Narrowly defined accountability measures constrain adaptive capacity and divert attention away from addressing key biodiversity outcomes. Implications for learning were also evident, with protected area agencies demonstrating successful learning for on-ground issues but less success in applying this learning to deeper policy change. Poor capacity to buffer political and community influences in managing significant cross-border drivers of biodiversity decline signals poor fit with the institutional context and has implications for functional fit. While cooperative federalism provides potential benefits for buffering through diversity, it also means protected area agencies have restricted authority to address cross-border threats. Restrictions on staff authority and discretion, as public servants, have further implications for deploying capacity. This analysis, particularly the possibility of fostering “ambidexterity”—creatively responding to political pressures in a way that also achieves a desirable outcome for biodiversity conservation—is one promising way of building capacity to buffer both political influences and ecological pressures. The findings and the supporting analysis provide insight into how institutional capacity to conserve biodiversity can be enhanced in protected areas in Australia and elsewhere, especially those governed by public agencies and/or multiple organizations and across jurisdictions.

Fatos e tendências da biocatálise

Brazil is renowned for its biodiversity; however, its economy is based on exotic plants, extraction and unsustainable use of natural resources. This issue was addressed in a recent QN review entitled "Chemistry without Borders." In order to explore the potential of Brazilian biodiversity fully, sustainable development is required in key technological areas, such as biotechnology. This research field is consistent with the green chemistry and white technology principles. Therefore, biotechnology is a sustainable alternative to conventional technologies and is expected to account for 20% of global chemicals by 2020. Brazil is the second largest grower of biotech crops and biodiesel, but its main activities rely on the fermentative process. In order to stimulate the national biotechnology development, the Brazilian Federal Government launched a national policy for biotechnology in 2007 and the National Committee of Biotechnology was created. Among the outstanding biotechnological processes, biocatalysis is one of the most important alternatives to conventional processing, and this field has changed dramatically with the advent of recombinant DNA technology in the 1970s, when large quantities of enzymes were accessible. The direct evolution methodology in the 1990s was a breakthrough and allowed tailoring of enzymes possessing high stability and stereoselectivity. However, about 60 years after the first industrial enzymatic biotransformation of steroids, the full potential of biocatalysis is far from being achieved. Future challenges in this field concern the multienzyme cascade reactions associated with optimized chemoenzymatic processes, and some recent industrial application of biocatalysts are also highlighted in this perspective.

Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index

Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the regional context, this could help to classify the density of risk and to accordingly target resources and measures for elimination.

Review of the ecology of Australian urban fauna: A focus on spatially explicit processes

Cities have a major impact on Australian landscapes, especially in coastal regions, to the detriment of native biodiversity. Areas suitable for urban development often coincide with those areas that support high levels of species diversity and endemism. However, there is a paucity of reliable information available to guide urban conservation planning and management, especially regarding the trade-off between investing in protecting and restoring habitat at the landscape level, and investing in programmes to maintain the condition of remnant vegetation at the local (site) level. We review the literature on Australian urban ecology, focusing on urban terrestrial and aquatic vertebrate and invertebrate fauna. We identify four main factors limiting our knowledge of urban fauna: (i) a lack of studies focusing at multiple ecological levels; (ii) a lack of multispecies studies; (iii) an almost total absence of long-term (temporal) studies; and (iv) a need for stronger integration of research outcomes into urban conservation planning and management. We present a set of key principles for the development of a spatially explicit, long-term approach to urban fauna research. This requires an understanding of the importance of local-level habitat quality and condition relative to the composition, configuration and connectivity of habitats within the larger urban landscape. These principles will ultimately strengthen urban fauna management and conservation planning by enabling us to prioritize and allocate limited financial resources to maximize the conservation return.

Rapid assessment of the fish biodiversity of the Mburo-Nakivali wetland systems and Opeta-Bisina wetland systems, Uganda

There are 46 different fish species in the Lake Kyoga basin with some of them endemic. The Nile Perch (Lates niloticus) was introduced into the main Lake Kyoga, Nakuwa and Bisina in the late 1950s to increase the fish production. The Nile Perch profileration in lakes Kyoga and Nakuwa led to the almost complete elimination of many native fish species such as Orechromis esculentus and variabilis, Mormyrus kanumme, Schilbe mystus and several Haplochromines species. Lakes Mburo, Kachera, Nakivali and Kijjanebalora are part of the complex system of lakes separated from Lake Victoria by extended swamps known as the Koki lakes, some of the satellite lakes in the Lake Victoria basin. The fisheries of these lakes are important as they contribute to government efforts of increasing food security, poverty reduction and conservation of natural resource base. These lakes are important biodiversity areas because some of these lakes have been found to contain the native tilapiine Oreochromis esculentus (Ngege), absent or threatened with extinction in the main Lakes Victoria and Kyoga. It’s also important to note that this species is only unique to the Victoria and Kyoga lake basins (Graham, 1929, Worthington, 1929). The values of some of these lake fisheries are however, threatened by human activities such as over exploitation, introduction of exotics especially water hyacinth that is already present in River Rwizi and habitat degradation among others.

Rich task implementation: modernism meets postmodernism

School renewal', 'productive pedagogies', 'rich tasks', 'New Basics', 'key learning areas'--these are some of the discourses of change in selected Queensland schools. This paper will report on teaching as an insider/outsider in a school's Health and Physical Education department during a time of intense pressure for structural, curriculum and pedagogical shifts. As a teacher/researcher, I spent ten weeks in a government secondary school attempting to implement rich tasks as well as collect data using formal and informal interviews, field note, and document analyses, with a focus upon teachers', students' and administrators' sense of change processes and outcomes. It is suggested that the processes of, and barriers to, curriculum change in this context are best explained in terms of tensions between modernist and postmodernist phenomena.

Evaluating Flexible Transport Solutions

Flexible transport services (FTS) have been of increasing interest in developed countries as a bridge between the use of personal car travel and fixed route transit services. This paper reports on findings from a recent study in Queensland Australia, which identified lessons from an international review and implications for Australia. Potential strategic directions, including a vision, mission, key result areas, strategies, and identified means of measuring performance are described. Evaluation criteria for assessing flexible transport proposals were developed, and approaches to identifying and assessing needs and demands outlined. The use of emerging technologies is also a key element of successful flexible transport services.

Anaesthetics, Pain Relief and Critical Care Follow Up (PDF 797 KB)

In 2003/2004 the Department of Health, Social Services and Public Safety commissioned a value for money follow-up audit of Anaesthetics, Pain Relief and Critical Care (APRCC) services at twelve Trusts and covering fourteen hospital sites. The original study had reported in 1999/2000. Detailed follow-up reports, together with action plans have been agreed locally with Trusts. The objectives of the follow-up review were to: • Ascertain the progress made in implementing recommendations from the original study; • Provide data to compare performance across Trusts in areas such as: - Pre-operative assessments; - Organisation of post-operative pain relief; - Organisation of chronic pain services; - Levels of admissions to critical care units; - Occupancy in critical care units; and åÊ • Assess the extent of progress made by Trusts in the implementation of the Chief Medical Officer’s (CMO) recommendations from ‘Facing the Future –Building on the Lessons of Winter 1999/2000’. To enable comparisons across Trusts, data was collected for the financial year 2002/2003. In addition, relevant findings from the Audit Commission’s Acute Hospitals Portfolio have also been included. The Acute Hospital Portfolio is a collection of reviews that are undertaken at acute and specialist Trusts. They focus on key service areas and are reported along the key performance criteria of patient experience, efficiency and capacity. åÊ

NICaN Regional Supportive & Palliative Care Network

NICaN Regional Supportive & Palliative Care Network Friday 30th May 2008 Lecture Theatre, Fern House Antrim 2.00 pm - 5.00 pm Welcome, Introductions Stuart MacDonnell, Chair of the Supportive and Palliative Care network welcomed everyone to the meeting. This meeting had been rescheduled to accommodate the validation workshop for the regional palliative care model, which took place on Friday,18th April. Acknowledging the full agenda, several items were pulled forward to accommodate speakers SPC_0809_03 Modernisation and Reform of Supportive and Palliative care Mr MacDonnell welcomed Dr Sonja McIlfatrick and Dr Donna Fitzimons, members of the Phase 1 Project Team for the Modernisation and Reform of palliative care. Their presentation highlighted the journey taken by the Project Team since January 2008 - May 2008. Seeking to deliver the network vision, for any person with palliative care need, cancer or non - cancer, the project team incorporated several methodologies. The literature review identified best practice. An assessment of need including epidemiological data and review of service provision. Consultation reflected the engagement with patients, carers and professional forums, primary care and non-malignant focus groups. The breadth of consultation confirmed the evidence for the identified components of the model. These were validated at the April workshop. External review of the work was provided by Dr Phil Larkin (Galway Uni) Prof David Clark (End of Life Care Observatory, Lancaster University) and Mr Bob Neillans (Chair of the Mid Trent Palliative care network, which has been involved in the Delivering choice programme within Lincolnshire). The Guiding Principles of the model reinforced Patient and family centred care, enhanced community provision and supported by specialists. The components of the model are · Identification of patient with Palliative careened · Holistic Assessment · Integration of services · Coordination of care · End of Life Care and Bereavement Care The consultation process also highlighted the need for Increased Public and Professional Awareness. This was recognised as an encompassing component. Underpinning the model is the need for robust Education and common core values e.g. dignity, choice, advocacy, empowerment, partnership working. Stuart MacDonnell, who also chaired the steering group during the project, congratulated the Project Team for delivering the comprehensive document on schedule. The Report has been submitted to the NICaN Board and the DHSSPSNI. In addition, an outline for Phase 2 of this work has been submitted. Mr MacDonnell recognised that there is real opportunity for palliative care to benefit from the DHSSPSNI commitment to concrete developments. Phase 2 will progress the current high-level components of the model into quality services developments at a local level, demonstrating integration throughout. The methods propose continued engagement with the Delivering Choice Programme enabled through a Central and also Local Teams. The report and the Appendices care available on the NICaN website www.nican@n-i.nhs.uk SPC_0809_01 Chairman's Business · Update on the Cancer Service Framework, the document has been submitted and presented to the Departmental Programme Board. Next stages will include the review of costs and development of a implementation guidance It is hoped that the completed document should be available for public consultation in Autumn 2008. with a launch of the framework document and accompanying implementation guide in Spring 2009. Some funding has already been identified to advance key areas of work including, Advanced communication skills training, peer review and an appointment of a post to develop the cancerni.net, focusing on children and e-learning tools. · Children's and Adolescent Cancer network group , Liz Henderson is to convene a group to consider how this is to be taken forward. · NICaN appointments Recognition was given to the significant contribution made by Dr Gerard Daly during his position as NICaN Lead Clinician, particularly throughout the early establishment of the NICaN. Dr Dermott Hughes (Western Trust) has been appointed as the NICaN Medical Director. The Primary Care Director post has been advertised and it is hoped that the Director of Network will be advertised later in Summer. Endorsement of End of Life care paper. The Paper was presented and endorsed at the March 2008 NICaN Board meeting. Mr David Galloway (Director of Secondary Care) emphasised the need for this important work to be recognised within the regional model to ensure that it is reflected in future models of service delivery Congratulations were again echoed to the Chair of the End of Life Group for this work, Dr Glynis Henry, and the working group Other recognition Mr MacDonnell congratulated the significant achievements across the network. These include: · Dr Francis Robinson (Consultant Palliative Medicine, Western Trust) Awarded - Consultant of the year at the NI Health Care awards. · Mrs Evelyn Whittaker Hospice Nurse Specialist, NI Hospice, Joint Second Prize in the Development award within the International Journal of Palliative Nursing Awards, for her work in development of palliative care education in nursing homes. · Mr Ray Elder is the newly appointed Team Leader of Community Palliative care, SE Trust. · Mrs Bridget Denvir, who managed the establishment of one of the first community multiprofessional palliative care teams is moving to work with establishing integrated teams within the Belfast Trust. Bridget has been an active core member of the network and here contribution has been much appreciated. Mrs Sharon Barr will attend in future. SPC_0809_02 Minutes & matters Arising from Meeting, 13th December 2007 No amendments were made to the draft minutes from the December meeting. These will be posted on the NICaN website for future reference. Palliative Care Research Following consultation, the response to the business case for the All Ireland Institute was forwarded on 22 February 2008 to Prof David Clark. Prof Judith Hill informed the group that terms of tender are now being developed. Awareness raising across academic institutions continues to engage interest in potential partnerships. Atlantic Philantrophies have offered financial support to the venture and match funding is being sought from across jurisdictions. Previous discussions at Network meetings have endorsed the need to establish a work strand for research and development within palliative and end of life care. To identify the body of interested parties and explore the strengths and weaknesses of a collaborative model for research, a workshop, - Building collaboration for Palliative and End of life Care Research -will take place on 4 June 10am - 2pm.in the Comfort Hotel.Antrim, The workshop will be chaired by Prof David Clark, Director of the International Observatory on End of Life Care. Prof Shelia Payne, Help the Hospices Chair in Hospice Studies and co director of the Cancer Experiences Collaborative will present the Experiences and Results from Research Collaborative. Feedback from this event will be brought back to the next meeting in September. SPC_0809_04 Patient Information pathways - a pathway for advanced disease Ms Danny Sinclair, NICaN Regional Coordinator for Patient Information informed the network of how patient information pathways have been developed in line with the Cancer Services Collaborative. Emerging themes, with regard to information needs of patients with advanced disease, are being identified from the work undertaken across the tumour groups. It is important to identify all information needs to develop a generic pathway of information resources for advanced disease to be endorsed by the Supportive and Palliative care network. This could be used across the all tumour specific information pathways and across organisational boundaries. The resulting pathway could potentially be used for non- cancer condition. A group is to be established to take this work forward. The group will: · Develop a list of advanced disease information themes · .Identify when they become relevant for the patient or their carer · .Identify existing resources · .Develop resources where needed · .Participate or nominate when review is required Dr Sheila Kelly nominated Helen Hume (SETrust) Paula Kealey will also contribute to this work; a nomination from the Patient and Public Information Forum has also been identified. A date will be circulated across the network to engage further interest and establish group SPC_0809_08 Development of a Regional Syringe Driver Prescription Chart Ms Kathy Stephenson reported that the second consultation of the draft regional syringe driver prescription chart and the focus group discussions, Pilots of the chart are to be undertaken within Trust, Hospices and General Practices. SPC_0809_05 A framework for Generalist and Specialist Palliative and End of Life Care Competency Dr Kathleen Dunne, lead of the Education works strand, reported on the findings following consultation of the Education framework. The report was widely appreciated across the network and valued as a significant and timely document for the commissioning of generalist and specialist adult palliative care education. Mr MacDonnell congratulated Dr Dunne and the members of the education workstrand for developing the framework aligning its significance to the underpinning needs of the regional model Amendments will be made to the document and then forwarded to the NICaN Board for endorsement. A process of implementation will be explored and reported to the network group at the September meeting. Key target areas for generalist palliative care education were highlighted within care of the elderly and general medicine. . SPC_0809_06 Pallcareni.net-a website for people with palliative care needs Ms Danny Sinclair, reminded the group of the pending amalgamation of the CAPriCORN and NICaN website. The resulting new web address will be www. cancerni.net. Recurrent funding has been secured to ensure the development of the supportive and palliative care website.www.Pallcareni.net The new website will host good information for people with palliative care needs, regardless of diagnosis. It will be accessible via the cancerni.net portal or independently as the pallcareni portal. It will signpost people with palliative care needs to condition- specific websites. The website will also enable the communication needs of the NI Regional Supportive & Palliative Care Network. This is a very significant method of seeking to enable greater understanding of palliative care for public and professionals, as highlighted within the regional model. Currently the material from the CAPriCORN website is being migrated onto cancerni and /or pallcareni.net as appropriate. To enable the further development of this opportunity a steering group of interested individuals is to be established. Their role will be to: · Drive the development of the website so it meets the needs of public and professionals through the sourcing and development of additional content · Identify any support that is needed, e.g. technical support · Review the website as a whole as it grows (coordinating condition-specific developments) · Review the functions of the website to aid communication throughout the Supportive and Palliative care network The steering group representation should reflect the constituencies within the Supportive and Palliative Care network. Current expressions of interest have come from Heather Reid and Valerie Peacock. A date will be circulated across the network to engage further interest and establish group SPC_0809_07 Update of Guidelines workstrand Dr Pauline Wilkinson presented the current work within the guidelines workstrand. 1. Brief Holistic Assessment & Referral Criteria to Specialist Palliative Care The development of an Holistic assessment Tool will help to identify holistic need at generalist and specialist level. Recognition of complex need prompts appropriate referral to specialist palliative care. The regional referral form is compatible with the Minimum Data set. The final drafts of this work are to be circulated widely, inclusive of service framework groups, primary care, secondary care and the supportive and palliative care network. Consultation will take place during June and July. Piloting of the forms will also be undertaken. 2. Control of Pain in Cancer Patients The original guidelines where developed 2003 and are now ready for review. The Mapping exercise, undertaken in May 2007, highlighted that the Guidelines were poorly adopted. The group have reviewed the pending SIGN 2 guidelines for pain with regard to practice in Northern Ireland. These are highly evidence based and are due to be launched this Summer. Whilst an excellent resource their comprehensiveness limits their readability, this may result in poor compliance. The Guidelines group feel it is important to have accessible and user-friendly guidelines particularly for Generalists and Out of hours. There are examples of good work that has taken place across the province, but there is a need for regional consistency. Dr Wilkinson has contacted Dr Carolyn Harper (Deputy CMO) and GAIN with regard to enabling funding to progress this work. The Guidelines group hope to approach the NICaN Primary Care Group to work in collaboratively on this piece, based on the templates already available. The works should be available in both electronic and paper versions. 3. Care of the dying & Breaking bad news Dr Gail Johnston has now completed an Audit of the Care of the Dying Pathways within the EHSSB. Gail is also seeking to examine to what extent the Regional Guidelines for Breaking Bad News are being implemented in the EHSSB with a view to identifying the need for further training or organisational structures that would facilitate future uptake. 4. Advances in new Technology Syringe Drivers Dr Wilkinson reported on a presentation made to the guidelines group by Mr Jim Elliot, Principle Engineer, Cardiology & Ann McLean, and Macmillan Palliative Care Nurse RVH. There is increasing concern with regard to how devices meet the recommended safety standards and how to reduce error. New devices have 3 point checking, automatic detection of syringe, automatic flow rates, full range of alarms, battery status and data download to provide an event log. There are now 2 companies in UK who have devices that meet these safety criteria. The current Graseby syringe drivers, which have been on the market and used predominately within Northern Ireland over the past 27 years Most new devices are not compatible with the regionally available monoject syringe, however contractual changes will lead to the withdrawal of the monoject syringes in October 2008. The Guidelines group supports a regional approach to this matter. This was echoed in the Supportive and Palliative care network. An option appraisal, identifying costs, and training issues should be developed through the engagement with Trusts and DHSSPSNI. The issue of Patient safety should be raised with the DHSSPSNI. SPC_0809_09 Evaluation of Supportive and Palliative Care network Deferred to next meeting. . SPC_0809_10 Emerging Issues Mrs Anne Coyle, Bereavement Coordinator, Southern Trust, announced that the Regional Bereavement Strategy is soon to be released. Anne supported the close alignment between the content of the strategy and the work of the regional model and other workstrands within the Supportive and Palliative care network. Ms Eleanor Donaghy, Transplant Coordinator, briefly highlighted the issue of tissue donation. Each year Northern Ireland has a dearth of corneal donations. There is no upper age limit for donation and retrieval is not limited by a cancer diagnosis. Recipients do not require immunosuppressive and the transplant is lifelong. The National Blood Service provided coordination of this donation they may be contacted via 07659180773. It is hoped that Mrs Coyle and Ms Donaghy could provide more comprehensive presentations at a future meeting. Events · Irish Psycho- Oncology Group Seminar, Cork 6 June, Exploring the Struggle for meaning in Cancer · Integrated Care: Putting Research into Practice, 13June, Trinity College, Dublin · Macmillan online conference Friday 13 June 2008, 9am - 5pm · Delivering effective end of life care: developing partnership working 15 Oct 2008, 9.30 -4.15 pm London Network Meeting was closed at 5.00pm SPC_0607_ Dates of Future Meetings (please note the change of venue) 10th September 2008, 1.30 - 5pm venue to be decided15th January 2009, 1.30 - 5pm venue to be decided12th May 2009, 1.30 - 5pm venue to be decided Attendances Apologies Stuart MacDonnellLorna NevinSonja McIlfatrick Donna FitzsimonsKathleen DunnePauline WilkinsonKathy StephensonSheila KellyMarie Nugent,Anne CoyleFiona GilmourJudith HillLorna DicksonMargaret CarlinLoretta GribbenYvonne Duff Lesley NelsonLiz HendersonSue FosterCathy PayneGraeme PaynePatricia MageeGeraldine WeatherupPaula KealyCaroline McAfeeLinda WrayValerie PeacockAnn McCleanRay Elder Martin BradleyHelen HumeGillian RankinHeather MonteverdeJulie DoyleAlison PorterYvonne SmythLiz Atkinson,Glynis HenryMaeve HullyCaroline HughesAnn FinnBob BrownSharon BarrJulie DoyleJanis McCulla .

Attitudes of the public towards policies to address obesity

Key points Obesity and the related health burden is a growing problem in Ireland. Understanding public attitudes to policy interventions is important, as it provides a key indicator of the potential effectiveness of interventions and the readiness of the general public for policy implementation. The present research aimed to determine public acceptance of a range of policies to address obesity in Ireland. To this end, a survey of attitudes towards obesity-oriented policies among a nationally representative sample of the population of Irish adults was conducted. Strikingly high levels of public support were evident for a wide range of obesity-oriented interventions. The findings support prior research on behaviour change in key policy areas such as diet and smoking which demonstrates that support for interventions tends to decrease as the intrusiveness of interventions increases. Consistent with previous research, socio-demographic factors only explain a small portion (2 - 6%) of the variance in policy support. Overall, the findings indicate substantial public readiness for addressing obesity in Ireland, particularly through child-focused policies, informational measures, subsidies for healthy foods and co-operation between government and the food industry. - See more at: http://www.safefood.eu/Publications/Research-reports/Attitudes-of-the-public-towards-policies-to-addres

Hungry for Change: Social Exclusion, Food Poverty and Homelessness in Dublin

This study investigates the impact of poverty and social exclusion on the food, diet and nutrition of people out-of-home in Dublin. The research involved a food frequency survey carried out with 75 people out of home, qualitative interviews with 12 individuals as well as a self-completion questionnaire administered to 18 food service providers in Dublin city. One of the main findings from the study was that the extent and experience of food poverty among homeless people was not only conditioned by income inadequacy and other socio-economic and cultural determinants, but particularly, by access to accommodation, as well as the quality of that accommodation. The report makes a number of practice and policy recommendations to tackle food poverty and homelessness. The qualitative approaches to food poverty employed for use with this sample of people out-of-home aimed to deal in depth with issues around food consumption. Through drawing a sub-sample from those who participated in the survey research (a process of recapture), the authors sought to expand on the survey questionnaire information on food issues. The themes for the Focus Group Discussions (FGDs) emerged from the analysis of the survey questionnaires and 4 key thematic areas were selected. i) Access to cooking, preparation and storage facilities ii) Access, choice and constraints in food purchase and consumption iii) Access to information about healthy diet, food preparation and storage iv) Expectations, cultures, values and choice concerning eating The qualitative aspect of the research enquiry eventually generated one FGD and seven semi-structured interviews representing the views of a total of 12 persons all of whom had completed the initial survey questionnaire.This resource was contributed by The National Documentation Centre on Drug Use.