Top Tips for healthier providers of health-care in Merseyside and Cheshire

Top tips for healthier providers of health-care aims to support organisations in focusing on the actions they can take to improve the health their patients, their staff, and the wider community that they serve. It builds on a previous report that was carried out by Liverpool Public Health Observatory in 2006, which focused on hospitals. The report is a review of secondary data, alongside examples of local delivery from Merseyside and Cheshire

Health needs assessment of young offenders in the youth justice system on Merseyside

Liverpool Health Observatory (LPHO) was commissioned to undertake a health needs assessment (HNA) for young offenders across the youth justice system on Merseyside. The HNA covers Liverpool, , Knowsley, Sefton, St Helens, Wirral and Halton. It includes a detailed description of the young offender population, both nationally and on Merseyside, and a brief review of relevant literature, as well as interviews with young people and health care staff, in both secure and community setting

Rapid Health Impact Assessment for Royal Liverpool and Broadgreen University Hospitals Trust - ‘A New Health Service for Liverpool, World Class Hospitals, World Class Services’

The overall aim of this HIA was to maximise the health benefits, which could result from implementation of the proposals by the Royal Liverpool and Broadgreen Hospitals to redesign its services, develop a new hospital to replace the Royal Liverpool University Hospital (RLUH) on its existing site, and make further investment at Broadgreen Hospital. In order to do this, the following objectives had to be achieved; Identify and profile the population groups who will be affected by the proposal. Identify the potential positive and negative health impacts of the proposal and set out clearly who will be affected by these impacts. Make recommendations for the elimination or mitigation of negative impacts (or compensation for those affected). Make recommendations for the maximisation of positive impacts

Health needs assessment for ex-Armed Forces personnel

Liverpool Health Observatory (LPHO) was commissioned to undertake a health needs assessment (HNA) for ex-Armed Forces personnel, and their families, in Cheshire and on Merseyside. The HNA focuses on personnel aged under 65. It includes a brief review of relevant literature, as well as a description of provision for ex-Armed Forces personnel at a local and national level

Rapid Health and Equality Impact Assessment (HEqIA)of Mersey Care NHS Trust’s Outline Business Case for Mental Health and Learning Disability Services

The aim of this assessment is to look at the health and equality impacts of Mersey Care's Outline Business Case which aims to: Establish home treatment as the norm; Refocusing in-patient services around patients who are acutely ill with shorter lengths of stay; Developing a local Psychiatric intensive Care in-patient Unit (PICU); Strengthen community and primary care services. The results of this Health and Equality Impact Assessment will be used to feed the Outline Business Cas

Fixed odds betting terminal use and problem gambling across the Liverpool City region

Liverpool Public Health Observatory was commissioned to look at problem gambling, and Fixed Odds Betting Terminal (FOBT) use, across the Liverpool City Region. The aims of the project were to develop a local evidence base in relation to FOBT use and problem gambling, look at reasons for excess gambling, and to investigate the availability and adequacy of local support services for problem gamblers. The project included an online survey on FOBT use, licensing officer visits to Licensed Betting Offices across the region, as well as interviews with problem gamblers, and staff working with them, across the region

Maternal Rest/Nrsf Regulates Zebrafish Behavior through snap25a/b

During embryonic development, regulation of gene expression is key to creating the many subtypes of cells that an organism needs throughout its lifetime. Recent work has shown that maternal genetics and environmental factors have lifelong consequences on diverse processes ranging from immune function to stress responses. The RE1-silencing transcription factor (Rest) is a transcriptional repressor that interacts with chromatin-modifying complexes to repress transcription of neural specific genes during early development. Here we show that in zebrafish, maternally supplied rest regulates expression of target genes during larval development and has lifelong impacts on behavior. Larvae deprived of maternal rest are hyperactive and show atypical spatial preferences. Adult male fish deprived of maternal rest present with atypical spatial preferences in a novel environment assay. Transcriptome sequencing revealed 158 genes that are repressed by maternal rest in blastula stage embryos. Furthermore, we found that maternal rest is required for target gene repression until at least 6 dpf. Importantly, disruption of the RE1 sites in either snap25a or snap25b resulted in behaviors that recapitulate the hyperactivity phenotype caused by absence of maternal rest. Both maternal rest mutants and snap25a RE1 site mutants have altered primary motor neuron architecture that may account for the enhanced locomotor activity. These results demonstrate that maternal rest represses snap25a/b to modulate larval behavior and that early Rest activity has lifelong behavioral impacts

Serum lipid and glucose concentration in relation to some physiological varibles in college students from Nnewi, Nigeria

Background: Serum lipid and glucose levels are largely determined by and or related to certain physical, physiological and biochemical parameters/variables. This study therefore, is aimed at determining the levels of serum lipid and glucose and the relationship between the serum lipid and glucose concentrations and the physical and physiological parameters/variables of apparently healthy individuals. Method: The blood samples of twenty-five medical students in the age range of 20 and 25 years were analyzed, for the serum glucose, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDLc) levels after overnight fast, and LDLc calculated.Result: The mean serum glucose, HDLc, TC and LDLc were not significantly different in females and males students. The serum TG was however significantly lower in females than in the males (90.22 ± 25.17 vs. 116.93 ± 21.54 mg/dl;

Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.

INTRODUCTION: There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy. METHODS: A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010. RESULTS: There were 145 pregnancies in 135 women: 89 conceived whilst taking atazanavir-based combination antiretroviral therapy (cART), "preconception" atazanavir exposure; 27 started atazanavir-based cART as "first-line" during the pregnancy; and 29 "switched" to an atazanavir-based regimen from another cART regimen during pregnancy. Gastrointestinal intolerance requiring atazanavir cessation occurred in five pregnancies. Self-limiting, new-onset transaminitis was most common in first-line use, occurring in 11.0%. Atazanavir was commenced in five switch pregnancies in the presence of transaminitis, two of which discontinued atazanavir with persistent transaminitis. HIV-VL < 50 copies/mL was achieved in 89.3% preconception, 56.5% first-line, and 72.0% switch exposures. Singleton preterm delivery (<37 weeks) occurred in 11.7% preconception, 9.1% first-line, and 7.7% switch exposures. Four infants required phototherapy. There was one mother-to-child transmission in a poorly adherent woman. CONCLUSIONS: These data suggest that atazanavir is well tolerated and can be safely prescribed as a component of combination antiretroviral therapy in pregnancy

A Novel Unsupervised Method to Identify Genes Important in the Anti-viral Response: Application to Interferon/Ribavirin in Hepatitis C Patients

Background: Treating hepatitis C with interferon/ribavirin results in a varied response in terms of decrease in viral titer and ultimate outcome. Marked responders have a sharp decline in viral titer within a few days of treatment initiation, whereas in other patients there is no effect on the virus (poor responders). Previous studies have shown that combination therapy modifies expression of hundreds of genes in vitro and in vivo. However, identifying which, if any, of these genes have a role in viral clearance remains challenging. Aims: The goal of this paper is to link viral levels with gene expression and thereby identify genes that may be responsible for early decrease in viral titer. Methods: Microarrays were performed on RNA isolated from PBMC of patients undergoing interferon/ribavirin therapy. Samples were collected at pre-treatment (day 0), and 1, 2, 7, 14 and 28 days after initiating treatment. A novel method was applied to identify genes that are linked to a decrease in viral titer during interferon/ribavirin treatment. The method uses the relationship between inter-patient gene expression based proximities and inter-patient viral titer based proximities to define the association between microarray gene expression measurements of each gene and viral-titer measurements. Results: We detected 36 unique genes whose expressions provide a clustering of patients that resembles viral titer based clustering of patients. These genes include IRF7, MX1, OASL and OAS2, viperin and many ISG's of unknown function. Conclusion: The genes identified by this method appear to play a major role in the reduction of hepatitis C virus during the early phase of treatment. The method has broad utility and can be used to analyze response to any group of factors influencing biological outcome such as antiviral drugs or anti-cancer agents where microarray data are available. © 2007 Brodsky et al