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Due to an ageing population and improvements in healthcare, the prevalence of chronic disease (CD) is rising in Ireland and internationally. In Ireland, CD care is often characterised by siloed, reactive care, culminating in repeated hospital admissions. This is neither patient-centred nor sustainable. Health services need to evolve to meet changing population need. How can Irish health services meet population need in a sustainable way? The National Clinical Programmes (NCPs) in Ireland draw together healthcare professionals from primary and secondary care to improve specific areas within the health service. Public Health Practitioners (PHPs) have been central to the population health approach taken by the NCPs. Over the past decade, an integrated approach to CD care with an emphasis on prevention and population health has been advocated by PHPs, underpinned by a compelling epidemiological case. The use of a generic model of care for the prevention and management of CD, within an integrated approach to service delivery, is associated with positive health outcomes. The ‘‘National framework for the integrated prevention and management of chronic disease in Ireland’’ is a national clinical model that focuses on shifting the vast majority of CD care into the community. The Framework takes a generic approach to the prevention and management of four major CDs: type 2 diabetes; asthma; COPD; cardiovascular disease. It is now being implemented under PHP leadership. The sustained action of many PHPs over the past decade has resulted in the funding of this seminal programme. This project highlights the importance of working alongside Primary and Secondary Care Clinicians in achieving service reform. Key messages: This Framework provides an integrated approach to CD care and will transform service delivery. PHPs have a central role in the development and delivery of sustainable, evidence-based health services. [ABSTRACT FROM AUTHOR]

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The equations of motion describing the non-linear behavior of a perfectly flexible travelling cable are derived from first principles. Influences due to changes in the cross-sectional area of the cable and mass conservation are included. A homogenous isotropic non-linearly elastic cable material is assumed and the qualitative nature of a class of its equilibria is analyzed. The dependence of this equilibrium on the constitutive equations and the translational speed is discussed. It is shown that, under gravitational loading, the stretch in this equilibrium is a monotonically increasing function of the translational speed. Furthermore, if this speed is unbounded, so too is the stretch. Related results are proven for the particular cases of a cable composed of a St. Venant-Kirchhoff and an inextensible material. [ABSTRACT FROM AUTHOR]

A general treatment of constraints in the mechanical theory of a Cosserat point is proposed where the constraint forces are calculated using a normality assumption. The treatment is applicable to internal and external constraints. In cases where a body is modeled using several connected Cosserat points, a merging procedure is established. This procedure yields an equivalent single Cosserat point which may be more efficient to analyze in applications. To illustrate the treatment and the merging procedure, the equations governing the vibrations of a clamped bar are derived. [ABSTRACT FROM AUTHOR]

This survey was carried out in the Spring of 1987 on a stratified random sample of 445 post-primary schoolpupils in County Kilkenny, Ireland. Knowledge, attitudes and behaviour relevant to non-communicable diseases were examined using a questionnaire developed from a World Health Organization core questionnaire. The results showed that levels of adolescent alcohol and tobacco use were similar to those found in neighbouring European countries. Smoking and drinking increased during adolescence and were more prevalent in males. Physical activity decreased throughout adolescence and a high intake of 'snack foods' was found. Health-related knowledge levels were high but were not related to behaviour. [ABSTRACT FROM AUTHOR]

Trends in mortality from cardiovascular diseases in Ireland from 1950 to 1986 are examined and compared with trends in some other developed countries. There was a decline in mortality from all causes which was greater in women than in men. Mortality from coronary heart disease (CHD) increased in males from 1953 to 1974 and has been declining slowly since. Mortality rates in men in Canada and the United States are now lower than those in Ireland and rates in Finnish men are approaching those in Ireland. CHD mortality in Irish males was sixth highest of developed countries in 1985. In women, CHD mortality declined in the 1950s, was stable in the 1960s and early 1970s and has been decreasing slowly since 1974. CHD mortality in Irish women was fifth highest of developed countries in 1985. Mortality rates from cerebrovascular disease have been falling in Irish women since 1958 and in men since 1969. The continuing high mortality from CHD in Ireland warrants the establishment of effective community prevention programmes. [ABSTRACT FROM AUTHOR]