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The information provided here gives a sense of the value of comparing population studies between the Republic and Northern Ireland, albeit incomplete comparisons in this case since the studies were conducted independently. We share enough that is both common and unique in our attitudes, health profiles and health systems to enable fruitful comparisons for both sides. Future opportunities for comparison should be more explicitly incorporated into the planning stages of such studies. We hope that this report will provide a catalyst for joint survey planning, such that information forthcoming can inform and benefit policy and practice in the pursuit of good health and well-being in the coming years in both the Republic of Ireland and Northern Ireland.

The career progression of migrant nurses within the Irish health system was an issue raised in our discussions with key stakeholders. Concern was raised that few migrant nurses had achieved managerial grades in Ireland (CNM1 or CNM2) and that perhaps this stemmed from a reluctance to apply for senior posts. Evidence internationally suggests that migrant health workers frequently occupy less desirable posts [1,2] within the health systems of their host countries and that they struggle to achieve career progression [3]. A number of reasons have been cited for their stalled career progression and these include poor take-up of training [4], a lack of transparency in the management of promotions [3] and ���discrimination in the quality of support given to candidates in the promotion process. . .whereby chosen candidates were pre-selected and coached whilst others were ignored or received inadequate or misleading support��� [3]. This policy brief, which presents findings on the skills and expertise of Ireland���s migrant nurses and offers an insight into their perception of promotions and career progression in Ireland.

CPR 4 Schools is an ambitious training programme developed by the Irish Heart Foundation (IHF) to equip post-primary school students with cardiopulmonary resuscitation (CPR) skills. In the 2008–09 school year, a pilot of the programme was rolled out to 27,000 Transition Year students. The programme is one element of the IHF’s strategy to improve survival rates from sudden cardiac arrest, which causes an estimated 5,000 deaths in Ireland every year. Most of these deaths occur at home. If there is a witness, it is most often a relative.

Background Ireland has one of the highest rates of mortality from cardiovascular disease in Europe. Time to medical treatment is crucial in the management of Acute Coronary Syndromes (ACS). The aim of the present study was to provide an overview of the current patterns of presentation and management of ACS in Ireland. Treatment of both acute myocardial infarction (AMI) and other ACS patients was assessed. Findings were compared to a previous national survey conducted in 1994. The prevalence of depression post-ACS event was also assessed.

The Cardiovascular Health Policy Group was established with the following terms of reference: Having regard to the audit of the implementation of the cardiovascular health strategy, Building Healthier Hearts, and the audit of stroke services, Irish National Audit of Stroke Care, and consistent with developments in relation to the management of chronic diseases and the Primary Care Strategy, to develop a policy framework for the prevention, detection and treatment of cardiovascular disease, including stroke and peripheral arterial disease, which will ensure an integrated and quality-assured approach in their management. This new cardiovascular policy, Changing Cardiovascular Health covering the period 2010-2019, comes a decade after the first national cardiovascular health strategy, entitled Building Healthier Hearts, was published by the Department of Health in 1999. The new policy is timely given the pace of scientific discovery and related changes in medical practice, changes in health service structures, and patterns and influences on population health behaviours in Ireland over the decade. Cardiovascular health and its maintenance is a microcosm of health more generally. A policy that can improve cardiovascular health and cardiovascular disease management will have beneficial effects for the whole healthcare system and population.

Economic Evaluation The aim of the economic evaluation was to examine the cost effectiveness of the two screening models tested in the Chlamydia Screening in Ireland Pilot (CSIP) study: (a) Clinical Setting screening, and (b) ’Pee-in-a-pot’ periodic screening in third level institution/college settings. The methodological approach comprised of a dynamic transmission model paired with an economic model. In both analyses, screening was compared to a control strategy of no organised screening, that is existing care in Ireland. A public health system or provider perspective was adopted with respect to costs. The analysis considered the cost of screening to the health service, and the costs of infection and complications, not any additional costs reported by young people in accepting a chlamydia screening test. Health outcomes were assessed in terms of major outcomes (MOs) averted and quality adjusted life years (QALYs) gained. The costs of Clinical Setting screening were presented in terms of the cost per offer (€26 ), the cost per negative case (€66), the cost per positive case (€152), and the cost per partner notified and treated (€74). The costs of ’Pee-in-a-pot’ screening were presented in terms of the cost per negative case (€39), the cost per positive case (€125), and the cost per partner notified and treated (€74). In both analyses, screening was estimated to result in fewer major outcomes, fewer QALYs lost, and higher healthcare costs compared to the control strategy. The incremental cost effectiveness analyses indicated that screening in the Clinical Setting would result in an incremental cost per MO averted of €6,093 and an incremental cost per QALY gained of €94,717. ’Pee-in-a-pot’ screening was estimated to result in incremental cost effectiveness ratios of €2,294 per MO averted and €34,486 per QALY gained respectively. In Ireland, there is no fixed and generally agreed cost effectiveness threshold below which health care technologies would be considered by policy makers to be costeffective. Nonetheless, on the basis of other technologies that are currently funded, it is not likely that screening delivered in the Clinical Setting, given an incremental cost per QALY in the region of the €94,717 found in this study, would be considered cost effective. ’Pee-in-a-pot’ screening in third level institution/college settings may be considered cost effective if a cost effectiveness threshold in the region of €45,000 per QALY gained is used. This is open to question, however, given the current economic climate and its resulting impact in terms of imposing further constraints on future healthcare budgets. It is also important to note that this strategy would have minimal in impact in reducing overall chlamydia prevalence in the population, if not supported by general population screening and prevention strategy.

Recent changes to the health services have initiated a consumer-oriented approach to health care. The current national health strategy in Ireland ���Quality and fairness: a health service for you��� emphasises the principles of equity and fairness, a peoplecentred service, clear accountability and quality of care (Department of Health and Children, 2001). A consequence of these changes is the consideration of patient views of their health care, and this is often evaluated in the form of patient satisfaction studies. There is a growing realisation that patient input can give a greater understanding of the quality of services and how best to improve them.

The Irish Contraception and Crisis Pregnancy Study 2010 (ICCP-2010) is a cross-sectional telephone survey of adults aged from 18 to 45 years and living in Ireland. ICCP-2010 follows on from two other national sexual health surveys: the 2003 Irish Contraception and Crisis Pregnancy Study (ICCP-2003) and the 2006 Irish Study of Sexual Health and Relationships (ISSHR). It seeks to provide: (1) data on current knowledge, attitudes and behaviours in relation to sex, contraception and pregnancy in Ireland; and (2) an opportunity to explore trends in relation to sex, contraception and pregnancy in Ireland over a number of years. An overview of the main findings from ICCP-2010, as well as comparisons with ICCP- 2003, are presented in this report. Tests were conducted to explore whether differences between the two surveys were statistically significant, where appropriate, and are highlighted below and in the main report.

This project involves a cross-sectional study of community- dwelling older people aged 65 + years in the Republic of Ireland and Northern Ireland. Significant differences exist in policy, structures, coverage and funding between the two healthcare systems. These differences ��� a ���one island ��� two systems��� situation ��� provide a unique opportunity to learn by comparing the health, social status and service experiences of two groups of older people on one island with two differing health and social services. Little comparative research has been conducted on the island to date. The aim of this report is to compare health and social status and related service provision in the Republic and Northern Ireland from the perspective of community-dwelling older people needing and/or using these services. Part of this comparison includes evaluation of possible urban/rural differences within and across regions.

The ISSHR was commissioned by the Department of Health and Children and the Crisis Pregnancy Agency in response to a recommendation by the National AIDS Strategy Committee. It is the largest nationally representative study of sexual knowledge, attitudes and behaviour ever undertaken in Ireland. International evidence indicates that aspects of sexual health, such as contraception, crisis pregnancy and sexually transmitted infections, should be examined jointly. To this end, the Crisis Pregnancy Agency and the Department of Health and Children instigated the ISSHR. The ISSHR findings have been outlined in a suite of reports – the Main Report, the Summary Report and three sub-reports; the latter provide detailed information in defined areas of interest. This, the second sub-report, focuses on the area of sexual risk-taking and the use of relevant services. The Crisis Pregnancy Agency (CPA) and the sexual-health sector in general need robust evidence in order to develop sexual-health policies, to plan strategies and to inform the effective promotion of sexual-health messages. The ISSHR findings will be invaluable not only to the work of the CPA in preventing crisis pregnancy, but also to that of other organisations concerned with promoting sexual health , providing sexual-health services, preventing sexually transmitted infections, and providing sex education for young people.

SAVI and SAVI Revisited

The SLÁN 2007 survey contained a series of questions relating to alcohol use. These included questions about frequency (how often) an quantity (how much) of alcohol consumed, as well as questions about alcohol-related harm. Quantity of alcohol consumed was assessed by asking respondents how many standard drinks were taken, a ‘standard’ drink being defined as a half pint or a glass of beer, lager or cider; a single measure of spirits; a single glass of wine, sherry or port; or a bottle of alcopop (long neck). This report forms part of a series of reports which seek to contextualise the SLÁN 2007 findings (see p. iv for full list of SLÁN 2007 reports).