Search PubMed⌕ Search

Biomedical subjects

C Kelleher

Publications and source records attributed to C Kelleher.

At least 37 records · Page 2Linked to original sources
PubMed1999

Health and safety practices among farmers and other workers: a needs assessment.

The development of appropriate health and safety interventions for farmers and agri-workers is important world-wide but data on present practices and attitudes to change are lacking. A representative quota sample (n = 1,938) of the Irish population was surveyed on lifestyle practices and workplace risk assessment and control measures, in relation to chemical exposure, manual handling and machinery. Focus group discussions were conducted also with 47 representatives of national farming organizations. As compared with the general workforce, farmers had a significantly (p < 0.01) lower level of assessment of risk hazards associated with manual handling and machinery. Both farmers and employees in workplaces with less than 20 employees reported a significantly lower level of safety training. Male farmers had a particularly negative health profile with only 18% reporting regular dental checks, 26% practising skin protection and 29% taking regular exercise. Discussions indicated that barriers to change included low perceived susceptibility, lack of time and resources. Mental health issues were particularly highlighted. We conclude farmers differ significantly in many instances from the rest of the workforce in regard to occupational health and safety issues and specific interventions in key areas are required for the agri-sector.

Adolescent↗
PubMed1998

Incidence and occupational pattern of leukaemias, lymphomas, and testicular tumours in western Ireland over an 11 year period.

STUDY OBJECTIVE: To determine incidence of the following malignancies, testicular tumours, all leukaemias and all lymphomas in the West of Ireland in an 11 year period. Secondly, to examine the relation between disease patterns and available occupational data in male subjects of working age. DESIGN: A census survey of all cases occurring in the three counties in the Western Health Board (WHB) area, Galway, Mayo and Roscommon, for the 11 year period 1980 to 1990 inclusive. Average annual age standardised incidence rates for the period were calculated using the 1986 census data. Rates for the area are compared with rates from the southern region of Ireland, which had a tumour registry. Trends over the time period are evaluated. All male subjects for whom occupational data were available were categorised using the Irish socioeconomic group classification and incidence rates by occupation were compared using the standardised incidence ratio method. In one of the counties, Galway, a detailed occupational history of selected cases and an age matched control group was also elicited through patients' general practitioners. SETTING: All available case records in the West of Ireland. RESULTS: There are no national incidence records for the period. Compared with data from the Southern Tumour Registry, the number of cases of women with myeloid leukaemias was significantly lower. Male leukaemia rates were significantly lower as a group (SIR 84 (95% CI 74, 95) but not when considered as individual categories. Regression analysis revealed an increasing trend in the number of new cases of non-Hodgkin's lymphoma among both men (r = 0.47, p = 0.02) and women (r = 0.90, p = 0.0001) and of chronic lymphocytic leukaemia in men (r = 0.77, p = 0.005) and women (r = 0.68 p = 0.02) in the WHB region over the last decade. Four hundred and fifty six male cases over the age of 15 years were identified and adequate occupational information was available for 74% of these. Standardised incidence ratios of testicular tumours 100, 938) and agriworkers other than farmers (SIR 377, 95% CI 103, 967). There were also significantly increased incidence ratios for both non-Hodgkin's lymphoma (SIR 169, 95% CI 124, 266) and three categories of leukaemias among farmers. Hodgkin's disease and acute myeloid leukaemias were significantly increased among semi-skilled people. Interview data with 90 cases and 54 controls of both sexes revealed that among farmers, cases (n = 31) were significantly less likely than controls (n = 20) to use tractor mounted spraying techniques (OR = 0.19 (95% CI 0.04, 0.80)) and less likely to wear protective masks (OR 0.22 (95% CI 0.05, 0.84)). CONCLUSIONS: Trends of increase in non-Hodgkin's lymphoma and some leukaemias are consistent with studies elsewhere. The study provides further evidence of the relation between agricultural work and certain lymphoproliferative cancers. The possible carcinogenic role of chemicals used in agricultural industries must be considered as an explanation.

Adolescent↗
PubMed1998

Do doctors benefit from their profession?--A survey of medical practitioners' health promotion and health safety practices.

Three hundred Irish Medical Organisation members were surveyed on health promotion and health and safety issues. 64.7% responded (65.3 males; 33.7% < thirty-five years). Over half (54.9%) were aware of the safety legislation and very few reported available occupational health services. A majority wanted more such services. Nearly all believed health promotion was important yet only 35.2% always availed of opportunities to give such advice. 36.3% were often stressed, particularly at work. Alcohol was sometimes or frequently used to cope by around half of respondents. Although less than half (47.7%) used whole milk, one third usually or always added salt to their food. 15.5% took no weekly aerobic exercise but 42.0% claimed to do so three times weekly. 11.4 were current smokers. A third of women had never had a cervical smear. We conclude doctors require adequate occupational health services.

Adult↗
PubMed1997

Chronic debilitating fatigue in Irish general practice: a survey of general practitioners' experience.

BACKGROUND: Doctors are called upon to treat chronic debilitating fatigue without the help of a protocol of care. AIMS: To estimate the incidence of chronic debilitating fatigue in Irish general practice, to obtain information on management strategy and outcome, to explore the attitudes of practitioners (GPs) towards the concept of a chronic fatigue syndrome (CFS), and to recruit practitioners to a prospective study of chronic fatigue in primary care. METHOD: A total of 200 names were selected from the database of the Irish College of General Practitioners (ICGP); 164 of these were eligible for the study. RESULTS: Altogether, 118 questionnaires were returned (72%). Ninety-two (78%) responders identified cases of chronic fatigue, giving an estimated 2.1 cases per practice and an incidence of 1 per 1000 population. All social classes were represented, with a male to female ratio of 1:2. Eleven disparate approaches to treatment were advocated. Many (38%) were dissatisfied with the quality of care delivered, and 45% seldom or hardly ever referred cases for specialist opinion. The majority (58%) accepted CFS as a distinct entity, 34% were undecided, and 8% rejected it. Forty-two (35%) GPs volunteered for a prospective study. CONCLUSION: Chronic fatigue is found in Irish general practice among patients of both sexes and all social classes. Doctors differ considerably in their management of patients and are dissatisfied with the quality of care they deliver. Many cases are not referred for specialist opinion. A prospective database is required to accurately assess the scale of this public health problem and to develop a protocol of care.

Adult↗
PubMed1996

Nutrition surveillance of Ireland.

In summary then we can say that diet in Ireland is changing continuously, that the patterns as documented in diet are consistent with the epidemiological patterns of the major chronic diseases, although predictions for the future will be complex because of both positive and negative changes in diet behaviours. The major influences on diet relate to changes in the food chain, which have been enormous in 100 years; at consumer level, health concerns appear to be one of many considerations in food choices. We need a more consistent, comprehensive database in order to make meaningful inferences about diet and health. Furthermore, to be really useful such databases should include both quantitative and qualitative information.

Diet↗
PubMed1995

Model of Epstein-Barr virus infection of human thymocytes: expression of viral genome and impact on cellular receptor expression in the T-lymphoblastic cell line, HPB-ALL.

Infection of B lymphocytes and epithelial tissue by Epstein-Barr virus (EBV) is associated with malignancy and autoimmunity. The cellular receptor for EBV has been identified as CD21 (CR2). A molecule, which is biochemically and immunologically similar to B-cell CD21, has been identified on a subpopulation of immature thymocytes, suggesting a role for this molecule in the regulation of T-cell development and further suggesting that immature T cells might be susceptible to EBV infection. A growing body of literature now documents the presence of EBV in tumors of T-cell origin. We have evaluated the susceptibility of the human immature T cell line, HPB-ALL, to infection by EBV. Electron microscopy studies showed a rapid internalization of virus by HPB cells. Southern blotting showed the intracellular presence of linear EBV genomes, and components of the virus replicative cycle were identified. Expression of the BamHI Z region of the genome, encoding the nuclear protein, ZEBRA, which is strictly associated with productive infection in B cells, was detected in HPB-ALL cells. A spliced variant of Z, RAZ, was also identified. Cell surface expression of EBV late antigens was observed to occur transiently. Infection of HPB cells was also accompanied by altered expression of T-cell surface molecules involved in antigen recognition, a process critical to normal development of the T-cell repertoire. Delineation of the outcome of T-cell infection by EBV may lead to a better understanding of the role of this virus in autoimmune processes and malignancy.

Autoimmune Diseases↗
PubMed1995

Cardiovascular risk factor changes in the Kilkenny Health Project. A community health promotion programme.

The Kilkenny Health Project was a community research and demonstration programme which aimed to reduce risk of cardiovascular disease in a county in the south-east of Ireland with a total population of approximately 70,000. The health promotion programme was carried out in Kilkenny from 1985 to 1992. Outcome evaluation was by means of population surveys of independent samples of men and women aged 35 to 64 years in Kilkenny (n approximately 800) and in the reference county (n approximately 600) in 1985/1986 and in 1990/1991. Survey methods for health behaviour questionnaires and risk factor measurements were similar to those of the WHO MONICA Project. Mean systolic blood pressure (SBP) declined significantly (P < 0.01) in men and women in both counties, from 144.0 by 5.4 mmHg and from 143.2 by 5.4 mmHg in men and from 139.5 by 7.7 mmHg and from 136.5 by 6.6 mmHg in women in the intervention and reference counties. The prevalence of hypertension declined from 23.1% by 2.8% and from 26.1% by 6.0% in men in the two counties. Prevalence declined from 24.1% by 6.2% (P < 0.05) in women in the intervention county but was unchanged, increasing by 0.5% from 17.5%, in women in the reference county. Mean serum total cholesterol declined from 6.04 mmol.l-1 by 0.09 mmol.l-1 and from 6.00 by 0.44 mmol.l-1 (P < 0.01) in men and from 6.01 by 0.36 (P < 0.01) and from 5.90 by 0.31 (P < 0.01) in women in the intervention and reference counties, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

A novel technique for measuring bladder wall thickness in women using transvaginal ultrasound.

A new technique of measuring bladder wall thickness using transvaginal ultrasound is described. Measurement of the bladder wall using ultrasound was found to have a good intra- and interobserver reproducibility. Measurements of the bladder wall thickness were altered if more than 50 ml of fluid was within the bladder. Forty-five women with urinary symptoms were recruited from the urodynamic clinic; those with urodynamically diagnosed detrusor instability were found to have significantly thicker bladder walls than women with urodynamically diagnosed genuine stress incontinence. Application of this technique may be useful in the diagnosis of detrusor instability.

Journal Article↗
PubMed1993

Relationship of physician ratings of severity of illness and difficulty of clinical management to length of stay.

In a concurrent prospective study, medical and surgical residents rated the severity of illness and difficulty of clinical management of each of their patients within 24 hours of admission, and on a daily basis throughout the patient's stay. Data were collected on consecutive admissions resulting in 661 admissions with complete data for analysis. Results indicate that difficulty and severity are correlated, each explaining variations in length of stay (LOS), and together explaining up to 44 percent. Four alternative measures are tested, first-day values, average values over the stay, peak or highest values, and a zero-one measure indicating whether or not the severity or difficulty fluctuated over the stay. First-day and average measures of severity and difficulty explain little variation in LOS; peak and fluctuating measures are highly explanatory. After adjusting for diagnosis-related groups (DRGs), fluctuating severity adds 34 percent, and adjusting for both DRGs and severity, fluctuating difficulty adds 10 percent for a total of 53 percent variance explained. In comparable results, peak severity adds 21 percent, and peak difficulty 4 percent, for a total of 34 percent variance explained. Findings indicate that difficulty had independent value as a predictor, and the high explanatory power of the fluctuating measures suggests that a third dimension, instability, may be as important as severity and difficulty in explaining LOS.

Baltimore↗
PubMed1991

Ly-49 multigene family. New members of a superfamily of type II membrane proteins with lectin-like domains.

Ly-49 (YE1/48, A1) is a dimer protein expressed on subpopulations of murine NK cells. It is a member of a superfamily of type II transmembrane proteins containing carbohydrate recognition domains (CRD). In the mouse genome, the detection of multiple restriction fragments that cross-hybridize with Ly-49 cDNA probes suggests the presence of related genes. In this study, we have isolated several genomic clones encoding portions of CRD sequences highly homologous to the CRD of Ly-49. By using primers based on the consensus sequences of the genomic clones, expression of Ly-49-related genes was detected by the polymerase chain reaction in various organs, including lung, kidney, liver, spleen, and thymus. Two full-length cDNA clones that are highly homologous to the Ly-49 gene were subsequently isolated from a lung cDNA library. At the nucleotide level, the two clones are 72% and 80% identical to Ly-49 in their translated regions, but their sequences are different from those of the genomic clones characterized to date. The two cDNA clones potentially encode type II transmembrane proteins containing CRD that are very similar to Ly-49. These amino acid sequences are also homologous to other members of the superfamily of CRD-containing type II transmembrane proteins, including hepatic lectins and the low affinity IgER (CD23). The homology is most evident in the CRD but is also significant in other domains. These results demonstrate the existence of several functional genes that are highly related to Ly-49. These genes comprise a subfamily within the superfamily of type II transmembrane proteins containing CRD.

Amino Acid Sequence↗
PubMed1990

Fibrinogen, factor VII clotting activity and coronary artery disease severity.

To asses the relationship between fibrinogen, factor VII coagulant (VIIc) activity and extent of coronary artery disease, we studied 43 white males shown to have greater than 50% stenosis of at least one major coronary artery. Thirty six had a definite history of myocardial infarction at least 3 months earlier and were classified as having 1, 2 or 3 vessel disease while 7 had 2 or 3 vessel disease, but no prior infarction. Groups were similar with regard to age, body mass index and blood pressure. In those with documented prior infarction, there was a significant relationship between the extent of atheroma and coagulation variables factor VIIc and fibrinogen. However, given a similar degree of atheroma, patients with prior infarction had significantly higher levels of factor VIIc activity compared with patients without such a history. These results corroborate those from prospective studies confirming a significant role for the coagulation system in the clinical manifestation of coronary artery disease.

Cholesterol↗