Search PubMed⌕ Search

Biomedical subjects

M Boland

Publications and source records attributed to M Boland.

At least 19 recordsLinked to original sources

Emerging advantages and drawbacks of telephone surveying in public health research in Ireland and the U.K.

BACKGROUND: Telephone surveys have been used widely in public health research internationally and are being increasingly used in Ireland and the U.K. METHODS: This study compared three telephone surveys conducted on the island of Ireland from 2000 to 2004, examining study methodology, outcome measures and the per unit cost of each completed survey. We critically examined these population-based surveys which all explored health related attitudes and behaviours. RESULTS: Over the period from 2000 to 2005 the percentage of calls which succeeded in contacting an eligible member of the public fell, from 52.9% to 31.8%. There was a drop in response rates to the surveys (once contact was established) from 58.6% to 17.7%. Costs per completed interview rose from 4.48 euro to 15.65 euro. Respondents were prepared to spend 10-15 minutes being surveyed, but longer surveys yielded poorer completion rates. Respondents were willing to discuss issues of a sensitive nature. Interviews after 9 pm were less successful, with complaints about the lateness of the call. Randomisation from electronic residential telephone directory databases excluded all ex-directory numbers and thus was not as representative of the general population as number generation by the hundred-bank method. However the directory database was more efficient in excluding business and fax numbers. CONCLUSION: Researchers should take cognisance of under-representativeness of land-line telephone surveys, of the increasing difficulties in contacting the public and of mounting personnel costs. We conclude that telephone surveying now requires additional strategies such as a multimode approach, or incentivisation, to be a useful, cost-effective means of acquiring data on public health matters in Ireland and the U.K.

Attitude to Health↗

Trends in medical student use of tobacco, alcohol and drugs in an Irish university, 1973-2002.

Questionnaire surveys of medical students in an Irish university were carried out in 1973 (n=765), 1990 (n=522) and 2002 (n=537), with differentiation of western students (e.g., from the Republic of Ireland, the UK, or Australia) and non-western students (e.g., Malaysia). We report on changes in tobacco smoking, drinking and drug-taking over three decades, and we note that, among western students, estimated prevalence of being a current smoker has declined overall from 28.8% in 1973 to 15.3% in 1990 to 9.2% in 2002 (p<0.001), falling in both males (p<0.001) and females (p<0.01). Ex-smokers rose from 5.9% to 15.1% between 1990 and 2002, corresponding with the decline in current smokers. The prevalence of current drinkers has risen over the period, to 82.5% among western students in 2002 (p<0.05); female drinking has increased steadily since 1973 (p<0.001), and the overall proportion of CAGE-positive drinkers has risen since 1990 (p<0.001). The mean weekly alcohol consumption has risen in both sexes since 1990 (males 14.3 units to 19.4, p<0.01; females 6.0 to 9.5, p<0.001). There was an increase in the proportion of students ever offered drugs between 1973 and 2002 (p<0.001). Although smoking rates have fallen, our findings show a marked increase in alcohol and drug consumption between 1973 and 2002. Personal misuse of addictive substances by doctors may mean that doctors will fail to take misuse by patients seriously. A need for preventative and ameliorative action during the medical school years is clear.

Adolescent↗

Urban-rural variation in mortality and hospital admission rates for unintentional injury in Ireland.

OBJECTIVE: To explore urban-rural differences in the mortality and hospital admission rates for unintentional injuries in the Republic of Ireland. DESIGN: Standardised mortality ratios (SMRs) in residents of urban and non-city areas (called rural areas) from all causes of unintentional injury were calculated using Central Statistics Office mortality data from 1980-2000. Hospital admission data (Hospital In-Patient Enquiry) from 1993-2000 were used to calculate standardised hospital admission ratios (SARs) in urban and rural residents. Population data were obtained from the 1981, 1986, 1991, and 1996 censuses. RESULTS: The rate of unintentional injury mortality was significantly higher in rural residents for all-cause unintentional injury mortality (SMR 103.0, 95% confidence interval 101 to 105), and specifically for deaths related to motor vehicle trauma (MVT), drowning, machinery, and firearms. There were significantly higher SMRs in urban residents for falls and poisoning. The rate of unintentional injury hospital admission was significantly higher in rural residents for all-cause unintentional injury (SAR 104.6, 95% confidence interval 104 to 105) and specifically for injuries from falls, MVT, being struck by or against an object, injuries in pedal cyclists, fire/burn injuries, and machinery injuries. SARs were significantly higher in residents of urban areas for poisoning and injuries in pedestrians. CONCLUSIONS: There are urban-rural differences in mortality and admissions for injuries in Ireland. Possible reasons for the higher rural mortality rates are higher case fatality in MVT and rural exposure to hazardous farm machinery, firearms, and open areas of water. This information could assist in targeting prevention programmes under the proposed National Injury Prevention Strategy.

Accidental Falls↗

A cluster of leptospirosis cases in canoeists following a competition on the River Liffey.

On 6 November 2001, a possible case of leptospirosis was notified in a canoeist following a white-water event on the River Liffey. It emerged that a second race participant was also a possible case. An outbreak control team coordinated the epidemiological investigation, laboratory investigation, environmental assessment, communication and control measures. A cluster of six laboratory-confirmed cases of leptospirosis, serologically Leptospira interrogans serogroup Icterohaemorrhagiae was found. The attack rate was 9.2% (6/65). Fever, chills, red eyes and shortness of breath were significantly associated with being a confirmed case. Five cases were hospitalized. Swallowing more than one mouthful of water was associated with an increased risk of developing leptospirosis. Increased rainfall and release of hydroelectric water may have contributed to this outbreak. A multidisciplinary approach and use of the Internet and e-mail facilitated rapid and effective communication.

Adolescent↗

Compton scattering from the deuteron and extracted neutron polarizabilities.

Differential cross sections for Compton scattering from the deuteron were measured at MAX-Lab for incident photon energies of 55 and 66 MeV at nominal laboratory angles of 45 degrees, 125 degrees, and 135 degrees. Tagged photons were scattered from liquid deuterium and detected in three NaI spectrometers. By comparing the data with theoretical calculations in the framework of a one-boson-exchange potential model, the sum and the difference of the isospin-averaged nucleon polarizabilities, alpha(N)+beta(N)=17.4+/-3.7 and alpha(N)-beta(N)=6.4+/-2.4 (in units of 10(-4) fm(3)), have been determined. By combining the latter with the global-averaged value for alpha(p)-beta(p) and using the predictions of the Baldin sum rule for the sum of the nucleon polarizabilities, we have obtained values for the neutron electric and magnetic polarizabilities of alpha(n)=8.8+/-2.4(total)+/-3.0(model) and beta(n)=6.5-/+2.4(total)-/+3.0(model), respectively.

Journal Article↗

Helicobacter Pylori eradication therapy: getting research into practice.

Helicobacter Pylori (H. Pylori) is the primary cause of duodenal ulcer (DU). Guidelines recommend that all patients with DU be considered for Helicobacter Pylori Eradication Therapy (HPET). However, the proportion of patients with DU on long term anti-ulcer medication receiving HPET is small. This study examined the effectiveness of the continuing medical education (CME) network of the Irish College of General Practitioners (ICGP) in promoting best practice in DU treatment among GPs in an eastern region of Ireland. Ninty eight GPs recruited from the CME network of the ICGP were randomised in two cohorts. Cohort 1 received an (early) intervention; GPs were asked to identify their patients with DU receiving long term anti-ulcer medication and prescribe HPET according to defined criteria. Cohort 2 received the intervention later. Prescribing of HPET was monitored using routine prescribing data. Twenty per cent (286/1,422) of patients in cohort 1 and 19.2% (127/661) in cohort 2 had a DU. After exclusions, 53% (152/286) in cohort 1 and 30.7% (39/127) in cohort 2, were eligible for HPET. A significantly higher proportion of patients in cohort 1 received HPET compared with cohort 2 during the early intervention period (13.8% vs 0.0%, p<0.05). Reasons for not prescribing HPET included concurrent illness in patients, failure to comply with treatment. Best practice guidelines on HPET treatment of DU can be successfully applied using CME networks. This model could be repeated in another therapeutic area where established research is not yet current practice.

Algorithms↗

Paternal influence on the time of first embryonic cleavage post insemination and the implications for subsequent bovine embryo development in vitro and fertility in vivo.

The objectives of this study were: (1) to evaluate the effect of sire on the time from insemination to first cleavage following insemination in vitro and the relationship of this parameter to field fertility and (2) to establish the relationship between the kinetics of cleavage in vitro and oocyte developmental competence for bulls of known field fertility. Frozen semen from six bulls with 150-day non-return rates ranging from 57-78% was used. In experiment 1, after insemination with semen from one of the six bulls, presumptive zygotes were transferred to IVC in droplets of synthetic oviduct fluid. Droplets were examined at 24, 27, 30, 33, 36, 42, and 48 hr after insemination and the number of cleaved oocytes was recorded. Blastocyst yield was recorded on Days 6-, 7-, and 8-post insemination. In experiment 2, culture droplets were examined at 30, 36, and 48 hr after insemination. At each time point, the number of cleaved embryos was recorded and these embryos were transferred into new droplets and were cultured separately for the duration of the experiment. The proportion of embryos developing to the blastocyst stage was recorded for each of the groups for each bull. The best predictor of field fertility was a model containing 33-hpi-cleavage percentage only (r = 0.689, P < 0.0001). There was also a significant correlation between blastocyst yield and non-return rate, with Day 7 blastocyst yield having the highest correlation (r = 0.356), although this was relatively low in comparison. In experiment 2, irrespective of sire, a significantly higher proportion of those early-cleaving oocytes (before 30 hpi) developed to blastocysts than those cleaving later. In most cases, a higher proportion of blastocysts derived from early-cleaving oocytes hatched from the zona pellucida suggesting that such blastocysts are of superior quality to those derived from late-cleaving oocytes. In conclusion these data confirm our earlier observations that earliest cleaving zygotes are more competent in terms of development to the blastocyst stage than those that cleave later. This phenomenon is independent of the sire used. However, we have demonstrated that the kinetics of early embryonic development as measured by the timing of the first cleavage division post insemination vary between different bulls and that these differences can be used to discriminate between bulls of high and low bull field fertility.

Animals↗

Relationship between time of first cleavage and the expression of IGF-I growth factor, its receptor, and two housekeeping genes in bovine two-cell embryos and blastocysts produced in vitro.

We have previously demonstrated that there is a clear relationship between the time interval between insemination and first cleavage in vitro and the development to the blastocyst stage of bovine embryos. In addition we have shown that this developmental ability can be linked to the stability of the mRNA for several gene transcripts measured in 2-cell bovine embryos cleaving at different times. The aim of this study was to examine the relationship between bovine embryo developmental competence, assessed in terms of time of first cleavage, and the expression of insulin-like growth factor-I (IGF-I) ligand and receptor, hypoxanthine phosphoribosyl transferase (HPRT) and glucose-6-phosphate dehydrogenase (G6PD). The expression of beta-actin was used as a reference value. No differences were observed in the mRNA expression of G6PD and HPRT genes between male and female 2-cell embryos. However, the expression of these two genes was significantly higher in female blastocysts than in male blastocysts. Moreover, when the relative amount of G6PD and HPRT mRNA detected in these groups of male and female embryos was compared, there was a significant relationship between the time of first cleavage and the relative amount of mRNA: 2-cell embryos and blastocysts derived from oocytes that cleaved at 27 and 30 hr post insemination had higher levels of mRNA for G6PD and HPRT than those that cleaved after 33 hr. IGF-I ligand and receptor was detected in all blastocysts analyzed, irrespective of stage of development or time of first cleavage. In addition, the receptor was detected in all 2-cell embryos examined. In contrast, while IGF-I ligand was found in all 2-cell embryos that cleaved at 27 and 30 hpi, it was only found in some of those cleaving between 33 and 36 hpi and in none of those cleaving after 36 hr. In conclusion, we have demonstrated differences in gene expression in the early embryo that are reflective of differences in developmental competence between early- and late-cleaving zygotes.

Animals↗

Bovine oocyte and embryo development following meiotic inhibition with butyrolactone I.

In this study we have shown that butyrolactone I (BL-I), a potent inhibitor of cyclin-dependent kinases, inhibits meiotic resumption in bovine oocytes by blocking germinal vesicle breakdown in a dose-dependent manner. A concentration 100 microM blocked over 60% of oocytes, while 150 microM inhibited almost all oocytes compared to the control in which over 80% resumed meiosis. Following a second 24 hr culture under conditions permissive to normal maturation, almost all (95%) of blocked oocytes resumed meiosis and progressed to metaphase II. In terms of developmental competence, oocytes maintained in meiotic arrest for 24 hr with 100 microM exhibited a similar capacity to develop to the blastocyst stage as nonblocked control oocytes following maturation, fertilization, and culture in vitro. Cryopreservation was employed as a tool to detect differences in the oocyte viability between blocked and control oocytes. Cleavage of oocytes was significantly reduced following vitrification and activation both in BL-I treated (40.2% vs. 71.9%, P < 0.05) and the control groups (45.6% vs. 81.7%, P < 0.05). However, BL-I treated oocytes were less likely to develop into blastocysts following vitrification (20.0% from vitrified vs 42.5% from nonvitrified cleaved oocytes, P < 0.05, based on cleaved oocytes) compared to nontreated oocytes (34.0% from vitrified vs. 42. 9% from nonvitrified oocytes, P < 0.05). These results demonstrate the feasibility of maintaining bovine oocytes in artificial meiotic arrest without compromising their subsequent developmental competence and may represent a tool for improving the development of less competent oocytes.

4-Butyrolactone↗

Nucleus ultrastructure and transcriptional activity of bovine oocytes in preantral and early antral follicles.

An understanding of the recruitment and growth of follicles within the bovine ovary is crucial to their successful exploitation in vitro. The aim of the present study was to describe the nuclear ultrastructure and transcriptional activity of primordial to early tertiary follicular oocytes from bovine adult ovaries. Small blocks of ovarian cortex were incubated in medium enriched with 3H-uridine for 30 min. Subsequently, the tissue blocks were fixed in Karnowsky's fixative, dehydrated, epon embedded, sectioned (2 microns), processed for autoradiography, and examined under light microscopy. Sections showing preantral follicles with presumptive oocyte nucleoli were reembedded for transmission electron microscopy. The follicles were divided into five categories: 1) resting primordial, with a single layer of flattened granulosa cells, 2) activated primordial, with a single layer of flattened and some cuboidal granulosa cells, 3) primary, with a single layer of cuboidal granulosa cells, 4) secondary, with a complete or incomplete bilayer of cuboidal cells, and 5) tertiary, with more than two layers of granulosa cells delineating one or more intercellular cavities. The granulosa cells of all follicle classes were transcriptionally active. However, the oocytes did not display transcriptional activity, as measured by the present means, until the secondary and tertiary follicular stages. The oocyte nucleolus was granular in the primordial follicles. Following follicular activation, fibrillar centres invaded the nucleolus and, in the early tertiary follicle, numerous fibrillar centres were distributed throughout the nucleolus. In conclusion, the oocyte nucleolar function is gradually activated at follicle activation, and oocyte transcription is initiated at approximately the time of the secondary follicle stage.

Animals↗

Oocyte ultrastructure in bovine primordial to early tertiary follicles.

The aim of the present study was to describe in detail the changes occurring in the cytoplasmic ultrastructure of the bovine oocyte from the onset of growth in the primordial follicle until the completion of growth in the tertiary follicle. Bovine oocytes from primordial, primary, secondary and early to mid-antral follicles were processed and analysed by light and transmission electron microscopy. The primordial follicular oocyte was characterized by numerous coated pits on the oolemma and the accumulation of free and organelle-related smooth (SER) and rough (RER) endoplasmic reticulum, round mitochondria and Golgi complexes around the nucleus, which was located slightly off centre. Up to the secondary follicular stage the oocyte displayed an increase in the number of microvilli, elongated mitochondria and Golgi complexes. During the secondary follicular stage, formation of the zona pellucida, development of gap junctions between the oocyte and the granulosa cells, formation of the cortical granules in the oocyte and reduction in the number of coated pits on the oolemma were seen. In the tertiary follicular oocyte up to 100 microm in diameter, the number of Golgi complexes and lipid droplets increased and the organelles were dislocated to the deep cortical region. During the final growth of the oocyte up to >120 microm, the organelles were dislocated further to the peripheral region, the extent of the free SER and RER compartments were reduced, the number of individual cortical granules increased, hooded mitochondria became abundant and the perivitelline space developed. In conclusion, the growth of the bovine oocyte is associated with the relocation and modulation of a number of cytoplasmic organelles as well as the development of oocyte specific structures such as the zona pellucida and cortical granules.

Animals↗

Nucleus structure and transcriptional activity in relation to oocyte diameter in cattle.

Bovine abattoir ovaries were sliced, and recovered oocytes were washed and incubated in medium enriched with 3H-uridine for 30 min. Uridine incorporation was stopped by washing at 4 degrees C in PBS supplemented with cold uridine. The oocytes were grouped according to their inside diameter- < 100, 100- < 110, 110- < 120, and > or = 120 microns-and processed for autoradiography and transmission electron microscopy. Oocytes < 110 microns in diameter typically presented fibrillogranular nucleoli and were actively transcribing; in contrast, most oocytes > 110 microns displayed electron-dense fibrillar nucleoli and lacked transcriptional activity, as measured by the present means. Based on morphological and transcriptional information, a dynamic model of nucleolus inactivation is proposed. The degree of chromatin condensation varied among oocytes. Fibrillogranular nucleoli were most frequently accompanied by lightly condensed chromatin. The dense fibrillar nucleoli were usually encapsulated by heavily condensed chromatin. The oocyte nuclei underwent a peripheral translocation as the oocyte diameter increased from < 100 to 110 microns. In conclusion, RNA synthesis appeared to cease as the oocyte diameter exceeded 110 microns, and concomitantly the nucleoli restructured from fibrillogranular to dense fibrillar.

Animals↗

Overview of perinatally transmitted HIV infection.

Over the past 12 years there have been many advances in the recognition, diagnosis, and treatment of pediatric AIDS as well as the unfolding of a pandemic that is a worldwide concern. Whereas in the United States 1100 cases of pediatric HIV and more than 6000 cases of pediatric AIDS have been reported, the greatest devastation by this disease is occurring in Africa and Asia, where heterosexual transmission of HIV is the most common means of infection. This article discusses prevention of pediatric HIV, major diagnostic and treatment advances, understanding perinatal transmission, and approaches to caring for the child with HIV.

AIDS Serodiagnosis↗

What do people expect from their doctors?

Surprisingly few people seem to worry about the technical competence of doctors. What they worry about is their doctor's ability to understand the patient as a person and provide the right guidance. Financial, legal or managerial techniques seem powerless to ensure that this demand is met. The solution should be sought within the medical profession itself.

Clinical Competence↗