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PubMed2005

Retrospective search for evidence of the 1957 Windscale fire in NE Ireland using 129I and other long-lived nuclides.

The accident at Windscale in October 1957 resulted in the release to the atmosphere of a large quantity of radioactivity. The presented work is a retrospective search for evidence of contamination from the accident in the northeastern region of Ireland. A lake yielding a high-resolution sedimentary record was identified near the northeast coast of Ireland. This site was used to reconstruct the history of radionuclide input to the region, based on the analysis of a set of cores extracted from the lake. A chronology for sediment accumulation within the lake was established using radioisotopic dating techniques (including 270Pb). High-resolution gamma and alpha spectrometry techniques were used to quantify concentrations of 137Cs, 239,240Pu and 241Am, all of which were released during the accident. The primary radioactive component of the release was 131I (T1/2 = 8 days), but this short-lived isotope has long since decayed. However, 129I (T1/2 = 1.57 x 10(7) years) was also released during the accident, and in a known ratio to 131I. Recent advances in accelerator mass spectrometry now make it feasible to measure 129I at ultra-trace level and thereby retrospectively reconstruct 131I deposition. Clearly resolved concentration profiles for 137Cs, 239,240Pu and 241Am in the lake cores reflect known historical fallout trends. The data suggest that any contamination from the Windscale fire that might have reached this catchment has been overwritten by input from the testing of nuclear weapons in the atmosphere. A time-series for 129I in lake sediment shows that concentrations in recent sediments are approximately 10 times greater than concentrations recorded in strata corresponding to the period of maximum fallout of other radionuclides from atmospheric testing of nuclear weapons (1964). These recent increases in 129I are attributed to increased emissions from the nuclear industry. The study yields no evidence of any enhancement in radioisotope concentrations, over and above global fallout, in strata dated to 1957, and we conclude that contamination from the Windscale fire had negligible impact on the northeastern region of Ireland.

Accidents↗
PubMed1998

Homocystinuria due to cystathionine beta-synthase deficiency in Ireland: 25 years' experience of a newborn screened and treated population with reference to clinical outcome and biochemical control.

Homocystinuria (HCU) due to cystathionine beta-synthase deficiency (Mudd et al 1964) was independently described by Gerritsen and colleagues (USA) and Carson and colleagues (Northern Ireland) in 1962. The worldwide frequency of HCU has been reported as 1 in 344,000, while that in Ireland is much higher at 1 in 65,000, based on newborn screening and cases detected clinically. The national newborn screening programme for HCU in Ireland was started in 1971 using the bacterial inhibition assay. A total of 1.58 million newborn infants have been screened over a 25-year period up to 1996. Twenty-five HCU cases were diagnosed, 21 of whom were identified on screening. The remaining four HCU cases were missed and presented clinically; three of these were breast-fed and one was pyridoxine responsive. Twenty-four HCU cases were pyridoxine nonresponsive. Once the status of pyridoxine responsiveness was identified, all pyridoxine nonresponsive cases, but one, were started on a low methionine, cystine-enhanced diet supplemented with pyridoxine, vitamin B12 and folate. Dietary treatment commenced within 6 weeks of birth (range 8-42 days) for those cases detected by screening, while for the late-detected cases treatment was started upon presentation and diagnosis. Biochemical control was monitored measuring deproteinized plasma methionine, free homocystine and cystine at least once a month. Review of the clinical outcome of the 25 HCU cases with 365.7 patient-years of treatment revealed no HCU-related complications in 18 screened, dietary-treated cases. Fifteen of these had lifetime medians of free homocystine < or = 11 mumol/L (range 4-11). The remaining three cases with higher lifetime medians of free homocystine (18, 18 and 48 mumol/L) have developed increasing myopia recently. Among the three screened non-dietary-compliant cases, two have ectopia lentis, one has osteoporosis and two have mental handicap. Of the four cases missed on screening, three presented with ectopia lentis after the age of 2 years. There were no thromboembolic events in any of the 25 HCU cases. The lifetime medians for methionine ranged from 47 to 134 mumol/L. The Irish HCU clinical outcome data suggest that newborn screening, early commencement of dietary treatment and a lifetime median of free homocystine of < or = 11 mumol/L had significantly reduced the probability of developing complications when it was compared to the untreated HCU data (Mudd et al 1985).

Adolescent↗
PubMed2003

Physical activity patterns in 50-59 year men in France and Northern Ireland. Associations with socio-economic status and health behaviour.

BACKGROUND: This study aimed to compare physical activity patterns and their associations with socio-economic status (SES) and health behaviour in two countries at contrasting risk for coronary heart disease (CHD). METHODS: This paper is a cross-sectional analysis of 7359 French and 2398 Northern Irish 50-59 year men of the PRIME cohort. Net energy expenditure due to physical activity (PAE) was assessed by means of the MOSPA-Q taking high-intensity recreational activities into account. SES was evaluated by educational attainment and material conditions. Different behavioural factors (smoking, alcohol intake and healthy eating patterns) were considered. RESULTS: The prevalence of walking or cycling to work was greater in Northern Ireland (p < 10(-5)) whereas leisure PAE (p < 10(-5)) and high-intensity leisure-time activity (p < 10(-5)) were higher in France. Education was positively associated with leisure-time PAE in Northern Ireland but negatively in France. However education in both countries and material conditions in France were favourably associated with the regular practice of high-intensity recreational activities. Alcohol consumption was positively associated with leisure PAE in France only (p < 10(-3)). A weak negative association was also observed between smoking and leisure-time activities while healthy eating patterns were associated with greater physical activity in both countries. CONCLUSIONS: Physical activity patterns and their relationships with SES and alcohol consumption differ in France and in Northern Ireland. Our results underline the need to focus on low socio-economic groups for health promotion but, also, to adapt strategies to promote physical activity according to cultural differences between countries. Our results also show that healthy behaviours tend to cluster in middle-aged men.

Coronary Disease↗
PubMed2003

Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland.

OBJECTIVES: To determine the prevalence of legionellae in dental unit waterlines (DUWL) in general dental practices in London and rural Northern Ireland and whether the organism occurs at a high enough frequency and magnitude in DUWL to represent a threat to dentists' health. MATERIALS AND METHOD: Two hundred and sixty six (166 London, 100 Northern Ireland) randomly selected dental surgeries were recruited. Standardised 250 ml water samples were taken from the DUWL and 1 litre samples from the surgery cold water tap to measure the prevalence of legionellae. The dentists provided a blood sample for legionella serology. RESULTS: The prevalence of legionellae was very low (0.37%). Legionellae were not isolated from DUWL or surgery basin taps in Northern Ireland. Legionella spp were isolated from the DUWL and surgery basin of one practice in London and from the cold water supply of a further three practices. The prevalence of Legionella pneumophila antibodies was less than that seen in a comparable group of London blood donors. CONCLUSION: The risk to dentists' health from potential exposure to legionellae in this cohort of dentists was very low and this was confirmed by the very low seroprevalence and antibody titres to legionella detected in the dentists.

Antibodies, Bacterial↗
PubMed2006

Challenges to teaching posterior composites in the United Kingdom and Ireland.

Recent surveys from general dental practice have found increased placement of direct composite resin restorations in occlusal (Class I) and occlusoproximal (Class II) cavities in permanent teeth by general dental practitioners. This has been matched, and possibly driven, at least in part, by the development of new composite resin materials and bonding technologies. Recent studies by the authors have found an increase in the teaching of Class I and Class II composite resin restorations in the UK, Ireland, the US, and Canada. The increased teaching in the UK and Ireland, however, was not as great as in North America, and several worrying trends were observed. The aim of this paper is to discuss these trends and related factors considered important to the necessary further development of the teaching of Class I and Class II direct composite resin restorations, let alone modern operative dentistry in general, in the UK and Ireland.

Acrylic Resins↗
PubMed2004

Recent trends in cervical cancer mortality in Britain and Ireland: the case for population-based cervical cancer screening.

This study used published mortality data and regression techniques to look at time trends in cervical cancer mortality between 1970 and 2000 in the UK and the Republic of Ireland. Mortality from cancer of the cervix has been declining in the UK for at least the past 30 years. The rate of decrease has been greatest in England, Wales and Scotland and has accelerated in these countries since the reorganisation of screening services in the late 1980s. Mortality in Northern Ireland is also decreasing, but at a lesser rate and without significant change over the same period. In contrast, cervical cancer mortality in the Irish Republic, which, unlike the UK, does not have comprehensive population-based screening, has been increasing by an average of 1.5% per year since 1978. The mortality rate, which was half of that in the UK in the late 1970s, now exceeds that in any of the region of the UK. The absence of population-based screening for cervical cancer in the Republic of Ireland is the most plausible explanation for these differences in trend.

Adult↗
PubMed2003

Origin and colonization history of the white-clawed crayfish, Austropotamobius pallipes, in Ireland.

The presence of the white-clawed crayfish Austropotamobius pallipes complex in Ireland is suspected to be a result of human translocations. Two hypotheses have been formulated about the origin of the crayfish: from British populations or from western French populations. In order to resolve this question, nine Irish crayfish populations (a total of 124 individuals) were sampled along a south-north cline and investigated by combining two molecular markers: mtDNA and RAPDs. The mtDNA marker, analysed by RFLP on the entire molecule, showed an absence of polymorphism within and among Irish populations. The RFLP haplotype found in Irish populations was only recorded in western French populations and was different from those found in English populations. This result may be explained by a human introduction of crayfish to Ireland from western French populations. RAPD analysis showed a clinal reduction of genetic variability within Irish populations from south to north, associated with an increase in their genetic differentiation. A stepwise model of translocation from the south to the north of Ireland is proposed and discussed.

Animals↗
PubMed2005

Review of spinal cord injuries in Ireland.

STUDY DESIGN: Prospective data collection on all patients with spinal cord injury (SCI) admitted for a comprehensive management programme. OBJECTIVES: To examine the epidemiology of SCI in Ireland over 1 year. SETTING: Ireland's National Spinal Cord Injury Centre. METHODS: Systematic data collection on all patients admitted with SCI for management. RESULTS: A total of 46 patients (40 males) were admitted from January to December 2000; median age was 37 years (range 6-82 years). In all, 23 of the patients presented with cervical injuries, 19 patients had thoracic injuries. In all, 18 patients had complete injuries (American spinal injuries association (ASIA)). Motor vehicle collisions were the cause of 50% of SCI. CONCLUSIONS: The incidence of SCI in Ireland is 13.1 per million population. Demographic data from this study can go towards improving care for patients with SCI and also in the prevention of SCI.

Accidental Falls↗
PubMed2006

Local and regional air pollution in Ireland during an intensive aerosol measurement campaign.

An intensive two month measurement campaign has been performed during a two year study of major component composition of urban PM10 and PM2.5 in Ireland (J. Yin, A. G. Allen, R. M. Harrison, S. G. Jennings, E. Wright, M. Fitzpatrick, T. Healy, E. Barry, D. Ceburnis and D. McCusker, Atmos. Res., 2005, 78(3-4), 149-165). Measurements included size-segregated mass, soluble ions, elemental carbon (EC) distributions, fine and coarse fraction organic carbon (OC) and major gases along with standard meteorological measurements. The study revealed that urban emissions in Ireland had mainly a local character and therefore were confined within a limited area of 20-30 km radius, without significantly affecting regional air quality. Gaseous measurements have shown that urban emissions in Ireland had clear, but fairly limited influence on the regional air quality due to favorable mixing conditions at higher wind speeds, in particular from the western sector. Size-segregated mass and chemical measurements revealed a clear demarcation size between accumulation and coarse modes at about 0.8 microm which was constant at all sites. Carbonaceous compounds at the urban site accounted for up to 90% of the particle mass in a size range of 0.066-0.61 microm. Nss SO4(2-) concentrations in PM2.5 were only slightly higher at the urban site compared to the rural or coastal sites, while NO3- and NH4+ concentrations were similar at the urban and coastal sites, but were a factor of 2 to 3 higher than at the rural site. OC was highly variable between the sites and revealed clear seasonal differences. Natural or biogenic OC component accounted for <10% in winter and up to 30% in summer of the PM2.5 OC at urban sites. A contribution of biogenic OC component to PM2.5 OC mass at rural site was dominant.

Aerosols↗
PubMed1999

Live kidney donor assessment in the UK and Ireland.

BACKGROUND: The criteria and methods for assessing live kidney donors are not clear. This study was undertaken to establish whether there is a consensus regarding the organization and methods of assessment of living kidney donors by renal transplant centres in the UK and the Republic of Ireland. METHODS: All transplant centres in the UK and Ireland involved in living donor kidney transplantation were contacted by telephone survey followed by postal questionnaire. RESULTS: Considerable variation was observed in the organization of living kidney donor evaluation and the methods of assessment used. The upper and lower age limits considered acceptable for kidney donation were variable, with six of 29 centres setting no lower age limit and 11 setting no upper age limit. Four centres do not currently offer living donor kidney transplantation. Of the 29 centres involved with living donor transplantation ten had no protocol for donor assessment. A dedicated transplant coordinator/nurse practitioner was employed by 20 centres and ten routinely used an independent medical assessor to evaluate living related donors. The frequency and duration of donor follow-up after kidney donation also varied widely, with 18 centres providing life-time, seven limited and three no follow-up after initial postoperative assessment. CONCLUSION: The wide variation in organizational structure and method of assessment of living kidney donors in the UK and Ireland supports the need for establishment of guidelines for this practice.

Adolescent↗
PubMed2001

Service to the poor: the foundations of community nursing in England, Ireland and New South Wales.

This paper describes the foundations of community nursing in England, Ireland and New South Wales. It is guided by Foucault's work on power, discourse and knowledge, and argues that the common discourse of poverty coupled with the influence of socially advantaged women in the nineteenth century was the impetus for the development of community nursing in England, Ireland and New South Wales. Throughout the nineteenth century in Great Britain, economic and industrial development, coupled with an unprecedented growth in the population (particularly among the poor) inspired socially advantaged women to extend traditional gender-specific roles to address the needs of the poor. Protestant women in England advanced professional nursing as a career for women and in Ireland and New South Wales; Catholic women pioneered professional nursing, targeting the poor as the focus of their practice. These women used prevailing social conditions to enhance their life options within the limits prescribed by social norms.

Catholicism↗
PubMed2001

A survey of deep venous thrombosis management by consultant vascular surgeons in the United Kingdom and Ireland.

OBJECTIVES: The aim of this study was to detail the current consensus amongst vascular surgeons in Great Britain and Ireland regarding their investigation and management of patients with suspected or proven deep vein thrombosis (DVT). METHODS: The database of the Vascular Surgical Society of Great Britain and Ireland (VSS) was utilised to send coded postal questionnaires to all consultant surgeon members. RESULTS: Replies were received from 281 (65%) consultants. Duplex ultrasound is used alone to confirm DVT by 69% of respondents. A thrombophilia screen is always performed by 14% of consultants, for patients with proven DVT, and is more commonly requested by consultants based in a teaching hospital. The majority (57%) of consultants treat DVT with unfractionated heparin (UFH) and warfarin, whereas only 38% utilise low molecular weight heparins (LMWH) and warfarin. A management policy for DVT is reported to be in place by 59%, and a set policy for the specific management of calf vein DVT by just 20%. CONCLUSION: New diagnostic modalities and treatments have been developed for DVT that are more convenient and cost-effective. Although clinical guidelines for the management of patients with DVT are beginning to emerge, there is still a wide discrepancy in many areas of DVT management, and practice at variance with the current evidence base, amongst vascular surgeons in the United Kingdom and Ireland.

Anticoagulants↗
PubMed2001

Surveillance of hospital-acquired infection in the Republic of Ireland: past, present and future.

There is increasing interest in the surveillance of hospital-acquired infection (HAI) in the Republic of Ireland due to a greater awareness of the consequences of antibiotic resistance, and consumer pressure in the form of public expectations of the quality of health care. To date there have been no nationwide prospective surveillance projects but surveillance has taken place in the form of participation in international and national studies, and the description of local outbreaks. Infection control teams and others have participated in projects such as a European study of HAI in intensive care units conducted in 1992, the second national prevalence study conducted in the UK in 1993 and two surveys of methicillin-resistant Staphylococcus aureus (MRSA) carried out in 1995 and 1999, the latter involving colleagues in Northern Ireland. There have been a number of local surveys of antibiotic-resistant bacteria including the molecular characterization of MRSA in Dublin hospitals, vancomycin-resistant enterococci, and Gram-negative bacteria such as Enterobacter spp. and Serratia spp. affecting compromised patients such as bone marrow transplant recipients. In the future, it is hoped to standardize case definitions, automate data entry, increase collaboration with surveillance initiatives in Northern Ireland and link in with European networks such as EARSS and HELICS. Apart from the need to improve the quality of health care in Irish hospitals, approximate costings suggest that there are potential savings of 7.5 pounds sterling -15 pounds sterling m to be made following a reduction of HAI rates of 15%.

Cross Infection↗
PubMed1995

Using census data: religion as a key variable in studies of Northern Ireland.

"For the first time since a question on religion was first included in the Census of Population (in 1861), the recently published results of the 1991 Census show that less than half of the population of Northern Ireland declared themselves as belonging to a Protestant Christian denomination. Discussions surrounding the future political and constitutional arrangements for Northern Ireland frequently include evidence adduced about the relative size of the two 'tribes' widely identified by the labels 'Protestant' and 'Catholic'. The major source of that evidence comes from the question on religion contained in the Northern Ireland Census, and this paper is concerned with the nature and use of that data. The legitimacy of certain uses of the data is questioned; the reliability of the data is considered; and certain tentative findings are presented based on the data published in the (hard copy) reports."

Censuses↗
PubMed2003

Educational homogamy in Ireland and Britain: trends and patterns.

This paper examines the pattern of educational homogamy in Ireland and Britain. Using contemporary data on recent marriages from the early 1970s through to the mid-1990s, we show that these two countries share a broadly similar pattern of educational homogamy, which is quasi-symmetric in character, with no tendency for women to marry up over and above that which can be attributed to the gender difference in educational attainment. In the 1970s, the strength of homogamy was much weaker in Ireland than in Britain. But we discern a clear inter-country difference in how the net strength of homogamy has changed over time. While it has declined in Britain since the 1970s, in Ireland the strength of homogamy has first increased and then levelled off. Our findings are inconsistent with the inverted U-shaped relationship between economic development and homogamy reported by Smits, Ultee and Lammers (1998) - an argument premised on secular change in the criteria of spouse selection. Instead, our results are better understood in terms of Mare's (1991) life course argument that homogamy is inversely related to the time-gap between school departure and first marriage.

Adolescent↗
PubMed2002

Epidemiology of adult brain tumours in Great Britain and Ireland.

The objective of this study was to review published reports on the epidemiology of primary brain tumours in adults and present the body of knowledge related to these tumours in Great Britain and Ireland. A literature search of all published epidemiological data on brain tumours was conducted in Pre-Medline, Medline, Embase and the Cochrane databases from 1966 to the present. A hand search of all the references alluded to was conducted and older studies identified. The articles were reviewed and tabulated. The papers were subjected to descriptive analysis. Information available to the public and held with the Cancer Registries was reviewed, and cross-referenced with published evidence. To our knowledge, only seven papers have discussed the epidemiology of primary brain tumours in adults. The different methodology of the population-based studies of brain tumours and the different time periods they investigated makes them incomparable. Two papers with comprehensive and detailed strategies for case ascertainment have both recorded tumour incidences of 21 per 100,000 person years. The results of the better studies are at variance with reports from the Cancer Registries. On the basis of the current studies, Cancer Registries appear to under-estimate the incidence of such tumours in adults. It is apparent that a significant number of tumours especially benign varieties are not recorded by some Cancer Registries. The previous estimates, patterns of incidence, prevalence, and survival of brain tumours in Great Britain and Ireland, may thus be incorrect. Patterns of primary brain tumours in adults have not been widely reported in GB and Ireland and the aetiology remains largely unknown. The need for current estimation of geographical and secular variations was identified. This demands closer co-operation between medical and allied staff, and the Cancer Registries. Prospective regional studies of incidence patterns and up to date epidemiological appraisal is deemed necessary. Meanwhile, Cancer Registries should seriously consider the inclusion of all primary brain tumours in their database.

Adolescent↗
PubMed1989

Living on their nerves: nervous debility in Northern Ireland.

Divis Flats was a high-rise public housing project on the Falls Road in Belfast, Northern Ireland. It was frequently described as the worst ghetto in Western Europe, and was widely reputed to be a political hotbed, an Irish Republican Army stronghold, and one of the most violent housing estates in the United Kingdom. The complex exhibited some of the worst manifestations of Northern Ireland's considerable political, economic, social, health, and housing problems, and had been the scene of some of the worst violence that had occurred since the outbreak of the political "troubles" (as the war in Northern Ireland is euphemistically called) in 1969. Generalized ghetto conditions in combination with political violence created a powerful environment for the development of nervous complaints, and many people in Divis Flats, but particularly women, suffered from "nervous debility" or "bad nerves." Although this problem derived from multiple causes--political, economic, and social--terror stands out as the single most important causal factor. This article describes and analyzes the causes and experience of "nerves" and explores the relationship between gender and nerves in a Northern Irish ghetto.

Female↗
PubMed2001

Risk behaviors among injecting drug users in Northern Ireland.

Compared to elsewhere in the United Kingdom, drug policy in Northern Ireland has for the most part failed to incorporate harm reduction strategies. In light of the conservative drug policies, the purpose of this study was to investigate the nature and extent of risk behaviors among injecting drug users (IDUs) in Northern Ireland. Data for this study were drawn from in-depth interviews with 39 IDUs in Northern Ireland. The findings suggest that most IDUs engage in extensive risk behaviors that pose risk for HIV, Hepatitis B and C. and other infectious disease. Moreover, these risk behaviors are linked to the scarcity of new needles and a general lack of knowledge about injection practices that reduce risk for infectious disease. These findings are discussed in the context of conservative drug policies.

Acquired Immunodeficiency Syndrome↗