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At least 379 records · Page 21Linked to original sources
PubMed1995

Critical limb ischaemia: management and outcome. Report of a national survey. The Vascular Surgical Society of Great Britain and Ireland.

AIM: A prospective national survey of patients with critical lower limb ischaemia was carried out to estimate the prevalence of critical lower limb ischaemia in Britain and Ireland; and to assess the average national outcome following treatment. METHOD: The surgeons were selected randomly but stratified according to the number of vascular surgical operations performed annually to match the profile of the vascular surgical population of the country as a whole. OUTCOME MEASURES: The main outcome measures were the primary treatment intention; final treatment undertaken; duration of hospital stay; final outcome in terms of mortality and limb salvage rates and destination on discharge. RESULTS: The data reveal that the extrapolated incidence of critical lower limb ischaemia in Great Britain and Ireland was 21,450 limbs in 20,000 patients, equating to a prevalence of 1 in 2500 of the population annually. Thirty per cent of the patients were diabetic. The overall mortality and amputation rates were 13.5% and 21.5% respectively. The mean duration of hospital stay was 25 days. Nearly 70% of patients were offered some form of revascularisation as the primary treatment option with a 75% chance of successful limb salvage. Amputation was associated with a significantly higher mortality (Chi square = 10.79, p = 0.001), longer hospital stay (t = 4.589, p < 0.0001) and a greater proportion of patients requiring long-term institutional support, than revascularisation. The ratio of revascularisation to amputation was 4:1. Surgeons with a lower annual experience of patients with vascular disease tended to undertake fewer revascularisations (Chi square = 6.737, p = 0.0094) and more amputations (Chi square = 10.445, p = 0.0012) than those treating larger numbers. The mean limb salvage rate achieved by surgeons with a lower throughput of vascular operations was significantly lower that achieved by other groups of surgeons (Chi square = 7.544, p = 0.0045).

Aged↗
PubMed1997

Carotid endarterectomy in the U.K. and Ireland: audit of 30-day outcome. The Audit Committee for the Vascular Surgical Society.

OBJECTIVES AND DESIGN: A prospective study of 709 patients undergoing carotid surgery in the U.K. and Ireland was performed to evaluate the performance of vascular surgeons. MATERIALS AND METHODS: Fifty-nine surgeons (range 2-39 cases each) were sampled and all patients undergoing surgery over a 6-month period (1 March 1994-31 August 1994) were included in the study. Indications for surgery were TIA (35.9%), AF (23.3%), CVA (21.4%) and "others" (19.6%). RESULTS: Mean ipsilateral stenosis was 82% (30%-99%). Thirty-one percent of patients had preoperative neurological consults. Shunts were used in 67.6%, tacking sutures in 40.1%, drains in 71.9% and patches in 54.4% of cases. At 30 days there were nine (1.3%) deaths (four cardiac, three neurological). There were 15 ipsilateral postoperative CVAs (2.1%); 19% of patients had one or more complication, usually minor. Statistical analysis showed no independent risk factor for CVA other than seniority of the surgeon. CONCLUSIONS: A combined stroke/death rate of 3% for the series was obtained at 30 days for all cases. This large, validated study suggests that members of the Vascular Society of G.B. and Ireland currently have a very low morbidity/mortality rate for performing carotid surgery. Continued audit is required to ensure that this quality of service does not deteriorate.

Adult↗
PubMedDate not supplied

Decision making of psychiatric nurses in Finland, Northern Ireland, and the United States.

The purpose of this study was to describe the decision-making process of 339 psychiatric nurses in Finland, Northern Ireland, and the United States and to discuss any differences observed among nurses in these countries. The instrument used in the study was a 56-item, Likert-type questionnaire tested in several previous studies that have confirmed its validity and reliability. Three different models of decision making were identified on the basis of factor analysis. Overall, it may be concluded that the decision-making process of psychiatric nurses is broadly based, but it varies between countries. Nurses from Northern Ireland used only analytical decision-making models; nurses from Finland made decisions strongly favored analytical decision-making models but also used some intuitive models; and American nurses used intuitive decision-making and analytical-processing models.

Cross-Cultural Comparison↗
PubMed1995

Population biology of Pomphorhynchus laevis in brown trout from two lakes in the west of Ireland.

Since Ireland is the only country in which Pomphorhynchus laevis (Acanthocephala) uses brown trout (Salmo trutta) as its preferred definitive host, the population biology of the parasite in this host was investigated thus enabling a comparison to be made with data collected on P. laevis from other hosts, particularly the cyprinids, chub and barbel. Over a period of 12 months, 549 brown trout were caught from two lakes, Lough Feeagh and Bunaveela Lake, in the Burrishoole River system, Co. Mayo, Ireland. The parasite component community was dominated by a single species, P. laevis. Fifty eight percent of the trout sample were infected with the acanthocephalan and the mean abundance (+/- SD) was 3.1 +/- 5.1 The relationships between the prevalence and abundance of P. laevis and season and site of host capture and host age and sex were explored. As single factors one of these parameters emerged as significant contributions to changes in parasite abundance although some interaction terms proved to the significant. A random sample of over 700 P. laevis parasites were subjected to further investigation and their size, position in the intestine and maturity status are described. Parasites attained an average weight of 7 mg and occupied the posteriad positions within the fish intestine (77%). Parasites from this sample of Irish brown trout attained a similar average size to those found in chub and barbel from England. 42.3% of the total parasites examined contained ovarian balls only and 17% contained fully mature acanthors. Therefore only a moderate proportion of female worms contained mature acanthors in these trout whereas the majority of worms recovered from a sample of chub were gravid. Utilizing a logistic regression model, parasite size, season, and site of host capture emerged as particularly significant factors which contribute to whether a parasite contains mature eggs.

Acanthocephala↗
PubMed1987

Incidence of schizophrenia in Ireland.

This paper reports an investigation of the incidence of schizophrenia in Ireland by means of standardized case-finding procedures. Our findings do not support the popular belief, based on first admissions figures, of a raised incidence in Ireland. We show this to have been considerably overestimated.

Adolescent↗
PubMed1996

Evidence of hantavirus in wild rodents in Northern Ireland.

A survey of evidence of rodent hantavirus infection in County Down, Northern Ireland was carried out by using immunofluorescence to detect virus antigen and antibody. Antibodies to hantavirus (R22 strain of Seoul virus and Hantaan 76-118) were found in 11/51 (21.6%) brown rats (Rattus norvegicus), 1/31 (3.2%) field mice (Apodemus sylvaticus) and 17/59 (28.8%) house mice (Mus domesticus). Seven rodents had evidence of hantavirus antigen in lung tissues. Antibody positive animals were significantly more likely to be adults than juveniles (P = 0.04) but and there was no sex difference between antibody positive and negative animals. House mice were more likely to be antibody positive if captured inside farm outbuildings (P = 0.08). Attempts to culture virus from the rodent material were unsuccessful. This work demonstrates a substantial rodent reservoir for hantavirus in Northern Ireland.

Animals↗
PubMed1990

Zoonotic infections in Northern Ireland farmers.

Evidence of past zoonotic infection was investigated serologically in randomly selected Northern Ireland farmers. The percentage of farmers with antibody was: Brucella abortus (0.7), Leptospira interrogans serovars (8.1), Borrelia burgdorferi (14.3), Toxoplasma gondii (73.5), Coxiella burnetii (28.0), Chlamydia psittaci (11.1) and Hantavirus (1.2). The results show that Northern Ireland farmers have been exposed in the past to zoonotic infections. It is not known if these infections contributed to ill health in farmers but it is now time for the health of farm workers and their medical services to be reassessed.

Adult↗
PubMed2006

Tracking of energy and nutrient intakes from adolescence to young adulthood: the experiences of the Young Hearts Project, Northern Ireland.

OBJECTIVE: To assess tracking of energy and nutrient intakes between adolescence and young adulthood. DESIGN: Longitudinal study of a random sample of adolescents (aged 15 years at baseline). The extent of tracking of dietary intakes (assessed by diet history) was investigated using weighted kappa statistics (kappa). SETTING: Northern Ireland population survey. SUBJECTS: Adolescents who participated in the Young Hearts Project, Northern Ireland at age 15 years, and subsequently at young adulthood aged between 20 and 25 years (n=245 males, n=231 females). RESULTS: Despite overall increases in height and weight (both P<0.001), increases in body mass index in males (P<0.001) and body fatness in females (P<0.001), median reported intakes of energy (kJ kg(-1) day(-1)), carbohydrate (g day(-1)) and fat (g day(-1)) decreased (all P<0.001) over time. Expressed as nutrient densities (per MJ), diets at young adulthood were overall richer in thiamin, vitamin B6, total folate (all P<0.001), vitamin C (P<0.01) and vitamin D (P<0.05). Whereas the nutrient density of the males' diets decreased over time for calcium (P<0.05) and vitamin A (P<0.001), iron and riboflavin densities increased in the females' diet (P<0.001). Tracking of energy (MJ day(-1)) and nutrient intakes (expressed per MJ day(-1)) at the individual level was only poor to fair (all kappa<0.25), indicating substantial drift of subjects between the low, medium and high classes of intake with increasing age. CONCLUSIONS: These data suggest that individual dietary patterns exhibited at 15 years of age are unlikely to be predictive of dietary intakes at young adulthood.

Adolescent↗
PubMed2001

Nursing and residential care for the elderly in Northern Ireland: the contribution of the pharmacist.

AIM OF THE STUDY: To gain more detailed information on the current pharmaceutical service provision in nursing and residential homes in Northern Ireland and to assess the views of care staff on future pharmacy services. METHOD: A structured questionnaire was developed and mailed to all nursing and residential homes (n = 586) in Northern Ireland on two occasions. RESULTS: A response rate of 68% (n = 396) was obtained. The most frequent services currently provided by community pharmacists were the supply of medication and the collection of unwanted, discontinued or out-of-date medicines. The majority of respondents also reported receiving advice on safe-keeping, correct administration of medicines, advice on more appropriate formulations and advice on patient medication records from the community pharmacist. Over a third of all the respondents received advice on compliance devices. A similar proportion stated that their care staff were trained by the pharmacist on broad medication management issues. Over 90% of all homes strongly supported staff training by pharmacists on the recognition of medication-related problems as a future service. Over 70% of all respondents thought additional guidelines and advice for missed dosages and the use of home remedies would be beneficial. A review of patient medication records to assess drug-drug interactions and possible adverse drug reactions by pharmacists was supported by over 65% of all respondents. CONCLUSIONS: This work has demonstrated that those responsible for care in nursing and residential facilities strongly support further involvement by the pharmacist in these care facilities; pharmacy policy makers must ensure that such services are developed to meet the needs of these vulnerable elderly residents.

Aged↗
PubMed2006

Suicide and other external-cause mortality statistics in Ireland: a comparison of registration and occurrence data.

There are two sets of annual mortality statistics released by the Central Statistics Office (CSO) in Ireland, one based on deaths registered in the particular year and the other based on the deaths that occurred in that year. We compared the registration and occurrence figures for suicide and for other deaths by an external cause for the years 1987-2003. The occurrence figures were, on average, 6% higher than the registration figures. There was evidence that the extent of the discrepancy increased over the study period, reaching almost 20% in recent years. The findings suggest that caution needs to be taken in the media reporting of registration figures for suicide and other external causes of death in Ireland and in the interpretation of these figures by health professionals.

Cause of Death↗
PubMed1991

Poor prognosis for malignant melanoma in Northern Ireland: a multivariate analysis.

All cases of cutaneous malignant melanoma, CMM, diagnosed in Northern Ireland between 1974-1978 were reviewed, classified and followed up until the end of 1984. The overall 5 year survival is 54%, among the worst reported in recent literature. Multivariate analysis of these cases confirms some previous findings from other studies, but also reveals features not apparent in univariate analysis. Prognosis worsens with increasing thickness and the presence of ulceration. Likewise histopathological type has an independent effect on survival, ALM having the worst prognosis. Tumour profile emerges as a significant feature affecting prognosis, flat lesions having the poorest outlook, given their thickness. Survival is worse with increasing age. Anatomical site is less important than suggested by previous univariate analysis. Sex has little influence on prognosis when adjusted for the other variables. Cell type and pigmentation are of no prognostic value. Several features including diagnostic delay contribute to the poor overall survival for CMM in Northern Ireland. Educational intervention is essential if this trend is to be reversed.

Female↗
PubMed2000

A survey of the teaching of conscious sedation in dental schools of the United Kingdom and Ireland.

AIM: To assess and compare, for the first time, the quantity and quality of dental undergraduate teaching in conscious sedation in the dental schools of the UK and Ireland. This was achieved using a prospective, questionnaire-based survey. METHODS: Questionnaires were designed to collect information about undergraduate sedation education from teaching staff and final year dental undergraduates at the 16 dental schools in the UK and Ireland. Staff questionnaires were distributed to a nominated sedation teacher at each dental school and sought details of didactic and clinical sedation teaching methods, plus the quantity and perceived quality of sedation teaching. Student questionnaires were distributed to 5th year dental students and enquired about the quantity and quality of clinical sedation teaching received. The survey was undertaken during May-June 1998. RESULTS: Thirteen dental schools returned staff questionnaires (81%). Seven also provided a student response (44%). The proportion of final year students within the 7 schools who returned completed questionnaires was 38%. Sedation teaching was undertaken primarily by oral surgery and paediatric dental departments. Three schools also utilised anaesthetic departments and 2 schools had dedicated dental sedation departments. All but 2 schools provided didactic teaching on sedation (mean: 4.2 lectures, 1.8 seminars). Of the 7 schools which returned staff and student questionnaires, all provided some clinical training using inhalational and intravenous demonstration cases (mean 5.1 and 4.4 cases, per student, respectively). All but one school provided hands-on inhalational sedation experience (mean 2.6 cases per student) but only two schools provided any hands-on intravenous sedation experience. The quantity of hands-on experience was greater at the two dental schools with dedicated dental sedation departments. Across the schools students rated the overall quality of sedation teaching at average or above, but most staff graded the overall quality of teaching at below average. CONCLUSION: Dental undergraduate sedation teaching shows considerable variation across the dental schools surveyed. At most schools students gained little or no hands-on experience in sedation, especially in intravenous techniques. The undergraduate foundation for sedation education must improve if conscious sedation is to become the principal alternative to general anaesthesia in dental practice.

Anesthesia, Dental↗
PubMed1995

Prevention and detection of oral cancer: the views of primary care dentists in Northern Ireland.

Our objective was to describe the management of oral cancer and pre-cancer as stated by primary care dentists and their views on screening. We conducted a survey of all general dental practitioners and community dentists in Northern Ireland (n = 635), to which 428 replied (response rate: 67%). 94% stated that examination of the oral soft tissues constituted part of their usual practice during the regular dental check-up. Suspicious lesions were generally referred early, 68.5% of dentists referring white lesions within one month of presentation. The corresponding figures for red lesions, lumps and persistent ulcers were 80.1%, 89.7% and 91.7%. The incidence of oral cancer was over-estimated (median '70' cases/year, versus the true figure of approximately 40/year) as, in all likelihood, was the percentage by which mortality could be reduced by screening (median: 50%). Accordingly the adoption of a screening programme was favoured over investment in health promotion. Indeed, only 14% said that their patients records routinely contained information about smoking or alcohol habits. Although there are some areas of practice which could improve and the potential of screening is probably over-valued, primary care dentists in Northern Ireland already opportunistically screen and refer patients promptly.

Alcohol Drinking↗
PubMed1999

Genetic basis of transferase-deficient galactosaemia in Ireland and the population history of the Irish Travellers.

Transferase-deficient galactosaemia, resulting from deficient activity of galactose-1-phosphate uridyltransferase (GALT), is relatively common among the Travellers, an endogamous group of commercial/industrial nomads within the Irish population. This study has estimated the incidence of classical transferase-deficient galactosaemia in Ireland and determined the underlying GALT mutation spectrum in the Irish population and in the Traveller group. Based upon a survey of newborn screening records, the incidence of classical transferase-deficient galactosaemia was estimated to be 1 in 480 and 1 in 30,000 among the Traveller and non-Traveller communities respectively. Fifty-six classical galactosaemic patients were screened for mutation in the GALT locus by standard molecular methods. Q188R was the sole mutant allele among the Travellers and the majority mutant allele among the non-Travellers (89.1%). Of the five non-Q188R mutant alleles in the non-Traveller group, one was R333G and one F194L with three remaining uncharacterized. Anonymous population screening has shown the Q188R carrier frequency to be 0.092 or 1 in 11 among the Travellers as compared with 0.009 or 1 in 107 among the non-Travellers. The Q188R mutation was shown to be in linkage disequilibrium with a Sac I RFLP flanking exon 6 of the GALT gene. This represents the first molecular genetic description of classical transferase-deficient galactosaemia in Ireland and raises intriguing questions concerning the genetic history of the Irish Travellers.

Cohort Studies↗
PubMed2006

The scale and nature of Viking settlement in Ireland from Y-chromosome admixture analysis.

The Vikings (or Norse) played a prominent role in Irish history but, despite this, their genetic legacy in Ireland, which may provide insights into the nature and scale of their immigration, is largely unexplored. Irish surnames, some of which are thought to have Norse roots, are paternally inherited in a similar manner to Y-chromosomes. The correspondence of Scandinavian patrilineal ancestry in a cohort of Irish men bearing surnames of putative Norse origin was examined using both slow mutating unique event polymorphisms and relatively rapidly changing short tandem repeat Y-chromosome markers. Irish and Scandinavian admixture proportions were explored for both systems using six different admixture estimators, allowing a parallel investigation of the impact of method and marker type in Y-chromosome admixture analysis. Admixture proportion estimates in the putative Norse surname group were highly consistent and detected little trace of Scandinavian ancestry. In addition, there is scant evidence of Scandinavian Y-chromosome introgression in a general Irish population sample. Although conclusions are largely dependent on the accurate identification of Norse surnames, the findings are consistent with a relatively small number of Norse settlers (and descendents) migrating to Ireland during the Viking period (ca. AD 800-1200) suggesting that Norse colonial settlements might have been largely composed of indigenous Irish. This observation adds to previous genetic studies that point to a flexible Viking settlement approach across North Atlantic Europe.

Chromosomes, Human, Y↗
PubMed2002

A longitudinal study through adolescence to adulthood: the Young Hearts Project, Northern Ireland.

The Young Hearts (YH) Project is an ongoing study of biological and behavioural risk factors for cardiovascular disease in a representative sample of young people from Northern Ireland, a region of high coronary mortality. This article describes the cross-sectional clinical, dietary and lifestyle data obtained from individuals (aged 20-25 y) who participated in phase 3 of the project (YH3). A total of 489 individuals (251 males, 238 females) participated in YH3 (48.2% response rate). Some 31.1% of participants at YH3 were overweight (BMI >25 kg/m(2)) with 4.4% of males and 8.0% of females were obese (BMI >30 kg/m(2)). More females than males had a very poor fitness (55.0 vs 22.1%, chi-squared 51.70, d.f. 1, P<0.001) and did not participate in any sporting or exercise activity (38.4 vs 24.9%, chi-squared 10.26, d.f. 1, P=0.001). Over 20% of participants had a raised total serum cholesterol (>5.2 mmol/l). More females had a raised serum LDL-cholesterol (>3.0 mmol/l) than males (44.6 vs 34.6%, chi-squared 4.39, d.f. 1, P<0.05). Over 46% of participants reported energy intakes from fat above recommended levels, and 68.5% of participants had saturated fat intakes above those recommended (Dietary reference values for food energy and nutrients for the United Kingdom. HMSO: London, 1991). Just over half of the study population reported alcohol intakes in excess of recommended sensible limits set by the Royal College of Physicians (A great and growing evil: the medical consequences of alcohol abuse. Tavistock: London, 1987), with 36.7% of males and 13.4% of females reporting intakes over twice these recommended limits. A total of 37% of the study population smoked. During young adulthood, individuals may be less amenable to attend a health-related study and recruitment of participants to the current phase of the study proved a major problem. However, these data constitute a unique developmental record from adolescence to young adulthood in a cohort from Northern Ireland and provide additional information on the impact of early life, childhood and young adulthood on the development of risk for chronic disease.

Adolescent↗