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PubMed2004

Prejudiced or not? Hidden sectarianism among students in Northern Ireland.

The authors developed a new measure of implicit prejudices of students in Northern Ireland, which they derived from a study by G. Haddock, M. Zanna, and V. M. Esses (1993). Using two student surveys, the authors modified and tested the new implicit prejudice measure, which was based on a "Budget Survey." The present study's results indicate that the measure is valid and useful in the student context. Investigators can easily adapt the measure to groups other than students in Northern Ireland, and it may hence be useful for the future investigation of hidden prejudice in a society that experiences low-level ethnopolitical conflict.

Adult↗
PubMed2004

Determination of the principal points of product contamination during beef carcass dressing processes in Northern Ireland.

To determine the principal points of microbial contamination of carcasses during beef carcass dressing in Northern Ireland, 190 carcasses were sampled by swabbing 1,000 cm2 of the brisket. A detailed survey of one abattoir was initially conducted, with sampling of a total of 100 carcasses immediately after hide removal (H), after carcass splitting (S), and immediately after washing (W) before dispatch to the chiller. The total bacterial counts after incubation at both 22 and 37 degrees C indicated that there was no significant increase in the numbers of bacteria after the first sampling point, H (P > 0.05). To determine whether this was the case in the majority of Northern Ireland abattoirs, 15 carcasses were then sampled at each of an additional six abattoirs, at points H and W only. Total bacterial counts were significantly higher (P < 0.05) at H than at W, indicating that hide pulling was the major point of bacterial contamination of beef carcasses and hence a critical control point for the final microbiological quality of the carcasses. Mean counts of Enterobacteriaceae at both incubation temperatures were very low (< 10 CFU/cm2) but were higher at W than at H, probably indicating that washing was redistributing bacteria from the posterior to the anterior region.

Abattoirs↗
PubMed1996

Ireland's competent authority initiatives.

Ireland is one of the countries in the European Union, that have transposed both directives on medical devices into national legislation. A detailed discussion on issues regarding the transposition of the directives, the implementation of the vigilance system, the registration requirements in Ireland as well as the Department's view in current developments, particularly the potential use of EDI for the information exchange between all Competent Authorities, is presented in this paper.

Equipment and Supplies↗
PubMed1999

Cochlear implantations in Northern Ireland: an overview of the first five years.

During the last few years cochlear implantation (CI) has made remarkable progress, developing from a mere research tool to a viable clinical application. The Centre for CI in the Northern Ireland was established in 1992 and has since been a provider of this new technology for rehabilitation of profoundly deaf patients in the region. Although individual performance with a cochlear implant cannot be predicted accurately, the overall success of CI can no longer be denied. Seventy one patients, 37 adults and 34 children, have received implants over the first five years of the Northern Ireland cochlear implant programme, which is located at the Belfast City Hospital. The complication rates and the post-implantation outcome of this centre compare favourably with other major centres which undertake the procedure. This paper aims to highlight the patient selection criteria, surgery, post-CI outcome, clinical and research developments within our centre, and future prospects of this recent modality of treatment.

Adolescent↗
PubMed1999

The PWH Grieve Memorial Award. A study looking at regional general practice training schemes in Britain and Ireland.

BACKGROUND: This is a report of a study tour of four regional GP training schemes in Britain and Ireland. The award was made in 1997 for a study that occurred during 1998. OBJECTIVE: The aim of the study was to gather experience for the new Gippsland Regional Training Program and to look at the levels of support given to GP supervisors in the schemes visited. DISCUSSION: There appears to be a greater focus on the professional development of GP supervisors in the UK and Ireland than here in Australia. Other key features of support for supervisors include feedback from the program to supervisors and accreditation/reaccreditation by the program of teaching practices.

Administrative Personnel↗
PubMed1999

Characteristics of children referred to a general anaesthetic service in Northern Ireland.

General anaesthetics are still frequently given to children for dental extractions and this method of treatment is most prevalent in regions such as Northern Ireland where high levels of dental disease persist in children. The aim of this study was to establish the social and dental characteristics of the children receiving general anaesthetics for dental extractions. Parents of children referred to the community dental extraction service in the Craigavon and Banbridge area of Northern Ireland completed a closed-ended questionnaire. In the sample there was a significantly lower level of maternal education than seen in the general population. There was a significantly higher level (p < 0.01) of dental anxiety seen in the sample group of children compared to the general population. For the primary dentition the corrected dmft values were higher than in the general population as was the untreated decay component while lower numbers of filled and of extracted teeth were seen. In the permanent dentition the caries experience and levels of extractions were similar to those seen in the general population while the level of untreated decay was higher and the mean number of fillings was lower. There was a similar pattern of attendance as that seen in the general child population.

Adolescent↗
PubMed2000

Unexplained illness and death among injecting-drug users--Glasgow, Scotland; Dublin, Ireland; and England, April-June 2000.

Since April 19, 2000, 30 injecting-drug users (IDUs) died or were hospitalized with unexplained severe illness in Glasgow, Scotland. Illness was characterized by extensive local inflammation at a subcutaneous or intramuscular injection site often followed by hypotension and circulatory collapse. Since April 24, 2000, 15 IDUs in Dublin, Ireland, and 14 IDUs in England with similar illnesses have been identified. Despite debridement and broad spectrum antibiotics, 30 (51%) of the 59 patients in all three countries have died. This report further describes the clinical syndrome and key epidemiologic features of the illness as characterized by a preliminary investigation by health authorities in Scotland, Ireland, England, and the United States (1).

Adult↗
PubMed2000

Update: Clostridium novyi and unexplained illness among injecting-drug users--Scotland, Ireland, and England, April-June 2000.

Since April 19, 2000, health authorities in Scotland, Ireland, England, and the United States have been investigating an outbreak of unexplained illness and death among injecting-drug users (IDUs) in the United Kingdom and Ireland (1-3). Initial testing of specimens from 76 IDUs identified Clostridium species in 18 (24%) patients; nine were Clostridium novyi. This report updates the investigation of this outbreak, which indicates that Clostridium species may be associated with these illnesses.

Adult↗
PubMed2000

Voluntary euthanasia in Northern Ireland: general practitioners' beliefs, experiences, and actions.

BACKGROUND: There has been much recent interest in the press and among the profession on the subject of euthanasia and physician-assisted suicide. The BMA recently conducted a 'consensus conference' over the internet to collect views on physician-assisted suicide. Any surveys to date have addressed a variety of specialties; however, no recent surveys have looked at general practitioner (GP) attitudes and experiences. AIM: To explore the attitudes of GPs in Northern Ireland towards the issue of patient requests for euthanasia, their nature, and doctors' experiences of such requests. METHOD: An anonymous, confidential postal survey of all (1053) GP principals in Northern Ireland. RESULTS: Seventy per cent of responders believe that passive euthanasia is both morally and ethically acceptable. Fewer (49%) would be prepared to take part in passive euthanasia. However, over 70% of physicians responding consider physician-assisted suicide and voluntary active euthanasia to be wrong. Thirty per cent of responders have received requests from patients for euthanasia in the past five years. One hundred and seven doctors gave information about these requests. Thirty-nine out of 54 patient requests for passive euthanasia had been complied with, as had one of 19 requests for physician-assisted suicide and four out of 38 patient requests for active euthanasia. Doctors perceived the main reasons why patients sought euthanasia was because of fear of loss of dignity and fear of being a burden to others. CONCLUSIONS: While the majority of GPs support passive euthanasia, they, in common with those who approve of assisted suicide and active euthanasia, often express a reluctance to take part in such actions. This may reflect the moral, legal, and emotional dilemmas doctors encounter when facing end-of-life decisions.

Attitude of Health Personnel↗
PubMed2000

Proximal femoral fracture in Northern Ireland between 1985-1997--trends and future projections.

The aims of this study were to identify changing trends with time of the incidence of proximal femoral fracture and to enable future number of hip fractures to be projected. Hospital theatre records in Northern Ireland were surveyed in 1985, 1991, 1994 and 1997 to establish the number of surgical procedures for proximal femoral fracture. The age and sex specific rates for males and females aged 50+ years were calculated. Analysis of age and sex specific incidence rates was undertaken using linear regression and Poisson regression. A 1.6% increase per annum (95% CI 1.0-2.2) was noted in males and females from 1985 to 1997. Projected increases in rates of proximal femoral fracture were calculated using population projection for 2001, 2006, 2011 and 2016. Modelling (a) assuming the age standardised rates in 1997 remain static and continue predicted a 55% fracture increase in males and a 29% increase in females by 2016, (b) assuming the secular increases continued predicted a 93% fracture increase in males and a 67% increase in females and (c) assuming further linear growth on a log-scale predicted a fracture increase in males of 135% and 99% in females. The number of proximal femoral fractures in Northern Ireland is increasing faster than that anticipated due to demographic changes alone, supporting a secular increase which was evident throughout the period of time studied, in contrast to that reported from other regions in the United Kingdom.

Age of Onset↗
PubMed2000

Paediatric renal transplantation in Northern Ireland (1984-1998).

Over the last 20 years a comprehensive paediatric nephrology service has been developed in Northern Ireland, based in the academic medical unit at the Royal Belfast Hospital for Sick Children (RBHSC). In the 15 years 1984-1998 a total of 77 renal transplants have taken place in patients aged 18 years and under. Initially transplants were only considered in children over five years of age but in the past eight years children as young as two years have successfully received kidneys. Aggressive nutritional support combined with peritoneal dialysis has enabled survival to a size when transplantation is feasible. The 5 year graft survival was 64%, with two children dying following transplantation. The complexity of managing this age group is reflected by the fact that a total of 10 transplants (13%) failed in the first 30 days. These figures compare favourably with statistics reported by similar paediatric centres from across the United Kingdom and Republic of Ireland, and with local results in adult patients. This demonstrates that a successful end stage renal replacement programme for children is achievable in a relatively small population, which is geographically isolated.

Adolescent↗
PubMed2000

The current epidemiology of SIDS in Ireland.

This paper examines some epidemiological factors associated with SIDS to give a general profile of SIDS cases occurring in Ireland between the years 1993 to 1997. There has been a dramatic decrease in the incidence of the Sudden Infant Death Syndrome (SIDS) in the Republic of Ireland in the last decade from an average rate of 2.2/1000 live-births in the 1980s to 0.8/1000 live-births in the years 1993-1997, a decrease of 100 deaths a year. The fall in the SIDS rate has been seen in many countries and is felt to be associated with Reduce The Risks (RTR) of SIDS campaigns and the avoidance of the prone sleeping position. The use of the prone sleep position averaged at 6% of children being put prone in the years 1993-1997 but the prone position has progressively decreased from 13% of children being put prone in 1994 to only 2% in 1997. The profile of the Irish SIDS cases is similar to that of SIDS cases in other countries following similar RTR campaigns with a male predominance, the characteristic clustering of deaths in the first six months of life and the majority of cases (75%) occuring in the night sleep period. The loss of the seasonal variation of the time of death is also shown and factors such as lower socio-economic status, unemployment and medical card eligibility were seen in higher proportions in SIDS families than in the general population. A high percentage of SIDS mothers smoked (73%). Higher smoking rates were seen among younger and single mothers and smoking rates were inversely related to educational level and socioeconomic grouping. An urgent question that needs to be addressed is how socioeconomic disadvantage increases the SIDS risk and what factors influence socioeconomically disadvantaged families to adopt life style and parenting practices such as smoking that influence their children's health.

Adult↗
PubMed2000

Outcome of medical screening of Kosovan refugees in Ireland: 1999.

In March 1999 armed conflict broke out in Kosova and about 900,000 ethnic Albanians were displaced. We reviewed the health care offered to the 945 Kosovan refugees who arrived in Ireland in 1999, which included screening for tuberculosis (TB) and hepatitis B. On arrival in Ireland 540 refugees had already received oral polio vaccine (57%), 512 diphtheria, tetanus, and acellular pertussis or diphtheria and tetanus vaccine (54%), 310 BCG (33%), 207 measles, mumps, and rubella vaccine (22%) and 60 Haemophilus influenzae type b (6%). Twelve refugees were diagnosed with TB. Twenty-six refugees were HBsAg positive (3%) and 168 were anti-HBcAg positive (18%). Organised screening of Kosovan refugees on a voluntary basis (uptake > 95%) revealed low percentages who had been immunised and relatively high rates of TB and hepatitis B. The provision of optimum immunisation, screening, and treatment services to address these issues requires substantial staffing and financial resources.

Albania↗
PubMed2001

Idiopathic intracranial hypertension; incidence, presenting features and outcome in Northern Ireland (1991-1995).

OBJECTIVES: To determine the age and sex specific incidence rates, presenting features, and visual outcome of idiopathic intracranial hypertension in Northern Ireland. METHODS: A case-note review of all patients with idiopathic intracranial hypertension, diagnosed at the Royal Victoria Hospital, Belfast between 1991 and 1995. RESULTS: Forty-two patients were identified corresponding to an average annual incidence rate per 100,000 persons of 0.5 for the total and 0.9 for the female population. The commonest presenting symptoms were headache (84%), transient visual obscurations (61%) and sustained visual loss (34%). Impaired Snellen visual acuity and visual field loss were documented in 21% and 62% of patients respectively at presentation, and in 24% and 39% at last follow-up. One patient suffered deterioration in visual functioning sufficient to interfere with normal daily activities. CONCLUSIONS: The age and sex specific incidence rates of IIH in Northern Ireland are lower than have been reported in previous population-based series. Disabling visual loss occurs in a small number of patients despite all interventions.

Adolescent↗
PubMed2001

Factors affecting caries levels amongst 5-year-old children in County Kerry, Ireland.

OBJECTIVE: To investigate the factors associated with high caries levels in 5-year-old children in the Kerry Community Care Area of the Southern Health Board in Ireland. DESIGN: Cross-sectional study. SETTING: County Kerry, Ireland in 1997. SUBJECTS: A random sample of 5-year-old children. METHOD: Six hundred and thirty-six 5-year-old children were examined for caries following WHO diagnostic criteria. Information on possible caries risk factors was collected by means of a parental questionnaire. RESULTS: Using multivariate logistic regression analysis the variables most significantly associated with the presence of caries were water fluoridation status, whether or not the child took the baby feeding bottle to bed, the age at which tooth brushing started and the number of sweet snacks and drinks taken in a day. While there was a wide variation in caries levels between nine geographic areas in Co. Kerry the only significant geographic variation found was between fluoridated and non-fluoridated areas. CONCLUSION: The prevalence of dental caries amongst 5-year-old children in Co. Kerry was highest in those residing in non-fluoridated communities, in those who took a baby feeding bottle to bed, in those who did not commence tooth brushing until after two years of age and in those who had sweet snacks or sweet drinks between meals three or more times per day.

Bottle Feeding↗
PubMed2001

Analysis of outbreaks of infectious intestinal disease in Ireland: 1998 and 1999.

Surveillance of general outbreaks of infectious gastroenteritis was introduced in 1998 by the Food Safety Authority of Ireland (FSAI), in co-operation with the eight health boards. A total of 67 general outbreaks of gastroenteritis in Ireland were reported to the FSAI in 1998 and 1999. Over 1900 people were ill as a result of these outbreaks. Four percent required hospitalisation and there were two deaths. The duration of the outbreaks varied between one day and 38 days. Salmonellae (44%) and small round structured viruses (SRSV) (12%) were the most commonly reported pathogens. In 25% of the outbreaks the aetiology was unknown. The commonest settings were restaurants, hotels and take-aways, which accounted for 45% (30/67) of all outbreaks. Sixteen percent of all outbreaks occurred in hospitals and residential institutions. Over half of the outbreaks were reported to be foodborne, 63% of which were due to various serotypes of Salmonella enterica. Eggs were implicated as the vehicle of infection in 13% of all outbreaks. An infected food handler was identified in almost one third of outbreaks, although it could not be established if this had contributed directly to the outbreak.

Cross Infection↗
PubMed2001

The North Dublin Diabetes Shared Care (DiSC) Project: a profile of current diabetes care in Ireland.

The DiSC Project aims to assess the feasibility, effectiveness and costs of diabetes shared care in Ireland. Baseline results provide a profile of diabetes care in Ireland. Thirty general practices are participating in this randomised controlled trial. Outcomes include biophysical and psychosocial measures. The majority of patients agreed to participate in diabetes shared care. Data was collected from 183 patients with type 2 diabetes. The mean age of the patients is 65 years, 56% are male and 63% are GMS eligible. The mean HBA1c was 6.8% though 21% of patients had a HBA1c>8%. The majority of patients had a blood pressure, total cholesterol and body mass index above recommended guidelines. Only half the patients are attending a dietician or a chiropodist. The majority of patients have good glycaemic control but poor blood pressure and cholesterol control. The full trial results will determine if a shared care approach can improve clinical and psychosocial outcomes for patients.

Adult↗
PubMed2001

The characterisation, treatment and sustainable reuse of biosolids in Ireland.

Ireland is an island country on the western boundary of the European Union. A suite of environmental legislation over the last decade has combined to increase the amount of municipal sludge for treatment fourfold, while, simultaneously, eliminating traditional disposal methods. The Irish Government has instituted a comprehensive programme of policy development, infrastructure provision and drafting of "codes of good practice" to meet these environmenta; and legislative challenges. As the programme has developed, it has become clear that the sludge/biosolids issue shares many of the philosophical and logistical elements of other environmental issues that are developing apace in Ireland, including municipal waste management, agricultural waste management and overall integrated development. In many ways, it represents a model of the ultimate "sustainable development" issue. To provide specific data for decision making and policy/infrastructure/technology development, the Irish Government has funded a US$600k programme of research in The Characterisation, Treatment and Sustainable Reuse of Biosolids. The design philosophy of the programme is a "cradle-to-grave" approach, in order to integrate the outcomes of specialised research studies into an overall sustainable development model.

Conservation of Natural Resources↗