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PubMed1982

Schizophrenia and religious affiliation in Northern Ireland.

First admissions for schizophrenia in Northern Ireland are significantly higher for the Roman Catholics than for the rest of the population, although not as high as in the Irish Republic. The excess of Catholic cases affects only the never-married, and derives much more from the rural west of the territory than from the industrial east. It does not appear to be accounted for by geography per se, by the differential use of services, diagnostic bias, social class distribution, or mean age at marriage. There are indications that some conflict around sex and marriage and, more doubtfully, a sense of relative deprivation may be contributing factors.

Adolescent↗
PubMed1988

150 years of mapping Ireland's population distribution.

"Over the last 150 years various approaches to the construction of maps showing the distribution of population in Ireland have been explored. This article reviews these approaches, and is particularly intended to illustrate how the compilers of Irish population maps have confronted that central issue facing all cartographers, namely the selection of an appropriate level of generalisation."

Demography↗
PubMed1990

The context of migration: the example of Ireland in the nineteenth century.

"A classic case where out-migration interacted with many other geographical phenomena is provided by rural Ireland in the nineteenth century. The apparent turning point was the Great Famine of the 1840s, but the areas with the greatest suffering from starvation did not necessarily show the greatest population decline, suggesting that other forces were active. Considerable economic and social changes were already taking place before the Famine: fertility was being reduced, later marriage was becoming established and considerable emigration was already taking place. Immediately after the Famine those areas which had been hardest hit often reverted to pre-Famine conditions and did not show strong population decline until the 1870s. The Famine was a most serious event, but the modernization of Irish rural life, which linked emigration with changes in family structure, agriculture and population numbers, was more important in bringing about geographical change."

Conservation of Natural Resources↗
PubMed1991

Evidence for geographical variations in the prevalence of schizophrenia in rural Ireland.

Geographical variations in the rate of occurrence of schizophrenia have been the subject of much speculation and controversy, but it has proved extremely difficult to establish the existence of the phenomenon within a given study area. Using current inpatient and outpatient records and information from key informants active in the community, this study sought to identify all cases of schizophrenia in 36 District Electoral Divisions, constituting a clinical catchment area of 25,178 persons in a rural Irish county. Though the overall prevalence rate (3.3 per 1000) was unremarkable, this obscured a substantial and significant variation in prevalence rates (from 0.0 to 14.3 per 1000) between District Electoral Divisions. Prevalence rates in five District Electoral Divisions made particular contributions to the overall deviation from a statistical model for random occurrences in space. The results indicate spatial inhomogeneity in the prevalence of schizophrenia in rural Ireland and imply geographical variation in environmental or genetic factor(s) of etiologic relevance.

Adolescent↗
PubMed1996

Three keratin gene mutations account for the majority of dominant simplex epidermolysis bullosa cases within the population of Ireland.

We have located three extended families in Ireland (population 3.5 million) with autosomal dominant simplex forms of Epidermolysis Bullosa (EBS). A mutation within the keratin type I (K14) gene (Met-->272-->Arg) in one family suffering from the generalized simplex (Koebner) form of the disease has been previously described (Humphries et al., Hum Mutat 2:37-42, 1993). Here we report on the identification of mutations within the remaining two families, both of whom suffer from the Weber-Cockayne form of the disease. These mutations, within the type II keratin (K5) gene, are Asn-->193-->Lys and Met-->327-->Thr. They have been shown in each case to co-segregate with the disease and are not present in the normal population. Within the three families, a total of 44 living persons with such mutations have been identified, providing a minimum prevalence estimate for the disease in the Irish population of approximately 1 in 80,000, compared to an overall estimated global incidence at birth for all forms of EB of 1 in 50,000. Therefore, these three mutations probably account for the majority of cases of EBS within this population.

Amino Acid Sequence↗
PubMed2000

The economic and social cost of dementia in Ireland.

The economic and social burden of dementia on society is the value of all the resources used to prevent, diagnose, treat, and generally cope with the illness. There is increasing pressure to define the cost components of dementia with a view to improving resource allocation and accountability in this area in the future. We have assessed the overall resource implications of dementia in Ireland. Six main areas are covered in the cost analysis as follows: mortality and life years lost, in-patient acute care, in-patient psychiatric care, residential long-stay care, family care, and primary and social care in the community. While the results indicate that the baseline cost of illness associated with dementia is substantial at just under IR pound250 million, the most important aspect of the work is the distribution of the burden. The critical role of carers in maintaining people with dementia in their own home is reflected in the results showing that family care accounts for almost 50% of the overall resource burden, based on an opportunity cost valuation of carer time.

Acute Disease↗
PubMed2000

Association of serum AACT levels and AACT signal polymorphism with late-onset Alzheimer's disease in Northern Ireland.

alpha1-antichymotrypsin (AACT) is a serine protease inhibitor that has been associated with amyloid plaques in the brains of patients with Alzheimer's disease (AD). It has been reported that AACT serum levels are higher in AD patients than in age and sex matched controls. In addition, polymorphisms in the signal peptide and 5' of the AACT gene have been reported to increase the risk of developing AD. Serum AACT has also been suggested to be associated with cognitive decline in elderly subjects. Our objective was to investigate whether a relationship existed between serum AACT levels, AACT genotypes and risk for AD in a case control association study using 108 clinically well defined late onset AD cases and 108 age and sex matched controls from Northern Ireland. We also wished to determine whether higher serum AACT affected levels of cognition as had been previously reported. Serum AACT levels were found to be significantly raised in cases compared to controls (t=3.8, df=209, p<0.001). However, we detected no relationship between serum AACT levels and cognitive decline. We report allelic association of the AACT signal polymorphism with AD (chi(2)=3.70, df=1, p=0.04) but we failed to show any correlation between AACT serum levels and genotype.

Age Factors↗
PubMed1986

Concurrent familial myeloma in Northern Ireland.

Three families are presented containing two members of each family with myeloma over a 13-year period in Northern Ireland. In all three families, the disease was concurrent, and the first reported cases of concurrent myeloma in a father and son and also identical twins are included. This incidence represents a greater frequency than would be expected and gives credence to the idea of an etiologic agent in this disease.

Aged↗
PubMed1981

The effects of aging and secular trend on adult stature in rural western Ireland.

Cross-sectional data, consisting of anthropometric measurements for 347 adults males and 261 adult females in western Ireland measured during the 1930s, were used to determine the effects of aging and secular change upon stature. Estimates of statural loss due to aging were obtained using partial regression of stature on age while controlling for subischial length, and regression of the difference between observed stature and maximum predicted stature on age. Males show the effects of aging to a greater extent than do females. After correction for the effects of aging, the adjusted values of stature were progressed on age to estimate secular trend of stature. For males, there is a general increase of stature with time, excepting those born around 1878, while females generally show random variation with time. Both male and female adjusted stature decrease sharply around 1878, for which alternative historical explanations are proposed, relating to differential migration and survival.

Adolescent↗
PubMed1990

Survey of the use of thrombolysis for acute limb ischaemia in the UK and Ireland.

A total of 156 vascular surgeons from the UK and Ireland responded to a postal questionnaire on the use of thrombolysis in acute limb ischaemia. Almost half had used thrombolysis in the previous 12 months. Low dose intra-arterial streptokinase (89 per cent) was the regimen most frequently used, but 33 per cent had used intravenous streptokinase. Detailed results for 103 patients (limb salvage rate 60 per cent, amputation rate 35 per cent, mortality rate 5 per cent) were similar to those of previously published reports. Complications in most series were infrequent, but in the entire survey there were six bleeding-related deaths and one death from anaphylaxis. A total of 67 per cent of surgeons with working experience indicated that selected patients with acute arterial thromboses were most suitable for thrombolysis, particularly if there was no neurological deficit and no run-off for surgical bypass. Distal or late emboli and graft occlusions were regarded as appropriate by some surgeons. This study demonstrated that many vascular surgeons currently use thrombolysis, although sparingly and in selected cases. Patients with acute limb ischaemia should be managed by experienced vascular surgeons who are aware of the new therapeutic alternatives, an ideal supported by almost three-quarters of respondents to this survey.

Acute Disease↗
PubMed1994

Carotid endarterectomy in Great Britain and Ireland: practice between 1984 and 1992.

Of 356 questionnaires on carotid endarterectomy sent to all vascular surgeons in Great Britain and Ireland likely to undertake this procedure, 326 (92 per cent) were returned. Of those who replied 131 (40 per cent) performed at least one carotid endarterectomy in 1992; 57 (44 per cent) of these carried out ten or fewer operations and 74 (56 per cent) more than ten. The 131 surgeons were collectively responsible for 2628 operations in 1992, twice as many as were undertaken in either 1984 or 1989, years for which similar survey data are available. This sharp rise in the number of operations was accounted for by increased activity on the part of experienced operators, rather than any rise in the number of 'occasional' carotid surgeons. In 1992, although the neurologist remained a major source of patient referral, general practitioners (and others) were also referring patients in large numbers direct to the vascular surgeon; this represents a change in practice compared with previous years. Many of the technical aspects surrounding carotid endarterectomy remained unchanged over the years surveyed (1984, 1989, 1992) but by 1992 duplex scanning, intra-arterial (but not intravenous) digital subtraction angiography and transcranial Doppler ultrasonography had become established as clinically useful techniques.

Anesthesia↗
PubMed2004

Genotoxicity of field-collected inter-tidal sediments from Cork Harbor, Ireland, to juvenile turbot (Scophthalmus maximus L.) as measured by the Comet assay.

The alkaline single cell gel electrophoresis (SCGE) or Comet assay was employed to test the potential of surficial sediment collected from Cork Harbor, Ireland, to induce DNA damage in turbot (Scophthalmus maximus L.) in a laboratory exposure experiment. Turbot were exposed for 21 days to field-collected sediment from Cork Harbor and from a relatively clean reference site at Ballymacoda and sampled at 0, 7, 14, and 21 days. As a positive control for the sediment exposure experiment, a subsample of the turbot was exposed to cadmium chloride-spiked seawater. DNA damage analysis was performed on epidermal, gill, spleen, liver, and whole blood cell preparations. Liver, gill, and blood were the most sensitive tissues while a lower level of damage was detected in the epidermis and spleen. The blood was determined to be a suitable predictor of DNA damage in the whole organism. Chemical analysis of the sediment indicated that polycyclic aromatic hydrocarbons formed the bulk of the contaminants, with the harbor sites having almost double the levels of those from the reference site. The data indicated that turbot exposed to sediments from Cork Harbor elicited a significant increase in DNA damage in comparison with those exposed to sediment from the reference site and that exposure to the contaminated sediments caused a multi-organ genotoxic response. Results from the study indicate a relationship between the presence of genotoxicants in sediment and DNA damage. This finding was encouraging with regard to the potential use of the Comet assay as part of a marine biomonitoring strategy.

Animals↗
PubMed2001

Health insurance and health services utilization in Ireland.

The numbers buying private health insurance in Ireland have continued to grow, despite a broadening in entitlement to public care. About 40% of the population now have insurance, although everyone has entitlement to public hospital care. In this paper, we examine in detail the growth in insurance coverage and the factors underlying the demand for insurance. Attitudinal responses reveal the importance of perceptions about waiting times for public care, as well as some concerns about the quality of that care. Individual characteristics, such as education, age, gender, marital status, family composition and income all influence the probability of purchasing private insurance. We also examine the relationship between insurance and utilization of hospital in-patient services. The positive effect of private insurance appears less than that of entitlement to full free health care from the state, although the latter is means-tested, and may partly represent health status.

Attitude to Health↗
PubMed2005

GP reimbursement and visiting behaviour in Ireland.

In Ireland, approximately 30% of the population receive free GP services (medical card patients) while the remainder (private patients) must pay for each visit. In 1989, the manner in which GPs were reimbursed by the State for their medical card patients was changed from fee-for-service to capitation while private patients continued to pay on a fee-for-service basis. Concerns about supplier-induced demand were in part responsible for this policy change. The purpose of this paper is to examine the extent to which the utilisation of GP services is influenced by the reimbursement system facing GPs, by comparing visiting rates for the two groups before and after this change. Using a difference-in-differences approach on pooled micro-data from 1987, 1995 and 2000, we find that medical card eligibility has a consistently positive and significant effect on the utilisation of GP services. However, the differential in visiting rates between medical card patients and others did not narrow between 1987 and 1995 or 2000, as might have been anticipated if supplier-induced demand played a major role prior to the change in reimbursement system.

Adult↗
PubMed2003

Comparison of the CFTR mutation spectrum in three cohorts of patients of Celtic origin from Brittany (France) and Ireland.

This study aims to compare the spectrum of the mutations identified in the gene responsible for cystic fibrosis in three cohorts of patients of Celtic origin from Brittany and Ireland. It included 389 patients from Brittany, 631 from Dublin and 139 from Cork. The CFTR gene analysis relied on the detection of the most common mutations, followed by a complete gene scanning using DGGE or D-HPLC. High mutation detection rates were obtained in each cohort: 99.6%, 96.8%, and 96.0% respectively. A high frequency of the c.1652_1655 del3 mutation (F508del: 74.8% to 81.3%) and of the "Celtic" mutation (c.1784G>A (G551D): 3.7% to 9.7%) was observed in each population. Apart from this, the mutation spectrums differed. In Brittany, the most common abnormalities were: c.1078delT (3.6%), c.4041C>G (N1303K: 1.4%), c.2670G>A (W846X(2): 1.0%) and c.1717-1G>A (1.0%), whereas in the cohort of Dublin, the main mutations were: c.482G>A (R117H: 3.0%), c.1811G>C (R560T: 2.4%) and c.621+1G>T (1.7%). Finally, in the Cork area, only the c.482G>A mutation (R117H) reached a frequency of 1%. Two previously-unreported mutations were identified in the Dublin cohort: c.2623-2A>G and c.3446T>G (M1105R). This collaborative study highlights the similarities of the CFTR alleles in the Breton and Irish populations, but also the disparities that exist between these populations, despite their common origin. Each population has its own history, with its mixture of founder effects and genetic drifts, which are at the origin of the current mutation distribution. The molecular study of the CFTR gene provides new tools for retracing European populations' histories.

Alleles↗
PubMed2001

Dental experience of cleft affected children in the west of Ireland.

AIM: To investigate caries experience and initial access to dental services in a group of children with cleft lip/palate in the west of Ireland. DESIGN AND METHOD: Cross sectional study with prospective data capture and matched control. Details of children born with a cleft were obtained from all health professionals likely to be involved in delivering care to these children. Existing databases were cross-referenced to eliminate duplication or missed patients. A matched control sample was recruited from 14 schools in the region. RESULTS: A sample of 90 cleft affected children (48 male, 42 female) with any category of cleft born between 1980-1996 (i.e. 16 years) was compared with a control group of 100 non cleft children (60 male, 40 female). The DMF index was determined by a trained and calibrated clinician. Twenty-two percent (n=20) of the cleft group were caries free compared to 41% (n=41) in the control group. The combined dmf/DMF for the cleft group was 2.09 compared to 1.50 for the control (P<0.05). Separate analysis of the dmf and DMF between the two groups indicated that the difference lay in the caries found in the deciduous dentition of the cleft group. The first dental visit was at 4 years of age for the cleft group. CONCLUSIONS: Cleft affected children in the region did not receive adequate and regular dental care at the appropriate time. In view of the significantly greater risk of dental disease in clefting, particularly in the deciduous dentition, all cleft affected children should be referred for comprehensive and continued preventive dental care from the first year of life.

Adolescent↗
PubMed2001

Molecular detection and sequencing of "Norwalk-like viruses" in outbreaks and sporadic cases of gastroenteritis in Ireland.

Norwalk-like viruses (NLVs) are now established as the most important causative agents of epidemic gastroenteritis worldwide. The overall objective of this study was to determine the molecular epidemiology of Irish NLV isolates for the first time by obtaining sequence data from specimens originating from outbreaks and sporadic cases of gastroenteritis. Eight samples from sporadic cases of gastroenteritis and nine isolates from separate NLV outbreaks were examined. Of the sporadic isolates, six were shown to be genogroup 2 (G2) by RT-PCR, while two were G1. All of the outbreak isolates were G2. All isolates were partially sequenced within a highly conserved region of ORF1 (RNA-dependent RNA polymerase gene). Sequence data were aligned and a dendogram was constructed. The results indicated that the majority of G2 isolates were seen to cluster with Bristol and Lordsdale virus, while the two G1 specimens were related most closely to Southampton virus. Further downstream sequence analysis of a number of the isolates confirmed this result. It is concluded that the majority of NLV isolates circulating in Ireland belong to the Bristol/Lordsdale clade.

Base Sequence↗
PubMed2004

Nucleotide sequence analysis of the recA gene and discrimination of the three isolates of urease-positive thermophilic Campylobacter (UPTC) isolated from seagulls (Larus spp.) in Northern Ireland.

Nucleotide sequencing after TA cloning of the amplicon of the almost-full length recA gene from three strains of UPTC (A1, A2, and A3) isolated from seagulls in Northern Ireland, the phenotypical and genotypical characteristics of which have been demonstrated to be indistinguishable, clarified nucleotide differences at three nucleotide positions among the three strains. In conclusion, the nucleotide sequences of the recA gene were found to discriminate among the three strains of UPTC, A1, A2, and A3, which are indistinguishable phenotypically and genotypically. Thus, the present study strongly suggests that nucleotide sequence data of the amplicon of a suitable gene or region could aid in discriminating among isolates of the UPTC group, which are indistinguishable phenotypically and genotypically.

Animals↗