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Incidence of the mucopolysaccharidoses in Northern Ireland.

An epidemiological study of the mucopolysaccharidoses (MPS) in Northern Ireland using multiple ascertainment sources was carried out and the incidence rate for the period 1958-1985 was estimated. An incidence of approximately 1 in 76,000 live births was obtained for MPS 1H (Hurler phenotype); 1 in 280,000 for MPS 1 H/S (Hurler/Scheie phenotype); 1 in 140,000 live births (1 in 72,000 male live births) for MPS II (Hunter syndrome); 1 in 280,000 for MPS III (Sanfilippo syndrome) and 1 in 76,000 for MPS IV A (Morquio syndrome type A). No cases of MPS IS (Scheie phenotype), MPS IV B (Morquio syndrome type B) or MPS VI (Maroteaux-Lamy syndrome) were ascertained during the study period. Three cases of non-immune hydrops fetalis born to consanguineous parents were thought to be due to beta-glucuronidase deficiency (MPS VII) on the basis of placental histology and enzyme studies on both parents but no living cases of MPS VII were ascertained. The overall incidence for all types of mucopolysaccharidosis was approximately 1 in 25,000 live births. A comparison is made with incidence estimates obtained from other published studies.

Humans↗

Ectomycorrhizas associated with a relict population of Dryas octopetala in the Burren, western Ireland. I. Distribution of ectomycorrhizas in relation to vegetation and soil characteristics.

The distribution of ectomycorrhizas on Dryas octopetala L in grass heaths of the 450 km2 karst region known as the Burren in Western Ireland was examined in relation to soil factors and vegetation type. Ectomycorrhizas were identified or characterised from 56 soil cores from 30 sites, and the occurrence of each ectomycorrhizal (EM) type was quantified by estimating the total length of mycorrhizal tips of each type. Soil organic matter, total nitrogen, extractable phosphorus, pH and depth were the soil factors determined. In total, 24 EM types were recorded. The EM community of Dryas roots was significantly more species-rich in one vegetation type--Hyperico-Dryadetum--than in others (Arctostaphylo-Dryadetum or Asperulo-Seslerietum). Multiple linear regression analyses indicated that soil organic matter and soil depth explained a significant portion of the variation in EM abundance, while soil organic matter and extractable phosphorus explained a significant portion of the variation in EM diversity. Canonical correspondence analysis showed that some individual EM types (e.g. Craterellus lutescens, Cenococcum geophilum, Tomentella sp., Boletus sp.) exhibited distinct soil preferences, most markedly in relation to soil organic matter, which, in this analysis, was the main significant soil variable distinguishing the three vegetation types.

Ascomycota↗

Ectomycorrhizas associated with a relict population of Dryas octopetala in the Burren, western Ireland II. Composition, structure and temporal variation in the ectomycorrhizal community.

The composition, structure and temporal variation of ectomycorrhizal (EM) communities associated with mountain avens (Dryas octopetala) in grass heaths of the Burren, western Ireland were assessed by using soil core sampling in two permanent plots and 30 other sites (196 cores in total). Of the 34 different EM types observed, 11 were common and constituted over 80% of the EM biomass. Four EM types, Craterellus lutescens, Tomentella sp., Dryadirhiza fulgens and Cenococcum geophilum were the most abundant as measured by EM length and frequency of occurrence in cores. The species profile and relative abundances were very similar in cores from the permanent plots and different sites in the Burren, indicating that they were all representative of the same EM community. The below-ground EM community in both plots was compared with production of basidiomes, and the latter was found to be an unreliable indicator of EM community structure. Temporal variation in the EM community was assessed by repeated core sampling of the two permanent plots over a 14-month period (between March 1998 and May 1999). No statistically significant shifts in EM abundance were found between sampling dates, probably as a consequence of the large variation in EM abundance between core samples over the sampling period. No significant relationship was found between rainfall, soil moisture or soil temperature and fluctuations in EM abundance. Patterns of total EM abundance and fluctuations in EM diversity were strongly correlated between the two permanent plots over the sampling period. Temporal fluctuations in the dominant EM type, Craterellus lutescens, were similar in both plots with respect to mycorrhizal length, biomass and relative abundance, and the patterns between both plots were positively correlated. EM diversity was negatively correlated with biomass of ectomycorrhizas of Craterellus lutescens in both plots, but it was significant only in plot 1.

Ascomycota↗

Children's perceptions of negative events in Northern Ireland: a ten year study.

This study examines changes in Northern Irish children's perceptions of negative events over ten years. Ten year old children's perceptions of potentially distressing situations were obtained from two groups of children in 1983 and 1994 using a 25 item self-report measure. The children's perceptions of the events are contrasted across time and also comparisons between socioeconomic and religious groups are made. The comparison shows that the children's perceptions of the events remains relatively constant across time, with certain events being consistently viewed as the most stressful and least stressful across time and between groups. Comparison of religious and socioeconomic groups suggests that working class and Roman Catholic children in Northern Ireland frequently rate negative events as more stressful than others in their cohort.

Catholicism↗

The potential impact of implementing a system of generic substitution on the community drug schemes in Ireland.

This study estimated the potential savings in Ireland in 2003 if a system of generic substitution were introduced, under the two main Community Drug Schemes (General Medical Services, GMS, and Drugs Payment, DP). The GMS and DP schemes accounted for 82% of state expenditure on the Community Drug Schemes in 2003. Twenty one per cent of prescription items on the GMS scheme and 23% of items on the DP scheme were dispensed as a proprietary preparation when a generic equivalent was available. Substitution of the cheapest generic equivalent preparations of the top 30 drugs by expenditure in each scheme would result in estimated annual savings of 12.7 million on the GMS and 9.1 million on the DP scheme. Potential savings if the most expensive generic drugs were dispensed would be in the region of 9.0 million on the GMS and 6.4 million on the DP scheme. Comparison of these results with a similar analysis of 2001 data illustrates the potential for an increase in savings over time.

Cost Control↗

Serious eye and adnexal injuries from fireworks in Northern Ireland before and after lifting of the firework ban--an ophthalmology unit's experience.

BACKGROUND/AIMS: To report serious fireworks-related eye and adnexal injuries presenting to the Department of Ophthalmology in the Royal Victoria Hospital, Belfast. To assess the effect of lifting of the legislative ban on fireworks in Northern Ireland in 1996. METHOD: Twelve year retrospective review from 1990 to 2001 inclusive of all ocular and adnexal injuries from fireworks requiring hospitalisation to the ophthalmology department. RESULTS: Twenty three patients with 23 injured eyes were reported. Six were female. The mean age was 18 years (+/- 13 SD). Six patients presented between the years 1990 and 1995. The remaining 17 patients presented between 1996 and 2001. Nearly half of the patients required ophthalmic surgical procedures. Thirty-six percent of patients had a final visual acuity of 6/60 or less. Superficial trauma not requiring hospitalisation was not included. CONCLUSION: Removal of the legislative ban on fireworks in 1996 has had a significant effect on the incidence of eye injuries. These injuries are potentially preventable with stricter control on the availability of fireworks and a greater awareness of the ocular risks they pose.

Adolescent↗

Prevention of timber felling and chainsaw-related accidents in the Republic of Ireland.

A one-year prospective survey in four rural Irish counties was performed between January 1 and December 31, 1986, to analyse chainsaw accidents in a representative sample of domestic chainsaw users. Of the 62 accident cases recorded, the largest group were farmers, followed by a medley of self-employed "loggers" and domestic users. Every age group was represented, the commonest age group being 16-30 years. One of three female cases was an old-aged pensioner, and three other cases were aged under 12 years. Two of the latter cases had been using the saw when the accident occurred. Most injuries were sustained to the lower extremities, mostly due to a slip or misdirection of the saw. Of the 27 cases admitted to a hospital, 25 (93%) required surgical procedures with an average inpatient stay of eight days. Only 2 (3%) of the 62 cases wore an item of protective gear; in both cases, this was steel capped boots that were unsuitable for protection against chainsaw injuries. First aid at the accident site was very inadequate. The research indicates few of the cases were competent to use a power saw, and there was a general lack of appreciation of the risks associated with these implements and a disregard for safety procedures. While new forthcoming legislation on safety at work may improve safety standards in the future, a substantial proportion of chainsaw users in Ireland are currently at risk from further accidents.

Accidents, Occupational↗

Are traffic deaths in Ireland related to alcohol consumption? Restudying a time series model.

The traffic death rate and per capita alcohol consumption in Ireland were found by Walsh to be correlated. However, a more detailed analysis shows that changes in traffic deaths precede changes in alcohol consumption. Therefore, the correlation can not reflect a causal relation. When a speculative variable is included, the relation becomes concurrent. The overall conclusion is that there is no credible evidence for a relation between per capita alcohol consumption and traffic deaths.

Accidents, Traffic↗

Pregnancy complicated by maternal heart disease at the National Maternity Hospital, Dublin, Ireland, 1969 to 1978.

Three hundred eighty-seven pregnancies (295 patients) complicated by maternal heart disease, managed at the National Maternity Hospital, Dublin, Ireland, during the years 1969 to 1978, were reviewed. The incidence was 0.5%. Three hundred twenty-three (83.5%) were of rheumatic origin, 52 (13.4%) were congenital, and the remaining 12 (3.1%) were a miscellaneous group and included cases of cor pulmonale and coronary artery disease. There were two maternal deaths--one from congenital heart disease and one from postpartum suicide, unrelated to mild rheumatic heart disease. The perinatal mortality rate was 3.3%. Five pregnancies (three patients) were complicated by surgically uncorrected cyanotic congenital heart disease. One of the maternal deaths and three of the perinatal deaths occurred in this group. There were 38 episodes of cardiac failure (38 patients) in cases of rheumatic heart disease. The New York Heart Association grading was grade 1 in 15 (39%) of these before the onset of failure. Prophylactic antibiotics were not used and infective endocarditis did not occur. Therapeutic abortion was not practiced and a conservative approach was adopted in obstetric intervention and in all drug therapy.

Adolescent↗

Malignant melanoma excision margins: plastic surgery audit in Britain and Ireland, 1991, and a review.

In 1991, 146 consultant plastic surgeons in Britain and Ireland were sent a short questionnaire about their policies for excision margins for primary cutaneous malignant melanoma. 106/146 (73%) replied. 39/106 (37%) considered narrow margin (2-3 mm) excision biopsies adequate in certain cases. The minimum tumour thickness for a margin of more than 1 cm was 1 mm or more for 67/106 (63%) on the leg and for 57/106 (54%) on the back. The maximum margin was specified as 4 cm or more on the leg by 37/106 (35%) and on the back by 42/106 (40%). Other sub-groups of results were analysed. A review of the literature is presented.

Attitude of Health Personnel↗

The changing pattern of paramilitary punishments in Northern Ireland.

Paramilitary punishments in Northern Ireland traditionally involved shooting in the limbs with low-velocity handguns. During the recent IRA ceasefire they were replaced with beatings by clubs and similar objects. We carried out a retrospective review of patients who had suffered punishment beatings who presented to the Royal Victoria Hospital, Belfast. Patients were more likely to have fractures and more severe soft-tissue injuries. The time spent in hospital was often longer, and there was a greater chance of requiring operations (often multiple).

Fractures, Bone↗

Women as mothers in northern Ireland and Jamaica: a critique of the transcultural nursing movement.

Participant observation and structured interviews with selected groups of mothers in Northern Ireland and Jamaica revealed a variety of individual experiences that highlighted contrasts between the two cultures, and differences within each culture. The findings are used to illustrate the danger of cultural stereotyping, and the implications for the transcultural nursing movement are discussed.

Adolescent↗

Analysis of the attention deficit in schizophrenia: a study of patients and their relatives in Ireland.

County Roscommon, a rural area in the western part of Ireland, was the site of a family study of schizophrenia. As part of this study, we have assessed several elements of attention, identified by principal components analysis in previous investigations, in a group of subjects with schizophrenia, first-degree relatives of subjects with schizophrenia and age- and education-matched controls. The schizophrenic subjects performed significantly more poorly than the controls; the performance of the relatives fell somewhere between the other two groups. Those relatives with a DSM-III-R diagnosis (most frequently, alcohol abuse or an affective disorder) tended to perform more poorly on some of the attention elements than relatives without a diagnosis; in contrast, control subjects with diagnoses were not distinguishable from other controls. The attention elements appeared to differ in their capacity to differentiate the groups and each seemed to have a distinctive profile. The effects of alcohol abuse were also considered. The results obtained with this cohort may provide clues concerning the pathophysiological basis of schizophrenia and the heterogeneity of its expression.

Adult↗

Northern Ireland: political violence and self-reported physical symptoms in a community sample.

In order to investigate the possible relationship between physical health and political violence in Northern Ireland a random sample of residents of four electoral areas (two with relatively high violence and two with relatively low violence) was interviewed at home. Each person was asked to rate their health in terms of common physical symptoms, to indicate their use of family doctor and hospital services, and to rate the level of political violence in their neighbourhood. Analysis of covariance (with a measure of psychological well-being, a measure of trait neuroticism plus age and socioeconomic status as covariates) revealed that women reported more physical symptoms than did men, people in the 'high' violence areas reported more symptoms than did those in the 'low' violence areas, while those who rated their own neighbourhood most highly in terms of perceived violence also reported the greatest number of physical symptoms. However, a series of chi 2 tests revealed no association between political violence or perceived political violence and uptake of services.

Cross-Sectional Studies↗

Dinophysistoxin-2: the predominant diarrhoetic shellfish toxin in Ireland.

Diarrhoetic shellfish poisoning (DSP) in Europe is due mainly to the presence of the dinoflagellate toxin, okadaic acid (OA). However, analysis of cultivated mussels (Mytilus edulis) from southwest Ireland revealed that an isomer of OA, dinophysistoxin-2, was the major toxin present during DSP episodes. Using fluorimetric HPLC, following derivatisation with 9-anthryldiazomethane, both OA and DTX-2 were found in shellfish during a prolonged toxic episode in 1991. However, examination of similar mussel cultivation locations in 1994 showed that DTX-2 was even more predominant. During this DSP period, OA levels were less than 0.7 microgram/g, whereas maximum DTX-2 levels of 6.3 micrograms/g hepatopancreas were recorded. This toxicity in shellfish occurred soon after high cell counts of Dinophysis acuta were observed. As well as large seasonal variability in toxin levels in rope cultured mussels, substantial variations were also observed, both horizontally and vertically, within the water column.

Animals↗

Indoor natural radiation levels in Ireland.

The principal results of a preliminary study made on indoor radiation levels in Ireland are presented. During the period 1983-84 measurements were made in over 250 houses. Most measurements were made using passive devices: TLDs for penetrating radiation and CR-39 alpha track plastic detectors for radon measurements. The median value of the doses from penetrating radiation was 0.78 milligray/year with a maximum value of 1.47 m Gy/year detected. The radon concentrations showed a large degree of variability with a median value of 43 Bq/m3. About 10% of the houses had radon air concentrations in excess of 100 Bq/m3 with a maximum of 700 Bq/m3 being recorded. A tentative analysis of the data with regard to the geological situation is presented.

Environmental Exposure↗

Occurrence and characteristics of Listeria in foods produced in Northern Ireland.

The incidence of L. monocytogenes and other Listeria species was determined for 513 food samples produced in Northern Ireland. Selected L. monocytogenes isolates were typed using MEE and RFLP analysis. The overall incidence of Listeria in the foods examined was 35% (Listeria monocytogenes 18.3%). The incidence of Listeria and L. monocytogenes in four different food categories (graded I-IV according to decreasing extent of processing) being: I, 11.1% Listeria and 4.7% L. monocytogenes; II, 27.1% Listeria and 12.2% L. monocytogenes; III, 89.1% Listeria and 50% L. monocytogenes and IV, 100% Listeria and 100% L. monocytogenes. Within food categories I and II, the incidence of Listeria on occasions varied markedly between similar products produced by different processors. The most frequently isolated species was L. innocua, followed by L. monocytogenes, L. seeligeri and L. welshimeri. The L. monocytogenes isolates were predominantly serogroup 1. A modified USDA method was the most productive of four enrichment procedures investigated. Over the one-year duration of the survey, a distinctive Listeria microflora could be discerned in products from certain processors and was confirmed in some cases by MEE and RFLP typing of L. monocytogenes isolates.

DNA, Bacterial↗