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PubMed1999

Student midwives' views of 'learning to be a midwife' in Ireland.

OBJECTIVE: To explore the opinions, feelings and views of student midwives of their education as they progressed through their two-year programme in Ireland, with the intention of interpreting and understanding the working and learning world of the participants so that future students might be assisted to improve their educational experiences. DESIGN: Quantitative and qualitative methods. A phenomenological approach was used to guide the qualitative section of the study. SETTING: All seven midwifery schools in Southern Ireland. PARTICIPANTS: All students in the first intake of 1995 in every midwifery school in Ireland (n = 125). DATA COLLECTION: Individual and group interviews, diary-keeping and questionnaires. KEY CONCLUSIONS: The findings presented in this paper illustrate the students' views of their education. Students perceived themselves as part of the workforce and believed that their educational needs were denied. They were given little clinical teaching and guidance and were not assisted to learn the skills of decision-making or judgement. Much of their learning took place by trial and error. The 13 weeks allocated for theoretical input in the midwifery education programme in Southern Ireland is far too short and many students thought that time was wasted. Relationships with the teaching staff were good, although some authoritarian attitudes were evident and teaching did not appear to be student-focused. IMPLICATIONS FOR PRACTICE: Theoretical teaching needs to be broadened and thought given to the integration of theory and practice. Clinical teaching is a necessity throughout the two-year programme and opportunities to teach while giving care should be identified and utilised. The use of prepared mentors, sufficient support staff and longer allocations to each area are recommended.

Education, Nursing, Graduate↗
PubMed2001

'Knowing your place': student midwives' views of relationships in midwifery in Ireland.

OBJECTIVE: to explore the feelings and views of student midwives of their education as they progressed through their two-year programme in Ireland, with the intention of interpreting and understanding the working and learning world of the participants so that future students might be assisted to improve their educational experiences. DESIGN: phenomenology, using the technique of triangulation in a number of ways. SETTING: all seven midwifery schools in Southern Ireland. PARTICIPANTS: all students in the first intake of 1995 in every midwifery school in Ireland (n=125). DATA COLLECTION: individual and group interviews, diary-keeping and questionnaires. KEY CONCLUSIONS: the findings presented in this paper illustrate the students' views of their relationships with qualified midwives and obstetricians. IMPLICATIONS FOR PRACTICE: an attitude of respect for all students needs to be fostered in hospitals educating midwives if we are to produce caring midwives in the future. The new, extended programme of midwifery education in Ireland should include an emphasis on communication skills and conflict management. A re-organisation of the hierarchical structures evident in midwifery management would lead to an improvement in the experiences of students and childbearing women alike.

Adult↗
PubMed2003

Phenotypic and genotypic relationship between Campylobacter spp isolated from humans and chickens in Northern Ireland--a comparison of three phenotyping and two genotyping schemes.

Human campylobacteriosis is currently the most common cause of acute bacterial gastroenteritis on the island of Ireland, accounting for over 3,000 laboratory reports per year, where circa 2,000 reports originate from the Republic of Ireland and circa 1,000 reports from Northern Ireland. Elsewhere, consumption of contaminated poultry has been associated with the zoonotic transmission of disease, therefore it was the aim of this study to examine the phenotypic and genotypic relatedness of campylobacters isolated from chickens and humans locally. Sixty isolates were subtyped using phenotyping techniques (biotyping, phage-typing), as well as genotyping techniques (multilocus enzyme electrophoresis (MEE), ribotyping) and the data compared. The frequency of shared phenotypes and genotypes between poultry and humans varied depending on the typing technique employed ranging from 98.2% of human isolates sharing a similar resistotyping (MAST) disc type with poultry strains to 20% similarity with MEE typing. Overall, this small study is the first report on phenotypic and genotypic relatedness between human and poultry campylobacters in Northern Ireland, isolated under controlled conditions. The study demonstrated an association between chicken and human sub-species types, taken from a relatively contained epidemiological environment. Further work is required with larger numbers of isolates coupled with typing schemes, which are able to reliably cluster strains from chicken and humans, which share high degrees of clonality, before local poultry can be conclusively proven to be a significant source of human campylobacteriosis.

Animals↗
PubMed1998

Fertility decline in Scotland, England and Wales, and Ireland: comparisons from the 1911 census of fertility.

Data on family size by year of marriage, age at marriage, and duration of marriage, from the 1911 Fertility Census, are compared between Scotland, England and Wales, Irish county boroughs, and the rest of Ireland. While means show significant inter-country differences, from the 1880s marked similarities are found across all the countries in the pattern of fertility decline, strongly suggesting significant fertility limitation in rural Ireland well before 1911. Noting the implications for the use of rural Ireland as a natural fertility population, the data are instead compared with the Coale-Trussell and Hinde-Woods schedules. The former provides more plausible results, which imply strong period rather than cohort effects in the fertility decline. Except in rural Ireland, little evidence is found for significant fertility limitation early in marriage among younger marrying couples, but many older marrying couples appear to have stopped childbearing at very low parities from an early date.

Censuses↗
PubMedDate not supplied

The origins of the Irish travellers and the genetic structure of Ireland.

Ireland's unique and well-documented history provides insight into the formation and origins of population subdivisions. Of particular interest, is the controversial ethnogenesis of an itinerant population of Ireland: the Travellers. The objectives of this study were: (1) to determine the genetic affinity of the Travellers to the general Irish population based on gene frequency data, subdivided by county, and (2) to explore the relationship between subpopulations of Ireland, given its turbulent history. The gene frequencies of standard genetic markers collected from populations residing in counties of Ireland and the Travellers were calculated and analysed using several multivariate methods. First, a relationship (R) matrix was used to ascertain the scaled variance covariance matrix of population similarity. Second, mean per locus heterozygosity (H) was regressed on distance of the region from the gene frequency centroid (r(ii)). The results of this study include: (1) the confirmation of Crawford's (1975, in Biosocial Interrelations in Population Adaptations, E. S. Watts et al. (eds), pp. 93-103) conclusions concerning the origins and genetic affinity of the Travellers; (2) based on several multivariate analyses, the major influence on population structure was unique historical events; and (3) Relethford and Crawford's (1995, American Journal of Physical Anthropology, 96, 25-38) hypothesis concerning the distinctiveness of the midland counties was verified by this study.

Emigration and Immigration↗
PubMedDate not supplied

Influence of religion and birthplace on the genetic structure of Northern Ireland.

The effect of geographic and religious subdivision on the genetic structure of Northern Ireland was assessed using data on 10 craniofacial measurements collected on 755 adult males that were born in five counties and belonged to one of three religious affiliations (Catholic, Church of Ireland, Presbyterian). Fifteen samples were defined based on birth county and religious affiliation. Two-way univariate and multivariate analysis of variance shows significant effects of birth county and religious affiliation, with somewhat greater subdivision due to religion. Distance matrix correlations reveal a small, but significant, effect of birth county and religious affiliation on the pattern of genetic distances between the 15 samples, with a slightly greater influence of religion. The Church of Ireland samples show the greatest differences. perhaps revealing the combined influence of differential population origins and religious differences as a barrier to gene flow. Overall, religion has a significant, though minor, influence on genetic variation in Northern Ireland.

Adult↗
PubMed2005

Dying for heroin: the increasing opioid-related mortality in the Republic of Ireland, 1980-1999.

BACKGROUND: Over the past 20 years there has been a steady rise in mortality associated with opioid misuse in several Western countries. We aimed to examine trends in opioid-related mortality over a 20-year period in the Republic of Ireland. METHODS: Retrospective analysis of deaths attributed to ICD-9 codes 304.0 (morphine-type dependence) and E850.0 (accidental poisoning by opiates and related narcotics) in the Republic of Ireland between 1980 and 1999. RESULTS: The Republic of Ireland has seen a rapid increase in the number of opioid-related deaths over the 20-year period studied, from 0.01% of total deaths in 1980 to 0.15% in 1999. This is most marked in the younger age groups where, for example, it rose to 23% of 15-19 year old male deaths for 1997. The opioid-related mortality rate in the 15-44 years age range increased by nearly 14 times between 1980-1984 and 1995-1999. Over the whole period, 87% of opioid-related deaths were amongst males. Outside Dublin there has been a considerable increase in opioid-related mortality, nearly doubling the percentage of the total from 6% in the 1980s to 11% in the 1990s. CONCLUSIONS: Opioid-related mortality is an increasing problem in the Republic of Ireland, as in other Western countries. Today, young people have a very low mortality rate, and hence this rapid increase may need specific targeted interventions. The spread of opioid-related mortality outside Dublin to rural and other urban areas will have implications for service planning and provision.

Adolescent↗
PubMed2002

Psychosocial risk factors for heart disease in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME).

BACKGROUND: France has a substantially lower level of premature mortality from cardiovascular diseases (CVD) relative to its comparators. Compared with Northern Ireland, France has one-half the rate, despite having a similar cardiovascular risk profile to Northern Ireland. In this prospective longitudinal study the psychosocial risk hypothesis for CVD was tested. METHOD: A cohort of 9758 men (7359 in France and 2399 in Northern Ireland) aged 50-59 years who were initially free of any CVD were recruited. At baseline the subjects completed a psychosocial questionnaire, measuring hostility, depression, social support, and the Type A behaviour pattern. At 5-years follow-up their clinical status was determined. RESULTS: Multivariate analysis indicated that, contrary to prediction, France had a substantially more negative psychosocial risk profile than Northern Ireland. The psychosocial risk factors were not successful at predicting at 5-years follow-up the hard clinical endpoint of definite fatal/non-fatal myocardial infarction. In the case of the softer clinical endpoint, angina pectoris/unstable angina, only depression predicted outcome with a small effect size. CONCLUSION: The findings provide little support for the psychosocial risk hypothesis. The psychosocial risk profile was more negative in France, the opposite of that predicted. The finding of a relationship between depression and angina may reflect a tendency for individuals who respond negatively on mood state to report more cardiac symptoms irrespective of physical disease state.

Depressive Disorder↗
PubMed1976

Suicide and self-poisoning in Great Britain and Ireland.

Reported national rates of suicide remain fairly stable from year to year and considerable differences persist between countries. Reported rates of suicide also differ from actual rates according to the social influences and the legal procedure both in attributing suicide and also in how the death is recorded and coded. This paper compares the rates of suicide and non-fatal self-poisoning in Scotland, England and Wales, and Ireland, and also examines suicide rates in people born in Ireland but now resident in England and Wales. The rise in overdose admissions to hospital which is continuing in relative degrees in all communities of Great Britain and Ireland, except Northern Ireland, does not seem to be correlated with trends in fatal suicide behaviour. Further studies on all aspects of the subject are needed to clarify the social determinants involved and to identify ways in which further increases can be contained.

Adolescent↗
PubMed2005

Surveillance for Barrett's oesophagus: results from a programme in Northern Ireland.

BACKGROUND: The reported incidence of adenocarcinoma in patients with Barrett's oesophagus in surveillance programmes varies widely. Great Britain has one of the highest incidence rates of this cancer in the world, but there are no data from Ireland reporting its incidence in patients with Barrett's oesophagus undergoing surveillance. We carried out a study of all such patients at a large District General Hospital in Northern Ireland. METHODS: A retrospective review of all patients with Barrett's oesophagus from January 1986 to March 2004 at Altnagelvin Area Hospital, Derry, Northern Ireland was performed. Barrett's oesophagus was defined as specialized intestinal metaplasia present in the tubular oesophagus. RESULTS: A total of 277 patients had Barrett's oesophagus. Twenty-one patients had adenocarcinoma and two patients had high-grade dysplasia at initial endoscopy and were excluded. Of the remaining 254 patients, 178 were entered into the surveillance programme (127 men, 51 women). The average follow-up period was 3.4 years, resulting in 613 patient-years of follow-up. Three patients developed adenocarcinoma, an incidence of 1/204 patient-years of follow-up. Two of the three patients had early-stage (T1 or T2) cancers detected and are alive and well. A total of 429 surveillance endoscopies were performed, and a marked year-on-year increase in the workload generated as a result of the surveillance programme was observed. CONCLUSIONS: The incidence of adenocarcinoma in patients in Northern Ireland was similar to the incidence reported by other large institutions. Clinical benefit is suggested but is not certain from these data, because of biases that affect surveillance programmes. Large multicentre studies are required to determine whether surveillance is beneficial.

Adenocarcinoma↗
PubMed1997

External cephalic version at term: a survey of consultant obstetric practice in the United Kingdom and Republic of Ireland.

OBJECTIVE: To undertake a survey of external cephalic version (ECV) in the United Kingdom and Republic of Ireland. DESIGN: In June 1995 every consultant obstetrician and gynaecologist in the United Kingdom and Republic of Ireland was sent a postal questionnaire which asked whether ECV was routinely performed for breech presentation after 37 weeks of gestation, assuming no contraindications. If consultants did not perform ECV, a supplementary question inquired whether they referred patients to a colleague who would perform ECV. The questionnaires were colour coded for country and dispatched from the Postgraduate Education Department of the Royal College of Obstetricians and Gynaecologists (RCOG). RESULTS: Overall, 78% of questionnaires were returned. The percentage of consultants routinely practising ECV in each country was as follows: Northern Ireland 82%; Scotland 64%; Republic of Ireland 64%; England 43%; and Wales 41%. When these figures were compared with the latest RCOG Annual Statistical Returns for breech delivery and caesarean section for breech delivery, there was an inverse correlation between the percentage of obstetricians performing ECV in any one country and the incidence of breech delivery (P < 0.001). There was a similar inverse correlation for the percentage of obstetricians performing ECV and the caesarean section rate for breech delivery (P < 0.001). CONCLUSION: Although postal survey results are not necessarily an accurate reflection of what happens in clinical practice, these data are supported by evidence from the Cochrane Database of Systematic Reviews indicating that ECV after 37 weeks reduces the incidence of both breech delivery and caesarean section for breech delivery.

Breech Presentation↗
PubMed2006

Dental school admissions in Ireland: can current selection criteria predict success?

INTRODUCTION: Entry into university education in Ireland, including dental school, is based solely on academic performance in the Leaving Certificate Examination, held at the end of formal school education. The aim of this investigation was to examine the suitability of this process for the selection of dental students in Ireland. MATERIALS AND METHODS: Information for all dental students who entered the dental degree programme immediately following completion of the Leaving Certificate Examination at the National University of Ireland, Cork, during the years 1997-1999 was retrieved. Information was collected relating to gender, the number of times the student had attempted the Leaving Certificate Examination, their performance in this examination, the total number of marks awarded to each student at the end of the First and Final Dental Examinations, and their performance in individual modules. RESULTS: Whilst there was a significant relationship between performance in the Leaving Certificate Examination and the First Dental Examination (correlation coefficient = 0.22, P < 0.05), this relationship could only explain 12% of the variation within the performance of students in this examination. There was no relationship between performance in the Leaving Certificate and the Final Dental Examination (correlation coefficient = 0.09, P > 0.05). There was a significant correlation between performance in the Leaving Certificate Examination and performance in seven of the 55 programme modules, all of which were pre-clinical modules, and of which five were related to basic sciences. CONCLUSIONS: Based on the limitations of this study, the current selection process for dental students in Ireland seems to be of limited value.

Clinical Competence↗
PubMed1989

Colour naming of violence-related words in Northern Ireland.

To investigate the hypothesis that people in Northern Ireland are using denial to cope with the impact of political violence, a specially designed version of the Stroop test was developed. English students living in Northern Ireland evidenced significantly greater interference on the Violent Stroop compared to either English students living in England or Northern Irish students living in Northern Ireland suggesting that while the Northern Irish natives had habituated to the violence the English students living in Northern Ireland had not yet done so.

Adult↗
PubMed2003

Penicillin susceptibility and epidemiological typing of invasive pneumococcal isolates in the Republic of Ireland.

A national study was undertaken to investigate the incidence of invasive pneumococcal disease in the Republic of Ireland and to examine the associated isolates. In 1999, 144 S. pneumoniae isolates, all recovered from cases of invasive disease, were received from 12 microbiology laboratories. The incidence of invasive pneumococcal disease was estimated to be 6.6/100000 population. All isolates were analyzed for serotype, penicillin susceptibility, chromosomal relatedness (by using pulsed-field gel electrophoresis [PFGE]), and penicillin-binding protein (pbp) fingerprinting. Several findings of note were observed regarding the pneumococcal population in Ireland. First, isolates of 25 different serotypes were represented, with serotypes 14, 9V, 8, 5, 4, and 3 being the most common. This finding, together with the pbp fingerprinting and PFGE typing results, indicated the clonal spread of strains of these serotypes in Ireland. Second, 27 (18.7%) isolates had reduced susceptibility to penicillin, and 74% of these were serotype 9V. Of these, 80% appeared to belong to the same clone. This could suggest the spread of the international Spanish/French 9V penicillin-resistant clone into Ireland. Third, nine different pbp genotypes were identified, four of which were new. Two pbp genotypes accounted for the majority of isolates dividing them according to their penicillin susceptibility status but irrespective of serotype and PFGE type. This is strong evidence for the occurrence of horizontal transfer of pbp genes between strains, observed with both penicillin-susceptible and penicillin-nonsusceptible isolates. Fourth, there was evidence of serotype transformation since isolates, indistinguishable by pbp fingerprinting and PFGE typing, expressed different capsular types.

Base Sequence↗
PubMed2000

A survey of the causes of sudden death in sport in the Republic of Ireland.

BACKGROUND: Sudden death in sport is rare, but when it occurs the effects are devastating. There have not been any reports to date describing the frequency and causes of sudden death in sport in the Republic of Ireland. AIM: To describe the incidence, possible causes, associated factors, and pathological findings in people who died while exercising in the Republic of Ireland in the 10 year period from January 1987 to December 1996. METHODS: All 49 regional coroners in the Republic of Ireland were approached and details on all cases of sudden death in sport from 1 January 1987 to 31 December 1996 were requested. A questionnaire was used to document age, sex, participating sport, previous symptoms, previous medical investigations, circumstances of death, and main pathological finding in all reported cases. RESULTS: Of the 49 coroners surveyed, 45 replied. A total of 51 cases of sudden death in sport were identified. The median age was 48 (range 15-78). Fifty of the deaths were of men. Golf was the most popular participating sport. In 42 cases, the pathological cause of death was atherosclerotic coronary artery disease. CONCLUSIONS: This is the first time the incidence of sudden death in sport in the Republic of Ireland has been described. The main cause of death in all age groups was atherosclerotic coronary artery disease.

Adolescent↗
PubMed1977

The use of the FST statistic of Wright for estimating the effects of genetic drift, selection and migration populations, with special reference to Ireland.

The Fst of Wright has been used to examine the available blood group, serum protein and enzyme data for the world, NW Europe and the counties of Ireland. These include the ABO, secretor, Lewis, MNSs, Rh, Kell, Duffy, Lutheran, Kidd, P, Diego, haptoglobin, Gc, Lp, Ag, adenosine deaminase, adenylate kinase, acid phosphatase, 6-phosphogluconate, phosphoglucomutase and transferrin systems. The highest value was found for the Fy gene. Much lower values than those calculated for world data were found for NW Europe and Ireland with the exception of the Lpa antigen which had high values in Ireland. sigma2p was used to estimate rates of genetic drift in an Irish population and it was estimated that a migration rate of 4% would counter genetic drift in Ireland.

Blood Group Antigens↗
PubMed2001

A survey of attitudes to abortion law in Northern Ireland amongst obstetricians, gynaecologists and family planning doctors.

CONTEXT: The Abortion Law in Northern Ireland - professional attitudes to change. OBJECTIVE: To elicit the attitudes of doctors in Northern Ireland, practicing obstetrics and gynaecology or family planning. METHOD: Questionnaires (n = 155) were sent to all grades of doctors working in obstetrics and gynaecology or family planning in Northern Ireland during 1996. RESULTS: One hundred and two (65.8%) of the questionnaires were returned. The majority of doctors believed that abortion should be legalised and a service provided. There was no consensus on how this should be achieved. Fifty percent of family planning doctors supported importing the British Abortion Law, but the majority of hospital doctors favoured a new law specific to Northern Ireland. Over 90% were in favour of providing medical abortions in certain circumstances. There was no agreement on who should be responsible for the service.

Abortion, Induced↗
PubMed2002

Awareness, treatment and control of hyperlipidaemia in middle-aged men in France and northern ireland in 1991-1993: the PRIME study. Prospective epidemiological study of myocardial infarction.

OBJECTIVE: To assess how well screening and preventive measures are implemented in the general population. METHODS AND RESULTS: Sample of 9,609 men aged 50-59 devoid of history of CHD living in France and Northern Ireland. Hyperlipidaemia was defined as total cholesterol > or = 240 mg/dl or triglycerides > or = 200 mg/dl or HDL cholesterol < 0.35 mg/dl or hypolipidaemic drug treatment. Treated subjects were considered as controlled if total cholesterol was < 200 mg/dland triglycerides < 200 mg/dl and HDL cholesterol > or = 0.35 mg/dl. The prevalence of hyperlipidaemia was higher in Northern Ireland, whereas awareness, treatment and control rates were higher in France. Only one third of aware subjects had a hypolipidaemic diet, and less than half of treated subjects was adequately controlled. Lower educational level, smoking, obesity and a history of hypertension were significantly related to higher rates of hyperlipidaemia in both countries. In France, history of hypertension or diabetes, and ex- or non-smoking status were related to higher levels of awareness and treatment. In Northern Ireland, awareness of hyperlipidaemia was positively related to educational level. CONCLUSIONS: Awareness, treatment and control rates for hyperlipidaemia are low in Northern Ireland compared to France, and implementation of preventive measures should be performed in both countries.

Awareness↗