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Biomedical subjects

Domhnall MacAuley

Publications and source records attributed to Domhnall MacAuley.

13 recordsLinked to original sources
PubMed2005

Genetic consultations in primary care: GPs' responses to three scenarios.

OBJECTIVE: This study investigated general practitioners' responses to three scenarios in which patients consulted regarding genetic conditions. DESIGN: Self-completed postal study. Setting. Primary care in Northern Ireland. SUBJECTS: Questionnaire were distributed to all the GPs in Northern Ireland (n = 1079). A total of 541 GPs participated (50%). MAIN OUTCOME MEASURES: Responses to three scenarios in which patients consulted regarding their family history and risk of bowel cancer, breast cancer, and cystic fibrosis. RESULTS: Most GPs correctly identified the patients' risk of bowel cancer, recommended regular colonoscopy, advised lifestyle changes, and did not refer to the genetic clinic. GPs who were qualified for longer were more likely to recommend colonoscopy and less likely to advise lifestyle changes. With the breast cancer patient GPs adopted a cautious approach; most would refer to the genetic and mammography clinics. With the cystic fibrosis example, most correctly identified the patient's risk of carrying the gene, would refer to the genetic clinic, and would encourage the patient to discuss the risk with his partner. In general, doctors were unsure, but would pass on genetic information to insurance companies if requested. CONCLUSION: The study suggests that, in most cases, general practitioners correctly identify at-risk individuals but there may still be some uncertainty regarding referrals. The results suggest that ways of educating GPs should be explored. Educational interventions should be linked to a greater understanding of factors involved in referral (including the influence of gender and experience). The guidelines provided to GPs in relation to the provision of genetic information to insurance companies may need to be reviewed in some countries.

Adult↗
PubMed2003

Life expectancies in the United Kingdom and Japan.

BACKGROUND: Compared with other developed countries, the United Kingdom has exhibited less of an increase in life expectancy over the past 30 years. METHODS: We compared the chronological changes in the age-adjusted mortality rates (AMRs) from all causes or major causes, and in life expectancy in the United Kingdom and Japan between 1970 and 1997. RESULTS: In both 1970 and 1997 the AMRs for most major causes were higher in the United Kingdom than in Japan; the difference in the AMR between countries was smaller in 1970 than in 1997. The difference in the AMR from all causes between the United Kingdom and Japan in 1997 was mainly due to differences in the AMR for heart diseases. The trend for an increasing difference over time between the United Kingdom and Japan in the AMR from all causes was due to the decreased rate of AMR from heart diseases from 1970 to 1997 in the United Kingdom being lower than those from cerebrovascular diseases in same period in Japan. CONCLUSIONS: These data suggest that mortality rates could be reduced by a change in focus of the National Health Service toward an emphasis on primary rather than secondary prevention and associated clinical interventions. The greatest priority should be placed on reducing the incidence of heart disease by aggressively improving primary prevention.

Adolescent↗
PubMed2003

No preventive effect of dietary fiber against colon cancer in the Japanese population: a cross-sectional analysis.

The report of Fuchs et al. in 1999 on the protective effects of dietary fiber (DF) against colon carcinogenesis has led many researchers to question the benefits of DF. We analyzed the relationship between dietary intake and mortality from colon cancer in Japan cross-sectionally. Dietary data were taken from the National Nutrition Survey. The standardized mortality ratio (SMR) was calculated using data from "Vital Statistics" and "the Population Census in Japan." Multiple regression analysis (stepwise variable selection method) was performed with the SMR of colon cancer as the objective variable and intake of DF, nutrients, and food groups in 1966 as the explanatory variables. The beta regression coefficient was significantly positive for intakes of fat, protein, and vitamin C and significantly negative for intakes of calcium and vitamin A to the SMR of colon cancer. However, no significant correlation was observed for DF or for any of the various food groups analyzed. In conclusion, our data do not demonstrate any protective effect of DF on colon cancer in subjects with a low fat intake (Japanese subjects), which supports Fuchs' findings in subjects with high fat intake (U.S. subjects).

Colonic Neoplasms↗
PubMed2002

Comparison of etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West.

BACKGROUND AND AIMS: Colonic diverticula are located predominantly on the right-side in patients in Japan, in contrast to those in Europe and the United States. This study compared the etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West. METHODS: A literature review was conducted from 1950 to 2001 using Medline and Index Medicus. RESULTS: Diverticula occur predominantly in the right-sided colon (over 70%) in Japanese patients, and even among Japanese who emigrate, in contrast with the diverticula in Western. Incidence (detection) rates of colon diverticula have rapidly increased in Japan since World War II with the increased dietary fiber intake. The increased detection rate over time is higher in urban areas than in rural areas, and it corresponds to the distribution of dietary fiber intake. Birth cohort analysis suggests that right-sided diverticula is affected more by environmental factors than other types. Furthermore, the significant relationship of right-sided diverticula with intraluminal pressure in Japan is similar to that of left-sided diverticula in the West, and the pathological feature of these diverticula are similar. CONCLUSION: The etiology of right-sided diverticula in Japan (and perhaps also other Mongolian peoples) is very similar to that of left-sided diverticula in the West. The location may represent a difference in morphology of the large intestine between Mongolians (including Japanese), and Westerners, rather than environmental differences.

Age Distribution↗
PubMed2002

Trends in dietary fiber intake in Japan over the last century.

BACKGROUND: Insufficient intake of dietary fiber (DF) is currently a major problem in the overall promotion of health in the general population in Japan. AIM OF THE STUDY: To analyze the time trends in DF intake, including DF density (total DF intake/1,000 kcal), and the ratio of water-insoluble fiber to water-soluble fiber (IS ratio) in Japan. METHODS: The time trend in DF intake in Japan was calculated from data compiled in the Japanese National Nutrition Survey. RESULTS: The mean daily DF intake (total DF intake) in 1952 was 20.5 g/day, which rapidly declined to about 70 % of the 1952 level in 1970, after which there was little change to 1998. DF density in 1952 was 9.7 g/1000 kcal, which declined by about 30 % in 1970, and remained at about the same level to 1998. The IS ratio has remained stable over this period. Whereas total DF intake and DF density in Japan are similar to those in Western countries, the IS ratios are higher in Japan. Therefore, the higher incidence of, and mortality from, colon diverticulosis, coronary heart disease, hyperlipidemia, etc., which are all thought to be related to fiber deficiency, in Western countries compared to Japan might be due to the differences in the IS ratio. CONCLUSIONS: A decline in total DF intake and DF density is predicted for Japan in the future, because these parameters were lower among the younger generation. This may be due to the marked changes in the dietary habits of the younger generation, and is a problematic trend for Japanese health.

Adult↗
PubMedDate not supplied

The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.

BACKGROUND: There are wide variations in the clinical use of cryotherapy, and guidelines continue to be made on an empirical basis. STUDY DESIGN: Systematic review assessing the evidence base for cryotherapy in the treatment of acute soft-tissue injuries. METHODS: A computerized literature search, citation tracking, and hand searching were carried out up to April 2002. Eligible studies were randomized-controlled trials describing human subjects recovering from acute soft-tissue injuries and employing a cryotherapy treatment in isolation or in combination with other therapies. Two reviewers independently assessed the validity of included trials using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Twenty-two trials met the inclusion criteria. There was a mean PEDro score of 3.4 out of of 10. There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients. Few studies assessed the effectiveness of ice on closed soft-tissue injury, and there was no evidence of an optimal mode or duration of treatment. CONCLUSION: Many more high-quality trials are needed to provide evidence-based guidelines in the treatment of acute soft-tissue injuries.

Athletic Injuries↗