The HLA-DR antigen frequency in Northern Ireland compared to the frequency in Bristol, Edinburgh and Eire.
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England↗
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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↗
Nurse-patient communication skills in Northern Ireland--the educational problems.
Northern Ireland forms a discrete province within the U.K., with its own National Board (forming part of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting) and its own training syllabus. This study is an appraisal of the current state of teaching nurse-patient communication skills in the province's six colleges/schools of nursing. Questionnaire samples were taken and analysed from student nurses (251), nurse tutors (35) and clinical teachers (36) in order to: (i) elicit the specific responses of both students and teachers concerning their perceived value of teaching/learning communication skills and (ii) to establish the existing satisfaction/dissatisfaction levels within the province on the current teaching practice of these interpersonal skills.
Communication↗
Experiences of school bullying in Northern Ireland: data from the Life and Times Survey.
Little is known about the levels of bully/victim behaviors in schools in Northern Ireland. The aim of the present study was to supplement previous research findings from Northern Ireland by examining the self-reported experiences of school bullying among Northern Ireland children through data collected as part of the 1998 "Youth Life and Times Survey." A random sample of 397 12 to 17-year-olds living throughout Northern Ireland were interviewed during 1998 and 1999. As part of the larger survey, six questions were asked relating to experience of bullying behaviors and being a victim of such behaviors. The findings suggests that the incidence of school bullying in Northern Ireland may be higher than those found in the rest of Ireland and the United Kingdom. Furthermore, the data supplements previous findings among Northern Irish children employing alternate measures of bully/victim problems.
Adolescent↗
Awareness and control of hypertension and hypercholesterolaemia in France and Northern Ireland.
We assessed awareness and control of hypertension and hypercholesterolaemia in a cross-sectional study of 586 men from France and 189 from Northern Ireland, aged 35-55, without known coronary artery disease. Prevalence of hypertension was 28% in France and 31% in Northern Ireland (p < 0.42). In France, 70% of hypertensive subjects were aware of their status, vs. 58% in Northern Ireland (p < 0.10). Overall, 40% of subjects with a history of hypertension were untreated, and only 32% of the French and 12% of the Northern Irish subjects treated for hypertension (diet with/without drugs) were normotensive. The prevalence of hypercholesterolaemia was 46% in France and 48% in Northern Ireland (p < 0.62). In France, 59% of hypercholesterolaemic subjects were aware of their status, vs. only 17% in Northern Ireland (p < 0.0001). In both countries, half of those with a history of hypercholesterolaemia were untreated, and only 47% of the French and 43% of the Northern Irish patients treated for hypercholesterolaemia (diet with/without drugs) were controlled. While awareness of hypertension is comparable in France and Northern Ireland, awareness of hypercholesterolaemia is much lower in the latter. Control of hypertension and hypercholesterolaemia in both countries is poor and should be improved.
Adult↗
Epidemiology of bovine spongiform encephalopathy in Northern Ireland 1988 to 1995.
The epidemiology of bovine spongiform encephalopathy (BSE) in Northern Ireland from 1988, when it was first confirmed, to the end of 1995 is described. All cases of BSE were subjected to a detailed epidemiological investigation, complemented by data from the national animal health records on every bovine animal. Data are presented on 1680 cases. Many of the epidemiological features of the disease were similar to those reported in Great Britain, but the incidence in Northern Ireland was approximately one-tenth that in Great Britain. The epidemic increased to a peak of 56 cases per month in January 1994, and decreased to nine cases in December 1995. Statutory intervention banning the use of meat and bone meal in ruminant feed in January 1989 has produced a marked and continuing reduction in the incidence. The majority of the cases were in Northern Ireland cattle, but 83 cases were imported from Great Britain and five from the Republic of Ireland. Many of the key epidemiological features have remained constant throughout the epidemic: the greater incidence of BSE in dairy herds than in beef suckler herds, the low within-herd incidence, the variation in incidence with herd size, the breed distribution, the distribution of the reported clinical signs and the proportion of purchased cases. Although the source of the BSE epidemic in Northern Ireland has not been established conclusively, the evidence suggests that the importation of meat and bone meal and protein concentrates from Great Britain may have been responsible.
Animals↗
Incidence and site distribution of colorectal cancer in Northern Ireland.
Death rates from colorectal cancer in Northern Ireland are higher than in most of the rest of the United Kingdom. Although local surgeons have recognised this problem for some time it has remained unclear whether this reflects a greater underlying incidence or a worse mortality. We have reviewed all histological diagnoses of colorectal cancer in the province over a three year period and we report the incidence and site distribution for this disease in this population of one and a half million. With the exception of rectal cancer in females the incidence of colorectal cancer, whether histologically diagnosed or registered, is higher than in England, Wales or Scotland. The site distribution accords with that in other high risk countries. These results indicate that Northern Ireland has the highest underlying incidence of colorectal cancer in the United Kingdom.
Adult↗
Results from the 1995 survey of prevalent clinically diagnosed HIV infection in England, Wales, and Northern Ireland.
Health districts in England, Wales, and Northern Ireland were surveyed in 1996 to collect summary information about people with diagnosed HIV infection who received care under the statutory services in 1995. The survey provided demographic and epidemiological information about the prevalent caseload by area of residence, and the extent to which patients with diagnosed HIV infection travelled to obtain care related to it. A total of 13362 people with diagnosed HIV infection were reported to be resident and treated in England, Wales, or Northern Ireland in 1995. Forty-four per cent of these were treated outside the health district where they lived, with regional specialist centres attracting patients from wider areas. At least 13% received care from more than one treatment centre. This national survey of prevalent diagnosed HIV infections provided public health specialists with information relevant to their own localities without compromising confidentiality. This information complements surveillance data from confidential AIDS case diagnosis reports, laboratory reports of HIV infections, and the unlinked anonymous HIV prevalence monitoring programme, all of which contribute to the assessment and projection of demands on health and social services, and provide evidence on which to develop and direct national and local health campaigns.
England↗
Cardiac pacing in Northern Ireland 1979-1988.
The implantation rate of cardiac pacemakers in Northern Ireland rose from 55.8 per million population in 1979 to over 180 per million in 1988, with the emergence of a second pacemaker implantation centre. However, the implantation rate in Northern Ireland remains less than that of many other countries. Over the period complete heart block fell as an indication from 45% to 34% and sinus node disease rose from 16% to 28%. Symptoms necessitating pacing remained unchanged, syncope being the most common. Ventricular demand pacemakers constituted a lower proportion of implants than anywhere else in the world and more atrial demand and dual chamber pacemakers were implanted than in most other countries. Insufficient patients are being referred for pacing in Northern Ireland but a high proportion of those who are referred receive modern sophisticated pacemakers.
Heart Diseases↗
Frequency of fruit and vegetable consumption and coronary heart disease in France and Northern Ireland: the PRIME study.
Fruit and vegetable consumption is associated with low CHD risk in the USA and Northern Europe. There is, in contrast, little information about these associations in other regions of Europe. The goal of the present study was to assess the relationship between frequency of fruit and vegetable intake and CHD risk in two European populations with contrasting cardiovascular incidence rates; France and Northern Ireland. The present prospective study was in men aged 50-59 years, free of CHD, who were recruited in France (n 5982) and Northern Ireland (n 2105). Fruit and vegetable intake was assessed by a food-frequency questionnaire. Incident cases of acute coronary events and angina were recorded over a 5-year follow-up. During follow-up there was a total of 249 ischaemic events. After adjustment on education level, smoking, physical activity, alcohol consumption, employment status, BMI, blood pressure, serum total and HDL-cholesterol, the relative risks (RR) of acute coronary events were 0.67 (95% CI 0.44, 1.03) and 0.64 (95% CI 0.41, 0.99) in the 2nd and 3rd tertiles of citrus fruit consumption, respectively (P for trend <0.03). Similar results were observed in France and Northern Ireland. In contrast, the RR of acute coronary events for 'other fruit' consumption were 0.70 (95% CI 0.31, 1.56) and 0.52 (95% CI 0.24, 1.14) respectively in Northern Ireland (trend P<0.05) and 1.29 (95% CI 0.69, 2.4) and 1.15 (95% CI 0.68, 1.94) in France (trend P=0.5; interaction P<0.04). There was no evidence for any association between vegetable intake and total CHD events. In conclusion, frequency of citrus fruit, but not other fruits, intake is associated with lower rates of acute coronary events in both France and Northern Ireland, suggesting that geographical or related factors might affect the relationship between fruit consumption and CHD risk.
Acute Disease↗
Distribution of properdin factor B and glyoxalase I (further genetic markers) in Northern Ireland.
The normal distribution in Northern Ireland of the genetic markers properdin factor B (Bf) and glyoxalase I (GLO) are described. These markers are available for comparison in disease studies, family studies and paternity studies.
Complement Factor B↗
Substance abuse in pregnancy: opioid substitution in a northern Ireland maternity unit.
An increase in illicit drug use in Northern Ireland may well have links to the resolution of political conflict, which started in the mid 1990s. Social issues, heretofore hidden, have emerged into the limelight and may be worsened by paramilitary involvement. Registered addicts in the four Health Board areas have shown an increase from 1997 with the greatest number resident within the Northern Board Area. As the prevalence of heroin use in Northern Ireland increased, the Department of Health and Social Services and Public Safety (DHSSPS) commissioned a report, to recommend the development of substitute prescribing services. A case series of pregnancies was reviewed, within the Northern Board Area, where the mother was taking opioid substitution therapy. This resulted in baseline data of outcome for both mother and baby specific to a Northern Ireland population. The different medications for opioid substitution are also assessed. This information will guide a co-ordinated approach that involves obstetrician, anaesthetist, psychiatrist, midwife and social worker to the care of these high-risk pregnancies. Eighteen pregnancies were identified in the study period. Sixteen of these had viable outcomes. One was a twin pregnancy. Outcome data was therefore available for 17 infants. Information was obtained regarding patients' social and demographic background, drug taking behaviour and substitution regimen. Antenatal and intrapartum care was assessed and infants were followed up to the time of hospital discharge.
Adult↗
The role of the community pharmacist in drug abuse: a comparison of service provision between Northern Ireland and England/Wales.
AIM: The aim of the present research was to establish the current extent of pharmacists' contact with illicit drug users in Northern Ireland, their willingness to provide services for this group and to compare the findings with data from a 1995 national survey of community pharmacies in England and Wales. METHOD: The questionnaire developed by the National Addiction Centre for research in England/Wales was used to collect data. It was mailed on two occasions (March and April 1999) together with a covering letter and a prepaid return envelope to all community pharmacies in Northern Ireland (n = 507). A final reminder letter was included in the local wholesalers' medical delivery for the attention of the pharmacist in May 1999. MAIN OUTCOME MEASURE: The extent to which Northern Ireland pharmacists had contact with and provided services to illicit drug users compared to pharmacists in England/Wales. RESULTS: A response rate of 67.5% was achieved. Respondents in Northern Ireland were providing fewer services to drug users than those in England/Wales. Respondents reported dispensing methadone for the treatment of addiction/misuse to only 9 patients, while only 17 pharmacists had been asked to sell injecting equipment in the previous week and no pharmacist was participating in a needle exchange scheme. However, most respondents indicated their willingness to provide such services. Barriers towards the provision of services were, however, highlighted e.g. the need for training and the establishment of support systems. CONCLUSION: Pharmacists in Northern Ireland are in a position to contribute to the policy agenda in Northern Ireland for drug misuse, prevention, treatment and harm minimisation--roles which the survey indicates they are willing to embrace. However, training programmes, support systems and adequate remuneration packages must be established before they will be in a position to participate fully.
England↗
An audit of tumour marker requests in Northern Ireland.
BACKGROUND: An audit of tumour marker requests was carried out in Northern Ireland. The aims were to establish the extent of inappropriate requesting, to effect change in request practice if required, and to standardize laboratory reports for tumour markers. METHODS: A baseline audit was conducted to investigate the appropriateness of tumour marker requesting patterns in Northern Ireland. Information booklets containing guidelines for tumour markers were then distributed to all clinicians and a post-intervention audit was carried out. RESULTS: At baseline, 80% of requests for tumour markers were appropriate for the source of the tumour; however, 54% of clinicians used tumour markers to screen for malignancy and there was a low index of suspicion in 35% of these. Requests for more than two tumour markers were received for 5% of request forms. The post-intervention survey showed no change in requesting practice. Comments were returned by requestors for 55% of questionnaires. They appeared to be appropriate in 72% of cases. CONCLUSIONS: There is a low level of inappropriate requesting of tumour markers in Northern Ireland. Audit and feedback combined with circulation of guidelines were unsuccessful interventions in improving the appropriateness of request practice for these tests.
Biomarkers, Tumor↗
Risk behaviors among injecting drug users in Northern Ireland.
Compared to elsewhere in the United Kingdom, drug policy in Northern Ireland has for the most part failed to incorporate harm reduction strategies. In light of the conservative drug policies, the purpose of this study was to investigate the nature and extent of risk behaviors among injecting drug users (IDUs) in Northern Ireland. Data for this study were drawn from in-depth interviews with 39 IDUs in Northern Ireland. The findings suggest that most IDUs engage in extensive risk behaviors that pose risk for HIV, Hepatitis B and C. and other infectious disease. Moreover, these risk behaviors are linked to the scarcity of new needles and a general lack of knowledge about injection practices that reduce risk for infectious disease. These findings are discussed in the context of conservative drug policies.
Acquired Immunodeficiency Syndrome↗
Restriction endonuclease analysis of Aujeszky's disease (pseudorabies) virus DNA: comparison of Northern Ireland isolates and isolates from other countries.
Aujeszky's disease (AD; pseudorabies) viruses isolated in Northern Ireland over a 20 year period were compared with isolates from other parts of the world using restriction endonuclease analysis of virus DNA. When the numbers of Bam H1, Kpn 1 and Sal 1 restriction sites were considered, pathogenic Northern Ireland isolates resembled viruses isolated in England, Hungary and the U.S.A. and could be differentiated from viruses isolated in Denmark, Belgium and the Netherlands. The avirulent Northern Ireland isolate NIA4 and the Bartha vaccine strain were very similar to each other and could be distinguished from pathogenic isolates. While almost all the pathogenic viruses isolated in Northern Ireland from 1963 to 1983 appeared to possess the same number of restriction sites none of the viruses, even those made at the same farm during one outbreak of infection, were identical. The differences were confined to variation in the sizes of certain fragments which map in "variable" regions of the genome.
Base Sequence↗
Prevalence of Arcobacter spp. in raw milk and retail raw meats in Northern Ireland.
A 1-year study was undertaken to determine the prevalence of Arcobacter spp. in raw milk and retail raw meats on sale in Northern Ireland. Retail raw poultry samples (n = 94), pork samples (n = 101), and beef samples (n = 108) were obtained from supermarkets in Northern Ireland, and raw milk samples (n = 101) were kindly provided by the Milk Research Laboratory, Department of Agriculture and Rural Development, Belfast, Northern Ireland. Presumptive arcobacters were identified by previously described genus-specific and species-specific PCR assays. Arcobacter spp. were found to be common contaminants of retail raw meats and raw milk in Northern Ireland. Poultry meat (62%) had the highest prevalence, but frequent isolations were made from pork (35%), beef (34%), and raw milk (46%). Arcobacter butzleri was the predominant species isolated from retail raw meats and was the only species isolated from raw milk samples. Arcobacter cryaerophilus was detected less frequently, and Arcobacter skirrowii was detected only as a cocontaminant. To our knowledge, this is the first report of Arcobacter spp. prevalence in a diverse range of products of animal origin in Northern Ireland.
Animals↗
A survey of diabetes care in general practice in Northern Ireland.
We aimed to describe some key features of diabetes care carried out in primary care settings in Northern Ireland using a descriptive postal questionnaire survey sent to every general practice in Northern Ireland. 252 (70%) of practices responded. Of these 92% of practices have active registers of people with diabetes, identifying 1.9% of their population as having diabetes and 85% of practices use these registers for call/recall visits. Seventy five per cent of practices held diabetes clinics run by the general practitioner and nurse (63%) or a nurse alone (32%). Only 47% of practices felt they received adequate support from the acute diabetes team; with 29% meeting with them this team regularly and only 19% having a shared care protocol. Overall practices provided most of the routine care for 60% of their diabetic patients. The majority of GPs and practice nurses had received some diabetes education in the previous year. There has been a considerable change in the delivery of routine diabetes care in Northern Ireland. A large proportion of diabetes care now takes place in the community, much of it delivered by practice nurses. The organisational infrastructure necessary for the delivery of care is in place. Many practices have special interest in diabetes but the survey highlights a need for better communication and cooperation with secondary care. General practitioners recognise their educational needs in diabetes. They should also be aware of their practice nurses' needs, which should be addressed. There should be initiatives to improve the primary-secondary care interface in Northern Ireland.
Continuity of Patient Care↗