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PubMed1995

Transplantation for chronic pulmonary disease: referral and outcome in Northern Ireland, 1986-1990.

Eighteen patients have been referred for lung transplantations from Northern Ireland in 1986-1990. Fourteen were accepted but only four achieved transplantation. These rates are lower than for comparable regions in the North of England. The lung donation rate from Northern Ireland during the same period was similar to that for the United Kingdom as a whole. The low referral and transplant rates for Northern Ireland require reassessment of the procedures involved.

Heart-Lung Transplantation↗

PubMed2001

Social mobility and constitutional and political preferences in Northern Ireland.

During the past thirty years Catholics in Northern Ireland have experienced unprecedented upward social mobility. Some commentators have suggested that this has led Catholics not merely to adopt the lifestyles of the middle class but also to modify their constitutional preferences, leading to a decline in nationalism. In this paper I examine the relationship between social mobility, on the one hand, and, on the other, both constitutional preferences and political (left or right wing) preferences among Catholics and Protestants in Northern Ireland, using survey data collected in 1996. There is no evidence that Catholics' constitutional preferences are related to their mobility experiences.

Choice Behavior↗

PubMedDate not supplied

Patterns of Catholic-Protestant intermarriage in Northern Ireland.

"Some of the social factors governing the incidence of religious intermarriage in Northern Ireland are reviewed before setting out data from a special tabulation of the 1971 census of Northern Ireland. According to the tabulation only some 2% of married couples enumerated declared themselves to be in Catholic-Protestant marriages....The tabulation suggests that the likelihood of marriage across the Catholic-Protestant divide is no greater for manual workers than for nonmanual workers when controls are introduced for relative group size.... There are indications that the incidence of Catholic-Protestant marriage was rising in Northern Ireland in the late 1960s."

Catholicism↗

PubMed2005

The epidemiology of peritonsillar abscess disease in Northern Ireland.

OBJECTIVES: 1. To describe the epidemiology of peritonsillar abscess disease in Northern Ireland. 2. To describe the impact of the nature of microbiological sampling on culture results. METHOD: Retrospective review of cases of peritonsillar abscess identified by diagnostic coding in three centres in Northern Ireland between August 2001 and July 2002. RESULTS: One hundred and twenty eight cases of confirmed peritonsillar abscess were treated as inpatients accounting for 1 in 10,000/year of the population in the hospitals' catchment area. The mean age was 26.4 (range 9-78) years. Sixty-nine patients were male; the mean length of hospital stay was 3 days. Culture yield was greatest from needle aspirates; throat swabs and blood cultures were typically unhelpful. Beta haemolytic streptococci were the most common isolates. Resistance among Group A haemolytic streptococci to macrolide antibiotics was present in 26% of isolates. Heterophile antibody testing was routine and revealed that Epstein-Barr virus infectious mononucleosis had a prevalence of 1.8% in this group of patients. CONCLUSION: In this population, although there were many similarities with the clinical features reported by other investigators, there were also several differences. Notably, we found a comparatively low proportion of anaerobic infections. Although cultures results did not influence individual patient treatment, reviewing data derived from populations is valuable for guiding empirical antibiotic therapy. SUMMARY: The epidemiology of peritonsillar abscess disease is not well described. Other investigators describing the bacteriology give differing results, presumably reflecting different countries and techniques. The need for routine microbiological testing has been questioned in several reports, but the benefit of routine culture and sensitivity data for planning empirical antibiotic treatment has not been explored. We present a retrospective review of 128 cases of confirmed peritonsillar abscess in Northern Ireland from August 2001 to July 2002. The annual population incidence in this region is 1 in 10,000/year. In this group concurrent Epstein-Barr virus infection was found to have a prevalence of 1.8%. The yield of positive cultures from routine microbiological sampling was low in comparison to that reported in detailed prospective studies, from various countries. Needle aspiration was the best technique for obtaining pus for culture; throat swabs and blood cultures were unhelpful. Culture results did not affect individual patient treatment, but may have a potentially useful role for selecting empirical therapy.

Adolescent↗

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↗

PubMed1999

Asbestos related mortality in Northern Ireland: 1985-1994.

BACKGROUND: The association between Belfast and research into the hazardous effects of asbestos exposure goes back many years. This paper aims to update previous papers and review the burden of asbestos related disease in Northern Ireland today. METHODS: A study was carried out of all deaths in Northern Ireland between 1985 and 1994 inclusive, in which an asbestos related disease was mentioned anywhere on the death certificate. RESULTS: During this 10 year period, 527 asbestos related deaths were recorded; 88 per cent of these were in men. A total of 410 (77.8 per cent) were registered as the primary cause of death but only 405 (76.9 per cent) of cases were the subject of an autopsy. Standardized rates of pleural cancer in males have been increasing at 3.2 per cent per year though the trend was not significant. Lower rates in the last two years may herald the commencement of a decline. Deaths were clustered around the Belfast estuary, the site of Northern Ireland's shipbuilding industry. High proportional mortality ratios were demonstrated for occupations associated with the shipbuilding and construction industries. Evidence is presented that casts doubt on the attribution of peritoneal cancers in females to asbestos exposure. If lung cancers are included, there may be an average of 81 asbestos related deaths in Northern Ireland every year. CONCLUSION: Asbestos related diseases continue to extract a heavy burden of ill health in Northern Ireland today. There are some indications that the upward trend may be on the wane but confirmation of this will have to await further data. Measures to reduce exposure in the workplace to both asbestos and to tobacco smoke are the only means of reducing this burden.

Aged↗

PubMed1994

Gynaecologists and abortion in Northern Ireland.

The evidence from gynaecologists in Northern Ireland shows confusion in interpretation and practice of abortion law, with some women even being denied abortion after rape. Over two-thirds of gynaecologists supported a change in the law which would leave the abortion decision to the woman and her doctor, but less than half wanted the introduction of the British law.

Abortion, Legal↗

PubMed1982

The flax industry in Northern Ireland twenty years on.

In 1961-62 a survey of respiratory symptoms in 2528 workers in flax mills in Northern Ireland and of dust levels in the mills was conducted. The workers were followed up in 1978, because recent developments suggested that an upturn in the industry was likely. Flax dust has an acute, reversible effect on the respiratory system, and byssinosis is a prescribed disease under the Industrial Injuries Act (1965). However, the follow-up study found no evidence of an effect on survival of either exposure to dust or byssinosis. The number of applications to compensation panels for assessment and certification of byssinosis has increased greatly in Northern Ireland. Although certification is independent of any subsequent common law claim by a worker for compensation on the grounds of disablement consequent on negligence by his employer, it must weight heavily in such a claim. About 50 common law claims have been settled out of court for large sums in Northern Ireland, and 950 claims are waiting to be heard. The future cost to the industry is estimated to be at least 16 million pounds. Since byssinosis appears not to cause excess mortality, it is unlikely to cause serious long-term morbidity. Although workers should be compensated for disablement due to negligence, in the absence of unequivocal evidence of disablement caused by byssinosis the financial settlements being reached in Northern Ireland seem unreasonable.

Byssinosis↗

PubMed2003

Does integration really make a difference? A comparison of old age psychiatry services in England and Northern Ireland.

OBJECTIVE: This paper seeks to address whether integrated structures are associated with more integrated forms of service. Northern Ireland has one of the most structurally integrated and comprehensive models of health and personal social services in Europe. Social and health services are jointly administered and this arrangement should, in theory, promote collaborative working and interdisciplinary arrangements. DESIGN: The study employed a cross-sectional survey of consultants in old age psychiatry in England and Northern Ireland. Potential respondents were sourced from the UK Royal College of Psychiatrists membership list and locally collected information. MEASURES: A self-administered postal questionnaire. Along with general service arrangements, the domains measured reflect core policy issues for older people's services. Under particular scrutiny in this study were the degree of integration of health and social service provision, as well as inter-professional team working. RESULTS: The integrated health and social care services in Northern Ireland do appear to provide more integrated patterns of working, primarily in managerial arrangements and in the location of staff. There was no evidence of the impact of integration on practice in areas such as: assessment, referral and medical screening. The factors found to be associated with greater integration of health and social care in the prediction model fell into three categories: provision of specialist services; provision of outreach activities; and shared policies by which the whole team worked. CONCLUSIONS: Health and personal social services in Northern Ireland have a distinct advantage over their counterparts in comparable areas of England. The results indicate that integrated structures in old age psychiatry services are associated more with integrated management systems and less with integrated practice-related activities. Further research is required on the effectiveness and cost effectiveness of integrating services in general. It is important that future intervention studies systematically measure the component parts, nature and extent of integration and their individual and joint contribution to the effectiveness and efficacy of services.

Aged↗

PubMed2003

Plasma fibrinogen explains much of the difference in risk of coronary heart disease between France and Northern Ireland. The PRIME study.

The incidence of coronary heart disease is higher in Northern Ireland than in France. These differences have not been adequately explained. We have investigated the associations of plasma fibrinogen concentration and factor VII activity with the incidence of coronary heart disease in a prospective cohort study involving 10600 men aged 50-59 living in four regions (Lille, Strasbourg, and Toulouse in France, Belfast in Northern Ireland). Baseline fibrinogen and factor VII were measured in 9489 men free of coronary heart disease at entry (7167 in France and 2322 in Northern Ireland). Over 5 years of follow-up, 161 participants developed myocardial infarction (MI) or coronary death (100 in France and 61 in Belfast) and 151 developed angina pectoris (94 in France and 57 in Belfast). The risk of future coronary events was 1.9 times higher in Belfast than in France (95% confidence interval: 1.5-2.4). Baseline mean levels of fibrinogen were significantly higher in Belfast than in France and they were higher in participants who experienced coronary events compared with those who did not in both countries. The age-adjusted relative risk of coronary heart disease associated with a rise of one standard deviation in fibrinogen level was 1.56 (95% confidence interval: 1.29-1.95, P<0.0001) in the whole cohort. This association remained significant after adjustment for other cardiovascular risk factors (relative risk:1.36; 95% confidence interval: 1.14-1.68; P<0.0001). There was no clear geographical variation in factor VII and no significant association between factor VII levels and the risk of coronary events was observed. Classic risk factors explained 25% of the excess risk of coronary heart disease in Belfast compared with France, while fibrinogen alone accounted for 30%. These findings add to the epidemiological evidence that elevated fibrinogen is a major risk factor for coronary heart disease.

Coronary Disease↗

PubMed1986

Therapeutic traditions in Northern Ireland, Norway and Sweden: II. Hypertension. WHO Drug Utilization Research Group (DURG).

A questionnaire survey based on hypertension case histories was performed among a representative sample of 400 GP's and hospital doctors in Northern Ireland, Norway and Sweden, countries having markedly different utilization of antihypertensive drugs. We found a greater propensity to start antihypertensive drug treatment in Northern Ireland than in Norway and Sweden. This was true both in mild diastolic and isolated systolic hypertension. Yet the utilization of antihypertensive drugs in Sweden is about 60% higher than in Northern Ireland and 30% higher than in Norway. Swedish physicians preferred beta-blockers as their first choice to a greater extent than physicians in Northern Ireland and Norway who selected thiazides more often. In general, the choice of drugs agreed with the sales and prescribing patterns in the three countries. Besides providing more insight in therapeutic traditions the study indicates that the lower prescribing of antihypertensive drugs in Northern Ireland, and to some extent in Norway, compared to Sweden, might be due to differences in true or apparent morbidity.

Antihypertensive Agents↗

PubMed1997

Mental disorders and suicide in Northern Ireland.

BACKGROUND: The aim of this part of the Northern Ireland Suicide Study was to investigate the prevalence of DSM-III-R axis I (clinical syndrome) and axis II (personality) disorders among suicides (14 years and older) in Northern Ireland during a one-year period. METHOD: A psychological autopsy study based on a variety of documentary sources and interviews with bereaved informants and health care professionals. RESULTS: Ninety per cent of suicides (106/118) had a current axis I and/or an axis II mental disorder. At least one current axis I disorder was diagnosed in 86% of suicides (102/118), and at least one axis II disorder was diagnosed in 44% (52/118). Suicides under 30 years (92% male) were less likely to have a current axis I disorder (68%; 26/38) than those 30 years and older (95%; 76/80). Psychiatric comorbidity was present in 55% of suicides (65/118). The time between the last contact with a health care professional and death was greater among suicides under 30 years and male suicides. CONCLUSIONS: Notwithstanding the aetiological complexity of suicide, the prevention, recognition and treatment of mental disorder will continue to play key roles in suicide prevention.

Adolescent↗

PubMed1980

Death anxiety among university students in Northern Ireland and Canada.

Male and female university students in Northern Ireland (n = 315) and Canada (n = 255) completed Templer's Death Anxiety Scale (DAS) and the Taylor Manifest Anxiety Scale (MAS). Results of a discriminant function analysis indicated that Canadian students showed more concern about being afraid to die and thoughts of death, while students from the North of Ireland were more concerned about getting cancer, the shortness of life, and the viewing of a corpse. However, total DAS scores failed to show significance between group differences (p greater than .10). Correlations between DAS and MAS total scores were r = .34 for Northern Ireland and r = .31 for Canadian students.

Adult↗

PubMed1991

Trends in the methods used for suicide in Northern Ireland.

As domestic gas was made less toxic in Northern Ireland during the period 1960-1988, it was used less often for suicide. During the same period, as car ownership increased, the use of car exhaust for suicide increased in popularity without there being a corresponding decrease in the use of other methods. Part of the temporal variation in suicide rates in Northern Ireland may be accounted for by the relative availability of lethal methods for suicide.

Data Collection↗

PubMed1994

A case-control investigation of perinatal risk factors for childhood IDDM in Northern Ireland and Scotland.

OBJECTIVE: To identify perinatal risk factors for childhood insulin-dependent diabetes mellitus (IDDM) and determine if they differ between early-onset and late-onset disease. RESEARCH DESIGN AND METHODS: We selected 258 diabetic children in Northern Ireland and 271 diabetic children in Scotland from population-based registers. For each diabetic child, five matched control subjects were drawn from the same population. All perinatal data were recorded routinely at birth. Odds ratios (ORs) were estimated for parental age, social class, breast-feeding, deprivation measures, and other perinatal variables. RESULTS: Scottish data indicated an increased risk among children born to older mothers (OR = 2.43, 95% confidence interval [CI] 1.49-3.97 for mothers > or = 35 years of age relative to those < 25 years of age). Northern Ireland data showed no such effect. Only Northern Ireland data showed an excess risk in children of professional or managerial families (OR = 1.51, 95% CI 1.11-2.04). A small but nonsignificant reduction in risk among breast-fed children was observed only after adjustment for social class (OR = 0.76, 95% CI 0.54-1.07). Deprivation measures were associated with reductions in risk. Children delivered by cesarean section were at increased risk in both Northern Ireland (OR = 1.66, 95% CI 1.10-2.50) and Scottish (OR = 1.70, 95% CI 1.12-2.59) data. In Northern Ireland data only, children of first pregnancies were at increased risk (OR = 1.41, 95% CI 1.03-1.93). Both data sets indicated that a first pregnancy was a more important risk factor for early-onset disease than for late-onset disease. CONCLUSIONS: Many reported risk factors are weak and show inconsistencies between studies. They may be secondary to more direct, as-yet-undiscovered risk factors. Although irrelevant in the majority of cases, the increased risk associated with delivery by cesarean section deserves further study.

Adult↗

PubMed1992

A comparison of community care of elderly people in Wales and Northern Ireland.

This study compares the provision of community services for elderly people in Wales and Northern Ireland using data from two independent surveys. Despite sampling and definitional problems, certain interesting comparisons can be obtained. In general, elderly people in the Northern Ireland sample seem more likely to be dependent and more disabled than those in Wales. Northern Ireland people receive less help, but the help given is more likely to be from statutory services than in Wales; in many cases statutory help is the sole source of support. Further, in Wales there is more specialized care for very disabled elderly people living in the community, and the work is more likely to be shared by carers and the statutory services. There is however still considerable unmet need in both countries. A comparative study using common definitions and methods would be of considerable interest in relation to the debate concerning the relative shares of health care resources in the United Kingdom.

Aged↗

PubMed2006

Genotypes and subtypes of Cryptosporidium spp. in neonatal calves in Northern Ireland.

Cryptosporidium spp. in diarrheic calves less than 30 days old from farms across Northern Ireland were examined over a year period by microscopic, genotyping, and subtyping techniques to characterize the transmission dynamics. Cryptosporidium oocysts were detected in 291 of 779 (37.4%) animals. The prevalence rates of rotavirus, coronavirus, and Escherichia coli K99+ were lower as seen in 242 of 806 (30.0%), 46/806 (5.7%), and 16/421 (3.8%) of animals, respectively. Of the 224 Cryptosporidium-positive specimens available for molecular analysis, Cryptosporidium parvum was identified in 213 (95.1%) specimens, Cryptosporidium bovis in eight (3.6%), and Cryptosporidium deer-like genotype in three (1.3%). Sequence analysis of the 60-kDa glycoprotein gene identified 16 IIa subtypes and a new subtype family, with 120 of the 216 (55.6%) positive specimens having the subtype IIaA18G3R1. Eight of the IIa subtypes were previously seen in humans in Northern Ireland. Several subtypes were temporally or geographically unique. The genetic diversity in calves in Northern Ireland was much greater than that reported from other areas. This work demonstrates the utility of genotyping and subtyping tools in characterizing the transmission of Cryptosporidium spp. in calves and humans.

Animals↗

PubMed1984

The impact of political violence on mild psychiatric morbidity in northern Ireland.

Evidence concerning the impact of the violence in Northern Ireland on psychiatric morbidity is limited to studies examining admission rates and psychotropic drug prescribing rates; their results varied from suggesting no effect to indicating that greater levels of violence are actually equated with higher levels of mental health. The present study is the first to use a community sample, in which respondents (797) from two towns, which have experienced contrasting levels of violence over the last ten years, completed the 30-item version of the General Health Questionnaire (GHQ), and also indicated their perception of the level of violence in their area and how safe they felt this was to live in. Those who lived in the more violent town scored higher on the GHQ, as did women compared to men and those who perceived that their area had experienced more violence. There was also a two-way interaction, such that the small number of people, who perceived much violence in their area and who also lived in the more violent town, scored more highly on the GHQ. It is possible that the majority of people in Northern Ireland deal effectively with stress generated by the political violence, but do so by denying the existence of this violence around them.

Adult↗