Sexual problems and their management: a survey of general practice in Northern Ireland

This survey suggests a similar prevalence of sexual problems in general practice in Northern Ireland compared with England and Wales. Of the respondents, 9.6% reported a much higher prevalence which may indicate a greater ability in detecting sexual problems and therefore implies that many cases are being missed. The majority of problems appear to be dealt with in general practice, although referral is often considered, with the Psychosexual Clinic being the preferred option. Difficulties encountered with referral are highlighted by the survey. It is suggested that provision of more information about the clinic, visits by therapists to practices and further training opportunities would help general practitioners in managing sexual problems.     

Schizophrenia in general practice: a national survey of general practitioners in Ireland

Background  

Chronic schizophrenia is challenging to manage in primary care.     

A survey of exercise based cardiac rehabilitation services in Northern Ireland.

A survey was undertaken to establish the extent of provision of phase III exercise-based cardiac rehabilitation in Northern Ireland. Detailed information was obtained on patient referral mechanisms, patient assessment, the exercise component of cardiac rehabilitation and the use of outcome measures. The results suggest that cardiac rehabilitation in Northern Ireland has developed on an ad hoc basis, and although most centres accept myocardial infarction and coronary artery bypass graft patients for cardiac rehabilitation, higher risk patients are generally excluded from these programmes. Currently, little in the way of standard outcome measures are being used to evaluate the effectiveness of existing cardiac rehabilitation services. This paper makes several recommendations to facilitate the development of a more standardised service within Northern Ireland.     

Drugs taken by mothers in the puerperium: inpatient survey in Northern Ireland

In an inpatient survey the medication records of 2004 mothers both breast and bottle feeding were examined and the drugs taken in the early postnatal period recorded. No notable differences existed between the types of drugs prescribed for breast feeding and bottle feeding mothers. Iron, vitamins, and mild analgesics were taken routinely by the population, and antibiotics, laxatives, and hypnotics were frequently prescribed. A wide range of other drugs and preparations were taken or used. Although data were available for some of the drugs, there were many whose concentrations in breast milk and potential risk to the suckling infant were unknown. Data are urgently required on hypnotics, narcotic analgesics, antiemetics, antihistaminics, and some antimicrobial agents with respect to their concentrations in breast milk and their safety for the suckling infant.     

Childhood circumcision in Northern Ireland: a barometer of the current practice of general paediatric surgery

Purpose:

Studies undertaken in England and Scotland have identified a decrease in the number of circumcision operations being performed during childhood. The aims of this study were two-fold. Firstly, to determine the trend in circumcision operations performed in boys in Northern Ireland over a ten year period. Secondly, to compare the number of operations performed by paediatric surgeons with the number performed by general surgeons over the same period.

Method:

Data were collected from the Northern Ireland Department of Health and Social Services and Public Safety. A retrospective analysis was conducted of the number of circumcisions performed in boys aged between 0 and 13 years for the year beginning 1^st September 1991 to the 1^st of September 1992 and for the year beginning 1^st September 2001 until the 1^st of September 2002.

Results:

769 circumcisions were performed in the year 1991 to 1992 compared with 264 in the year 2001 to 2002, representing a 66% decrease. In the ten year study period, the number of circumcisions performed by general surgeons fell by 71% whilst specialist paediatric surgeons performed 56% less.

Conclusions:

The decrease in rates of circumcision in boys aged 0 to 13 years in Northern Ireland is consistent with trends in the remainder of the United Kingdom. The results also suggest a greater decrease in the proportion of circumcisions being performed by general surgeons in district general hospitals compared to those performed by paediatric surgeons.     

Prophylactic oophorectomy in Northern Ireland.

A postal questionnaire was sent to all gynaecological consultants and senior registrars (n = 50) in Northern Ireland to establish the prevalence of prophylactic oophorectomy. Forty three (84%) replied. 72% performed prophylactic oophorectomy (28% unilateral), 28% did not. With reference to the world literature, there appears to be no benefit from the unilateral procedure but a consensus that bilateral oophorectomy is an option which should be considered in certain cases where there is a high risk of ovarian cancer.     

Home ventilation in Northern Ireland.

Thirteen patients were identified as receiving assisted ventilation at home in Northern Ireland in 1994. Two patients have since died. An increasing number of patients are starting home ventilation, especially by nasal mask. Recognition of the needs of these patients and provision of care require further consideration.     

Visual impairment in Northern Ireland.

Statistics on the registration of blind and partially-sighted patients in Northern Ireland underestimate the true extent of visual impairment within our community. In comparison to other UK regions, where between 0.53% and 0.59% of the population avail of blind or partial sight registration, only 0.35% of residents in Northern Ireland appear on the respective registers. Most patients on the combined registers are in the older age groups and many also suffer from other disabilities. Regional discrepancies may be attributed to a combination of factors including: patient attitudes to the registration process, medical attitudes to registration and local anomalies in the way in which social services departments both record and present annual registration returns. Better liaison is necessary between the community, hospital and voluntary sector providers to improve identification and support services for the visually impaired in the future.     

Post-transfusion hepatitis: a problem in Northern Ireland?

A retrospective analysis of post-transfusion hepatitis reported to us from 1980 through 1984 revealed 16 patients. We believe that this apparently low incidence is due to lack of notification and make a case for direct notification to us of any suspected cases. Disqualification of implicated blood donors is of prime importance in prevention of transfusion-associated hepatitis.     

Cancer in Northern Ireland by 2002.

An estimate of cancer deaths and incidence for the years 1997 and 2002, taking account of current trends and population projections for Northern Ireland is presented below. These numbers will be of value to those planning services and, in particular, for those implementing the report "Cancer Services - Investing for the Future". Cancer deaths are expected to rise by almost 13% to 4056 by the year 2002. Marked rises are expected in the number of deaths from cancer of the lung, oesophagus, kidney, bladder and prostate with smaller rises in deaths from breast and pancreatic cancer. The fall in stomach cancer is expected to continue as is the trend of lower deaths from cervical cancer. Deaths from cancer of the colon and rectum are expected to remain static. Estimates of cancer incidence currently and for the years 1997 and 2002 are also included. The impact of tobacco use by the population, which poses a current and future serious threat to public health is highlighted.     

Hereditary breast cancer in Northern Ireland.

The aim of this investigation was to document hereditary breast cancer in Northern Ireland. Family history details from over nine hundred women were obtained by postal survey and one hundred and twenty nine home visits were carried out to collect pedigree information. The families documented varied in the number of affected women from three, which was the minimum criteria for inclusion, to a maximum of nine and many families described other features of hereditary disease such as bilateral breast cancer, ovarian and gastrointestinal malignancies.