Established cardiovascular disease and CVD risk factors in a primary care population of middle-aged Irish men and women

Contemporary Irish data on the prevalence of major cardiovascular disease (CVD) risk factors are sparse. The primary aims of this study were (1) to estimate the prevalence of major cardiovascular disease risk factors, including Type 2 Diabetes Mellitus, in the general population of men and women between the ages of 50 and 69 years; and (2) to estimate the proportion of individuals in this age group at high absolute risk of cardiovascular disease events on the basis of pre-existing cardiovascular disease or as defined by the Framingham equation. Participants were drawn from the practice lists of 17 general practices in Cork and Kerry using stratified random sampling. A total of 1018 people attended for screening (490 men, 48%) from 1473 who were invited, a response rate of 69.1%. Cardiovascular disease risk factors and glucose intolerance are common in the population of men and women aged between 50 and 69 years. Almost half the participants were overweight and a further quarter met current international criteria for obesity, one of the highest recorded prevalence rates for obesity in a European population sample. Forty per cent of the population reported minimal levels of physical activity and 19% were current cigarette smokers. Approximately half the sample had blood pressure readings consistent with international criteria for the diagnosis of hypertension, but only 38% of these individuals were known to be hypertensive. Eighty per cent of the population sample had a cholesterol concentration in excess of 5 mmol/l. Almost 4% of the population had Type 2 Diabetes Mellitus, of whom 30% were previously undiagnosed. A total of 137 participants (13.5%) had a history or ECG findings consistent with established cardiovascular disease. Of the remaining 881 individuals in the primary prevention population, a total of 20 high-risk individuals (19 male) had a risk of a coronary heart disease event 30% over ten years according to the Framingham risk equation, giving an overall population prevalence of 2.0% (95% CI 1.3 - 3.0). At a risk level 20% over ten years, an additional 91 individuals (8.9%) were identified. Thus a total of 24.4% of the population were at risk either through pre-existing CVD (13.5%) or an estimated 10-year risk exceeding 20% according to the Framingham risk equation (10.9%). Thus a substantial proportion of middle-aged men are at high risk of CVD. The findings emphasise the scale of the CVD epidemic in Ireland and the need for ongoing monitoring of risk factors at the population level and the need to develop preventive strategies at both the clinical and societal level.

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Science Foundation Ireland (CSET - Centre for Science, Engineering and Technology, Grant No. 07/CE/11147)

Scientism and instrumentalism After the Bomb: Dr Strangelove, End Zone, Crash and The Wire

This thesis argues that through the prism of America’s Cold War, scientism has emerged as the metanarrative of the postnuclear age. The advent of the bomb brought about a new primacy for mechanical and hyperrational thinking in the corridors of power not just in terms of managing the bomb itself but diffusing this ideology throughout the culture in social sciences, economics and other such institutional systems. The human need to mitigate or ameliorate against the chaos of the universe lies at the heart of not just religious faith but in the desire for perfect control. Thus there has been a transference of power from religious faith to the apparent material power of science and technology and the terra firma these supposedly objective means supply. The Cold War, however was a highly ideologically charged opposition between the two superpowers, and the scientific methodology that sprang forth to manage the Cold War and the bomb, in the United States, was not an objective scientific system divorced from the paranoia and dogma but a system that assumed a radically fundamentalist idea of capitalism. This is apparent in the widespread diffusion of game theory throughout Western postindustrial institutions. The inquiry of the thesis thus examines the texts that engage and criticise American Cold War methodology, beginning with the nuclear moment, so to speak, and Dr Strangelove’s incisive satire of moral abdication to machine processes. Moving on chronologically, the thesis examines the diffusion of particular kinds of masculinity and sexuality in postnuclear culture in Crash and End Zone and finishing up its analysis with the ethnographic portrayal of a modern American city in The Wire. More than anything else, the thesis wishes to reveal to what extent this technocratic consciousness puts pressure on language and on binding narratives.