Selective migration from deprived areas in Northern Ireland and the spatial distribution of inequalities: implications for monitoring health and inequalities in health

Much of the evidence suggesting that inequalities in health have been increasing over the last two decades has come from studies that compared the changes in relative health status of areas over time. Such studies ignore the movement of people between areas. This paper examines the population movement between small areas in Northern Ireland in the year prior to the 1991 census as well as the geographical distribution of migrants to Northern Ireland over the same period. It shows that deprived areas tended to become depopulated and that those who left these areas were the more affluent residents. While immigrants differed a little from the indigenous population, the overall effect of their distribution would be to maintain the geographical socio-economic status quo. The selective movement of people between areas would result in the distribution of health and ill-health becoming more polarized, i.e. produce a picture of widening inequalities between areas even though the distribution between individuals is unchanged. These processes suggest potential significant problems with the area-based approaches to monitoring health and inequalities in health.

The CTLA4 + 49A/G and CT60 polymorphisms and chronic inflammatory arthropathies in Northern Ireland

Rheumatoid and juvenile idiopathic arthritis (RA, JIA) are chronic inflammatory arthropathies with an autoimmune background. The cytotoxic T-lymphocyte antigen-4 (CTLA-4) protein plays a key role in the down-regulation of T cell activation. We analyzed the CTLA4 +49A/G and CT60 polymorphisms in cohorts of Northern Irish RA and JIA patients and healthy control subjects using restriction fragment length polymorphism methods. The +49 A allele was increased in RA (61.2%; P=0.02; OR=1.28; 95% C.I.=1.04-1.58) and JIA (61.8%; P=0.14) patients compared to the control population (55.3%). No significant association was observed for the CT60 polymorphism. Haplotype analysis revealed a significantly different distribution of +49 A/G-CT60 haplotypes in RA and JIA patients compared to controls (P value

Prograded Holocene beach-ridges with superimposed dunes in north-east Ireland: mechanisms and timescales of fine and coarse beach sediment decoupling and deposition

Two depositional models to account for Holocene gravel-dominated beach ridges covered by dunes, occurring on the northern coast of Ireland, are considered in the light of infrared-stimulated luminescence ages of sand units within beach ridges, and 14C ages from organic horizons in dunes. A new chronostratigraphy obtained from prograded beach ridges with covering dunes at Murlough, north-east Ireland, supports a model of mesoscale alternating sediment decoupling (ASD) on the upper beach, rather than macroscale sequential sediment sourcing to account for prograded beach ridges and covering dunes. The ASD model specifies storm or fair-weather sand beach ridges forming at high-tide positions (on an annual basis at minimum), which acted as deflationary sources for landward foredune development. Only a limited number of such late-Holocene beach ridges survive in the observed prograded series. Beach ridges only survive when capped by storm-generated gravel beaches that are deposited on a mesoscale time spacing of 50–130 years. The morphodynamic shift from a dissipative beach face for dune formation to a reflective beach face for gravel capping appears to be controlled by the beach sand volume falling to a level where reflective conditions can prevail. Sediment volume entering the beach is thought to have fluctuated as a function of a forced regression associated with the falling sea level from the mid-Holocene highstand (ca. 6000 cal. yr BP) identified in north-east Ireland. The prograded beach ridges dated at ca. 3000 to 2000 cal. yr BP indicate that the Holocene highstand’s regressive phase may have lasted longer than previously specified.

Moderately elevated plasma homocysteine, MTHFR genotype and risk for stroke, vascular dementia and alzheimer's disease in northern ireland

BACKGROUND AND PURPOSE: Elevated plasma homocysteine level has been associated with increased risk for cardiovascular and cerebrovascular disease. Variation in the levels of this amino acid has been shown to be due to nutritional status and methylenetetrahydrofolate reductase (MTHFR) genotype. METHODS: Under a case-control design we compared fasting levels of homocysteine and MTHFR genotypes in groups of subjects consisting of stroke, vascular dementia (VaD), and Alzheimer disease patients and normal controls from Northern Ireland. RESULTS: A significant increase in plasma homocysteine was observed in all 3 disease groups compared with controls. This remained significant after allowance for confounding factors (age, sex, hypertension, cholesterol, smoking, creatinine, and nutritional measures). MTHFR genotype was not found to influence homocysteine levels, although the T allele was found to increase risk for VaD and perhaps dementia after stroke. CONCLUSIONS: We report that moderately high plasma levels of homocysteine are associated with stroke, VaD, and Alzheimer disease. This is not due to vascular risk factors, nutritional status, or MTHFR genotype