Alcohol and injuries in the accident and emergency department: a national perspective.

The purpose of this study was to examine the role of alcohol and injuries, with a specific focus in the A & E Departments in acute hospitals. The six hospitals were selected to achieve a wide geographic and demographic distribution across the country - Mater Misercordiae University Hospital in Dublin , Beaumont Hospital in Dublin, University College Hospital Galway, Sligo General Hospital, Letterkenny General Hospital and Waterford Regional Hospital. Data was collected using a standard 25 minute questionnaire, which included the type and cause of the presenting injury, drinking in the six hours prior to the injury, quantity and frequency of usual drinking habits, frequency of high consumption times during the last year, indicators of alcohol problems and alcohol dependency and demographic characteristics

DNA Typing of Mycobacterium bovis Isolates from Badgers (Meles meles) Culled from Areas in Ireland with Different Levels of Tuberculosis Prevalence

Badgers (Meles meles) have been implicated in the transmission of Mycobacterium bovis infection to cattle in Ireland and UK. Recent studies in Ireland have shown that although the disease is endemic in badgers, the prevalence of disease is not uniform throughout the country and can vary among subpopulations. The extent to which the prevalence levels in badgers impact on the prevalence in cattle is not known. Previously, DNA fingerprinting has shown that M. bovis strain types are shared between badgers and cattle, and that there are a large number of strain types circulating in the two species. In this study we have carried out spoligotyping and variable number tandem repeat (VNTR) analysis of M. bovis isolates from two groups of badgers, representing a wide geographic area, with different tuberculosis prevalence levels. The results of the typing show that there is no geographic clustering of strain types associated with prevalence. However, two VNTR profiles were identified that appear to be associated with high- and low-prevalence M. bovis infection levels, respectively. In addition, spoligotyping and VNTR analysis has provided evidence, for the first time, of multiple infections of individual badgers with different M. bovis strains

Antigen stimulation of peripheral blood mononuclear cells from Mycobacterium bovis infected cattle yields evidence for a novel gene expression program

<p>Abstract</p> <p>Background</p> <p>Bovine tuberculosis (BTB) caused by <it>Mycobacterium bovis </it>continues to cause substantial losses to global agriculture and has significant repercussions for human health. The advent of high throughput genomics has facilitated large scale gene expression analyses that present a novel opportunity for revealing the molecular mechanisms underlying mycobacterial infection. Using this approach, we have previously shown that innate immune genes in peripheral blood mononuclear cells (PBMC) from BTB-infected animals are repressed <it>in vivo </it>in the absence of exogenous antigen stimulation. In the present study, we hypothesized that the PBMC from BTB-infected cattle would display a distinct gene expression program resulting from exposure to <it>M. bovis</it>. A functional genomics approach was used to examine the immune response of BTB-infected (<it>n </it>= 6) and healthy control (<it>n </it>= 6) cattle to stimulation with bovine tuberculin (purified protein derivative – PPD-b) <it>in vitro</it>. PBMC were harvested before, and at 3 h and 12 h post <it>in vitro </it>stimulation with bovine tuberculin. Gene expression changes were catalogued within each group using a reference hybridization design and a targeted immunospecific cDNA microarray platform (BOTL-5) with 4,800 spot features representing 1,391 genes.</p> <p>Results</p> <p>250 gene spot features were significantly differentially expressed in BTB-infected animals at 3 h post-stimulation contrasting with only 88 gene spot features in the non-infected control animals (<it>P </it>≤ 0.05). At 12 h post-stimulation, 56 and 80 gene spot features were differentially expressed in both groups respectively. The results provided evidence of a proinflammatory gene expression profile in PBMC from BTB-infected animals in response to antigen stimulation. Furthermore, a common panel of eighteen genes, including transcription factors were significantly expressed in opposite directions in both groups. Real-time quantitative reverse transcription PCR (qRT-PCR) demonstrated that many innate immune genes, including components of the TLR pathway and cytokines were differentially expressed in BTB-infected (<it>n </it>= 8) versus control animals (<it>n </it>= 8) after stimulation with bovine tuberculin.</p> <p>Conclusion</p> <p>The PBMC from BTB-infected animals exhibit different transcriptional profiles compared with PBMC from healthy control animals in response to <it>M. bovis </it>antigen stimulation, providing evidence of a novel gene expression program due to <it>M. bovis </it>exposure.</p

Relative effectiveness of irish factories in the surveillance of slaughtered cattle for visible lesions of tuberculosis, 2005-2007

<p>Abstract</p> <p>Background</p> <p>In Ireland, every animal is examined at slaughter for its fitness for human consumption. The aim of this study was to determine the relative effectiveness of factories in submitting and subsequently in having suspect lesions confirmed as bovine tuberculosis (TB) lesions during the years 2005-2007. This work provides an update from previously published data for years 2003-2004. During 2005-2007 data were available on 4,401,813 cattle from attested herds (<it>i.e</it>. herds classified free of bovine TB), from which data for potential confounding factors were available for 3,344,057 slaughtered animals at one of the 37 export-licensed factories.</p> <p>Findings</p> <p>From these animals, 8,178 suspect lesions were submitted for laboratory confirmation. Lesions from 5,456 (66.7%) animals tested as positive, and 269 (3.2%) were inconclusive for bovine TB. Logistic regression was used to determine adjusted submission and confirmation risks for each factory while controlling for confounding factors. Factory rankings based on adjusted and crude risks were similar. The average crude submission risk for all the factories was 25 lesions per 10,000 animals slaughtered, ranging from 0 to 52. The crude confirmation risk varied between 30.3% and 91.3%.</p> <p>Conclusions</p> <p>Substantial variation in the effectiveness of lesion submission and subsequent confirmation as bovine TB was found among the 37 factories. Compared to previous years (2003-2004), there was an increased bovine TB lesion submission and confirmation risk. Continued monitoring of the effectiveness of slaughter surveillance in Ireland is recommended; emphasis should be placed on efforts to improve bovine TB surveillance in factories with lower rankings.</p

Innate gene repression associated with Mycobacterium bovis infection in cattle: toward a gene signature of disease

<p>Abstract</p> <p>Background</p> <p>Bovine tuberculosis is an enduring disease of cattle that has significant repercussions for human health. The advent of high-throughput functional genomics technologies has facilitated large-scale analyses of the immune response to this disease that may ultimately lead to novel diagnostics and therapeutic targets. Analysis of mRNA abundance in peripheral blood mononuclear cells (PBMC) from six <it>Mycobacterium bovis </it>infected cattle and six non-infected controls was performed. A targeted immunospecific bovine cDNA microarray with duplicated spot features representing 1,391 genes was used to test the hypothesis that a distinct gene expression profile may exist in <it>M. bovis </it>infected animals <it>in vivo</it>.</p> <p>Results</p> <p>In total, 378 gene features were differentially expressed at the <it>P </it>≤ 0.05 level in bovine tuberculosis (BTB)-infected and control animals, of which 244 were expressed at lower levels (65%) in the infected group. Lower relative expression of key innate immune genes, including the Toll-like receptor 2 (<it>TLR2</it>) and <it>TLR4 </it>genes, lack of differential expression of indicator adaptive immune gene transcripts (<it>IFNG, IL2, IL4</it>), and lower <it>BOLA </it>major histocompatibility complex – class I (<it>BOLA</it>) and class II (<it>BOLA-DRA</it>) gene expression was consistent with innate immune gene repression in the BTB-infected animals. Supervised hierarchical cluster analysis and class prediction validation identified a panel of 15 genes predictive of disease status and selected gene transcripts were validated (<it>n </it>= 8 per group) by real time quantitative reverse transcription PCR.</p> <p>Conclusion</p> <p>These results suggest that large-scale expression profiling can identify gene signatures of disease in peripheral blood that can be used to classify animals on the basis of <it>in vivo </it>infection, in the absence of exogenous antigenic stimulation.</p

The development and psychometric properties of a measure of clinicians’ attitudes to depression: the revised Depression Attitude Questionnaire (R-DAQ)

Background: Depression is a common mental disorder associated with substantial disability. It is inadequately recognised and managed, and clinicians’ attitudes to this condition and its treatment may play a part in this. Most research in this area has used the Depression Attitude Questionnaire (DAQ), but analyses have shown this measure to exhibit problems in psychometric properties and suitability for the health professionals and settings where depression recognition may occur. Methods: We revised the DAQ using a pooled review of findings from studies using this measure, together with a Delphi study which sought the opinions of a panel of relevant experts based in the UK, USA, Australia, and European countries (n = 24) using 3 rounds of questioning to consider attitude dimensions, content, and item wording. After item generation, revision and consensus (agreement >70%) using the Delphi panel, the revised DAQ (R-DAQ) was tested with 1193 health care providers to determine its psychometric properties. Finally the test-retest reliability of the R-DAQ was examined with 38 participants. Results: The 22-item R-DAQ scale showed good internal consistency: Cronbach’s alpha coefficient was 0.84; and satisfactory test-retest reliability: intraclass correlation coefficient was 0.62 (95% C.I. 0.37 to 0.78). Exploratory factor analysis favoured a three-factor structure (professional confidence, therapeutic optimism/pessimism, and a generalist perspective), which accounted for 45.3% of the variance. Conclusions: The R-DAQ provides a revised tool for examining clinicians’ views and understanding of depression. It addresses important weaknesses in the original measure whilst retaining items and dimensions that appeared valid. This revised scale is likely to be useful in examining attitudes across the health professional workforce and beyond the confines of the UK, and may be valuable for the purpose of evaluating training that aims to address clinicians’ attitudes to depression. It incorporates key dimensions of attitudes with a modest number of items making it applicable to use in busy clinical settings

Genome-wide transcriptional profiling of peripheral blood leukocytes from cattle infected with Mycobacterium bovis reveals suppression of host immune genes

Background Mycobacterium bovis is the causative agent of bovine tuberculosis (BTB), a pathological infection with significant economic impact. Recent studies have highlighted the role of functional genomics to better understand the molecular mechanisms governing the host immune response to M. bovis infection. Furthermore, these studies may enable the identification of novel transcriptional markers of BTB that can augment current diagnostic tests and surveillance programmes. In the present study, we have analysed the transcriptome of peripheral blood leukocytes (PBL) from eight M. bovis-infected and eight control non-infected age-matched and sex-matched Holstein-Friesian cattle using the Affymetrix® GeneChip® Bovine Genome Array with 24,072 gene probe sets representing more than 23,000 gene transcripts. Results Control and infected animals had similar mean white blood cell counts. However, the mean number of lymphocytes was significantly increased in the infected group relative to the control group (P = 0.001), while the mean number of monocytes was significantly decreased in the BTB group (P = 0.002). Hierarchical clustering analysis using gene expression data from all 5,388 detectable mRNA transcripts unambiguously partitioned the animals according to their disease status. In total, 2,960 gene transcripts were differentially expressed (DE) between the infected and control animal groups (adjusted P-value threshold ≤ 0.05); with the number of gene transcripts showing decreased relative expression (1,563) exceeding those displaying increased relative expression (1,397). Systems analysis using the Ingenuity® Systems Pathway Analysis (IPA) Knowledge Base revealed an over-representation of DE genes involved in the immune response functional category. More specifically, 64.5% of genes in the affects immune response subcategory displayed decreased relative expression levels in the infected animals compared to the control group. Conclusions This study demonstrates that genome-wide transcriptional profiling of PBL can distinguish active M. bovis-infected animals from control non-infected animals. Furthermore, the results obtained support previous investigations demonstrating that mycobacterial infection is associated with host transcriptional suppression. These data support the use of transcriptomic technologies to enable the identification of robust, reliable transcriptional markers of active M. bovis infection.This work was supported by Investigator Grants from Science Foundation Ireland (Nos: SFI/01/F.1/B028 and SFI/08/IN.1/B2038), a Research Stimulus Grant from the Department of Agriculture, Fisheries and Food (No: RSF 06 405) and a European Union Framework 7 Project Grant (No: KBBE-211602-MACROSYS). KEK is supported by the Irish Research Council for Science, Engineering and Technology (IRCSET) funded Bioinformatics and Systems Biology PhD Programme http://bioinfo-casl.ucd.ie/PhD

Joe Heaney

no abstract --- JSTOR link to article (restricted access) https://www.jstor.org/stable/2431813

New approaches to the diagnosis and control of tuberculosis in badgers

Department of Agriculture, Food and the MarineTeagascDeposited by bulk impor