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The aim of this analysis was to examine the association between public healthcare eligibility combined with private health insurance (PHI) status and the uptake of breast and prostate cancer screening services among middle and older age groups in Ireland. This is a cross-sectional analysis using The Irish Longitudinal Study on Ageing (TILDA). The analysis included 6902 people aged 50 years and older who completed an in-house interview as part of TILDA. The interview collects information on a range of demographic, socio-economic, health and health service usage variables including the uptake of cancer screening services. An eligibility variable was created using information on public healthcare entitlement and PHI status. The association between eligibility and the uptake of two cancer screening services—mammogram and prostate-specific antigen (PSA) test—was examined using weighted multivariate logistic regression analysis. The uptake of a mammogram and PSA testing was significantly higher in those with PHI. This relationship held after controlling for a range of confounders including health and socio-economic status. More research is required to identify the reasons for the higher uptake of cancer screening services among those with PHI, given that insurance does not confer any advantages in accessing these services. It is possible that the higher uptake is explained by differential access to secondary care services between those with and without PHI. Consideration of the integrated nature of healthcare systems is essential when seeking to maximise the uptake of services (such as cancer screening) that potentially involve multiple parts of the healthcare system. • Uptake of a mammogram and prostate-specific antigen (PSA) testing was positively associated with education and income. • Private health insurance (PHI) was also positively associated with the uptake of a mammogram and PSA testing. • The relationship between PHI and mammogram/PSA testing held after controlling for socio-economic status. [ABSTRACT FROM AUTHOR]

Cattle slurry storage is a major point source for methane (CH 4) and ammonia (NH 3) emissions globally. Efficacy of an oxygen-based amendment in reducing these emissions was investigated. Two 1.6 kg cattle slurry incubations, each lasting for 40-days, were carried out in a climate-controlled chamber with CH 4 and NH 3 emissions measured. Multiple peroxide sources acting as a source of oxygen were tested to examine how compatible they were for addition to cattle slurry. An amendment comprising of hydrogen peroxide (HP) and potassium iodide (KI) has been highlighted as method to reduce CH 4 emissions from this source. While urea hydrogen peroxide and sodium percarbonate reduced CH 4 emissions, they increased the slurry pH and subsequently NH 3 emissions by 209 and 42%, respectively. Hydrogen peroxide did not infer any pH increase upon the slurry and therefore no increase in NH 3 emissions was observed. Hydrogen peroxide and KI were able to reduce CH 4 emissions by 63% during slurry storage. The use of this treatment on a larger scale system should be considered in the future considering the large reductions achieved. [Display omitted] • A mix of hydrogen peroxide and potassium iodide abated 63% of methane emissions during storage. • The addition of urea to cattle slurry increased NH 3 emissions by 209%. • Agitation caused by the addition of hydrogen peroxide and potassium iodide did not increase NH 3 emissions. [ABSTRACT FROM AUTHOR]

The increased demand for animal-derived protein and energy for human consumption will have to be achieved through a combination of improved animal genetic merit and better management strategies. The objective of the present study was to quantify whether differences in genetic merit among animals materialised into phenotypic differences in commercial herds. Carcass phenotypes on 156 864 animals from 7301 finishing herds were used, which included carcass weight (kg), carcass conformation score (scale 1 to 15), carcass fat score (scale 1 to 15) at slaughter as well as carcass price. The price per kilogram and the total carcass value that the producer received for the animal at slaughter was also used. A terminal index, calculated in the national genetic evaluations, was obtained for each animal. The index was based on pedigree index for calving performance, feed intake and carcass traits from the national genetic evaluations. Animals were categorised into four terminal index groups on the basis of genetic merit estimates that were derived before the expression of the phenotypic information by the validation animals. The association between terminal index and phenotypic performance at slaughter was undertaken using mixed models; whether the association differed by gender (i.e. young bulls, steers and heifers) or by early life experiences (animals born in a dairy herd or beef herd) was also investigated. The regression coefficient of phenotypic carcass weight, carcass conformation and carcass fat on their respective estimated breeding values (EBVs) was 0.92 kg, 1.08 units and 0.79 units, respectively, which is close to the expectation of one. Relative to animals in the lowest genetic merit group, animals in the highest genetic merit group had, on average, a 38.7 kg heavier carcass, with 2.21 units greater carcass conformation, and 0.82 units less fat. The superior genetic merit animals were, on average, slaughtered 6 days younger than their inferior genetic merit contemporaries. The superior carcass characteristics of the genetically elite animals materialised in carcasses worth €187 more than those of the lowest genetic merit animals. Although the phenotypic difference in carcass traits of animals divergent in terminal index differed statistically by animal gender and early life experience, the detected interactions were generally biologically small. This study clearly indicates that selection on an appropriate terminal index will produce higher performing animals and this was consistent across all production systems investigated. [ABSTRACT FROM AUTHOR]

Chez les patients (pts) PR, la présence d'érosions osseuses est associée à un mauvais pronostic. Les érosions peuvent être associées à une inflammation subclinique et être un facteur prédictif de l'évolution structurale. L'essai clinique AVERT-2 (NCT02504268) a évalué abatacept (ABA) + MTX chez des pts ACPA+, atteints d'une PR récente et naïfs de MTX. L'objectif de cette analyse était d'évaluer l'impact du score d'érosion (SE) à l'inclusion (BL) sur la réponse clinique et l'évolution des lésions radiographique sur un an, à partir d'AVERT-2. Les données radiographiques à BL et à la semaine 52 ont été évaluées en utilisant le score de Sharp/van der Heijde. Les taux de rémission SDAI (≤ 3,3), les variations moyennes non ajustées du SDAI par rapport à BL et la durée du maintien de rémission ont été évalués sur 52 semaines. La progression radiographique a été évaluée par la variation moyenne du SE par rapport à BL à la semaine 52. Différentes valeurs seuils des SE à BL ont été analysées. Les résultats des pts ayant des SE bas ou élevés ont été comparés. Parmi les 994 pts dans l'étude, les données des SE à BL étaient disponibles pour 964 (97 %) pts (médiane : 2,0, écart interquartile [IQR] : 0,5–5,1) et 792 pts (80 %) avaient des données de SE à BL et à la semaine 52 (médiane : 2,5, IQR : 1,0–6,5). Les analyses ont été effectuées pour des seuils de SE de 2 et 5, avec respectivement 53 % et 75 % des pts considérés comme ayant un SE bas. Chez les pts traités par ABA + MTX, ceux ayant des SE bas avaient des taux de rémission SDAI plus élevés à 52 semaines que ceux ayant des SE élevés. La relation était plus prononcée avec des seuils plus élevés. Cet effet n'a pas observé avec MTX + placebo. Une baisse numériquement plus importante du SDAI a été observée chez les pts avec un SE élevé vs SE bas traités par ABA + MTX. Cet effet n'a pas été observé avec le MTX seul. Les pts qui ont reçu ABA + MTX ont eu une rémission SDAI plus rapide et plus durable vs ceux qui ont reçu MTX. Les pts ayant un SE bas traités par ABA + MTX, ont eu une rémission SDAI plus rapide et plus durable vs ceux ayant un SE élevé. Cet effet n'était pas observé avec MTX seul. Les variations du SE à la semaine 52 par rapport à BL étaient plus faibles dans le groupe ABA + MTX vs MTX seul. ABA semblerait protéger de la même façon les pts ayant des SE bas ou élevés ; avec le MTX seul, les pts ayant des SE élevés avaient des variations du SE plus importantes que les pts ayant des SE bas (Tableau 1). Cette stratification de la population PR précoce, ACPA+, dans AVERT-2, basée sur l'érosion souligne l'importance de traiter les pts avant le développement de la maladie érosive. Un traitement par ABA + MTX a conduit à des taux de rémission SDAI plus élevés chez les pts ayant un SE bas vs un SE élevé et a fourni une protection supplémentaire par rapport au MTX seul contre l'évolution radiographique chez les pts ayant un SE élevé. Une modélisation statistique supplémentaire et un ajustement des facteurs de confusion à BL seraient nécessaires. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To characterise and quantify the EEG during sleep in healthy newborns in the early newborn period. Methods: Continuous multi-channel video-EEG data was recorded for up to 2hours in normal newborns within 12hours of birth. The total amount of active (AS) and quiet sleep (QS) was calculated in the first hour of recording. The EEG signal was quantitatively analysed for symmetry and synchrony. Spectral edge frequency (SEF), spectral entropy (H) and relative delta power (δ R) were calculated for a ten-minute segment of AS and QS in each recording. Paired t-test and Wilcoxon rank sum test were used for data analysis. Results: Thirty normal newborn babies were studied, 10 within 6hours of birth and 20 between 6 and 12hours. All babies showed continuous symmetrical and synchronous EEG activity and well-developed sleep–wake cycling (SWC) with the median percentage of AS – 48.5% and QS – 36.6%. Quantitative EEG analysis of sleep epochs showed that SEF and H were significantly higher (p <0.0001) and δ R was significantly lower (p <0.0001) in AS than in QS. Conclusion: The normal newborn EEG shows symmetrical and synchronous continuous activity and well-developed SWC as early as within the first 6hours of birth. Quantitative analysis of the EEG in the early postnatal period reveals differences in SEF, H and δ R for AS and QS periods. Significance: These findings may have implications for quantitative analysis of the newborn EEG, including the EEG of babies with hypoxic ischaemic encephalopathy. [Copyright &y& Elsevier]

Informal care is a fundamental component of care in the community which, given current demographic trends and increasing prevalence of debilitating chronic disease, is likely to assume even greater significance in future. Research indicates that caregivers are more likely than non-carers to report poor health, though this has usually been measured in terms of psychological or emotional health such as depression or 'caregiver strain'. Relatively little is known about the effects of caring on physical health. This study examines the health of caregivers recorded in the 2001 Northern Ireland Census and their subsequent mortality over the following four years. Caregivers were a heterogeneous group, with those providing fewer hours of care being relatively more affluent than those providing care at greater intensities. Overall, caregivers had lower mortality risks than non-carers and effects were more pronounced for women, older people, and for those reporting poorer health at the start of the study period. While this study does not exclude the possibility of significant detrimental health effects of caring for some sub-groups of caregivers, it does add support to the growing body of literature which suggests that the positive aspects of caring have been underreported. [ABSTRACT FROM AUTHOR]

The circadian variation of paroxysmal atrial fibrillation (AF) was studied in 67 patients who received a dual-chamber pacemaker 3 months before a planned atrioventricular node ablation. A distinct circadian variation of AF was observed with 2 time peaks in initiation (1 in the early morning and 1 in the early evening hours), which was modulated by atrial pacing, the duration of AF, and the use of beta-adrenergic blocking agents. [ABSTRACT FROM AUTHOR]

During the past 15 years, the efficacy of antiarrhythmic drugs has been investigated for reducing premature death in patients at high risk of arrhythmia. Whereas the benefits of beta-blocker therapy are well established, a reduction in mortality with other antiarrhythmic drugs remains unproved and in some cases, there is evidence of increased mortality with class I and some class III agents. A limitation of individual clinical trials is inadequate sample size to detect significant differences between interventions. Meta-analysis, by combining results from multiple clinical trials, provides a technique to overcome sample size limitations and assess the benefits and limitations of an intervention. Thirteen randomized clinical trials evaluated the role of prophylactic amiodarone in patients at risk of death from cardiac arrhythmias. Whereas 3 of these studies reported a reduction in mortality, several others revealed no benefits of amiodarone. Because neither trial was designed to detect reductions in total mortality, it remained unclear whether the beneficial effect of amiodarone on arrhythmic death and resuscitated ventricular fibrillation translated into a beneficial effect on total mortality. To address this, a meta-analysis was performed from the 13 trials of amiodarone in patients after an acute myocardial infarction or with congestive heart failure. The results showed a significant reduction in mortality and in arrhythmic death with amiodarone. [ABSTRACT FROM AUTHOR]