Socio-economic and ethnic disparities in childhood cancer survival, Yorkshire, UK.

BACKGROUND: Establishing the existence of health inequalities remains a high research and policy agenda item in the United Kingdom. We describe ethnic and socio-economic differences in paediatric cancer survival, focusing specifically on the extent to which disparities have changed over a 20-year period. METHODS: Cancer registration data for 2674 children (0-14 years) in Yorkshire were analysed. Five-year survival estimates by ethnic group (south Asian/non-south Asian) and Townsend deprivation fifths (I-V) were compared over time (1997-2016) for leukaemia, lymphoma, central nervous system (CNS) and other solid tumours. Hazard ratios (HR: 95% CI) from adjusted Cox models quantified the joint effect of ethnicity and deprivation on mortality risk over time, framed through causal interpretation of the deprivation coefficient. RESULTS: Increasing deprivation was associated with significantly higher risk of death for children with leukaemia (1.11 (1.03-1.20)) and all cancers between 1997 and 2001. While we observed a trend towards reducing differences in survival over time in this group, a contrasting trend was observed for CNS tumours whereby sizeable variation in outcome remained for cases diagnosed until 2012. South Asian children with lymphoma had a 15% reduced chance of surviving at least 5 years compared to non-south Asian, across the study period. DISCUSSION: Even in the United Kingdom, with a universally accessible healthcare system, socio-economic and ethnic disparities in childhood cancer survival exist. Findings should inform where resources should be directed to provide all children with an equitable survival outcome following a cancer diagnosis.

Associations between age at first calving, rearing average daily weight gain, herd milk yield and dairy herd production, reproduction, and profitability.

The objective of this study was to evaluate the associations of variable intensity in rearing dairy heifers on 33 commercial dairy herds, including 23,008 cows and 18,139 heifers, with age at first calving (AFC), average daily weight gain (ADG), and milk yield (MY) level on reproduction traits and profitability. Milk yield during the production period was analyzed relative to reproduction and economic parameters. Data were collected during a 1-yr period (2011). The farms were located in 12 regions in the Czech Republic. The results show that those herds with more intensive rearing periods had lower conception rates among heifers at first and overall services. The differences in those conception rates between the group with the greatest ADG (≥0.800 kg/d) and the group with the least ADG (≤0.699 kg/d) were approximately 10 percentage points in favor of the least ADG. All the evaluated reproduction traits differed between AFC groups. Conception at first and overall services (cows) was greatest in herds with AFC ≥800 d. The shortest days open (105 d) and calving interval (396 d) were found in the middle AFC group (799 to 750 d). The highest number of completed lactations (2.67) was observed in the group with latest AFC (≥800 d). The earliest AFC group (≤749 d) was characterized by the highest depreciation costs per cow at 8,275 Czech crowns (US$414), and the highest culling rate for cows of 41%. The most profitable rearing approach was reflected in the middle AFC (799 to 750 d) and middle ADG (0.799 to 0.700 kg) groups. The highest MY (≥8,500 kg) occurred with the earliest AFC of 780 d. Higher MY led to lower conception rates in cows, but the highest MY group also had the shortest days open (106 d) and a calving interval of 386 d. The same MY group had the highest cow depreciation costs, net profit, and profitability without subsidies of 2.67%. We conclude that achieving low AFC will not always be the most profitable approach, which will depend upon farm-specific herd management. The MY is a very important factor for dairy farm profitability. The group of farms having the highest MY achieved the highest net profit despite having greater fertility problems.

Comparative assessment of chemical and gamma-irradiation procedures for implantable glucose enzyme electrodes.

Chemical and gamma-irradiation sterilisation were examined in this study for implantable needle electrodes. Exposure to isopropyl alcohol (IPA) led to response elevation, but time-dependent exposures up to 30 min variously to chlorhexidine, H2O2, HCl, HCl/IPA, and alcoholic iodine/potassium iodide, all caused substantial time-dependent response degradation. Sterility was not assessed for such electrodes. High dose (30 KGy) gamma-irradiation also compromised sensor response, with exposed electrodes exhibiting approximately 30% reduction in response, comparable in magnitude to 10 min exposure to chemical sterilisation. However, a lower dose (25 KGy) gamma-irradiation was well tolerated and subsequent microbiological testing (following contamination with Streptococcus epidermidis and Staphylococus aureus) proved device sterility with no culture growth following 7 days incubation at 37 degrees C in brain heart infusion medium.