Female, juvenile, and calf sperm whale Physeter macrocephalus (Linnaeus 1758) records from Ireland.

Sperm whales spatially segregate by sex and social behavior as they mature. In the North Atlantic, male whales move to higher latitudes as far as Svalbard at 80° N, while females and young whales typically remain around lower latitudes below 40-45° N. The Azores, Madeira, and the Canary Islands constitute important nursery grounds for female and young sperm whales. Irish waters represent a midpoint for this species' spatial segregation in the Northeast Atlantic, where the species occurs along the submarine canyon systems to the west of the country. Historically, just male whales were thought to be found in this region between 51 and 55° N, but one adult female was caught by commercial whalers in 1910, and a 5.49 m calf was found stranded in 1916. Between 1995 and 2023, 10 female sperm whales have been stranded around the coast of Ireland. Eight of these whales have been stranded since 2013, and there has been at least one stranding per year between 2019 and 2023. Four of these strandings have occurred in Donegal in the northwest of Ireland, indicating the presence of female whales along the continental shelf off this region. Two females were stranded within a day of each other and were found in similar states of decomposition in February 2022, indicating that they may have been part of the same group rather than being lone vagrant individuals. Sperm whale calves and juveniles were also sighted in Irish waters in 2001, 2004, and 2010 in the Rockall Trough, along the Porcupine Bank and Goban Spur, where between 1 and 3 individuals were observed on four occasions while one calf live stranded in 2004. These records indicate a historical presence of female and young sperm whales in this region but that an apparent increase in occurrence has taken place over the past decade.

Transformative reproductive futures in Northern Ireland.

A foundation of rights-based solidarity has fostered an environment of cooperation between LGBTQ+ (lesbian, gay, bisexual, transgender and queer) rights and reproductive justice in Northern Ireland (NI) following the introduction of equal marriage and the decriminalization of abortion in 2019. This article provides a grounded look at this reproductive justice organizing in NI as an example of transformative organizing for reproductive futures. The case study considers a conversation with two activists who have been central to this work. Emma Campbell coconvenor of Alliance for Choice and Danielle Roberts the coconvenor of Reclaim the Agenda and former Senior Policy and Development Officer of HERe NI. Reclaim the Agenda is a coalition of feminist, youth, LGBTQ+ and community organizations that connects and mobilizes women to promote feminist activism through education, campaigning and celebration. HERe NI is a community organization and registered charity based in Belfast that supports lesbian and bisexual women and their families across NI. Alliance for Choice campaigns for free, safe legal and local abortion access for everyone who needs it in NI. Together these groups approach reproductive justice using a framework informed by lesbian feminist organizing and an intersectional approach that views access to abortion as part of a broader understanding of gender justice inspired by Black-women led SisterSong through (1) cross-movement organizing (2) centering bodily autonomy and (3) trans affirming feminist approaches to navigating shifting language about gender. The case study will be of interest to those working provide abortion services in a queer-informed way, as well as those navigating the challenges of reforming abortion policy.

Examining the COVID-19 impact on cancer surgery in Ireland using three national data sources.

Background: The healthcare system in Ireland was profoundly affected by COVID-19. This study aimed to explore the impact of the pandemic on cancer surgery in Ireland, from 2019 to 2022 using three national health data sources. Methods: A repeated cross-sectional study design was used and included: (i) cancer resections from the National Histopathology Quality Improvement (NHQI) Programmes; (ii) cancer surgery from the National Cancer Registry Ireland (NCRI), and (iii) cancer surgery from Hospital Inpatient Enquiry (HIPE) System. Cancer surgery was presented by invasive/in situ and invasive only cancers (NCRI & HIPE), and by four main cancer types (breast, lung, colorectal & melanoma for NCRI & HIPE data only). Results: The annual number of cancer resections (NHQI) declined by 4.4% in 2020 but increased by 4% in 2021 compared with 2019. NCRI data indicated invasive/in-situ cancer surgery for the four main cancer types declined by 14% in 2020 and 5.1% in 2021, and by 12.3% and 7.3% for invasive cancer only, compared to 2019. Within HIPE for the same tumour types, invasive/in situ cancer surgery declined by 21.9% in 2020 and 9.9% in 2021 and by 20.8% and 9.6% for invasive cancer only. NHQI and HIPE data indicated an increase in the number of cancer surgeries performed in 2022. Conclusions: Cancer surgery declined in the initial pandemic waves suggests mitigation measures for cancer surgery, including utilising private hospitals for public patients, reduced the adverse impact on cancer surgery.

Identifying the essential elements to inform the development of a research agenda for Paramedicine in Ireland: a Delphi Study.

BACKGROUND: Paramedicine is a dynamic profession which has evolved from a "treat and transport" service into a complex network of health professionals working in a diverse range of clinical roles. Research is challenging in the paramedicine context, and internationally, research capacity and culture has developed slowly. International examples of research agendas and strategies in paramedicine exist, however, research priorities have not previously been identified in Ireland. METHODS: This study was a three round electronic modified Delphi design which aimed to establish the key aspects of the research priorities via end-user consensus. Participants included interested stakeholders involved in prehospital care or research in Ireland. The first round questionnaire consisted of open-ended questions with results coded and developed into themes for the closed-ended questions used in the second and third round questionnaires. A consensus level of 70% was set a priori for second and third rounds. RESULTS: Research Priorities that reached consensus included Staff Wellbeing, Education and Professionalism and Acute Medical Conditions. Respondents indicated that these three areas should be a priority in the next 2 years. Education, Staffing and Leadership were imperative Key Resources that required change. Education was a Key Processes change deemed imperative to allow the future research to occur. Outcomes that should be included in the future research strategy were Patient Outcomes, Practitioner Development, Practitioner Wellbeing, Alternate Pathways, Evidence-based Practice and Staff Satisfaction. CONCLUSION: The results of this study are similar to previously published international studies, with some key differences. There was a greater emphasis on Education and Practitioner Wellbeing with the latter possibly attributed to the timing of the research in relation to the COVID-19 pandemic. The disseminated findings of this study should inform sustainable funding models to aid the development of paramedicine research in Ireland.

Recent trends in psychotropic medication use in children and adolescents in Ireland.

In response to concerns regarding overprescribing of psychotropic medication in children/adolescents, this study examined trends in psychotropic medication use in Ireland by age group and gender. A retrospective, repeated, cross-sectional study of the Irish pharmacy claims database was conducted. Yearly prevalence of children/adolescents receiving dispensed psychotropic medications was analysed from January 2017 to December 2021 and compared across years, age groups (5-15 years, and stratified as 5-11 and 12-15 years) and gender. Yearly prevalence was defined as the mean number of patients in receipt of medication per month per 1000 eligible population during a given calendar year. Negative binomial regression was used to examine the association of year, age group and gender on prevalence. Prevalence ratios (PRs) per year (average change in prevalence between each year) were presented with 95% confidence intervals (CIs). The prevalence of included psychotropic medications dispensed in the 5-15 years group increased from 6.41 (95% CI: 6.22, 6.59) in 2017 to 8.46 (95% CI: 8.26, 8.68) in 2021 per 1000 eligible population (32% increase). The PR per year (adjusting for age category and gender) was 1.07 (95% CI: 1.035, 1.107; p < 0.001). An increasing trend over time was also observed for all individual drug classes. These findings suggest increased use of psychotropic medication in children/adolescents from 2017 to 2021. However, despite increased prevalence over time, comparison with the literature shows that psychotropic medication use in Ireland remains lower than international comparators.

Assessing care deficits in Ireland's international protection accommodation system: Lessons learned in COVID-19 and beyond.

Responding to the need for qualitative research that reveals the lived reality of how forced migrants endured the COVID-19 pandemic this paper presents findings from eleven interviews with asylum seekers residing in Ireland's Direct Provision (DP) accommodation system that detail care deficits before, during and after COVID-19 along with analysis of how care is discussed within Irish policy documents concerned with the health and wellbeing of asylum seekers. The research contributes personal testimony and documentary evidence of the inability of DP to properly adapt to the pandemic and its failure to protect the health and wellbeing of asylum seekers given pre-existing care deficits. The paper argues that an ethic of care practiced for and with asylum seekers must ensure they are not re-traumatised, and their health disparities are not exacerbated during public health crises and beyond. The findings are relevant to efforts to reform how international protection responsibilities are enacted in Ireland and other destinations of forced migrants, including EU member states.

Exploring the sugar-sweetened beverage tax (SSBT) pass-through rate in the Irish hospitality sector.

BACKGROUND: The World Health Organization (WHO) supports the use of Sugar-Sweetened Beverage Taxes (SSBTs) as a fiscal lever to help reduce sugar consumption and tackle obesity. Obesity is associated with a range of adverse health outcomes. In response to increasing levels of obesity in Ireland, an SSBT was introduced in 2018. Previous research in Ireland has noted that the pass-through rate of the SSBT in retail (off-site consumption) settings was poor. However, to date, no research has examined the SSBT pass-through rate in hospitality (on-site consumption) venues in Ireland. METHODS: This research examines the SSBT pass-through rate on Coca-Cola versus diet versions of Coca-Cola in a convenience sample of 100 hospitality venues in two provincial Irish cities. RESULTS: Wilcoxon signed rank test analysis revealed that regular Coca-Cola was significantly more expensive compared to the price charged for diet versions of Coca-Cola. However, in 85.6% of cases the same price was charged for both full-sugar and sugar-free drinks. The mean pass-through rate of the SSBT was 33.8%. CONCLUSION: The effective functioning of the SSBT is premised on persistent price differences between soft drink prices based on sugar content. However, this is barely evident in the hospitality sector in Ireland. A number of recommendations are suggested, including both increasing the SSBT, and increasing it annually in line with inflation.

Patterns of antidepressant prescribing and health-related outcomes among older adults in Northern Ireland: an administrative data study.

OBJECTIVES: This study identifies patterns of antidepressant prescribing and subsequent hospital admissions from 2010 to 2018 amongst older adults in Northern Ireland (NI). METHOD: Participants comprised all General Practitioner (GP)-registered adults aged fifty-five years and above on 01/01/2010 (n = 386,119). Administrative data linkage included demographic information; antidepressant prescribing data from the NI Enhanced Prescribing Database (EPD); and hospital patient admissions. Repeated measures latent class analysis (RMLCA) identified patterns of antidepressant prescribing (from 2010 to 2018). RESULTS: RMLCA identified four latent classes: decreasing antidepressant prescribing (5.9%); increasing antidepressant prescribing (8.0%); no-antidepressant prescribing (68.7%); and long-term antidepressant prescribing (17.5%). Compared with those in no-antidepressant prescribing class, persons in the remaining classes were more likely to be female and younger, and less likely to live in either rural areas or less-deprived areas. Compared with no-antidepressant prescribing, those with increasing antidepressant prescribing were 60% and 52% more likely to be admitted to hospital in 2019 and 2020, respectively, and their admission rate per year was 11% and 8% higher in 2019 and 2020, respectively. Similarly, those with long-term prescriptions were 70% and 67% more likely to be admitted to hospital in 2019 and 2020, respectively, and their admission rate per year was 14% and 9% higher in 2019 and 2020, respectively. CONCLUSION: Findings show that approximately 26% of the NI hospital admissions population were impacted by sustained or increasing antidepressant prescribing. Because of their increased likelihood of hospitalization, these individuals may benefit from psychosocial support and social prescribing alternatives to psychopharmacological treatment.

Is COVID-19 finally just a bad flu? Follow-up study comparing disease severity among COVID-19 and seasonal influenza hospital in-patients across pandemic waves in Ireland.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) was a more severe illness than seasonal influenza in hospitalised cohorts during the early phase of the pandemic. This study's aim was to determine if COVID-19 severity, relative to seasonal influenza, evolved across subsequent disease waves. STUDY DESIGN: Retrospective population-based cohort study. METHODS: COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes from the Irish national hospitalisation dataset. Descriptive comparative analysis of each group was carried out using Pearson's Chi-squared tests. Length of stay (LOS), intensive care unit (ICU) admission and in-hospital mortality were measured and compared using logistic regression analysis. RESULTS: Compared to influenza episodes, COVID-19 episodes for all ages and all waves combined, had a longer mean LOS (15.8 days, vs 11.4 days, P < 0.001); were more likely to receive ICU care (OR 1.24 95% CI 1.15-1.33, P < 0.001) and were more likely to die in hospital (OR 2.61, 95% CI 2.36-2-88). Despite the reduction in the proportion of patients with an intensive care unit (ICU) stay and dying in hospital in Wave 5 compared to the previous waves, the risk of having an ICU admission or dying in hospital remained higher in patients with COVID-19 in Wave 5 compared to those with influenza diagnosis. CONCLUSION: While the severity of COVID-19 has reduced with successive pandemic waves, it remains a more severe disease than influenza. Despite changes in strain, population immunity, vaccination and treatment, policymakers and the public must continue to approach COVID-19 as more than 'just a bad flu'.

Effects of a telehealth-delivered Mediterranean diet intervention in adults with Rheumatoid Arthritis (MEDRA): a randomised controlled trial.

OBJECTIVE: To compare the effects a Mediterranean diet (MedDiet) versus the Irish Healthy Eating Guidelines (HEG) on physical function and quality of life in adults with rheumatoid arthritis (RA) in Ireland. METHODS: Forty-four adults with RA were randomised (1:1) to the MedDiet or HEG for 12 weeks. The intervention included three video teleconsultations and two follow-up telephone calls facilitated by a Registered Dietitian (RD). Changes in physical function by Health Assessment Questionnaire- Disability Index (HAQ-DI) and quality of life by Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) were the primary outcomes measured. Secondary outcomes included changes in dietary adherence, physical activity by Yale Physical Activity survey (YPAS), patient-perceived pain and general health, and anthropometric measures. All measurements were administered at baseline and repeated at 6 and 12 weeks. RESULTS: Forty participants completed the study. Participants were primarily females (87.5%), mean age was 47.5 ± 10.9 years. At the end of the intervention, participants in the MedDiet group reported significantly better physical function (p = 0.006) and quality of life (p = 0.037) compared to HEG group. From baseline to 12 weeks, physical function significantly improved in both diet groups, MedDiet (0.9 ± 0.5 to 0.5 ± 0.4 units, p < 0.001) and HEG (1.4 ± 0.7 to 1.0 ± 0.6 units, p < 0.001). Quality of life also significantly improved in the MedDiet (10.1 ± 7.5 to 4.0 ± 4.7 units, p < 0.001) and HEG group (11.25 ± 7.2 to 7.9 ± 6.4 units, p = 0.048). Physical activity improved significantly in the MedDiet (56.7 ± 28.6 to 70.6 ± 33.5 points, p = 0.01) but not within the HEG group despite similar recommendations. CONCLUSION: Adhering to the MedDiet and Irish Healthy Eating Guidelines resulted in improvements in RA patient-reported outcomes. The changes observed in both diet groups are likely due to the improvement in overall diet quality irrespective of dietary prescription. TRIAL REGISTRATION NUMBER: NCT04262505.

Diversifying selection identified in immune epitopes of bovine coronavirus isolates from Irish cattle.

Bovine betacoronavirus (BoCoV) is a pneumoenteric pathogen of cattle that is closely related to human coronavirus OC43. Vaccines are administered to protect against diseases caused by BoCoV, but knowledge gaps exist with regard to correlates of protection and the effect of immune evasion on driving evolution. In this study, immune epitopes were mapped onto BoCoV structural proteins, including spike and haemagglutinin esterase (HE), and then supported with targeted gene sequencing of Irish clinical isolates and selective pressure analysis. Increased prevalence of diversifying selection and amino acid changes in some mapped immune epitopes suggests that immune escape is selecting for non-synonymous mutations arising in these regions. Selection analysis and sequencing provided increased support for neutralising antibody (nAb) epitopes compared to others, suggesting that nAbs are an important arm of the immune response to BoCoV. Phylogenetic analysis of spike and HE sequences showed that Irish isolates from this study were in the European clade, except for one HE sequence that sat in the Asian/American clade, while the spike gene of this sample was in the European clade. Recombination between a European and an Asian/American isolate would give rise to such a sequence. This study has gathered evidence suggesting that pressure to evade the nAb response is contributing to BoCoV evolution.

Financial incentives to stop smoking: Potential financial consequences of different reward schedules.

INTRODUCTION: Financial incentives to stop smoking (FISS) programs have been implemented internationally to encourage people who smoke to quit smoking. However, such programs require that the financial reward structure and its resulting effects on smoking quit rates are considered. We analyzed a number of scenarios for FISS reward schedules for current smoking individuals in Ireland, with a view to identify the potential implications in terms of financial consequences and expected effects. METHODS: Using national QuitManager services data 2021-2023, we defined smoking quit rates for smokers currently using the national Health Services Executive stop smoking services in Ireland. Smoking quit rates at 4, 12 and 52 weeks were defined, and additionally defined by sex, age and education level. Using scenarios assuming different FISS reward sizes, structures and targeted population sub-groups, we estimated the number of additional quitters, budget impact, and incremental cost-effectiveness ratio. RESULTS: A FISS program, if implemented for a cohort of 3500 smokers can result in a budget impact ranging €250000 - €870000. The cost-effectiveness trade-off between different payment schedules and the expected effect size suggested that FISS are cost-effective even at a moderate effect size. A FISS program implemented to approximately 20000 smokers nationally would cost between €2.0 million and €4.8 million, subject to the chosen reward schedule. Across social groups, FISS is more cost-effective for females, individuals in the youngest age group, and individuals with a medium level of education. CONCLUSIONS: This analysis highlights the importance of considering different FISS schedules and potential quit effects, when designing such programs. We highlight that FISS programs should be targeted at certain social groups to achieve highest long-term smoking cessation rates. We also identified important challenges that decision-makers face when designing the reward structure of FISS programs. The acceptability or otherwise of the FISS structures may differ among stakeholders and should be explored.

When missing becomes murder: An analysis of missing-femicide cases from the Republic of Ireland.

Many femicide cases are initially reported as missing persons to the police. Women who go missing have a greater risk of being a victim of homicide. This study explores the circumstances surrounding the disappearance and killing of women and girls in the Republic of Ireland from 1962 to 2023. A total of fifty-four cases were analysed, 52 cases were homicides. Most femicides occurred during 1990-1999 (n = 13; 24%) and 2000-2009 (n = 17; 32%). Twenty-five victims knew the offender and the leading cause of death was strangulation with 27 cases. Dumping/leaving the body on open ground with little or no concealment was the predominant method of disposal. The leading risk factors were the engagement of the victim in a fight or row before disappearance and domestic violence. The 'suicide narrative' should be treated with extreme caution in the disappearance of women.

Longitudinal relations between child emotional difficulties and parent-child closeness: a stability and malleability analysis using the STARTS model.

BACKGROUND: Past empirical evidence on the longitudinal relations between emotional mental health symptoms and parent-child close relationships has produced mixed and inconclusive results. Some studies suggest a unidirectional relation, whereas other studies point toward a bidirectional association. Additionally, most of the past research has been carried out with adolescent samples, rather than children. Hence, this study aimed to estimate the longitudinal relations between children's trait emotional difficulties and trait parent-child closeness, accounting for the time-invariant and time-varying state components of each factor. METHODS: Participants were 7,507 children (ages 3 years, 5 years, 7 years, and 9 years) from the Growing Up in Ireland cohort. Α bivariate stable trait, autoregressive trait, and state (STARTS) model was estimated using Bayesian structural equation modelling. RESULTS: The STARTS model revealed that children's emotional difficulties and parent-child closeness were relatively stable across time, and these overarching traits were strongly negatively correlated. Children's earlier trait emotional difficulties predicted later trait parent-child closeness and vice versa between 3 years and 5 years, and between 5 years and 7 years, but these effects disappeared between 7 years and 9 years. At all pairs of time points, state emotional difficulties and state parent-child closeness were weakly negatively correlated. CONCLUSIONS: Overall, the results suggest that early and middle childhood are critical stages for improving parent-child relationships and reducing children's emotional difficulties. Developing close parent-child relationships in childhood appears to be a key factor in reducing children's subsequent emotional difficulties. Children who face greater than usual emotional difficulties tend to be more withdrawn and less receptive to close parent-child relationships and this could serve as an important screening indicator.

Maximizing Satisfaction in Orthopedic Outpatient Clinics: Evidence From Ireland.

Background Patient satisfaction is a critical metric in healthcare, reflecting the quality of care provided and influencing clinical outcomes and healthcare utilization. In orthopedic outpatient clinics, patient satisfaction affects patient adherence to treatment plans and overall health outcomes. This study aims to identify and analyze key factors influencing patient satisfaction in orthopedic outpatient clinics. Methodology This cross-sectional study was conducted from April to May 2024 across 10 orthopedic outpatient clinics. In this study, family members were included as respondents to the Patient Satisfaction Questionnaire (PSQ) when patients were unable to complete the survey due to age, cognitive impairment, or physical disabilities. This approach was adopted to ensure that the experiences of all patients, particularly minors, elderly individuals, and those with disabilities, were accurately captured. The PSQ assessed various aspects of patient satisfaction, including communication, treatment plans, addressing concerns, clinic environment, and overall satisfaction. Quantitative data were analyzed using SPSS version 27.0 (IBM Corp., Armonk, NY, USA). Results The study included 172 respondents. High levels of overall satisfaction were reported, with 142 (82.6%) respondents very satisfied and 28 (16.2%) somewhat satisfied. Significant associations were found between overall satisfaction and several factors, namely, effective communication, thorough explanation of treatment plans, addressing patient concerns, and a clean, comfortable clinic environment. Shorter waiting times were also associated with higher satisfaction. Regression analysis revealed that staff rating and the thoroughness of treatment plans were significant predictors of overall satisfaction. Conclusions Effective communication, thorough treatment explanations, addressing patient concerns, and maintaining a clean clinic environment are key determinants of patient satisfaction in orthopedic outpatient clinics. Reducing waiting times and investing in staff training on communication and empathetic care can further enhance patient satisfaction. These findings provide valuable insights for healthcare providers and administrators aiming to improve patient experiences in orthopedic outpatient settings. Further research is recommended to explore these relationships in diverse settings and develop targeted interventions.

Mitigation of ammonia and methane emissions with manure amendments during storage of cattle slurry.

This study aimed at assessing the efficacy of manure amendments in abating ammonia (NH3) and methane (CH4) emissions during storage. Two experiments were carried out. Experiment 1 was conducted using 20 L of slurry for 98 days. Treatments were: aluminium sulphate (alum), lactogypsum, zeolite, actiglene, ammonium thiosulphate, biochar, dairy processing waste, Digest-IT and control (without amendment). Experiment 2 was conducted using 660 L of slurry in underground storage tanks for 77 days. Treatments were: sulphuric acid, gypsum, biochar and control (without amendment). NH3 measurements for experiment 1 and experiment 2 were conducted using the photoacoustic gas monitor and dynamic chamber techniques, respectively. CH4 was measured using the static chamber technique in both experiments. The effect of amendments on slurry composition was determined at the end of the experiments. Experiment 1 showed a significant reduction in NH3 emissions in the alum (82%), lactogypsum (46%) and zeolite (32%) treatments relative to the control (100.3% total ammoniacal nitrogen (TAN)). CH4 was reduced significantly in the alum (87%), ammonium thiosulphate (64%) and lactogypsum (67%) relative to the control (291.9 g m-2). Experiment 2 showed a significant reduction (32%) in NH3 emissions in the sulphuric acid relative to the control (4.4% TAN). CH4 was reduced significantly in the sulphuric acid (46%), gypsum (39%) and biochar (15%) treatments relative to the control (291.9 g m-2). In general, amendments altered slurry composition such as dry matter, volatile solids, carbon and nitrogen contents at the end of storage. Lactogypsum, alum and sulphuric acid were effective in abating both NH3 and CH4 emissions and can contribute to improving air quality.

SARS-CoV-2 Seropositivity in Urban Population of Wild Fallow Deer, Dublin, Ireland, 2020-2022.

SARS-CoV-2 can infect wildlife, and SARS-CoV-2 variants of concern might expand into novel animal reservoirs, potentially by reverse zoonosis. White-tailed deer and mule deer of North America are the only deer species in which SARS-CoV-2 has been documented, raising the question of whether other reservoir species exist. We report cases of SARS-CoV-2 seropositivity in a fallow deer population located in Dublin, Ireland. Sampled deer were seronegative in 2020 when the Alpha variant was circulating in humans, 1 deer was seropositive for the Delta variant in 2021, and 12/21 (57%) sampled deer were seropositive for the Omicron variant in 2022, suggesting host tropism expansion as new variants emerged in humans. Omicron BA.1 was capable of infecting fallow deer lung type-2 pneumocytes and type-1-like pneumocytes or endothelial cells ex vivo. Ongoing surveillance to identify novel SARS-CoV-2 reservoirs is needed to prevent public health risks during human-animal interactions in periurban settings.

Risk-Based Targeting of Animals for Ancillary Testing during a Bovine Tuberculosis Breakdown Is Associated with a Reduced Time to Test Failure: Indirect Evidence of Mycobacterium bovis Exposure?

Bovine tuberculosis (bTB) continues to have significant economic and veterinary health impacts on cattle herds where the disease remains endemic. The continual tailoring of policies to address such maintenance requires an in-depth analysis of national data, underpinning new control strategies. In Ireland, when outbreaks occur, ancillary testing of herd mates deemed to be at the highest risk of exposure to reactors is undertaken using the interferon gamma (GIF) test. This highest risk cohort was hypothesised to be of a higher future risk despite this ancillary testing. We used a dataset from Ireland to model bovine test failure to the comparative tuberculin skin test using a survival analysis (observations: 39,248). Our primary exposure of interest was whether an animal that tested negative had a GIF test after the disclosure of infection within a herd during a bTB breakdown. There was evidence that animals with a negative GIF test during a breakdown had an increased risk of failing a test relative to other animals from the same herds without this exposure. The time to failure was 48.8% (95%CI: 38.3-57.5%) shorter for the exposed group relative to the unexposed group during a two-year follow-up period (2019-2022; time ratio: 0.51; 95%CI: 0.43-0.62; p < 0.001). The results from this study suggest that animals who were GIF-tested, having been deemed to have a higher risk of exposure, subsequently had shorter time-to-test failure periods. The absolute numbers of failure are small (only 2.5% of animals go on to fail during 2-year follow-up). Importantly, however, a high proportion of these high-risk herds included in the dataset failed at least one test at the follow-up (21/54 herds), impacting breakdown duration or recurrence. Such risk-informed targeting of animals could be utilised in future control policies, though further research is warranted.

Direct healthcare costs in the first 2 years of life: A comparison of screened and clinically diagnosed children with cystic fibrosis - The Irish comparative outcomes study of CF (ICOS).

BACKGROUND: In July 2011, Cystic Fibrosis (CF) was added to the Newborn Bloodspot Screening Programme in Ireland. The Irish Comparative Outcomes Study (ICOS) is a historical cohort study established to compare outcomes between clinically-detected and screen-detected children with CF. Here we present the results of economic analysis comparing direct healthcare costs in the first 2 years of life of children born between mid-2008 and mid-2016, in the pre-CF transmembrane conductance regulator modulator era. METHODS: Healthcare resource use information was obtained from Cystic Fibrosis Registry of Ireland (CFRI), medical records and parental questionnaire. Hospital admissions, emergency department visits, outpatient appointments, antibiotics and maintenance medications were included. Costs were estimated using the Health Service Executive Casemix, Irish Medicines Formulary and hospital pharmacy data, adjusted for inflation using Consumer Price Index data from the Central Statistics Office. A Negative Binomial regression was used, with time in the study as an offset. RESULTS: Overall participation was 93 %. After exclusion of those with meconium ileus, data from 139 patients, with follow-up to 2 years of age, were available. 72 (51.8 %) were from the clinically diagnosed cohort. In the final model (n=105), clinically diagnosed children had 2.62-fold higher costs per annum (p<0.0001), when adjusted for confounders, including homozygous ΔF508 or G511D mutation, socio-demographic factors and time between diagnosis and first CFRI interaction. CONCLUSIONS: There are few studies evaluating economic aspects of newborn screening for CF using routine care data. These results imply that the benefits of newborn screening extend to direct healthcare costs borne by the State.

Overcoming socioeconomic adversity: Academic resilience in mathematics achievement among children and adolescents in Ireland.

Although socioeconomic disadvantage is linked with academic underachievement, many children from low-income backgrounds perform well in school. Which modifiable factors predict this academic resilience? We examine between- and within-person predictors of one important academic metric - mathematics performance - across adolescence in 1715 (796 male, 919 female) youth living in poverty in Ireland, using data from three waves (9, 13, and 17/18 years) of the Growing Up in Ireland study. Using linear mixed models, math performance was worse when adolescents had more socioemotional and behavioural difficulties, more child-parent relationship conflict, parents had lower expectations of the adolescent's educational achievement, and when primary caregivers had less education. Adolescents who had better intellectual self-concept and attended a non-disadvantaged school had greater math performance. This research adds to the growing body of work suggesting academic resilience is dynamic and multisystemic; it provides potential targets at multiple levels to promote such resilience.