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Purpose: Palmaria palmata ( P. Palmata) is reported to contain anti-inflammatory and antioxidant compounds albeit no study has investigated these effects in humans. Methods: A randomised parallel placebo-controlled human intervention study was carried out to investigate the effect of consuming P. Palmata (5 g/day) incorporated into a bread on serum markers of inflammation [C-reactive protein (CRP); cytokine analysis] with secondary analysis investigating changes in lipids (cholesterol, triglycerides), thyroid function [thyroid-stimulating hormone (TSH)] and antioxidant status ferric reducing antioxidant power. ANCOVA with baseline values as covariates, controlling for age, BMI, sex and smoking status, was used to compare differences between treatment groups over time . In vitro studies investigated the inflammatory activity of P. Palmata extracts (hot water, cold water and ethanol extract), protein extracts and associated protein hydrolysates using a Caco-2 inflammation cell model. Results: Consumption of P. Palmata-enriched bread significantly increased serum CRP (+16.1 %, P = 0.011), triglycerides (+31.9 %, P = 0.001) and TSH (+17.2 %, P = 0.017) when compared to the control group. In vitro evaluation of P. palmata extracts and protein hydrolysates identified a significant induction of IL-8 secretion by Caco-2 cells, and the hot water P. palmata extract was shown to increase adipocyte glycerol release ( P < 0.05). Conclusion: Evidence from this human study suggests that P. palmata stimulates inflammation, increases serum triglycerides and alters thyroid function; however, these changes are not likely to impact health as changes remained within the normal clinical range. The data from the in vitro study provided indications that IL-8 may contribute to the apparent immunostimulation noted in the human study. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to use general practice data to estimate the prevalence of diabetic nephropathy within the registered diabetes patients and examine variation in practice prevalence and management performance since introduction of this initiative. Methods Reported quality indicators from the Northern Ireland General Practice Quality and Outcomes Framework were analysed for diabetes and diabetic nephropathy prevalence and management in the period 2004-2008. Variation in prevalence at practice level was assessed using multiple linear regression adjusting for age, practice size, deprivation and glycaemic control. Results In 2006-2007, 57 454 (4.1%) adult diabetic patients were registered in the denominator population of 1.4 million comparedwith 51 923 (3.8%) in 2004-2005 (mean practice range 0.5-7.7%).Diabetic nephropathy prevalencewas 15.1 and 11.5%, respectively (8688 and 5955 patients). Documented diabetic nephropathy prevalence showed marked variation across practices (range 0-100%) and was significantly negatively correlatedwith diabetes list size, albumin creatinine ratio testing rates and renin-angiotensin-aldosterone system blockade use and positively correlated with exception reporting rates. Specifically, for every increase in 100 diabetic patients to a register, documented diabetic nephropathy prevalence reduced by 40% (P = 0.003). On the positive side, median albumin-creatinine ratio testing rates doubled to 82%compared with figures in the pre-Framework era. Conclusions Implementation of the Northern Ireland General Practice Quality and Outcomes Framework has positively benefitted testing for diabetic nephropathy and increased numbers of detected patients in a short space of time.Large variation in diabetic nephropathy prevalence remains and is associated with diabetes registry size, screening and treatment practices, suggesting that understanding this variation may help detect and better manage diabetic nephropathy. [ABSTRACT FROM AUTHOR]

The Northern Health and Social Care Trust developed an enhanced palliative care pharmacy service for acute inpatients within a large hospital in Northern Ireland during the initial COVID-19 surge. By training additional staff, there was an opportunity to increase service provision, utilising palliative care pharmacy skills to undertake activities such as the symptom management of patients, appropriate management of medicines, improved access to medicines, advice for other healthcare professionals, and supporting discharge from the hospital. The data collected showed a mean of 6.8 interventions per patient, and that, irrespective of the demand resulting from the COVID-19 pandemic, the palliative care pharmacy team had a role in improving the quality of care for palliative and end-of-life patients. Subsequent data analysis also demonstrated associated cost saving and the potential for the palliative care pharmacy team to reduce the length of stay at the hospital. [ABSTRACT FROM AUTHOR]

This case study explores the commitment of the second Lord Lurgan, Charles Brownlow (1831-1882), to the sport of coursing. Brownlow was a Protestant Whig peer and large landowner in Lurgan in County Armagh, whose wealth was based on land, agriculture, linen manufacture and market revenues. The paper sets both coursing and the Brownlow family in their historic contexts. Brownlow was strongly committed to coursing, and organized, entered and provided much of the prize money for the Lurgan coursing meeting from 1858 to 1877. He was president of the meeting and hosted leading visitors at his country house, while also acting as steward at meetings elsewhere. He bred greyhounds, and was also involved in English coursing, most successfully as a leading member of the exclusive Altcar Club near Liverpool. He won the leading British coursing event, the Waterloo Cup, three times with his dog, Master McGrath, wins that were popularly seized upon as Irish triumphs. His love of coursing, and high spending to maintain his involvement, contributed to financial problems, forcing him finally to abandon his hobby and sell up the estate. [ABSTRACT FROM AUTHOR]

Background: Maternal phenylketonuria (PKU) can result in multiple congenital anomalies. In Northern Ireland, the prevalence of PKU is relatively high at 1 in 4000. Objective: To assess the outcome of 39 pregnancies in 20 mothers. Results: Dietary control was established before conception in 17 pregnancies (44%). Five mothers with hyperphenylalaninaemia had 11 pregnancies. There were no congenital anomalies in this group, and all appear to be developing normally. Fifteen women with classical PKU had 28 pregnancies. One pregnancy ended in a first trimester miscarriage. Twelve out of 27 (44%) completed pregnancies produced babies with a congenital anomaly and/or developmental delay. Conclusions: Most problems occurred when dietary control was not established until after the 2nd trimester. As the cohort of young women with treated PKU is growing steadily, maternal PKU is going to become an even greater cause for concern. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to develop and validate an accurate risk prediction model for both mortality and a combined outcome of mortality and morbidity for maternal admissions to critical care.Design: We used data from a high-quality prospectively collected national database, supported with literature review and expert opinion. We tested univariable associations between each risk factor and outcome. We then developed two separate multivariable logistic regression models for the outcomes of acute hospital mortality and death or prolonged ICU length of stay. We validated two parsimonious risk prediction models specific for a maternal population.Setting: The Intensive Care National Audit and Research Centre Case Mix Programme is the national clinical audit for adult critical care in England, Wales, and Northern Ireland.Patients: All female admissions to adult general critical care units, for the period January 1, 2007-December 31, 2016, 16-50 years old, and admitted either while pregnant or within 42 days of delivery-a cohort of 15,480 women.Interventions: None.Measurements and Main Results: We aimed to develop and validate an accurate risk prediction model for both mortality and a combined outcome of mortality and morbidity for maternal admissions to critical care. For the primary outcome of acute hospital mortality, our parsimonious risk model consisting of eight variables had an area under the receiver operating characteristic of 0.96 (95% CI, 0.91-1.00); these variables are commonly available for all maternal admissions. For the secondary composite outcome of death or ICU length of stay greater than 48 hours, the risk model consisting of 17 variables had an area under the receiver operating characteristic of 0.80 (95% CI, 0.78-0.83).Conclusions: We developed risk prediction models specific to the maternal critical care population. The models compare favorably against general adult ICU risk prediction models in current use within this population. [ABSTRACT FROM AUTHOR]

Aim: To investigate the changing profile of children attending a special school for visually impaired children over a 30-year period., Methods: Between 1975 and 2004, 266 children were identified as having been students in the introductory years to secondary education at Jordanstown School. School records and records from the Regional Paediatric Low Vision Clinic at the Royal Victoria Hospital, Belfast were examined to obtain data regarding age, primary ophthalmic diagnosis, visual acuity and any additional impairment., Results: There was no statistically significant change in mean visual acuity of the children entering the secondary school over this period (p > 0.1). Albinism was the most common single condition (20.3%). Notable also was the reduction in incidence of visual impairment following congenital glaucoma and cataract and the corresponding increase in cortical visual impairment (CVI) during this period., Conclusion: During the last 30 years medical/surgical treatment has reduced the impact of treatable conditions (e.g. cataract) on visual impairment to the extent that their prevalence within this school has decreased. Consequently, children with non-treatable conditions (e.g. albinism) constitute a larger proportion of the school population. An increase in the proportion of children with CVI and learning disability in the school was noted.