An evaluation of the health-behaviours of farmers in the South-East of Ireland

An evaluation of the health-behaviours of farmers in the South-East of Ireland A. Storey1, A. Lane1, C. Cunningham2 and J. McNamara3. 1Department of Health, Sport and Exercise Science, Waterford Institute of Technology, 2School of Public Health, Physiotherapy and Population Science, University College Dublin, 3Health and Safety Officer, Teagasc, Kildalton College. Introduction Farming has traditionally been considered to be an active outdoor profession with largely positive health outcomes (Blair et al., 2005). Yet a recent evaluation of Irish population and mortality data over the period from 2000 to 2006 has indicated that of all occupational groupings, farmers and agricultural workers have the highest all-cause mortality rate and should therefore in themselves be considered a high risk group (Smyth et al., 2013). Within this study the highest standardised mortality ratios were reported for the behaviour-related chronic diseases: cardiovascular disease and cancer. The aim of the present study was to investigate the health behaviours that distinguish farmers from the general population as reported in the Survey of Lifestyles, Attitudes, and Nutrition (SLAN) in Ireland (Morgan et al., 2008), which may contribute to the differential in mortality statistics. Methods A self-administered paper-based questionnaire was used to obtain cross sectional data on the health and health behaviours of farmers in the South-East of Ireland. A total of 366 farmers attending either Teagasc organised training courses or Irish Farmers’ Association meetings between March and August 2013 completed the questionnaire. Non-probability quota sampling was the selection method employed in the study. The questionnaire was a modified version of the SLAN. It contained sections evaluating general health, physical activity (PA), smoking and alcohol consumption. Chi-squared comparisons were made between health behaviours of farmers the general population as reported in SLAN. Questionnaire results are presented together with general population data (Pop.), chi-squared and two-tailed significance (in parentheses). The study was approved by the Research Ethics Board of Waterford Institute of Technology. Results and Discussion The sample included 316 male and 50 female respondents with a combined mean age of 42 ± 14.1 (SD) years. Of the total sample, 64% of farmers (Pop.=58%; χ2=5.1; p=0.02) reported their health as being ‘very good’ or ‘excellent’ and only 0.5% (Pop.=3%; χ2=7.5; p30kg.m-2). Despite 60% being classified as overweight or obese, just 27% believed that they were too heavy. Fifty-four percent of farmers (Pop.=24%; χ2=170.7; p<0.01) achieved high levels of PA, 24% (Pop.=47%; χ2=75.0; p<0.01) moderate and 22% (Pop.=29%; χ2=8.1; p<0.01) low PA. Thirty-nine percent (Pop.=48%; χ2=11.3; p<0.01) reported that they had smoked at some point in their lives, while 18% (Pop.=29%; χ2=20.8; p<0.01) were current smokers. Of those who previously smoked, 26% had stopped smoking within the past year. Eighty-five percent (Pop.=80%; χ2=5.5; p=0.02) of farmers reported drinking alcohol on some occasions. 19% (Pop.=28%; χ2=13.9; p<0.01) of farmers reported binge drinking (having 6 or more standard drinks on one occasion) at least once per week. Conclusions Farmers’ self-perception of their health is good, although they perhaps do not fully acknowledge or address ill-health. Prevalence of LBP is significantly greater than in the general population. While PA, smoking and alcohol behaviours are healthier than the general population, there is a higher prevalence of overweight and obesity. In addition to being an independent risk factor for chronic disease, overweight is also a risk factor for LBP. As LBP-associated disability can precipitate other comorbidities (Schneider et al., 2007), farmers should pay attention to their risk factors for LBP including body weight and manual handling techniques, particularly in the context that lifting and carrying are integral components of farming activity. Acknowledgements We gratefully acknowledge the significant contributions of Teagasc, the Irish Farmers’ Association, Irish Rural Link in Midlands, the participating farmers and Bríd McNamara. References Blair, A., Sandler, D.P., Tarone, R., Lubin, J., Thomas, K., Hoppin, J.A., Zahm, S.H., Lynch, C.F., Rothman, N., Alavanja, M.C.R. (2005). Mortality among participants in the agricultural health study. Annals of Epidemiology, 15(4): 279–85. Morgan K., McGee H., Watson D., Perry I., Barry M., Shelley E., Harrington J., Molcho M., Layte R., Tully N., van Lente E., Ward M., Lutomski J. , Conroy R., Brugha R. (2008) SLÁN 2007: Survey of Lifestyle, Attitudes & Nutrition in Ireland. Main Report. Dublin: Department of Health and Children. Schneider S., Mohnen S.M., Schiltenwolf M., Rau C. (2007) Eur J Pain. 11(4):387-97 Smyth, B., Evans, D.S., Kelly, A., Cullen, L. & O'Donovan, D. (2013) Eur J Public Health. 23(1):50-5

New reactive fluorophores in the 1,2,3-trianze series

A one-pot synthesis of new fluorescent 2,5-dihydro-1,2,3-triazines with reactive functional groups and a large Stokes shift of 200 nm is described

New reactive fluorophores in the 1,2,3-trianze series

A one-pot synthesis of new fluorescent 2,5-dihydro-1,2,3-triazines with reactive functional groups and a large Stokes shift of 200 nm is described

Investigating the Dietary Habits of Male Irish Farmers to Prevent Mortality and Morbidity

peer reviewedExcess mortality and morbidity among Irish farmers from non-communicable diseases (NCDs) has been linked to a range of occupational risk factors. Obesity is a key risk factor underpinning this excess burden and unhealthy eating habits are linked to overweight/obesity and to disease occurrence. This study investigated the dietary habits of a sub-group of Irish male farmers and explored how these might potentially impact on health outcomes. Cross-sectional survey research was undertaken using self-reported quantitative data, based on convenience sampling and a 24-h food re-call survey. Data were analysed using frequency and chi-square analysis. Where possible, findings were compared to national survey data for Irish males. Findings revealed that a high proportion of farmers were overweight or obese and that dietary habits consisted of low intake of fruit, vegetables, and dairy and a high intake of meat, fried and processed foods, salt, and sugary and/or salty snacks. Younger farmers reported a significantly higher intake of processed meats; however, no associations were found between age, lifestyle behaviours, and dietary habits. The findings provide a greater understanding of how dietary habits potentially contribute to poorer health outcomes among farmers and underline the need for health promotion interventions, including healthy eating campaigns, aimed at farmers

Identification of nutrition factors in the metabolic syndrome and its progression over time in older adults: analysis of the TUDA cohort

BACKGROUND: Nutrition is recognized as playing an important role in the metabolic syndrome (MetS), but the dietary components involved are unclear. We aimed to investigate nutrition factors in relation to MetS and its progression in older adults over a follow-up period of 5.4 years.METHODS: Community-dwelling adults (≥ 60y) from the Trinity-Ulster-Department-of-Agriculture study, sampled at baseline (2008-12) and follow-up (2014-18; n 953), were classified as 'with MetS' by having three or more of: waist circumference (≥ 102 cm, males; ≥ 88 cm, females); HDL-cholesterol (&lt; 1.0 mmol/L, males; &lt; 1.3 mmol/L, females); triglycerides (≥ 1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and hemoglobin A1c (≥ 39 mmol/mol).RESULTS: MetS was identified in 67% of participants, increasing to 74% at follow-up. Predictors at baseline for the development of metabolic syndrome (MetS) at follow-up were higher waist circumference (odds ratio [95%CI]; 1.06 [1.01-1.11]), but not BMI, and increased triglyceride concentrations (2.01 [1.29-3.16]). In dietary analysis (at follow-up), higher protein (g/kg bodyweight/day) and monounsaturated fatty acid (g/day) intakes were each associated with lower risk of MetS (0.06 [0.02-0.20] and 0.88 [0.78-1.00], respectively), whilst higher protein was also associated with lower abdominal obesity (0.10 [0.02-0.51]) and hypertension (0.22 [0.00-0.80]). Furthermore, participants with, compared to without, MetS consumed less high-quality protein foods (P = 0.006) and more low-quality protein foods (P &lt; 0.001), as defined by the protein digestibility-corrected amino acid score.CONCLUSIONS: Dietary interventions targeting protein quantity and quality may have specific benefits in preventing or delaying the progression of MetS in at-risk older people, but this requires investigation in the form of randomized trials.</p

Association of dietary flavan-3-ol intakes with plasma phenyl-γ-valerolactones: analysis from the TUDA cohort of healthy older adults

Background: Dietary polyphenols, including flavan-3-ols (F3O), are associated with better health outcomes. The relationship of plasma phenyl-γ-valerolactones (PVLs), the products of colonic bacterial metabolism of F3O, with dietary intakes is unclear. Objectives: To investigate whether plasma PVLs are associated with self-reported intakes of total F3O and procyanidins+(epi)catechins. Design: We measured 9 PVLs by uHPLC-MS-MS in plasma from adults (&gt;60y) in the Trinity-Ulster-Department of Agriculture (TUD study (2008 to 2012; n=5,186) and a follow-up subset (2014 to 2018) with corresponding dietary data (n=557). Dietary (poly)phenols collected by FFQ were analyzed using Phenol-Explorer. Results: Mean (95% confidence interval [CI]) intakes were estimated as 2283 (2213, 2352) mg/d for total (poly)phenols, 674 (648, 701) for total F3O, and 152 (146, 158) for procyanidins+(epi)catechins. Two PVL metabolites were detected in plasma from the majority of participants, 5-(hydroxyphenyl)-γ-VL-sulfate (PVL1) and 5-(4'-hydroxyphenyl)-γ-VL-3'-glucuronide (PVL2). The 7 other PVLs were detectable only in 1-32% of samples. Self-reported intakes (mg/d) of F3O (r = 0.113, P = 0.017) and procyanidin+(epi)catechin (r = 0.122, P = 0.010) showed statistically significant correlations with the sum of PVL1 and PVL 2 (PVL1+2). With increasing intake quartiles (Q1-Q4), mean (95% CI) PVL1+2 increased; from 28.3 (20.8, 35.9) nmol/L in Q1 to 45.2 (37.2, 53.2) nmol/L in Q4; P = 0.025, for dietary F3O, and from 27.4 (19.1, 35.8) nmol/L in Q1 to 46.5 (38.2, 54.9) nmol/L in Q4; P = 0.020, for procyanidins+(epi)catechins. Conclusions: Of 9 PVL metabolites investigated, 2 were detected in most samples and were weakly associated with intakes of total F3O and procyanidins+(epi)catechins. Future controlled feeding studies are required to validate plasma PVLs as biomarkers of these dietary polyphenols

Advancing specificity in delirium: The delirium subtyping initiative

BACKGROUND: Delirium, a common syndrome with heterogeneous etiologies and clinical presentations, is associated with poor long-term outcomes. Recording and analyzing all delirium equally could be hindering the field's understanding of pathophysiology and identification of targeted treatments. Current delirium subtyping methods reflect clinically evident features but likely do not account for underlying biology. METHODS: The Delirium Subtyping Initiative (DSI) held three sessions with an international panel of 25 experts. RESULTS: Meeting participants suggest further characterization of delirium features to complement the existing Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision diagnostic criteria. These should span the range of delirium-spectrum syndromes and be measured consistently across studies. Clinical features should be recorded in conjunction with biospecimen collection, where feasible, in a standardized way, to determine temporal associations of biology coincident with clinical fluctuations. DISCUSSION: The DSI made recommendations spanning the breadth of delirium research including clinical features, study planning, data collection, and data analysis for characterization of candidate delirium subtypes. HIGHLIGHTS: Delirium features must be clearly defined, standardized, and operationalized. Large datasets incorporating both clinical and biomarker variables should be analyzed together. Delirium screening should incorporate communication and reasoning

Scaling up data curation using deep learning: An application to literature triage in genomic variation resources.

Manually curating biomedical knowledge from publications is necessary to build a knowledge based service that provides highly precise and organized information to users. The process of retrieving relevant publications for curation, which is also known as document triage, is usually carried out by querying and reading articles in PubMed. However, this query-based method often obtains unsatisfactory precision and recall on the retrieved results, and it is difficult to manually generate optimal queries. To address this, we propose a machine-learning assisted triage method. We collect previously curated publications from two databases UniProtKB/Swiss-Prot and the NHGRI-EBI GWAS Catalog, and used them as a gold-standard dataset for training deep learning models based on convolutional neural networks. We then use the trained models to classify and rank new publications for curation. For evaluation, we apply our method to the real-world manual curation process of UniProtKB/Swiss-Prot and the GWAS Catalog. We demonstrate that our machine-assisted triage method outperforms the current query-based triage methods, improves efficiency, and enriches curated content. Our method achieves a precision 1.81 and 2.99 times higher than that obtained by the current query-based triage methods of UniProtKB/Swiss-Prot and the GWAS Catalog, respectively, without compromising recall. In fact, our method retrieves many additional relevant publications that the query-based method of UniProtKB/Swiss-Prot could not find. As these results show, our machine learning-based method can make the triage process more efficient and is being implemented in production so that human curators can focus on more challenging tasks to improve the quality of knowledge bases

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Managing polyuria during lithium treatment: a preliminary prospective observational study

Objectives:Lithium-treated patients with polyuria are at increased risk of lithium toxicity. We aimed to describe the clinical benefits and risks of different management strategies for polyuria in community lithium-treated patients.Methods:This is a naturalistic, observational, prospective 12-month cohort study of lithium-treated patients with polyuria attending a community mental health service in Dublin, Ireland. When polyuria was detected, management changed in one of four ways: (a) no pharmacological change; (b) lithium dose decrease; (c) lithium substitution; or (d) addition of amiloride.Results:Thirty-four participants were diagnosed with polyuria and completed prospective data over 12 months. Mean 24-hour urine volume decreased from 4852 to 4344 ml (p = 0.038). Mean early morning urine osmolality decreased from 343 to 338 mOsm/kg (p = 0.823). Mean 24-hour urine volume decreased with each type of intervention but did not attain statistical significance for any individual intervention group. Mean early morning urine osmolality decreased in participants with no pharmacological change and increased in participants who received a change in medication but these changes did not attain statistical significance. Only participants who discontinued lithium demonstrated potentially clinically significant changes in urine volume (mean decrease 747 ml in 24 hours) and early morning urine osmolality (mean increase 31 mOsm/kg) although this was not definitively proven, possibly owing to power issues.Conclusions:Managing polyuria by decreasing lithium dose does not appear to substantially improve objective measures of renal tubular dysfunction, whereas substituting lithium may do so. Studies with larger numbers and longer follow-up would clarify these relationships