Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair

Objective

To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh.

Summary Background Data

Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce.

Methods

Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10].

Results

In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2).

Conclusions

Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.

A model framework to communicate the risks associated with aflatoxins

Risk communication is defined as the interactive exchange of information and opinions concerning risk, risk-related factors and risk perceptions amongst all the stakeholders of food safety throughout the risk analysis process. The interactive exchange of information occurs at three different levels i.e. informed level, dialogue level and engagement level. For an effective food safety risk communication (FSRC), it is important that the information should adhere to the core principles of risk communication which are transparency, openness, responsiveness and timeliness. Communication of a food safety risk within all the components of risk communication strategy constitutes a complex network of information flow that can be better understood with the help of a framework. Therefore, a model framework to communicate the risks associated with aflatoxins (AFs) dietary intake has been developed with the aim of (a) creating general awareness amongst public and (b) involving industry stakeholders in the prevention and control of risk. The framework has been motivated by the learnings and best practices outlined in the identified technical guidance documents for risk communication. Risk assessors, risk managers, industry stakeholders and general public have been identified as the major stakeholders for the present framework. Amongst them, industry stakeholders and general public has been selected as the major target audience for risk managers. Moreover, population residing in low- and middle-income countries (LMIC) has been identified as the main target group to reach.

Capturing the whole-school food environment in primary schools

OBJECTIVE

The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations.

DESIGN

SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion.

SETTING

Primary schools.

PARTICIPANTS

An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16).

RESULTS

The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %).

CONCLUSIONS

The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools.

Behaviour change interventions for responsible antimicrobial use on farms

BACKGROUND

In the coming years, major governance changes in the form of policy directives and regulations will catalyse major top-down change with respect to animal health on European farms in an effort to combat the OneHealth threat of antimicrobial resistance. This top-down approach must be met with bottom-up strategies to ensure target actors (namely, farmers and vets) are supported and motivated to change their practices, thus, avoiding unintended consequences of forced change. Although much behavioural research has explored the factors influencing antimicrobial practices on farms, a gap exists translating these findings into evidence-based behaviour change interventions that can be put into practice. The current study aims to fill this gap. It provides insights into identifying, understanding, and changing the behaviours of farmers and veterinarians with respect to the responsible use of antimicrobials in farming.

RESULTS

Through an inter-disciplinary and multi-actor approach, the study combines scientific knowledge from the behavioural sciences and animal health sciences, coupled with tacit knowledge from a co-design, participatory approach to recommend seven behaviour change interventions that can help to support good practices amongst farmers and vets, with respect to animal health, and reduce the use of antimicrobials on farms. The behaviour change interventions include message framing; OneHealth awareness campaign; specialised communications training; on-farm visual prompts and tools; social support strategies (for both farmers and vets); and antimicrobial use monitoring. The study details each intervention with respect to their evidence base and scientific concept, grounded in behavioural science, along with stakeholder feedback on design and delivery of the interventions.

CONCLUSIONS

These behaviour change interventions can be taken, adapted, and put into practice by the agri-food community to support good animal health practices and responsible antimicrobial use on farms.

Factors influencing dairy farmers' antibiotic use: An application of the COM-B model

In dairy farming, mastitis treatment is the most common reason for antimicrobial use. The overuse or misuse of antibiotics in agriculture has been associated with the development and spread of antimicrobial resistance (AMR). Traditionally, blanket dry cow therapy (BDCT), in which all cows receive antibiotic treatment, was used prophylactically to prevent and manage disease spread. In recent years, there has been a move toward selective dry cow therapy (SDCT), in which only clinically infected cows are treated with antibiotics. This study aimed to explore farmer attitudes toward antibiotic use (ABU), using the COM-B (Capability-Opportunity-Motivation-Behavior) model as a framework, to identify predictors of changing behavior toward SDCT and suggest interventions to encourage its uptake. Participant farmers (n = 240) were surveyed online between March and July 2021. Five items were found to be significant predictors of farmers having stopped BDCT: (1) having lower knowledge of AMR, (2) greater awareness of AMR and ABU (Capability), (3) feeling social pressure to reduce ABU (Opportunity), and (4) having greater professional identity, and (5) having positive emotions associated with stopping BDCT (Motivation). Direct logistic regression found that these 5 factors explained between 22 and 34.1% of the variance in making changes to BDCT practices. Additionally, objective knowledge was not correlated with current positive antibiotic practices, and farmers often perceived their antibiotic practices as more responsible than they actually were. A multifaceted approach, encompassing each of the predictors highlighted, should be taken to encourage farmer behavior change in relation to stopping BDCT. Additionally, as farmers' perceptions of their own behaviors may not align with their actual practices, awareness raising of what constitutes "responsible" behavior should be targeted at dairy farmers to motivate them to take action and adopt more responsible antibiotic practices.

Exploring veterinarians' behaviour relating to antibiotic use stewardship on Irish dairy farms using the COM-B model of behaviour change

Employing a theoretical model of human behaviour (COMB), the current study explores the factors influencing veterinarians' engagement with antibiotic use stewardship on Irish dairy farms. One-to-one semi structured interviews were carried out by telephone with 12 veterinarians whose daily work focused on dairy cattle. A thematic analysis approach was undertaken. The identified themes and sub-themes were then mapped to the COM-B model. This study identified challenges faced by veterinarians when trying to prescribe responsibly which included lack of training to encourage farmer behaviour change, issues with laboratory testing, pressures from farmers to prescribe antimicrobials, concern for animal welfare and farmers going elsewhere for prescriptions. Having a good knowledge of AMR, peers as an advice source, potential financial benefits for farmers as a result of reduced antimicrobial costs and accepting a shared responsibility for AMR, facilitate veterinarians in their role as antimicrobial stewards. The barriers and facilitators identified as influencing veterinarians' capability, opportunity and motivation to responsibly prescribe antimicrobials formed the basis for a number of practical recommendations which should be considered by advisory and policy making teams. Recommendations include; continuous training for veterinarians on AMR and alternatives to overcome the barriers faced when trying to promote reduced AMU, veterinarian peer support groups to improve confidence in their knowledge and decision making to minimise the effect of client pressures/expectations, setting up collaborative farmer and veterinarian working groups to promote a transparent working relationship and the development of affordable and efficient diagnostic and susceptibility testing.

An innovative food system approach to diversifying protein intake: Protein-I: Shared Island sustainable healthy nutrition

There is a need to transform our current food system if we are to feed the rapidly expanding global population while maintaining planetary health. Within the island of Ireland, there is an urgent need to diversify the foods that currently contribute to our populations' protein intake. A Shared Island Innovative Food System approach is required to achieve this in a manner that is sustainable and provides benefits to producers, consumers and other supply chain participants. The Protein-I project employs such an approach, with the paradigm focusing on production of plant food through to human health, while paying particular attention to the development of the rural bioeconomy. Using an interdisciplinary approach, the team will develop strategies to maximise sustainable plant protein production in a traceable/transparent fashion and assess the impact of changes to existing value chains and the development of new value chains for the rural economy. A smart supply chain technology solution tailored to the needs of the agri-food industry will be developed and tested. Additionally, we will co-design consumer-led approaches to diversify plant protein intake, model the impact of changes at the population level and perform human interventions to demonstrate efficacy in terms of achieving adequate nutrition and improved health. Comprehensive engagement with stakeholders is embedded throughout the whole project to embrace the multi-actor approach. Overall, the project will be a key step towards future-proofing our food system on the island of Ireland and moving towards protecting planetary and population health, within the context of a just transition.

The Power of Suggestion: Subjective Satiety Is Affected by Nutrient and Health-Focused Food Labelling with No Effect on Physiological Gut Hormone Release

Health claims on food labelling can influence peoples' perception of food without them actually eating it, for example driving a belief that a particular food will make them feel fuller. The aim of this study was to investigate whether nutrient and health claims on food labelling can influence self-reported, and physiological indicators of, satiation. A total of 50 participants attended two visits where they were asked to consume a 380 kcal breakfast (granola and yogurt) labelled as a 500 kcal 'indulgent' breakfast at one visit and as a 250 kcal 'sensible' breakfast at the other. The order of the breakfast descriptions was randomly allocated. Participants were unaware that the two breakfasts were the same product and that only the food labels differed. At each visit blood samples were collected to measure gut hormone levels (acylated ghrelin, peptide tyrosine-tyrosine and glucagon-like peptide-1) at three time points: 20 min after arrival (baseline), after 60 min (anticipatory, immediately prior to consumption) and after 90 min (post-consumption). Visual analogue scales measuring appetite (hunger, satiety, fullness, quantity and desire to eat) were completed prior to each sample. Between 60 and 90 min, participants consumed the breakfast and rated its sensory appeal. Participants reported a higher mean change in self-reported fullness for the 'indulgent' than the 'sensible' breakfast from anticipatory to post-consumption (mean difference: 7.19 [95% CI: 0.73, 13.6]; p = 0.030). This change was not observed for the other appetite measures at the other time points or gut hormone levels. This study suggests that nutrient and health claims on food labels may influence satiation as measured by self-reported fullness. It also suggests that the observed differences in satiety scores are not due to changes in the main appetite regulating gut hormones, but are more likely centrally mediated. More high-quality trials are required to confirm these findings.

OC-053 LONG-TERM FOLLOW-UP OF A SLOWLY RESORBABLE BIOSYNTHETIC MESH IN VHWG GRADE 3 HERNIA REPAIR

Background

Incisional hernia recurrence occurs frequently after initial repair. In potentially contaminated hernia, these numbers can rise up to 50%. Recently, resorbable meshes have been used to prevent infection in complicated incisional hernia and prevent long term mesh complications. Present study focuses on the long term outcomes of a resorbable mesh.

Methods

Patients included in the priorly conducted Phasix trial with Ventral Hernia Working Group (VHWG) grade 3 hernia were invited for an abdominal CT scan and physical examination. Primary outcome was hernia recurrence, secondary outcomes comprised of abdominal wall configuration, mesh resorption and long term mesh complications.

Results

Of the 84 patients included in the 2-year follow-up, 56 were available for long term follow-up up to five years. Mean follow-up time was 4.2 years. CT scan was made in 36 (64.3%) of patients. Kaplan-Meier analysis showed a recurrence rate of 16.7% after five years. Four (7.1%) new recurrences were found between 2-year and 4.2 years follow-up of which three by CT scan. In 50% of CT scans, no signs of postoperative distortions of the abdominal wall were observed. No long term mesh complications were reported.

Conclusion

After long term follow-up, VHWG 3 hernia repair with biosynthetic mesh demonstrated good performance with regard to hernia recurrence. Possibly, tissue reconstruction took place in the first two years after implantation by the use it or lose it principle, which led to sufficient native abdominal wall strength to prevent recurrences after resorption of the mesh.

An online survey of dietary quality during complementary feeding; associations with maternal feeding self-efficacy and adherence to dietary recommendations

Background

Parents are the gatekeepers of nutrition in early life and their feeding practices form children’s dietary behaviours. Although maternal characteristics have been associated with certain feeding practices, their relationship with overall quality of complementary feeding diets has not been explored. This study aimed to: assess dietary quality in complementary feeding age; explore its association with maternal and child characteristics; and evaluate the association between complementary feeding practices and child weight.

Methods

An online cross-sectional survey captured data from a self-selected sample of mothers living in the UK with a healthy full-term child in complementary feeding age. A total of 466 mothers completed a questionnaire on their complementary feeding practices, demographics, anthropometrics, rates of maternal food neophobia, feeding self-efficacy, social support, postnatal depression and infant temperament. Dietary quality was assessed using the Complementary Feeding Utility Index (CFUI). Children were classified into underweight, normal weight, overweight and obese.

Results

Majority of participants reported high levels of dietary quality as determined by a mean CFUI score of 80%. High dietary quality was associated with reliance on the NHS recommendation on timing of complementary feeding and maternal self-efficacy in promoting a healthy diet and limiting non-recommended foods. Responsive feeding, longer breastfeeding duration, frequent exposure to fruits and to a high variety of protein-rich animal foods were significantly associated with lighter child weight status. Consumption of sweetened drinks and delayed introduction of lumpy foods were associated with heavier child weight status.

Conclusions

This study provided an evaluation of dietary quality in complementary feeding in a UK sample of children and explored its relationship with maternal and child attributes. Increasing understanding of the current complementary feeding recommendations and strengthening maternal feeding self-efficacy may be key for healthcare professionals and researchers to improving complementary feeding practices.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-022-00595-8.

Consumers attitudes toward animal welfare friendly produce: An island of Ireland study

Public concern has arisen between increased productivity in animal production systems and farm animal welfare (FAW). Consumers demand ethical production systems and tend to purchase products that reflect their animal welfare concerns. They are becoming increasingly judicious, with growing expectations around animal produce. Nonetheless, positive attitudes concerning FAW do not always correspond to purchasing behavior, where higher concern is not related to higher purchasing frequency. The study seeks to determine if individuals behave differently in their dual roles as citizens and consumers, expressing preferences for FAW but ultimately failing to act on such preferences when making purchasing decisions. Theoretically, the research uses elements of the COM-B model to investigate the importance of capability, opportunity, and motivation for consumers. The study is conducted on an island of Ireland basis and investigates the perceptions and purchasing frequency of Irish and Northern Irish consumer’s (n = 972). Firstly, attitudes towards purchasing animal welfare products are elicited using Categorical Principal Component Analysis (CATPCA). Cluster analysis subsequently defines three distinct typologies based upon the final cluster centers attained from CATPCA. The largest cluster is characterized as being Indifferent (n = 672) and differentiated by relatively low concern for animal welfare. Despite this, their purchasing frequency of animal welfare products is monthly. The other two clusters, The Engaged and The Struggling, are similar in size and share the same concern for animal welfare but are polarized in their motivation, capability, and opportunity to purchase animal welfare friendly products. The Struggling typology act as citizens rather than consumers; while they are highly concerned for welfare they have significantly lower purchasing frequency even compared to The Indifferent. Finally, Non-Linear Canonical Correlation Analysis (NLCCA) is used to reveal and visually demonstrate the structure of the whole dataset. The analysis demonstrates that concern for animal welfare is not associated with purchase frequency of animal welfare friendly produce when contextual factors are not conducive to doing so. The findings are relevant to a broad audience including industry, policymakers, and academics.

The 11 sins of seafood: Assessing a decade of food fraud reports in the global supply chain

Due to complex, valuable, and often extremely opaque supply chains, seafood is a commodity that has experienced a high prevalence of food fraud throughout the entirety of its logistics network. Fraud detection and prevention require an in-depth understanding of food supply chains and their vulnerabilities and risks so that food business operators, regulators, and other stakeholders can implement practical countermeasures. An analysis of historical criminality within a sector, product, or country is an important component and has not yet been conducted for the seafood sector. This study examines reported seafood fraud incidents from the European Union's Rapid Alert System for Food and Feed, Decernis's Food Fraud Database, HorizonScan, and LexisNexis databases between January 01, 2010 and December 31, 2020. Illegal or unauthorized veterinary residues were found to be the most significant issue of concern, with most reports originating from farmed seafood in Vietnam, China, and India. For internationally traded goods, border inspections revealed a significant frequency of reports with fraudulent or insufficient documentation, indicating that deceptive practices are picked up at import or export but are occurring further down the supply chain. Practices such as species adulteration (excluding veterinary residues), species substitution, fishery substitution, catch method fraud, and illegal, unreported, and unregulated fishing were less prevalent in the databases than evidenced in the scientific literature. The analysis demonstrates significant differences in outcomes depending on source and underlines a requirement for a standardized and rigorous dataset through which food fraud can be scrutinized to ensure enforcement, as well as industry and research resources are directed accurately. Practical Application: Levels of historic food fraud in a product, sector, supply chain node or geographic location provide an indication of historic criminality, the methods used and the location of reported frauds. This study provides an overview of historic levels of seafood fraud that can be used to inform seafood fraud prevention and mitigation activities by the food industry, regulators and other stakeholders.

The effects of nutrition and health claims on the nutrient composition of single and subsequent meal servings

Nutrition and health claims (NHCs) can help individuals make better food choices. While NHCs have been found to influence consumer perceptions and consumption, there has been less focus on how claims influence the nutritional composition of servings. There has also been little attention paid to longer term or compensatory effects of claims on subsequent food selection. This manuscript details two studies considering these matters. Study 1 (n = 60) was a within-subjects experiment to measure the impact of NHCs on food selection and nutritional composition at single meal servings. Participants served from three fake food buffet meal stations (breakfast, hot meal, snacks) with NHCs present or absent. Study 2 (n = 55) was a within-subjects experiment to examine the impact of NHCs on food selection and nutritional composition at a subsequent meal. Participants served from a fake food buffet breakfast with or without NHCs followed by a lunch without NHCs. In study 1, while results varied for different meals, the presence of claims was found to significantly reduce the amount of energy, fat, saturated fat, sugar, carbohydrates, and sodium, and increase the amount of protein in meals that were served. Results for fibre were mixed. In addition, NHCs increased the quantity of food served in the snacks condition. There was no evidence of claims at breakfast impacting the nutritional composition of subsequent lunch servings in study 2. Despite claims potentially increasing serving quantities, the nutritional composition of chosen servings was more encouraging and claims may help individuals to meet recommended nutritional daily guidelines. These findings have wider implications in terms of government policy, food reformulation, and the continuing debate around the use of nutrient profiling regulations for products carrying claims.

Effective approaches for early identification and proactive mitigation of aflatoxins in peanuts: An EU-China perspective

Nearly 700,000 tonnes of peanuts are consumed annually in Europe. In the last 5 years, peanuts imported from China exceeded legal European Union (EU) aflatoxin limits more than 180 times. To prevent and mitigate aflatoxin contamination, the stages of the peanut chain most vulnerable to contamination must be assessed to determine how to interrupt the movement of contaminated produce. This paper discusses effective approaches for early identification and proactive mitigation of aflatoxins in peanuts to reduce a contaminant that is an impediment to trade. We consider (i) the results of the EU Commission's Directorate-General (DG) for Health and Food Safety review, (ii) the Code of Practice for the prevention and reduction of aflatoxins in peanuts issued by Food and Agriculture Organization/World Health Organization, (iii) the results from previous EU-China efforts, and (iv) the latest state-of-the-art technology in pre- and postharvest methods as essential elements of a sustainable program for integrated disease and aflatoxin management. These include preharvest use of biocontrol, biofertilizers, improved tillage, forecasting, and risk monitoring based on analysis of big data obtained by remote sensing. At the postharvest level, we consider rapid testing methods along the supply chain, Decision Support Systems for effective silo management, and effective risk monitoring during drying, storage, and transport. Available guidance and current recommendations are provided for successful practical implementation. Food safety standards also influence stakeholder and consumer trust and confidence, so we also consider the results of multiactor stakeholder group discussions.

Development of the Cook-EdTM Matrix to Guide Food and Cooking Skill Selection in Culinary Education Programs That Target Diet Quality and Health

Culinary education programs are generally designed to improve participants’ food and cooking skills, with or without consideration to influencing diet quality or health. No published methods exist to guide food and cooking skills’ content priorities within culinary education programs that target improved diet quality and health. To address this gap, an international team of cooking and nutrition education experts developed the Cooking Education (Cook-Ed^TM) matrix. International food-based dietary guidelines were reviewed to determine common food groups. A six-section matrix was drafted including skill focus points for: (1) Kitchen safety, (2) Food safety, (3) General food skills, (4) Food group specific food skills, (5) General cooking skills, (6) Food group specific cooking skills. A modified e-Delphi method with three consultation rounds was used to reach consensus on the Cook-Ed^TM matrix structure, skill focus points included, and their order. The final Cook-Ed^TM matrix includes 117 skill focus points. The matrix guides program providers in selecting the most suitable skills to consider for their programs to improve dietary and health outcomes, while considering available resources, participant needs, and sustainable nutrition principles. Users can adapt the Cook-Ed^TM matrix to regional food-based dietary guidelines and food cultures.

Consumer purchase intention towards a quick response (QR) code for antibiotic information: an exploratory study

Increasing awareness of antimicrobial resistance (AMR) has raised concerns surrounding antimicrobial use (AMU) in food-producing animals and has focused attention towards livestock production free from antibiotic use. As antibiotic-free livestock production proliferates in the UK, there is an increasing need to implement a system, such as the use of a QR code, to provide consumers with reliable antibiotic information while ensuring that animal welfare standards are upheld. Subsequently, this study aims to explore UK consumers’ perceptions and purchase intention towards QR code labelled pork, and to identify determinants of its purchase, incorporating various theoretical constructs from the Theory of Planned Behaviour. Based on results, consumers’ perceptions, perceived control, and attitudes towards QR code labelled pork are the main determinants of purchase intention. QR code labelled pork may offer a suitable alternative to antibiotic-free labelling as it provides consumers with antibiotic information without inadvertently communicating that conventionally produced pork is unsafe.

Current Consumer Perceptions of Animal Welfare across Different Farming Sectors on the Island of Ireland

Simple Summary

The well-being and welfare of animals on farms is a topic of interest to many people. On the island of Ireland, this issue has received increased attention because of political and governance changes, including Brexit and COVID-19. Policy-makers and industry are considering labelling schemes to inform the food consumer about welfare standards on farms. Focus groups and an online survey were carried out with members of the public on the island of Ireland to explore their awareness, perceptions, and attitudes toward farm animal welfare standards on farms in Ireland and Northern Ireland. Most consumers believed farm animal welfare standards were high, although different farming sectors were rated differently: beef and dairy farms were viewed more positively, and pig and poultry farms were viewed less positively. The living conditions of the animal, size and intensity of the farm, national standards and schemes, and visibility all influenced perceptions of welfare standards. The public also expressed a lack of knowledge and information on the topic. In developing new policies and labelling schemes, it is important to be apprised of the current awareness, attitudes, and perceptions that the public has regarding farm animal welfare standards, as identified in the current paper.

Abstract

There has been increased public interest and concerns in issues such as farm animal welfare (FAW) on the island of Ireland, stoked in part by political and governance changes, such as Brexit and COVID-19. Front-of-pack food labelling represents a primary information channel for many people. In advance of considering formalised food labelling schemes, specifically relating to FAW, it is important to ensure an up-to-date understanding of current consumer perceptions of FAW. With this aim, the current study utilised a mixed methodology. Nine focus group discussions (n = 41) and an online survey (n = 972) with food consumers in Ireland and Northern Ireland explored perceptions of FAW. Results suggest that overall perceptions of FAW are high, and consumers perceive FAW to have improved in the last decade. Quantitative (ANOVA) and qualitative results show variations in perception of FAW between sectors. Results from the focus group discussions identified factors underlying consumers’ perception of FAW: the living conditions of the animal, size and intensity of the farm, national standards and schemes, and visibility. Information insufficiencies and knowledge gaps were identified. The findings are discussed in relation to policy implications for the role of public engagement, front-of-pack welfare labelling, and quality assurance schemes.

Sequence Variant in the TRIM39-RPP21 Gene Readthrough is Shared Across a Cohort of Arabian Foals Diagnosed with Juvenile Idiopathic Epilepsy

Juvenile idiopathic epilepsy (JIE) is a self-limiting neurological disorder with a suspected genetic predisposition affecting young Arabian foals of the Egyptian lineage. The condition is characterized by tonic-clonic seizures with intermittent post-ictal blindness, in which most incidents are sporadic and unrecognized. This study aimed to identify genetic components shared across a local cohort of Arabian foals diagnosed with JIE via a combined whole genome and targeted resequencing approach: Initial whole genome comparisons between a small cohort of nine diagnosed foals (cases) and 27 controls from other horse breeds identified variants uniquely shared amongst the case cohort. Further validation via targeted resequencing of these variants, that pertain to non-intergenic regions, on additional eleven case individuals revealed a single 19bp deletion coupled with a triple-C insertion (Δ19InsCCC) within the TRIM39-RPP21 gene readthrough that was uniquely shared across all case individuals, and absent from three additional Arabian controls. Furthermore, we have confirmed recent findings refuting potential linkage between JIE and other inherited diseases in the Arabian lineage, and refuted the potential linkage between JIE and genes predisposing a similar disorder in human newborns. This is the first study to report a genetic variant to be shared in a sub-population cohort of Arabian foals diagnosed with JIE. Further evaluation of the sensitivity and specificity of the Δ19InsCCC allele within additional cohorts of the Arabian horse is warranted in order to validate its credibility as a marker for JIE, and to ascertain whether it has been introduced into other horse breeds by Arabian ancestry.

Consumers' perceptions and willingness to purchase pork labelled 'raised without antibiotics'

As a recent addition to the UK market, it is unknown how 'raised without antibiotics' labelled products are perceived or how they influence consumer food choice. Understanding consumers' perceptions towards the 'raised without antibiotics' label can determine knowledge of the label and what drives them to purchase products raised without antibiotics. Subsequently, using an online questionnaire with 1000 participants aged 18-92 years old, this study explored UK consumers' perceptions and willingness to buy 'raised without antibiotics' labelled pork, and examined their knowledge of antimicrobial use and antimicrobial resistance (AMR¹). Cross-sectional data were collected investigating consumer perceptions and willingness to purchase 'raised without antibiotics' labelled pork and hierarchical multiple regression analyses were conducted. Respondents had high levels of knowledge towards EU regulations however, their awareness of AMR was limited. Behavioural beliefs concerning animal welfare and product quality were the main predictors of consumers' willingness to buy 'raised without antibiotics' labelled pork, followed by pork purchasing habits based on animal welfare qualities. Additionally, consumers who were more concerned that AMR would personally affect them, as well as those who favoured antimicrobial use for the preservation of animal welfare were willing to buy this product. Perceptions towards animal antimicrobial use acceptance, beliefs that 'raised without antibiotics' labelled pork is expensive, and a lack of consideration for extrinsic qualities when purchasing pork i.e., appearance, had a negative influence on willingness to buy. Moderate perceptions towards 'raised without antibiotics' labelled pork, lack of knowledge of agricultural antimicrobial use, and the subsequent confusion surrounding this label suggests that it is necessary to explore other labelling options to provide consumers with the information they desire while also safeguarding animal welfare.

Antimicrobial use in agriculture: critical review of the factors influencing behaviour

Antimicrobial resistance (AMR) is a global health emergency affecting humans and animals, diminishing the effectiveness of medication used to treat illness. The agri-food sector has attracted increased attention for imprudent antimicrobial use (AMU) and its contribution to AMR. Thus, ascertaining farmers' and veterinarians' behaviours surrounding AMU is essential to address imprudent AMU and generate behaviour change within the agri-food sector. Therefore, the aim of this critical review is to investigate, assess and collate the current body of evidence to identify psychosocial factors including knowledge, understanding, perceptions, attitudes and behaviours surrounding AMU. Database searches were limited to articles utilizing qualitative and quantitative methodologies, available in English with no restriction on publication year. Of the 1156 articles identified, 103 were retained for this review. Findings on the psychosocial aspects were thematically analysed. Five key themes emerged from the data: (i) knowledge and awareness of antimicrobials; (ii) attitudes towards antimicrobials; (iii) influential relationships; (iv) resources; and (v) factors influencing AMU. Results indicated that to overcome barriers experienced by key stakeholders, a carefully considered, evidence-based approach, incorporating behaviour change theory, is required when designing intricate interventions/strategies, in order to elicit successful and sustained AMU behaviour change.

No lockdown in the kitchen: How the COVID-19 pandemic has affected food-related behaviours

The COVID-19 pandemic and especially the lockdowns coming with it have been a disruptive event also for food consumption. In order to study the impact of the pandemic on eating habits, self-reported changes in food-related behaviours were investigated in ten European countries by means of an online survey. A latent class cluster analysis distinguished five clusters and showed that different types of consumers can be distinguished based on how they react to the pandemic as regards their eating habits. While food-related behaviours were resilient for 60% of the sample, another 35% reported more enjoyment in cooking and eating, more time in the kitchen and more family meals. Among those, a slight majority also showed signs of more mindful eating, as indicated by more deliberate choices and increased consumption of healthy food, whereas a slight minority reported more consumption of indulgence food. Only 5% indicated less involvement with food. As the COVID-19 pandemic is a disruptive event, some of these changes may have habit-breaking properties and open up new opportunities and challenges for food policy and food industry.

Engaging with selective dry cow therapy: understanding the barriers and facilitators perceived by Irish farmers

BACKGROUND

Selective dry cow therapy (SDCT) is widely promoted in dairy farming as a method to reduce antimicrobial usage. New legislation introduced by the European Union will restrict and regulate the prophylactic and metaphylactic use of antibiotics from January 2022. Blanket dry cow therapy continues to be a practice engaged in by many farmers in Ireland and for many of these farmers, moving towards SDCT would require a significant infrastructural, behavioural and/or cultural change on their farm. Existing research has reported the important need to understand farmers' motivations to initiate any substantial behaviour change. However, it is currently unknown what farmers know, think and believe about SDCT in Ireland. The aim of this study was to use qualitative methods to explore what barriers and facilitators farmers perceived to exist with SDCT and explore if they had chosen to implement SDCT after voluntarily participating in a funded dry cow consult with a trained veterinarian, with the objective of maximising the dry period udder health performance and moving safely to SDCT.

RESULTS

In this study, 19 farmers were contacted, and telephone interviews were conducted regarding farmers' beliefs about the consequences of SDCT. Audio recordings were professionally transcribed verbatim and analysed qualitatively using an inductive thematic analysis. The analysis identified 6 barriers and 6 facilitators to implementing SDCT. A significant fear of increasing mastitis incidence was evident that caused reluctance towards SDCT and reliance on antibiotics. Mixed perceptions on SDCT, infrastructure limitations, a perceived lack of preventive advice as well as peer influence were presented as barriers to SDCT. Farmers can build confidence when a graded approach to SDCT is implemented, which could help overcome the fear of SDCT and reliance on antibiotics. Regulatory pressure, high standards of farm hygiene and use of targeted veterinary consults were found to facilitate SDCT. Education was suggested to motivate farmers in the future uptake of SDCT. Despite cited negative influences, peer influence can be utilised to encourage the farming community.

CONCLUSIONS

This study prioritises areas to facilitate the major behaviour change required as a dairy industry in order to move from blanket dry cow therapy to SDCT.

Cook Like A Boss: An effective co-created multidisciplinary approach to improving children's cooking competence

Cooking interventions are emphasised as promising methods for changing children's food-related preferences, attitudes and behaviours. However, criticisms remain, including relatively weak intervention designs; lack of validated tools, and limited underpinning theory. Therefore, this research aimed to assess the effectiveness of a theory-driven co-created children's cooking intervention with underpinning rationale for the content, using a validated measure. 'Cook Like A Boss' was a one week, controlled cooking camp style intervention. Thirty two children aged 10-12 years participated. The intervention was developed using the Cook-Ed model for planning, implementing and evaluating cooking programs and was underpinned by Social Learning theory and Experiential Learning theory. The intervention content was developed in a co-creation process with the research team, a chef and the children. The underlying developmental skills required for the recipes were assessed to ensure they were age-appropriate. Children completed pre and post measurements including perceived cooking competence. Process evaluations were also gathered. There was a significant increase in perceived cooking competence after the intervention (P < 0.05) and a significant difference between the intervention and control group (P < 0.001). Additionally, process evaluations found the intervention to have high fidelity and dose received and that it was received extremely positively. The 'Cook Like A Boss' children's cooking camp was an effective multidisciplinary co-created intervention with a vulnerable group, e.g. children, guided by a model and underpinned by theory. The content was developed to ensure it was age-appropriate and achievable for the children. This approach could act as a template for future children's cooking interventions.

Content of Brazilian supermarket circulars do not reflect national dietary guidelines

Previous research on foods advertised in supermarket circulars revealed that advertisement for foods at promotional prices influence food choices and shopping behaviour, but no paper reporting the Latin American context was identified. Furthermore, most studies only assessed the products advertised on the front pages and not in the entire circulars. This paper quantifies and categorizes, according to level of processing, the foods advertised in circulars from four Brazilian supermarket chains in order to assess their compatibility with the national dietary guidelines issued by the Ministry of Health. Printed and online circulars were collected between June and July 2016. Foods items advertised were identified and classified into one of four categories using the NOVA classification as unprocessed or minimally processed, processed culinary ingredient, processed or ultra-processed. Sixteen documents were analysed, and 1786 food items identified, where 23% were categorized as unprocessed or minimally processed, and 63% as ultra-processed foods. While the mean proportion of ultra-processed and unprocessed or minimally processed foods advertised on circular covers was similar (p = 0.49), the mean proportion of ultra-processed foods advertised in the entire circular was significantly higher than unprocessed or minimally processed foods (p < 0.001). Brazilian supermarket circulars are stimulating the acquisition of ultra-processed foods, which does not encourage food choices to be in line with what is recommended by the Dietary Guidelines for the Brazilian Population.

Recruiting 'hard to reach' parents for health promotion research: experiences from a qualitative study

Objective

Marginalised populations are less likely to take part in health research, and are sometimes considered ‘easy to ignore’. We aimed to describe our approach and results of recruiting parents who experience disadvantage, for focus groups exploring infant feeding on the island of Ireland. Upon receiving ethical approval, we implemented recruitment strategies that included building rapport with community organisations through existing networks, targeting specific organisations with information about our aims, and utilising social media groups for parents.

Results

We approached 74 organisations of which 17 helped with recruitment. We recruited 86 parents/carers (one male) for 19 focus groups (15 urban/4 rural). Seventy two percent met at the eligibility criteria. Most participants were recruited through organisations (91%), and the remainder on social media (9%). Recruitment barriers included multiple steps, research fatigue, or uncertainty around expectations. Factors such as building rapport, simplifying the recruitment process and being flexible with procedures were facilitators. Despite comprehensive, multi-pronged approaches, the most marginalised parents may not have been reached. Further alternative recruitment strategies are required for recruiting fathers, rural populations, or those without the capacity or opportunity to engage with local services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05653-1.

The Impact of the Covid-19 Pandemic on Food Consumers' Awareness of Antimicrobial Resistance, OneHealth, and Animal Welfare Information on Food Labels

Covid-19 is a OneHealth crisis with far-reaching and unexpected impacts on many aspects of society. Previous OneHealth issues, such as antimicrobial resistance (AMR), have not received a similar level of attention or action from the public despite representing significant public health and economic threats to society. The current study aimed to explore whether the Covid-19 pandemic may act as a catalyst to increase public awareness related to OneHealth issues, in particular, AMR. This short paper presents overview findings from a survey carried out in September 2020 with a representative sample of food consumers on the island of Ireland (n = 972). The survey revealed Covid-19 had increased awareness of AMR amongst 47% of respondents; increased awareness of connected animal and human health amongst 43% of respondents; and increased awareness of animal welfare information on food labels amongst 34% of respondents. A cluster analysis revealed five distinct consumer segments impacted differently by Covid-19. These segments differed in their levels of objective and subjective knowledge of antibiotic use practises in farming, AMR risk perception, and attributions of responsibility for action on AMR. Findings are discussed with respect to future efforts by the agri-food sector to communicate with the public about AMR and responsible antibiotic use in farming, with particular emphasis on the implications for strategies that incorporate front-of-pack labelling.

Comparing Maternal and Paternal Complementary Feeding Practices: Findings From an Online Survey

OBJECTIVE

To explore differences between mothers' and fathers' complementary feeding practices.

METHODS

An online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index.

RESULTS

In a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02).

CONCLUSIONS AND IMPLICATIONS

Study findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.

Understanding farmers' and veterinarians' behavior in relation to antimicrobial use and resistance in dairy cattle: A systematic review

To tackle antimicrobial resistance, it is vital that farmers' and veterinarians' antimicrobial use behaviors and attitudes toward resistance are understood so that we can identify how beliefs and motives influence practices. Current literature details qualitative and quantitative research that explores the knowledge, attitudes and perceptions of dairy farmers and veterinarians with respect to antimicrobial resistance and antimicrobial practices, and the reported findings are varied and conflicting. Our objective was to conduct a systematic review to assess the evidence and knowledge gaps in the published literature. We identified articles via database searches of Embase, Medline, PubMed, Scopus, and Web of Science; we limited findings to published articles available in English with no publication year restrictions. Article screening was conducted at 3 levels: title, abstract, and full text. Of the 349 articles identified, 35 were retained for systematic review. Transparency of reporting was assessed for each study using the Consolidated Criteria for Reporting Qualitative Research (COREQ) framework. Quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. Findings relating to dairy farmers' and veterinarians' knowledge, attitudes, and perceptions on antimicrobial resistance and practices were thematically analyzed. The comprehensiveness of reporting was variable: studies reported 5 to 26 of the 32 COREQ checklist items. Five key themes emerged from the data: knowledge and awareness of antimicrobial resistance; factors influencing farmer and veterinarian decision-making; perceived barriers and facilitators to reduced antimicrobial use; perceived responsibility for antimicrobial resistance; and the role of the farmer and veterinarian relationship in reducing antimicrobial use. Awareness of prudent antimicrobial use was not uniform between studies. Many factors influence farmers' and veterinarians' decisions to use antimicrobials, including animal welfare and available resources. The farmer-veterinarian relationship is a potential barrier or facilitator of reduced antimicrobial use, depending on the perceived relationship dynamic. Encouraging collaboration between farmers and veterinarians could lead to shared responsibility for reducing antimicrobial use. This review provided a coherent picture of what is currently known and identified gaps in the current knowledge to inform future behavioral intervention research. Increased knowledge, skill development, resources, engagement, and further research to address the gaps we identified are the main recommendations to effectively overcome barriers, elicit appropriate behavior change, and achieve reduced antimicrobial use in dairy cattle.

Food environment intervention improves food knowledge, wellbeing and dietary habits in primary school children: Project Daire, a randomised-controlled, factorial design cluster trial

Background

Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children’s health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions.

Methods

Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) ‘Nourish’, ii) ‘Engage’, iii) ‘Nourish’ and ‘Engage’ and iv) Control (Delayed). ‘Nourish’ was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. ‘Engage’ was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured.

Results

Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6–7 years and n = 458 aged 10–11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6–7 and 10–11 year old pupils) who received the ‘Nourish’ intervention compared with those that did not (adjusted difference in mean = − 0.82; 95% CI -1.46, − 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The ‘Nourish’ intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10–11 year old pupils. The ‘Nourish’ intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed.

Conclusions

Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the ‘Nourish’ whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted.

Trial registration

National Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01086-y.

CooC11 and CooC7: the development and validation of age appropriate children's perceived cooking competence measures

BACKGROUND

Learning cooking skills during childhood and adolescence is associated with positive dietary outcomes in adulthood as well as being tracked from adolescence to adulthood. In addition studies have found that perceived competence to be a greater motivator to perform a behaviour than actual competence. However, a lack of validated tools that effectively measure behavioural and dietary changes including cooking confidence in children is a limitation. Therefore, this research aimed to develop and validate age-appropriate perceived cooking competence measures for younger and older primary school aged children.

METHODS

Two measures of perceived Cooking Competence (CooC11 and CooC7) for older (8-12 years) and younger (6-7 years) children were developed from a critical evaluation of publically available recommendations and expert consultation. The cooking skills within the measures were illustrated by a graphic designer in consultation with a chef and reviewed in an iterative manner by the research team. The measures were piloted for clarity, ease of use and initial face validity. Multiple studies were used for both CooC11 and CooC7 to establish psychometric properties of the measures, temporal stability, internal consistency reliability, construct validity, as well as responsiveness to change for CooC11. Analysis included Exploratory Factor Analysis, Confirmatory Factor Analysis, Intraclass Correlation Coefficients, Pearson's Correlations, ANOVAs and Cronbach's Alphas.

RESULTS

Both measures had high levels of face validity and received positive user feedback. Two factors were shown in both measures with the measures showing excellent temporal stability (ICC > 0.9) and good internal consistency (Cronbach's Alphas > 0.7). Both measures showed initial discriminant validity, with significant differences (P< 0.001) between those who reported assisting their parents with dinner preparation and those who did not. Additionally, CooC11 was significantly correlated with an adult cooking measure and had a significant responsiveness to change (P< 0.01).

CONCLUSIONS

The CooC11 and CooC7 are the first validated age-appropriate measures for assessing children's perceived Cooking Competence for ages 8-12 and 6-7 years respectively. They can be used to evaluate the efficacy of children's cooking intervention studies or school nutrition education programmes.