'Turbulence even in a bubble': a reflexive thematic analysis with family caregivers of people with dementia in the United Kingdom during and beyond the COVID-19 pandemic.

OBJECTIVE: This study aimed to understand how family caregivers of people with dementia managed changes caused by COVID-19 restrictions and how they adjusted to the lifting of restrictions. A particular focus of the study was on understanding the impact of social isolation, a reduction of social interactions, and reduced access to healthcare services. METHODS AND MEASURES: Fourteen voluntary caregivers (nine women) were interviewed using a semi-structured interview schedule. RESULTS: Five themes were identified based on reflexive thematic analysis: (i) Outlets to cope with lockdown; (ii) 'Not all doom and gloom': A silver lining amid COVID-19; (iii) Optimism helps provide resilience; (iv) The challenges and joys of reopening; and (v) Caregiving toward a new normality. CONCLUSION: The research highlighted difficulties reported by family caregivers and people with dementia during COVID-19, while also showing how such carers coped. Interviews also identified ways that family caregivers often used optimism to help navigate through lockdown and to tackle the reopening stage. Family caregivers in this study reported coping well overall, but welcomed the lifting of restrictions.

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.

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.

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.

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.

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.

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

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.

From the pandemic to the pan: the impact of COVID-19 on parental inclusion of children in cooking activities: a cross-continental survey.

OBJECTIVE: This study aimed to investigate the impact of COVID-19 on time spent cooking and parental inclusion of children in cooking. The secondary aim was to investigate differences between those who frequently included their children in cooking activities during the COVID-19 pandemic and those who included their children less, on a number of factors such as working from home, parents' diet quality and cooking skills confidence. DESIGN: Cross-continental survey with Wilcoxon-signed ranks, Independent t tests, Mann-Whitney U, χ2 and a binomial logistic regression used for assessment. SETTING: Online. PARTICIPANTS: A convenience sample of parents over 18 years from the island of Ireland (n 180), Great Britain (n 312), the USA (n 120) and New Zealand (n 166). RESULTS: In three regions, parents' time spent cooking and inclusion of children in everyday cooking activities increased (P < 0·001). Country (OR = 3·6, 95 % CI 1·7, 7·6), education (OR = 1·6, 95 % CI 1·1, 2·4), cooking skills confidence (OR = 1·02, 95 % CI 1·009, 1·032) and a parental higher intake of vegetables (OR = 1·3, 95 % CI 1·1, 1·5) were significant predictors of a more frequent inclusion of children in cooking activities. CONCLUSIONS: While there a number of key benefits to including children in cooking for the children such as providing life skills and increases in diet quality, this study highlighted a higher intake of vegetables by parents who included children more frequently in cooking activities. With continued lockdowns due to COVID-19 and perhaps more flexibility in working from home in the future, including children in cooking activities should be a key public health message for both children and parents.

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.

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.

Changes in Consumers' Food Practices during the COVID-19 Lockdown, Implications for Diet Quality and the Food System: A Cross-Continental Comparison.

COVID-19 has led to dramatic societal changes. Differing movement restrictions across countries have affected changes in consumers' food practices, with a potentially detrimental impact on their health and food systems. To investigate this, this research explored changes in consumers' food practices during the initial COVID-19 phase and assessed the impact of location on these changes. A sample of 2360 adults from three continents (Island of Ireland (IOI), Great Britain (GB), United States (USA), and New Zealand (NZ)) were recruited for a cross-sectional online survey (May-June 2020). Participants completed questions in relation to their cooking and food practices, diet quality, and COVID-19 food-related practices. Significant changes in consumers' food practices during the pandemic were seen within and between regions, with fewer cooking practices changes found in the USA. Food practices, which may put added pressure on the food system, such as bulk buying, were seen across all regions. To prevent this, organisational food practices, including planning ahead, should be emphasized. Additionally, while positive cooking-related practices and increases in fruit and vegetable intake were found, an increase in saturated fat intake was also seen. With the additional pressure on individuals' physical and mental health, the essentiality of maintaining a balanced diet should be promoted.

Are the Claims to Blame? A Qualitative Study to Understand the Effects of Nutrition and Health Claims on Perceptions and Consumption of Food.

Nutrition and Health Claims (NHCs) have been found to influence perceptions of food and consumption behaviour. While previous quantitative research has identified factors that may explain these effects, the current study aimed to address the dearth of in-depth exploration as to the underlying reasons why and how claims may impact upon perceptions and behaviour and the relationships between key factors. Seventy-eight participants took part in 10 focus groups. Discussions were transcribed verbatim and Nvivo 11 was used for thematic analysis. Six themes were developed from the data: 1. Target populations for NHCs; 2. Influence of NHCs on purchasing behaviour; 3. Characteristics/perceptions of products displaying NHCs; 4. Believability of NHCs; 5. Superior yet superficial knowledge; 6. Consumption of products displaying NHCs. Knowledge was a key factor influencing how much individuals believe claims (Believability of NHCs) and their perceptions (Characteristics/perceptions of products displaying NHCs). These perceptions and the characteristics of products displaying claims also impacted believability, as well as purchasing behaviour and consumption. Future research should be cognisant of the role of knowledge and characteristics or perceptions of products in the relationship between NHCs and consumer behaviour, and modelling of these relationships would allow their relative strength to be identified.

Modern Transference of Domestic Cooking Skills.

As the primary source of learning cooking skills; it is vital to understand what mothers think about the transference of cooking skills to their children. The current analysis aimed to highlight mothers' perceptions of children's involvement and cooking practices within the home setting. Sixteen focus group discussions were conducted on the island of Ireland (Republic of Ireland and Northern Ireland [UK]) with 141 mothers aged 20-39 years old. All focus groups were transcribed verbatim and an inductive thematic analysis using NVivo software was undertaken. Seven themes emerged from the dataset; (1) "How we learned to cook"; (2) "Who's the boss"; (3) "Children in the way"; (4) "Keep kids out"; (5) "Involvement means eating"; (6) "Intentions versus reality"; and (7) "Kids' 'interest' in cooking". These themes illustrate a lack of cooking skill transference in relation to everyday meal preparation in modern times. The culture of children in the kitchen has vastly changed; and opportunities for children to learn basic skills are currently limited. Further research is required to confirm the findings that emerged from this analysis.

The Impact of Nutrition and Health Claims on Consumer Perceptions and Portion Size Selection: Results from a Nationally Representative Survey.

Nutrition and health claims on foods can help consumers make healthier food choices. However, claims may have a 'halo' effect, influencing consumer perceptions of foods and increasing consumption. Evidence for these effects are typically demonstrated in experiments with small samples, limiting generalisability. The current study aimed to overcome this limitation through the use of a nationally representative survey. In a cross-sectional survey of 1039 adults across the island of Ireland, respondents were presented with three different claims (nutrition claim = "Low in fat"; health claim = "With plant sterols. Proven to lower cholesterol"; satiety claim = "Fuller for longer") on four different foods (cereal, soup, lasagne, and yoghurt). Participants answered questions on perceived healthiness, tastiness, and fillingness of the products with different claims and also selected a portion size they would consume. Claims influenced fillingness perceptions of some of the foods. However, there was little influence of claims on tastiness or healthiness perceptions or the portion size selected. Psychological factors such as consumers' familiarity with foods carrying claims and belief in the claims were the most consistent predictors of perceptions and portion size selection. Future research should identify additional consumer factors that may moderate the relationships between claims, perceptions, and consumption.

Use of Prescription Medication by Individuals Who Died by Suicide in Northern Ireland.

To understand medication use prior to suicide in relation to patterns, polypharmacy, and adherence. A total of 1,371 suicide cases were coded and latent class analysis used to identify combinations of medications prescribed prior to death. Two thirds had been prescribed medication with 30.7% prescribed 3 or more. Latent class analysis revealed three classes: Mixed medication use, primarily mental medication use, and baseline/low medication use. There are potentially high rates of medication non-adherence. Not only medication use but also non-adherence rates were high in this sample of individuals who died by suicide. Potential implications and areas for future research are discussed.

The role of DNA-stained currency in gang robberies within the United Kingdom.

Cash-and-valuables-in-transit (CViT) robberies have become a substantial problem-especially in the current global economy. Over £19.4 million were stolen in 2008 and £17.1 million in 2009 in the United Kingdom alone. The transportation of cash and valuable items between financial institutions has long been a target of robberies in the U.K. After a robbery has occurred, police collect evidence in the form of ink-stained currency. These stained notes are submitted for analysis. Samples are subjected to polymerase chain reaction in order to amplify any possible botanically derived DNA markers present on the notes. After amplification, capillary electrophoresis allows for the deciphering of the "DNA profile." The DNA profile is then linked to a particular cash box, and this information is compared with records of whether or not that box had been stolen. The cases below are three such instances where botanically marked currency was used to help solve robberies.