Counting Farm Injuries and Fatalities: An Assessment of Irish Occupational Health and Safety Surveillance Data Systems.

OBJECTIVE: Generation of reliable data underpins the effectiveness of Occupational Health and Safety (OHS) surveillance systems. Despite the importance of understanding OHS data systems, there are few papers that provide overviews of their structure and/or content. This paper introduces a basic framework for assessing OHS data systems that will be of use to researchers internationally. We applied this approach to assess the Irish OHS data system by undertaking a data mapping exercise. METHOD: We developed a checklist based on recommendations of monitoring and measurement of OHS proposed by the National Academies of Sciences, Engineering, and Medicine (USA). An assessment of published reports that present systematic OHS surveillance data was undertaken to identify the institutions or organisations responsible for collecting and curating the data, their remit, and, associated with this, their respective case definitions. We then provide an overview of the variables collected and these are then mapped against the checklist. RESULTS: The assessment highlights that whilst the farm fatalities dataset provides complete coverage of all fatalities, regardless of age or employment status, the same is not true of the three non-fatal injuries datasets reviewed. There are important differences in the data collection methods and, associated with this, which populations are covered. PRACTICAL APPLICATION: The assessment approach provides valuable insights into the strengths and weaknesses of a critical element of OHS surveillance systems, namely the production of datasets. This knowledge is important for researchers as understanding the data that informs their research is fundamental to good science. It is critical for policy-makers and other stakeholders to understand the strengths and weaknesses on which OHS policy, strategies, or education and training interventions are developed.

Small group learning/assessment sessions: A method using test enhanced learning to increase engagement in a basic medical science neuroanatomy course.

Previous research has shown that test-enhanced learning with structured feedback facilitates durable learning. We describe a small group learning/assessment activity using these approaches intended to increase engagement and engagement with the course material. We divided our class into six groups of seven students each that worked together in the activity. During each weekly session, course related multiple choice questions were projected and each group instructed to work independently to arrive at a consensus answer for each question. After each question is considered, a faculty facilitator then randomly selects one group to share their choice with the other groups and provide and rationale for their choice. A different group or groups are then called upon to share their choice. When differences emerge, the instructor then facilitates discussion among the groups in an effort to resolve confusion or incomplete or incorrect understanding that becomes evident. We found that attendance for these sessions was greater than for the more traditional lecture based session also included in the course and that students were actively engaged in this learning activity. The success of the small group learning/assessment session is dependent on several factors including the difficulty of the questions and their relatedness to the course objectives, the timing and placement of the session or sessions within the course and the skill of the faculty facilitator in encouraging active participation while ensuring a safe environment in which students can openly share their sometimes incomplete or incorrect understanding of the material.

Assessment of the Clinical Pulmonary Infection Scores for prediction of ventilator associated pneumonia in patients with out of hospital cardiac arrest.

BACKGROUND: Patients suffering out-of-hospital cardiac arrest (OHCA) are at an increased risk of aspiration pneumonitis and development of subsequent aspiration pneumonia. The diagnostic uncertainty in this context can lead to a large proportion receiving broad spectrum antibiotics. METHODS: This was a three-year, retrospective cohort study of consecutive patients admitted with OHCA. Data were collected in an Australian tertiary centre intensive care unit (ICU) between December 2016-December 2019. We assessed the incidence of Ventilator associated pneumonia (VAP), admission Clinical Pulmonary Infection Scores (CPIS) in patients with OHCA and its' association with VAP at day 3 [1]. We also assessed antibiotics prescribing (timing of initiation and drug choice) and intensive care mortality relative to the day 1 CPIS. RESULTS: Over the three years, 100 patients were admitted with OHCA. The incidence of VAP was 6%. The CPIS on admission was not associated with development of VAP at day 3 (p = 0.75) and no significant association was found between choice of antibiotic regimens and VAP incidence. Timing of initiation of antibiotics was associated with VAP (12hrs vs 48hrs, p = 0.035) but not the choice of antibiotic (penicillin and cephalosporins vs antipseudomonal antibiotics). CPIS score at day 1 was not associated with ICU mortality in a multivariate analysis. CONCLUSION: We demonstrated a very low incidence of VAP in OHCA patients in comparison to published studies. In this context, there was no evidence for an association between CPIS score and VAP at day 3. The CPIS may have utility as a decision support tool for targeted antibiotic prescribing in this cohort.

Evaluation of quick sequential organ failure assessment and systemic inflammatory response syndrome in patients with gram negative bloodstream infection.

BACKGROUND: The quick sequential organ failure assessment (qSOFA) score predicts mortality in patients with suspected infection. We sought to understand how well qSOFA and the Systemic Inflammatory Response Syndrome (SIRS) criteria predict gram negative bacteraemia. METHODS: We prospectively evaluated 99 patients with gram negative bloodstream infection from a single tertiary centre. We assessed the utility of SIRS and qSOFA for their rate of positivity and association with early delivery of antibiotics (<3 h). RESULTS: The SIRS criteria had the highest positivity rate amongst patients with gram negative bacteraemia (85%) compared to the qSOFA criteria (25%) on the day of first positive culture. Positive SIRS criteria was the only score associated with delivery of antibiotics within 3 h (Relative risk 3.5, 95% Confidence interval 1.3 to 12.5, p = < 0.02). CONCLUSION: In patients with gram negative bloodstream infection SIRS criteria was the most common positive risk score and had a higher association with early delivery of antibiotics when compared to qSOFA.

Health and Safety Adoption from Use of a Risk Assessment Document on Irish Farms.

OBJECTIVES: This article describes levels of implementation of occupational health and safety (OHS) controls on a sample of Irish farms following completion of a risk assessment document (RAD) made available as part of a statutory code of practice (COP) for the agriculture sector. The article describes the legislation mandating the COP and the operation of a prevention initiative (PI) among key stakeholders to develop and promote farmer use of the COP and RAD. METHODS: RADs were collected for farmers (N = 475) and the number and type of OHS controls listed for action were tabulated. A farm audit of OHS standards and of implementation of controls listed for action in the RAD was undertaken among a randomly selected sample of farms (N = 94) where the RAD was completed. RESULTS: The study data indicates that farmers used the RAD to a limited extent, and that their focus in its use was on identifying physical rather than organizational controls. An association was found between farmers who actively implemented controls and positive OHS standards. Farm OHS standards were also associated with farmer attitude to OHS, farm enterprise, farmer age category, and work time needed to operate the farm. CONCLUSIONS: Overall, the study data suggests that standards of farm management are a crucial determinant of OHS standards. The study data also indicates that having knowledge of required OHS controls does not ensure implementation. Development of social learning in groups is considered as a significant means of increasing OHS farm adoption.

Detection of carbapenemase activity in Enterobacteriaceae using LC-MS/MS in comparison with the neo-rapid CARB kit using direct visual assessment and colorimetry.

It has been described that the sensitivity of the Carba NP test may be low in the case of OXA-48-like carbapenamases and mass spectrometry based methods as well as a colorimetry based method have been described as alternatives. We evaluated 84 Enterobacteriaceae isolates including 31 OXA-48-like producing isolates and 13 isolates that produced either an imipenemase (IMP; n=8), New Delhi metallo-ß-lactamase (NDM; n=3), or Klebsiella pneumoniae carbapenemase (KPC; n=2), as well as 40 carbapenemase negative Enterobacteriaceae isolates. We used the Neo-Rapid CARB kit, assessing the results with the unaided eye and compared it with a colorimetric approach. Furthermore, we incubated the isolates in growth media with meropenem and measured the remaining meropenem after one and 2h of incubation, respectively, using liquid chromatography tandem mass spectrometry (LC-MS/MS). Whilst all carbapenemase producing isolates with the exception of the OXA-244 producer tested positive for both the Neo-rapid CARB test using the unaided eye or colorimetry, and the 13 isolates producing either IMP, NDM or KPC hydrolysed the meropenem in the media almost completely after 2h of incubation, the 31 OXA-48-like producing isolates exhibited very variable hydrolytic activity when incubated in growth media with meropenem. In our study, the Neo-Rapid CARB test yielded a sensitivity of 98% for both the traditional and the colorimetric approach with a specificity of 95% and 100% respectively. Our results indicate that the Neo-Rapid CARB test may have use for the detection of OXA-48 type carbapenemases and that it may be particularly important to ensure bacterial lysis for the detection of these weaker hydrolysers.

The Roles of Financial Threat, Social Support, Work Stress, and Mental Distress in Dairy Farmers' Expectations of Injury.

Farming is dangerous, with fatalities among the highest in any occupation. Farmers often work alone, for long hours, with unreliable equipment and in difficult weather conditions with hazardous chemicals and livestock. In addition, farmers make large financial commitments exposing them to high levels of financial risk. Exposure to such financial risk can give rise to subjective experiences of financial threat (FT) that are psychologically challenging. The current study attempted to characterize the role that FT plays in farm injuries. One hundred and twenty one dairy farmers completed a battery of questionnaires assessing FT, social support (SS), depression, anxiety, farm job stress, and health and safety beliefs. Mental distress directly predicted farmers' expectations of injury and a direct effect of non-financial farm stress (FS) approached significance. Mental distress mediated these relationships as evidenced by significant indirect effects of FS and FT, and SS served to reduce distress. These findings support calls for interventions designed to reduce FS and FT and increase SS for farmers.

Costs of Foraging Predispose Animals to Obesity-Related Mortality when Food Is Constantly Abundant.

Obesity is an important medical problem affecting humans and animals in the developed world, but the evolutionary origins of the behaviours that cause obesity are poorly understood. The potential role of occasional gluts of food in determining fat-storage strategies for avoiding mortality have been overlooked, even though animals experienced such conditions in the recent evolutionary past and may follow the same strategies in the modern environment. Humans, domestic, and captive animals in the developed world are exposed to a surplus of calorie-rich food, conditions characterised as 'constant-glut'. Here, we use a mathematical model to demonstrate that obesity-related mortality from poor health in a constant-glut environment should equal the average mortality rate in the 'pre-modern' environment when predation risk was more closely linked with foraging. It should therefore not be surprising that animals exposed to abundant food often over-eat to the point of ill-health. Our work suggests that individuals tend to defend a given excessive level of reserves because this level was adaptive when gluts were short-lived. The model predicts that mortality rate in constant-glut conditions can increase as the assumed health cost of being overweight decreases, meaning that any adaptation that reduced such health costs would have counter-intuitively led to an increase in mortality in the modern environment. Taken together, these results imply that efforts to reduce the incidence of obesity that are focussed on altering individual behaviour are likely to be ineffective because modern, constant-glut conditions trigger previously adaptive behavioural responses.

The lived experience of low back pain among Irish farmers: case studies.

Low back pain (LBP) is the most commonly reported musculoskeletal disorder (MSD) among farmers. There is limited researching regarding the lived experience of LBP among farmers. Video interviews were conducted with three dairy farmers who reported having a significant episode of LBP. The interview data were transcribed and analyzed, and results were presented in relation to the constructs explored. The farmers experienced their first significant episode of LBP in their late 20s or early 30s and all attributed their LBP to farm work or a farm-related incident. Hours worked per day ranged from 9 to 13 hours. Tasks identified by farmers that they were unable to do due to LBP included physical work, working with sheep, building work, and "certain jobs." Work changes made due to LBP included getting help, slowing down, avoiding strenuous work, carrying smaller loads, mechanizing the farm, using the tractor more, and wearing a back belt for certain jobs. Each farmer had his own way of preventing or managing his LBP, including a mix of active self-management and passive coping strategies such as swimming, using ice, spinal manipulation, and taking medication. The farmers were unable to quantify how much their LBP had cost them directly or indirectly. The case studies illustrate farmers engaging in ongoing work despite significant pain. All of the farmers have adapted at work and engaged in self-management strategies to reduce the occurrence of LBP. Given the rich data produced by these case studies, future case studies are recommended to gain greater insights into farmers' experiences concerning LBP.

Is optimism optimal? Functional causes of apparent behavioural biases.

We review the use of the terms 'optimism' and 'pessimism' to characterize particular types of behaviour in non-human animals. Animals can certainly behave as though they are optimistic or pessimistic with respect to specific motivations, as documented by an extensive range of examples in the literature. However, in surveying such examples we find that these terms are often poorly defined and are liable to lead to confusion. Furthermore, when considering behaviour within the framework of optimal decision theory using appropriate currencies, it is often misleading to describe animals as optimistic or pessimistic. There are two common misunderstandings. First, some apparent cases of biased behaviour result from misidentifying the currencies and pay-offs the animals should be maximising. Second, actions that do not maximise short-term pay-offs have sometimes been described as optimistic or pessimistic when in fact they are optimal in the long term; we show how such situations can be understood from the perspective of bandit models. Rather than describing suboptimal, unrealistic behaviour, the terms optimism and pessimism are better restricted to informal usage. Our review highlights the importance of choosing the relevant currency when attempting to predict the action of natural selection.

Disability on Irish farms--a real concern.

Farmers operate within hazardous environments while conducting their day-to-day tasks, potentially resulting in injury or disability. Disability can serve as a major life-changing event for the farmer, the farm family, and the farm business. In Ireland, the agricultural sector reported the highest incidence of disability, yet there is relatively little known on the impact of agricultural-based disability. In 2007, a questionnaire was appended to the Teagasc (Irish Agricultural and Food Development Authority) National Farm Survey to obtain some metric of the prevalence and impact of disability on Irish farms, in addition to quantifying service/support requirements of farm operators experiencing disability. Almost 5.9% (approximately 6611) of Irish farm operators reported disability, primarily caused through illness/disease. Arthritis (31.4%), back problems (17%), and heart circulatory problems (12.5%) were most frequently reported. The lowest prevalence of disability was found among tillage (1.4%) and dairy (4.1%) farms, with the highest prevalence among cattle farms (7.1%). Family farm income was lower on disability-experiencing farms relative to nondisability farms (123 euros per hectare), with a lower participation in off-farm employment also identified. Many farm operators (approximately 20%) ceased off-farm employment following disability. Discontinuation of off-farm employment can further precipitate family farm income decline, but also place additional pressures on the farm business if quality services/supports are not available. The current provision of services/supports to farm operators experiencing disability is perceived largely insufficient across the entire service/support spectrum from when disability was first experienced through to retirement. Awareness and issues surrounding eligibility were the primary reasons for failing to avail of currently available service/supports.

The scaling of diving time budgets: insights from an optimality approach.

Simple scaling arguments suggest that, among air-breathing divers, dive duration should scale approximately with mass to the one-third power. Recent phylogenetic analyses appear to confirm this. The same analyses showed that duration of time spent at the surface between dives has scaling very similar to that of dive duration, with the result that the ratio of dive duration to surface pause duration is approximately mass invariant. This finding runs counter to other arguments found in the diving literature that suggest that surface pause duration should scale more positively with mass, leading to a negative scaling of the dive-pause ratio. We use a published model of optimal time allocation in the dive cycle to show that optimal decisions can predict approximate mass invariance in the dive-pause ratio, especially if metabolism scales approximately with mass to the two-thirds power (as indicated by some recent analyses) and oxygen uptake is assumed to have evolved to supply the body tissues at the required rate. However, emergent scaling rules are sensitive to input parameters, especially to the relationship between the scaling of metabolism and oxygen uptake rate at the surface. Our results illustrate the utility of an optimality approach for developing predictions and identifying key areas for empirical research on the allometry of diving behavior.

Teaching with evaluation in ants.

Tandem running in ants is a form of recruitment in which a single well-informed worker guides a naive nestmate to a goal [1-8]. The ant Temnothorax albipennis recently satisfied a strict set of predefined criteria for teaching in nonhuman animals [9, 10]. These criteria do not include evaluation as a prerequisite for teaching [10]. However, some authors claim that true teaching is always evaluative, i.e., sensitive to the competence or quality of the pupil [11-13]. They then assume, on the premise that only humans are capable of making such necessarily complex cognitive evaluations, that teaching must be unique to humans. We conducted experiments to test whether evaluation occurs during tandem running, in which a knowledgeable ant physically guides a naive follower to a goal. In each experiment, we interrupted the tandem run by removing the tandem follower. The response of the leader was to stand still at the point where the tandem run was interrupted. We then measured how long the leader waited for the missing follower before giving up. Our results demonstrate T. albipennis performs three different kinds of evaluation. First, the longer the tandem has proceeded the longer the leader will wait for the follower to re-establish contact. Second, ant teachers modulate their giving-up time depending on the value of the goal. Finally, leaders have shorter giving-up times after unusually slow tandem runs.

The hidden cost of information in collective foraging.

Many animals nest or roost colonially. At the start of a potential foraging period, they may set out independently or await information from returning foragers. When should such individuals act independently and when should they wait for information? In a social insect colony, for example, information transfer may greatly increase a recruit's probability of finding food, and it is commonly assumed that this will always increase the colony's net energy gain. We test this assumption with a mathematical model. Energy gain by a colony is a function both of the probability of finding food sources and of the duration of their availability. A key factor is the ratio of pro-active foragers to re-active foragers. When leaving the nest, pro-active foragers search for food independently, whereas re-active foragers rely on information from successful foragers to find food. Under certain conditions, the optimum strategy is totally independent (pro-active) foraging because potentially valuable information that re-active foragers may gain from successful foragers is not worth waiting for. This counter-intuitive outcome is remarkably robust over a wide range of parameters. It occurs because food sources are only available for a limited period. Our study emphasizes the importance of time constraints and the analysis of dynamics, not just steady states, to understand social insect foraging.

A theoretical analysis of the energetic costs and consequences of parental care decisions.

Should a parent care for its young or abandon them before they reach independence? We consider parental care behaviour as an adaptive decision, involving trade-offs between current and future reproduction. The condition of the parent is expected to influence these trade-offs. Using a dynamic programming model we explore how changes in the levels of energetic reserves, and time in the season, determine changes in parental care decisions. The novel feature of our model is that we have included the possibility of remating within the current breeding season in a consistent manner by explicitly modelling the behaviour of unmated animals. We show that there may be several fluctuations in the average duration of care during the breeding season. We also show that, because of the dependence of parental care behaviour on both the condition of the parent and time during the breeding season, changing some of the costs of care may increase the duration of care during one part of the season and decrease it at another. The model also shows that the conditions prevailing for animals with dependent offspring can affect the way in which an unmated animal behaves. For example, the behaviour of unmated animals may change to compensate (partly) for increases in the costs of raising offspring, which are produced at a later date (for example, by increasing the duration of foraging between breeding attempts). Overall, the model provides a good framework for understanding how various ecological and life-history variables should influence parental care behaviour during a breeding season.