A community-based approach to identifying and prioritising young people's mental health needs in their local communities.

BACKGROUND: Identifying locally relevant and agreed-upon priorities for improving young people's mental health, aligned with social and environmental factors, is essential for benefiting target communities. This paper describes a participatory approach to engage young people and professionals in identifying such priorities, whilst considering the social determinants related to them. METHODS: We utilised a community-based participatory approach to support young people and professionals in identifying, reviewing, refining, and prioritising, locally relevant opportunity areas that are crucial for understanding and addressing social determinants of young people's mental health. We adopted a flexible five-stage process, which enabled greater reflection and adaptation in response to young people's and professionals' feedback and reflections. RESULTS: Over seven months, we engaged with young people and professionals in Northern Devon, (a rural area in southwest England), involving over 290 individuals to identify locally relevant priorities for supporting young people's mental health. Three priorities were identified for subsequent exploration using co-design approaches: (1) identity and belonging; (2) mental health awareness and literacy; and (3) diverse opportunities (for education, employment and leisure). The engagements suggested that designing initiatives and strategies in these areas could contribute to improvements in young people's mental health. CONCLUSION: Young people in Northern Devon prioritised three themes for the next phase of the Kailo Programme-mental health literacy, access to diverse careers and employment opportunities, and identity and belonging within their communities. Rural communities face unique barriers associated with these issues, related to less diverse populations, lack of access to reliable and affordable transport and local industries, and seasonal working. The perceived neglect by authorities towards rural young people has resulted in a lack of activities and opportunities catering to their specific needs, compared to urban areas. Although the government has recognised the need to address these disparities, community members suggest that there is still more work to be done.

The Kailo project aims to help young people and their communities find local solutions for better mental health in the UK. This paper discusses our findings in Northern Devon, England. Through various conversations and workshops with young people and professionals, we identified three key themes: (1) identity and belonging; (2) mental health knowledge and awareness; and (3) a variety of career, education, and leisure opportunities. These themes will be of focus for Kailo's next phase where ideas and initiatives will be designed and developed with young people and community professionals with the aim to help address important mental health challenges young people are experiencing within Northern Devon.

Kailo: a systemic approach to addressing the social determinants of young people's mental health and wellbeing at the local level.

The mental health and wellbeing of children and young people is deteriorating. It is increasingly recognised that mental health is a systemic issue, with a wide range of contributing and interacting factors. However, the vast majority of attention and resources are focused on the identification and treatment of mental health disorders, with relatively scant attention on the social determinants of mental health and wellbeing and investment in preventative approaches. Furthermore, there is little attention on how the social determinants manifest or may be influenced at the local level, impeding the design of contextually nuanced preventative approaches. This paper describes a major research and design initiative called Kailo that aims to support the design and implementation of local and contextually nuanced preventative strategies to improve children's and young people's mental health and wellbeing. The Kailo Framework involves structured engagement with a wide range of local partners and stakeholders - including young people, community partners, practitioners and local system leaders - to better understand local systemic influences and support programmes of youth-centred and evidence-informed co-design, prototyping and testing. It is hypothesised that integrating different sources of knowledge, experience, insight and evidence will result in better embedded, more sustainable and more impactful strategies that address the social determinants of young people's mental health and wellbeing at the local level.

Knowledge Gaps in the Understanding of Antimicrobial Resistance in Canada.

Current limitations in the understanding and control of antimicrobial resistance (AMR) in Canada are described through a comprehensive review focusing on: (1) treatment optimization; (2) surveillance of antimicrobial use and AMR; and (3) prevention of transmission of AMR. Without addressing gaps in identified areas, sustained progress in AMR mitigation is unlikely. Expert opinions and perspectives contributed to prioritizing identified gaps. Using Canada as an example, this review emphasizes the importance and necessity of a One Health approach for understanding and mitigating AMR. Specifically, antimicrobial use in human, animal, crop, and environmental sectors cannot be regarded as independent; therefore, a One Health approach is needed in AMR research and understanding, current surveillance efforts, and policy. Discussions regarding addressing described knowledge gaps are separated into four categories: (1) further research; (2) increased capacity/resources; (3) increased prescriber/end-user knowledge; and (4) policy development/enforcement. This review highlights the research and increased capacity and resources to generate new knowledge and implement recommendations needed to address all identified gaps, including economic, social, and environmental considerations. More prescriber/end-user knowledge and policy development/enforcement are needed, but must be informed by realistic recommendations, with input from all relevant stakeholders. For most knowledge gaps, important next steps are uncertain. In conclusion, identified knowledge gaps underlined the need for AMR policy decisions to be considered in a One Health framework, while highlighting critical needs to achieve realistic and meaningful progress.

Public Perceptions Regarding Genomic Technologies Applied to Breeding Farm Animals: A Qualitative Study.

The societal acceptability of different applications of genomic technologies to animal production systems will determine whether their innovation trajectories will reach the commercialisation stage. Importantly, technological implementation and commercialisation trajectories, regulation, and policy development need to take account of public priorities and attitudes. More effective co-production practices will ensure the application of genomic technologies to animals aligns with public priorities and are acceptable to society. Consumer rejection of, and limited demand for, animal products developed using novel genomic technologies will determine whether they are integration into the food system. However, little is known about whether genomic technologies that accelerate breeding but do not introduce cross-species genetic changes are more acceptable to consumers than those that do. Five focus groups, held in the north east of England, were used to explore the perceptions of, and attitudes towards, the use of genomic technologies in breeding farm animals for the human food supply chain. Overall, study participants were more positive towards genomic technologies applied to promote animal welfare (e.g., improved disease resistance), environmental sustainability, and human health. Animal "disenhancement" was viewed negatively and increased food production alone was not perceived as a potential benefit. In comparison to gene editing, research participants were most negative about genetic modification and the application of gene drives, independent of the benefits delivered.

Committed vs. uncommitted meat eaters: Understanding willingness to change protein consumption.

There is a growing trend of consumers in developed countries substituting alternative protein sources for meat and purchasing meat products with specific production-system related credence attributes. This study of Australian meat consumers identifies consumer segments with varying levels of willingness to make the following changes to their protein consumption: reduce meat consumption, follow a meat-free diet most of the time, avoid meat consumption altogether, and follow a strict plant-based diet (i.e., stop eating all animal-products). Segments are characterised, and predictors of segment membership are determined. Discrete Factor analysis, based on a nationally-representative sample of 287 Australian meat consumers surveyed in 2016, identified four unique segments. Findings show that 46% of consumers are not willing to make any changes to their meat/protein consumption ('Committed Meat Eaters'), 22% are willing to reduce meat consumption ('Willing Meat Reducers'), 15% are willing to stop meat consumption/consume plant-based protein foods only ('Prospective Veg*ns'), and 17% are undecided about future change ('Undecided Meat Eaters'). The key factor differentiating Committed Meat Eaters from other segments is the perception that food choices are inadequate in meat-free diets. Committed Meat Eaters are also less likely to believe livestock farming contributes to climate change, and to report a recent reduction in the consumption of at least one type of meat than are Willing Meat Reducers and Prospective Veg*ns. These findings are expected to be of interest to individuals and organisations who may play a role in meeting current and future consumer demand for meat and alternative protein products.

Long-term impacts of bovine spongiform encephalopathy on beef risk perceptions and risk attitudes in Canada.

In this study, the objective was to examine whether or not changes in bovine spongiform encephalopathy (BSE) concerns exert an effect on people's risk perceptions and risk attitudes regarding consuming beef in Canada, 8 years after finding the first domestic animal with BSE. Data were collected from two surveys (2071 respondents) conducted with the same respondents in 2008 and 2011 in Canada. Data on meat consumption for the same households were also available from the Nielsen Homescan panel over the period 2002 to 2009. Based on census data, the current sample is generally not representative of the Canadian population, but the sample is unique in that the same individuals responded to two surveys and there is an ability to track their evolving household purchases of beef before the first survey and between the two surveys. In essence, alterations in beef risk perceptions are significantly influenced by changes in concerns regarding (1) feed given to livestock, (2) animal diseases and BSE, (3) trust in manufacturers, the government, and farmers, and (4) demographic characteristics. There were significant differences in beef purchases across households, with alterations to their risk perceptions and risk attitudes. In conclusion, although the first domestic incident of BSE was in 2003, concerns regarding BSE are still contributing to consumers' risk perceptions but not to their risk attitudes with respect to consumption of beef in 2011.

Caribou consumption in northern Canadian communities.

Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) found in both farmed and wild deer, elk, and moose in the United States and Canada. Surveillance efforts in North America identified the geographical distribution of the disease and mechanisms underlying distribution, although the possibility of transmission to other cervids, including caribou, and noncervids, including humans, is not well understood. Because of the documented importance of caribou (Rangifer tarandus) to human populations in the northern regions of Canada, a risk-management strategy for CWD requires an understanding of the extent of potential dietary exposure to CWD. Secondary 24-h dietary recalls conducted among Inuvialuit and Inuit in 4 communities in the Northwest Territories and Nunavut were employed in this study. Econometric demand systems were estimated to model the impacts of individual- and community-level socioeconomic characteristics on expenditures on caribou and other foods, in order to examine the households' ability to consume other foods in response to changing levels of caribou consumption. Thirty-five percent of respondents reported consuming caribou in the survey period, and caribou comprised, on average, 26% of daily dietary intake by weight, or approximately 65 g/d, across individuals in the 4 communities. Consuming caribou was also shown to exert positive impacts on dietary quality, as measured by calorie intake and dietary diversity. Communities with less access to employment, income and food stores are predicted to be constrained in their ability to obtain an adequate diet in the event of scarcity of caribou meat.

Using linked household-level data sets to explain consumer response to bovine spongiform encepalopathy (BSE) in Canada.

Household-level Canadian meat purchases from 2002 to 2008 and a Food Opinions Survey conducted in 2008 were used to explore consumer responses to bovine spongiform encephalopathy (BSE) at the national level in Canada. Consumption in terms of the number of unit purchases was analyzed with a random-effects negative binomial model. In this study, household heterogeneity in meat purchases was partially explained using data from a self-reported food opinions survey. Of special interest was the hypothesis that consumers responded consistently to BSE in a one-time survey and in actual meat purchase behavior spanning years. Regional differences appeared, with consumers in eastern Canada reacting most negatively to BSE. Consumers responded more to the perception that food decision makers are honest about food safety than to the perception that they are knowledgeable, in maintaining beef purchases during BSE events.

The role of psychological determinants and demographic factors in consumer demand for farm-to-fork traceability systems.

Traceability systems are an important tool (1) for tracking, monitoring, and managing product flows through the supply chain for better efficiency and profitability of suppliers, and (2) to improve consumer confidence in the face of serious food safety incidents. After the global bovine spongiform encephalopathy (BSE) crisis affected producers, consumers, trade, and the health status of animals and humans, new systems to help confirm the status of cattle products along the supply chain from farm to fork were implemented in many countries (Trautman et al. 2008 ). In this study, people's overall food safety beliefs are explored with the main objective of measuring the link between their food safety beliefs and their attitudes toward traceability. A comparison is made among English-speaking Canadians, French-speaking Canadians, and Japanese consumers. In the study, an Internet-based survey was used to collect data from nationally representative samples of the population in Canada-English (1275), Canada-French (343), and Japanese (1940) in the summer of 2009. Respondents' interests in traceability systems are clearly linked to their sense that the industry is primarily responsible for any food safety outbreaks. Moreover, it is clear that certain segments of the population in all samples feel strongly about the importance of farm to fork traceability in beef; thus, policymakers may wish to consider extending traceability beyond the point of slaughter as a way of encouraging beef sales in Canada.

Do beef risk perceptions or risk attitudes have a greater effect on the beef purchase decisions of Canadian consumers?

Cluster analysis is applied in this study to group Canadian households by two characteristics, their risk perceptions and risk attitudes toward beef. There are some similarities in demographic profiles, meat purchases, and bovine spongiform encephalopathy (BSE) media recall between the cluster that perceives beef to be the most risky and the cluster that has little willingness to accept the risks of eating beef. There are similarities between the medium risk perception cluster and the medium risk attitude cluster, as well as between the cluster that perceives beef to have little risk and the cluster that is most willing to accept the risks of eating beef. Regression analysis shows that risk attitudes have a larger impact on household-level beef purchasing decisions than do risk perceptions for all consumer clusters. This implies that it may be more effective to undertake policies that reduce the risks associated with eating beef, instead of enhancing risk communication to improve risk perceptions. Only for certain clusters with higher willingness to accept the risks of eating beef might enhancing risk communication increase beef consumption significantly. The different role of risk perceptions and risk attitudes in beef consumption needs to be recognized during the design of risk management policies.

Consumers' understanding and concerns about bovine spongiform encephalopathy (BSE): comparison among Canadian, American, and Japanese consumers.

In spite of much analysis of the impact of bovine spongiform encephalopathy (BSE) on consumer perceptions and meat purchases, there has been little explicit analysis of the level of BSE knowledge. In this study the role of knowledge about BSE was examined in Canada, the United States, and Japan. In addition, the level of knowledge was linked to human health concerns regarding BSE and whether there is agreement with paying a premium for beef with BSE animal tests. From a public policy perspective, understanding whether higher or lower knowledge is linked to public concern and desire for market intervention might help in the design of risk communication in any future animal disease outbreak. Should lack of knowledge about the disease be related to a public desire for market intervention (animal testing, for example), then an increase in detailed information about how humans might contract the disease might change public pressure for intervention. As compared to U.S. and Canadian respondents, Japanese respondents are more knowledgeable regarding the ways in which humans might be exposed to the human variant of BSE (variant Creutzfeldt-Jakob disease, vCJD) and are more concerned about the disease. However, U.S. respondents are more willing to pay a premium for beef tested to ensure that it will not result in vCJD. Japanese respondents who are more knowledgeable about BSE are more concerned about the risk of BSE to human health. In Canada, subjects who are more knowledgeable about the ways in which humans attain vCJD are less concerned about the risk of BSE to human health. Knowledge of the ways in which humans develop vCJD does not significantly influence concerns about the risk of BSE to human health in the United States or willingness to pay for BSE-tested beef in any of the three countries. The links between knowledge and concerns about BSE and between knowledge and agreement with paying premiums for BSE-tested beef were estimated for each country using ordered probit regressions.

Bovine spongiform encephalopathy, risk perceptions, and beef consumption: differences between Canada and Japan.

This study provides an assessment of the perceived relative risk of bovine spongiform encephalopathy (BSE) in the context of other aspects of livestock production and human health issues. The factors influencing consumers' concerns regarding these issues are identified. Consumers' risk perceptions and risk attitudes about beef and poultry and the factors that influenced any reduction in beef consumption due to food safety issues or BSE are analyzed. General population internet-based survey were used to collect data in Japan (2009) and Canada (2006, 2009). BSE remains the highest ranking livestock production concern in Japan, in 2009, 9 years after the first animal with BSE was found in Japan. In Canada (2009), 6 years after the first domestic animal was found to have BSE, BSE ranked 7 out of 8 in possible livestock production concerns. Respondents in both countries who are older and female have a higher probability of being concerned about all livestock production issues. Higher levels of education in Canada are associated with a lower probability of ranking BSE as a high risk issue, while in Japan the opposite occurs. Canadian respondents have higher risk perceptions about poultry than beef and are more willing to accept the risks of eating beef than poultry (higher risk attitudes) than Japanese respondents. Together with some of the demographic variables, risk attitudes and risk perceptions have significantly influenced reductions in beef consumption due to food safety issues over the past 4 years and since consumers first heard about BSE.

The evolution of risk perceptions related to bovine spongiform encephalopathy--Canadian consumer and producer behavior.

In this study the dynamics of risk perceptions related to bovine spongiform encephalopathy (BSE) held by Canadian consumers and cow-calf producers were evaluated. Since the first domestic case of BSE in 2003, Canadian consumers and cow-calf producers have needed to make decisions on whether or not their purchasing/production behavior should change. Such changes in their behavior may relate to their levels of risk perceptions about BSE, risk perceptions that may be evolving over time and be affected by BSE media information available. An econometric analysis of the behavior of consumers and cow-calf producers might identify the impacts of evolving BSE risk perceptions. Risk perceptions related to BSE are evaluated through observed market behavior, an approach that differs from traditional stated preference approaches to eliciting risk perceptions at a particular point in time. BSE risk perceptions may be specified following a Social Amplification of Risk Framework (SARF) derived from sociology, psychology, and economics. Based on the SARF, various quality and quantity indices related to BSE media information are used as explanatory variables in risk perception equations. Risk perceptions are approximated using a predictive difference approach as defined by Liu et al. (1998). Results showed that Canadian consumer and cow-calf producer risk perceptions related to BSE have been amplified or attenuated by both quantity and quality of BSE media information. Government policies on risk communications need to address the different roles of BSE information in Canadian consumers' and cow-calf producers' behavior.