Prevalence and associated risk factors for suicidal ideation, non-suicidal self-injury and suicide attempt among male construction workers in Ireland.

BACKGROUND: Suicide among male construction workers are reported to be disproportionally high compared to the working age population. However, there is minimal understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury, and suicide attempt among this occupational group globally. METHODS: A cross-sectional study was conducted on a large sample of male construction workers in Ireland (n = 1,585). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational, and mental health factors associated with these three outcomes. Multivariable Poisson regression was performed to estimate the prevalence rate ratio of suicidal ideation (model 1 primary outcome), while multivariable logistic regression was used to estimate the odds ratio of non-suicidal self-injury (model 2 primary outcome), and suicide attempt (model 3 primary outcome). RESULTS: The lifetime prevalence rate for suicidal ideation was 22%, 6% for non-suicidal self-injury, and 6% for suicide attempt. In univariate modelling, socio-demographic and occupation-specific factors associated with the three outcomes included younger age (suicidal ideation and non-suicidal self-injury), not being in a relationship (suicide attempt) and working 35-44 h per week (suicidal ideation and suicide attempt). The mental health factors generalized anxiety disorder, depression, and suicide bereavement were significantly associated with increased risk of the three outcomes. In fully adjusted multivariable models, increasing severity of generalized anxiety disorder and depression were associated with an increased prevalence rate ratio of suicidal ideation, and a higher odds ratio of non-suicidal self-injury and suicide attempt. CONCLUSION: Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for male construction workers that require specific attention. Findings highlight a need to support younger male construction workers and those bereaved by suicide. They also highlight the need for the early detection and treatment of generalized anxiety disorder and depression in order to intervene in, and potentially prevent, suicidality among male construction workers.

Understanding shedders: Which socio-demographic, health and wellbeing characteristics best inform appropriate health promotion action in men's sheds and a 'Shed for Life'?

ISSUE ADDRESSED: Men's sheds ('Sheds') have been identified as inherently health promoting and as potential settings to engage 'hard-to-reach' men in more structured health promotion initiatives. However, little is known about the socio-demographic or health and wellbeing characteristics of Shed members ('Shedders') on which such initiatives might be based. This study captures a baseline cross-sectional analysis of Shedders (n = 384) who participated in 'Sheds for Life', a health promotion initiative tailored to Sheds. METHODS: Objective health measures (body composition, blood pressure, blood lipids) captured via health screening as well as socio-demographic and health and wellbeing measures (physical activity, subjective wellbeing, mental health, social capital, cooking and diet) via questionnaires were assessed. Descriptive statistics were generated and differences between groups were determined via parametric and non-parametric testing. Bivariate analysis was used to determine associations and regression analysis then estimated various predictors on mental wellbeing, life satisfaction and loneliness. RESULTS: Participants were mostly over 65 years (77.3%), retired (88.6%) with limited educational attainment (77%). The majority were in the 'at-risk' categories for objective health measures, with most being referred to their GP following health screening (79.6%). Older Shedders were also more likely to meet physical activity guidelines. Mental wellbeing was positively correlated with life satisfaction and increased social capital and these were also positively correlated with physical activity (P < .05). CONCLUSIONS: Findings highlight the potential of Sheds in reaching a 'hard-to-reach' and 'at-risk' cohort of men. Despite a high prevalence of 'at-risk' objective health measures, participants report their health in positive terms. Future health promotion initiatives should capitalise on the inherent health-promoting properties of Sheds. SO WHAT?: Findings raise important implications for prioritising and designing health promotion initiatives in Shed settings.

Sheds for life: health and wellbeing outcomes of a tailored community-based health promotion initiative for men's sheds in Ireland.

BACKGROUND: Gender is increasingly recognised as a critical factor in designing community-based health promotion programmes. Men's Sheds ('Sheds') are community-based informal environments that represent a safe space in which to engage cohorts of hard-to-reach (HTR) men in health promotion. Sheds for Life (SFL), the first structured health promotion initiative evaluated globally in Sheds, is a 10-week initiative co-designed with Shed Members (Shedders) and delivered directly in the Shed setting in Ireland. This research describes the health and wellbeing outcomes experienced by SFL participants. METHODS: Purposive sampling was used to recruit a diverse representation of Shedders (n = 421) participating in SFL alongside a wait list control (n = 86). Questionnaires assessing constructs of health and wellbeing were administered one-to-one in Sheds at baseline, 3, 6 and 12 months. Descriptive data for health outcomes were generated for each time point and assessed for significant changes using inferential testing, while considering COVID-19 impact. RESULTS: Outcomes related to subjective wellbeing, mental wellbeing, physical activity, social capital and healthy eating significantly increased post SFL (p < 0.05). Mental wellbeing scores (SWEMWBS) post SFL remained significantly higher than baseline despite COVID-19 impact (p < 0.05). Binary logistic regression indicated that the odds of a meaningful SWEMWBS change was significantly higher for shedders that had lower SWEMWBS (OR 0.804), less loneliness (OR 0.638) and lived alone (OR 0.456) at baseline. Shedders with lower SWEMBWS had higher odds of experiencing positive changes in life satisfaction (OR 0.911) and trust (OR 0.928), while Shedders who lived alone had also higher odds of experience positive changes in healthy eating (OR 0.481). Finally, inactive Shedders at baseline had higher odds of experiencing increased levels of physical activity (OR 0.582). CONCLUSIONS: Findings suggest that the inclusive, community-based SFL model is effective in engaging Shedders and facilitating positive and sustained changes in health and wellbeing outcomes. Using gender-specific approaches in the informal and safe environment of the Shed are effective in engaging men in structured health and wellbeing initiatives, particularly those who may be more vulnerable, isolated or lonely. TRIAL REGISTRATION: This study has been retrospectively registered with the 'International Standard Randomised Controlled Trial Number' registry (ISRCTN79921361) as of 05/03/2021.

Economic evaluation of 'Men on the Move', a 'real world' community-based physical activity programme for men.

BACKGROUND: Physical activity (PA) interventions capable of producing health benefits cost effectively are a public health priority across the Western world. 'Men on the Move' (MOM), a community-based PA intervention for men, demonstrated significant health benefits up to 52-weeks (W) post-baseline. This article details the economic evaluation of MOM with a view to determining its cost-effectiveness as a public health intervention to be rolled out nationally in Ireland. METHODS: Cost-effectiveness was determined by comparing the costs (direct and indirect) of the programme to its benefits, which were captured as the impact on quality-adjusted life-years (QALYs). For the benefits, cost-utility analysis was conducted by retrospectively adapting various health-related measures of participants to generate health states using Brazier et al.'s (2002) short form-6D algorithm. This in turn allowed for 'utility measures' to be generated, from which QALYs were derived. RESULTS: Findings show MOM to be cost-effective in supporting an 'at risk' cohort of men achieves significant improvements in aerobic fitness, weight loss and waist reduction. The total cost per participant (€125.82 for each of the 501 intervention participants), the QALYs gained (11.98 post-12-W intervention, or 5.3% health improvement per participant) and estimated QALYs ratio costs of €3723 represents a cost-effective improvement when compared to known QALY guidelines. CONCLUSIONS: The analysis shows that the cost per QALY achieved by MOM is significantly less than the existing benchmarks of £20 000 and €45 000 in the UK and Ireland respectively, demonstrating MOM to be cost-effective.

Ethical considerations in xenotransplantation of thoracic organs - a call for a debate on value based decisions.

Xenotransplant covers a broad ethical territory and there are several ethical questions that have arisen in parallel with the technological advances that have allowed the first porcine transplants to occur. This brief communication highlights ethical considerations regarding heart and lung xenotransplantation, with an emphasis on unresolved value-based concerns in the field. The aim of this text is therefore to encourage the readers to consider the vast potential of this emerging technique to do good, but also the risk of doing harm, and to participate in a discussion. The list of questions presented here is not exhaustive but hopefully represents some of the questions that appear to be most pressing as the field advances. The focus is on the value-based, or ethical questions, not the questions related to the practical medical procedures.

An Economic Evaluation of 'Sheds for Life': A Community-Based Men's Health Initiative for Men's Sheds in Ireland.

Men's Sheds ('Sheds') attract a diverse cohort of men and, as such, have been identified as spaces with the potential to engage marginalized subpopulations with more structured health promotion. 'Sheds for Life' is a 10-week men's health initiative for Sheds in Ireland and the first structured health promotion initiative formally evaluated in Sheds. Cost is an important implementation outcome in the evaluation of Sheds for Life when operating in an environment where budgets are limited. Therefore, an economic evaluation is critical to highlight cost-effectiveness for decision makers who determine sustainability. This is the first study to evaluate the cost-effectiveness of health endeavors in Sheds. All costs from pre-implementation to maintenance phases were gathered, and questionnaires incorporating the SF-6D were administered to participants (n = 421) at baseline, 3, 6, and 12 months. Then, utility scores were generated to determine quality-adjusted life years (QALYS). Results demonstrate that the intervention group experienced an average 3.3% gain in QALYS from baseline to 3 months and a further 2% gain from 3 months to 6 months at an estimated cost per QALY of €15,724. These findings highlight that Sheds for Life is a cost-effective initiative that effectively engages and enhances the well-being of Shed members.

Evaluating a CTSA-funded pilot grant program.

INTRODUCTION: Pilot programs are integral to catalyzing and accelerating research at Clinical and Translational Science Award (CTSA) hubs. However, little has been published about the structure and operationalization of pilot programs or how they impact the translational research enterprise at CTSAs. The North Carolina Translational and Clinical Science Institute (NC TraCS), the CTSA hub at the University of North Carolina at Chapel Hill (UNC-CH) conducted an evaluation case study to describe the pilot program structure, assess process outcomes, and provide a framework for other institutions to utilize for the evaluation of their respective pilot programs. METHODS: We describe the operationalization of our pilot program, the evaluation framework utilized to evaluate the program, and how we analyzed available data to understand how our pilot funding opportunities were utilized by investigators. We calculated application volumes and funding rates by investigator position title and pilot application type. We also reviewed feedback provided by pilot Principal Investigators (PIs) to understand how many pilot projects were completed, NC TraCS service utilization, and barriers to research. Limited data on publications and subsequent funding was also reviewed. RESULTS: Between 2009 and 2019 the NC TraCS Pilot Program received 2343 applications and funded 933 projects, ranging from $2000 to $100,000 in amount, with an overall funding rate of 39.8%. Utilization of NC TraCS services had positive impacts on both resubmission funding and project completion rates. CONCLUSION: This process evaluation indicates that the program is being operationalized in a way that successfully fulfills the program mission while meeting the needs of a diverse group of researchers.

Angiotensin II-acetylcholine noncovalent complexes analyzed with MALDI-ion mobility-TOF MS.

Matrix-assisted laser desorption ionization-ion mobility-orthogonal time-of-flight mass spectrometry (MALDI-IM oTOF MS) is a new technique that allows laser desorbed ion to be preseparated on the basis of their shape prior to mas analysis. Using this instrument, we tested the postulate that addition of a quaternary ammonium compound such as acetylcholine to the model phosphorylated peptide angio tensin II would enhance its detection by MALDI in two ways. First of all, the acetylcholine-peptide complex could ionize more efficiently than the bare phosphopeptide. Furthermore the ion mobility could separate the complex ion on the basis of its charge/volume from isobaric interferences, which would otherwise limit detection sensitivity.

Biological evaluation of a multi-targeted small molecule inhibitor of tumor-induced angiogenesis.

RO4396686 is a small molecule KDR, FGFR, and PDGFR inhibitor with good pharmacokinetic properties in rodents. In a mouse corneal neovascularization assay, this compound inhibited VEGF-induced angiogenesis. Tested in a H460a xenograft tumor model this agent effected significant tumor growth inhibition at doses as low as 50mg/kg.

RO4383596, an orally active KDR, FGFR, and PDGFR inhibitor: synthesis and biological evaluation.

(+/-)-1-(anti-3-Hydroxy-cyclopentyl)-3-(4-methoxy-phenyl)-7-phenylamino-3,4-dihydro-1H-pyrimido[4,5-d]pyrimidin-2-one (RO4383596) is a potent and selective inhibitor of the pro-angiogenic receptor tyrosine kinases KDR, FGFR, and PDGFR. This agent has an excellent pharmacokinetic profile and is highly efficacious in rodent models of angiogenesis upon oral administration.

Lipid/peptide/nucleotide separation with MALDI-ion mobility-TOF MS.

Matrix-assisted laser desorption/ionization when combined with ion mobility-orthogonal time-of-flight mass spectrometry is a viable technique for fast separation and analysis of biomolecules in complex mixtures. Isobaric lipid, peptide, and oligonucleotide ions are preseparated before mass analysis by differences of up to 30% in mobility drift time. Ions of similar chemical type fall along well-defined "trend lines" (with deviations of approximately 3%) when plotted in two-dimensional representations of ion mobility as a function of m/z. Discussion of fundamental and technical limitations of the technique point to its potential for being most useful when applied to systems such as bodily fluids and intact tissue, where an alternative chemical or chromatographic preseparation step prior to mass analysis is either impractical or undesirable.