This study aims to identify fathers’ profiles integrating food parenting practices (FPP) and physical activity parenting practices (PAPP).

We analysed cross-sectional data. The fathers completed the reduced FPP and PAPP item banks and socio-demographic and family dynamics (co-parenting and household responsibility) questionnaires. We identified fathers’ profiles via latent profile analysis. We explored the influence of social determinants, child characteristics and family dynamics on fathers’ profiles using multinomial logistic regression.

Online survey in the USA.

Fathers of 5–11-year-old children.

We analysed data from 606 fathers (age = 38 ± 8·0; Hispanic = 37·5 %). Most fathers self-identified as White (57·9 %) or Black/African American (17·7 %), overweight (41·1 %) or obese (34·8 %); attended college (70 %); earned > $47 000 (62·7 %); worked 40 hrs/week (63·4 %) and were biological fathers (90·1 %). Most children (boys = 55·5 %) were 5–8 years old (65·2 %). We identified five fathers’ profiles combining FPP and PAPP: (1) Engaged Supporter Father (n 94 (15·5 %)); (2) Leveled Father (n 160 (26·4 %)); (3) Autonomy-Focused Father (n 117 (19·3 %)); (4) Uninvolved Father (n 113 (18·6 %)) and (5) Control-Focused Father (n 122 (20·1 %)). We observed significant associations with race, ethnicity, child characteristics, co-parenting and household responsibility but not with education level, annual income or employment status. We observed significant pairwise differences between profiles in co-parenting and household responsibility, with the Engaged Supporter Father presenting higher scores in both measures.

Understanding how fathers’ FPP and PAPP interact can enhance assessments for a comprehensive understanding of fathers’ influences on children’s health. Recognising the characteristics and differences among fathers’ profiles may enable tailored interventions, potentially improving children’s health trajectories.

Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.

To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.

Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).

Records were extracted for 2477 ‘cases’ and 24 777 ‘controls’; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10–17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4–3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7–7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02–13.29), aORfemale = 15.08 (95% CI, 8.07–28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64–2.21), aORfemale = 2.65 (95% CI, 1.94–3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81–2.34), aORfemale = 1.78 (95% CI, 1.50–2.10).

Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential ‘at-risk’ adolescents to prevent future suicidal acts, especially those in general hospitals.

Medical resuscitations in rugged prehospital settings require emergency personnel to perform high-risk procedures in low-resource conditions. Just-in-Time Guidance (JITG) utilizing augmented reality (AR) guidance may be a solution. There is little literature on the utility of AR-mediated JITG tools for facilitating the performance of emergent field care.

The objective of this study was to investigate the feasibility and efficacy of a novel AR-mediated JITG tool for emergency field procedures.

Emergency medical technician-basic (EMT-B) and paramedic cohorts were randomized to either video training (control) or JITG-AR guidance (intervention) groups for performing bag-valve-mask (BVM) ventilation, intraosseous (IO) line placement, and needle-decompression (Needle-d) in a medium-fidelity simulation environment. For the interventional condition, subjects used an AR technology platform to perform the tasks. The primary outcome was participant task performance; the secondary outcomes were participant-reported acceptability. Participant task score, task time, and acceptability ratings were reported descriptively and compared between the control and intervention groups using chi-square analysis for binary variables and unpaired t-testing for continuous variables.

Sixty participants were enrolled (mean age 34.8 years; 72% male). In the EMT-B cohort, there was no difference in average task performance score between the control and JITG groups for the BVM and IO tasks; however, the control group had higher performance scores for the Needle-d task (mean score difference 22%; P = .01). In the paramedic cohort, there was no difference in performance scores between the control and JITG group for the BVM and Needle-d tasks, but the control group had higher task scores for the IO task (mean score difference 23%; P = .01). For all task and participant types, the control group performed tasks more quickly than in the JITG group. There was no difference in participant usability or usefulness ratings between the JITG or control conditions for any of the tasks, although paramedics reported they were less likely to use the JITG equipment again (mean difference 1.96 rating points; P = .02).

This study demonstrated preliminary evidence that AR-mediated guidance for emergency medical procedures is feasible and acceptable. These observations, coupled with AR’s promise for real-time interaction and on-going technological advancements, suggest the potential for this modality in training and practice that justifies future investigation.

To identify the main foods determining SFA intakes and model the impact of food exchanges to improve compliance with dietary fat recommendations in Irish children.

Estimated food and nutrient intakes were obtained from a cross-sectional study, the National Children’s Food Survey II. Participants were categorised into low, medium and high SFA consumers, and the contribution of food categories to SFA intakes was compared. A food-exchange model was developed, whereby a selected range of high SFA foods was exchanged with lower SFA or unsaturated fat alternatives.

Participants were randomly selected from primary schools throughout the Republic of Ireland.

A representative sample of 600 Irish children (5–12 years).

The main determinants of low and high SFA consumers were milk, cheese and butter. These foods, including snack foods and meat and meat products, were considered exchangeable foods within the model. Compared with baseline data, modelled intakes for total fat, SFA, MUFA and trans-fat presented decreases of 3·2, 2·7, 1·6 and < 0·1 % of total energy (% TE), respectively. PUFA, n-6, n-3 and alpha-linolenic acid showed increases of 1·0, 0·8, 0·2 and 0·1 % TE, respectively. Compliance with total fat, MUFA and trans-fat recommendations remained adequate (100 %). Adherence to SFA and PUFA recommendations improved from 18 to 63 % and 80 to 100 %, respectively.

The food-exchange model decreased SFA intakes and increased PUFA intakes, suggesting modest dietary changes to children’s diets can effectively improve their overall dietary fat profile.

Rapid antigen detection tests (Ag-RDT) for SARS-CoV-2 with emergency use authorization generally include a condition of authorization to evaluate the test’s performance in asymptomatic individuals when used serially. We aim to describe a novel study design that was used to generate regulatory-quality data to evaluate the serial use of Ag-RDT in detecting SARS-CoV-2 virus among asymptomatic individuals.

This prospective cohort study used a siteless, digital approach to assess longitudinal performance of Ag-RDT. Individuals over 2 years old from across the USA with no reported COVID-19 symptoms in the 14 days prior to study enrollment were eligible to enroll in this study. Participants throughout the mainland USA were enrolled through a digital platform between October 18, 2021 and February 15, 2022. Participants were asked to test using Ag-RDT and molecular comparators every 48 hours for 15 days. Enrollment demographics, geographic distribution, and SARS-CoV-2 infection rates are reported.

A total of 7361 participants enrolled in the study, and 492 participants tested positive for SARS-CoV-2, including 154 who were asymptomatic and tested negative to start the study. This exceeded the initial enrollment goals of 60 positive participants. We enrolled participants from 44 US states, and geographic distribution of participants shifted in accordance with the changing COVID-19 prevalence nationwide.

The digital site-less approach employed in the “Test Us At Home” study enabled rapid, efficient, and rigorous evaluation of rapid diagnostics for COVID-19 and can be adapted across research disciplines to optimize study enrollment and accessibility.

Considerable literature has examined the COVID-19 pandemic’s negative mental health sequelae. It is recognised that most people experiencing mental health problems present to primary care and the development of interventions to support GPs in the care of patients with mental health problems is a priority. This review examines interventions to enhance GP care of mental health disorders, with a view to reviewing how mental health needs might be addressed in the post-COVID-19 era.

Five electronic databases (PubMed, PsycINFO, Cochrane Library, Google Scholar and WHO ‘Global Research on COVID-19’) were searched from May – July 2021 for papers published in English following Arksey and O’Malley’s six-stage scoping review process.

The initial search identified 148 articles and a total of 29 were included in the review. These studies adopted a range of methodologies, most commonly randomised control trials, qualitative interviews and surveys. Results from included studies were divided into themes: Interventions to improve identification of mental health disorders, Interventions to support GPs, Therapeutic interventions, Telemedicine Interventions and Barriers and Facilitators to Intervention Implementation. Outcome measures reported included the Seven-item Generalised Anxiety Disorder Scale (GAD-7), the Nine-item Patient Health Questionnaire (PHQ-9) and the ‘The Patient Global Impression of Change Scale’.

With increasing recognition of the mental health sequelae of COVID-19, there is a lack of large scale trials researching the acceptability or effectiveness of general practice interventions. Furthermore there is a lack of research regarding possible biological interventions (psychiatric medications) for mental health problems arising from the pandemic.

Agitated behaviors are frequently encountered in the prehospital setting and require emergent treatment to prevent harm to patients and prehospital personnel. Chemical sedation with ketamine works faster than traditional pharmacologic agents, though it has a higher incidence of adverse events, including intubation. Outcomes following varying initial doses of prehospital intramuscular (IM) ketamine use have been incompletely described.

To determine whether using a lower dose IM ketamine protocol for agitation is associated with more favorable outcomes.

This study was a pre-/post-intervention retrospective chart review of prehospital care reports (PCRs). Adult patients who received chemical sedation in the form of IM ketamine for agitated behaviors were included. Patients were divided into two cohorts based on the standard IM ketamine dose of 4mg/kg and the lower IM dose of 3mg/kg with the option for an additional 1mg/kg if required. Primary outcomes included intubation and hospital admission. Secondary outcomes included emergency department (ED) length of stay, additional chemical or physical restraints, assaults on prehospital or ED employees, and documented adverse events.

The standard dose cohort consisted of 211 patients. The lower dose cohort consisted of 81 patients, 17 of whom received supplemental ketamine administration. Demographics did not significantly differ between the cohorts (mean age 35.14 versus 35.65 years; P = .484; and 67.8% versus 65.4% male; P = .89). Lower dose subjects were administered a lower ketamine dose (mean 3.24mg/kg) compared to the standard dose cohort (mean 3.51mg/kg). There was no statistically significant difference between the cohorts in intubation rate (14.2% versus 18.5%; P = .455), ED length of stay (14.31 versus 14.88 hours; P = .118), need for additional restraint and sedation (P = .787), or admission rate (26.1% versus 25.9%; P = .677). In the lower dose cohort, 41.2% (7/17) of patients who received supplemental ketamine doses were intubated, a higher rate than the patients in this cohort who did not receive supplemental ketamine (8/64, 12.5%; P <.01).

Access to effective, fast-acting chemical sedation is paramount for prehospital providers. No significant outcomes differences existed when a lower dose IM ketamine protocol was implemented for prehospital chemical sedation. Patients who received a second dose of ketamine had a significant increase in intubation rate. A lower dose protocol may be considered for an agitation protocol to limit the amount of medication administered to a population of high-risk patients.

To examine current dietary fat intakes and compliance in Irish children and to examine changes in intakes from 2005 to 2019.

Analyses were based on data from the Irish National Children’s Food Survey (NCFS) and the NSFS II, two cross-sectional studies that collected detailed food and beverage intake data through 7-day and 4-day weighed food diaries, respectively.

NCFS and NCFS II, Republic of Ireland.

A nationally representative sample of 594 (NCFS) and 600 (NCFS II) children aged 5–12 years. Current intakes from the NCFS II were compared with those previously reported in the NCFS (www.iuna.net).

Current intakes of total fat, SFA, MUFA, PUFA and trans fat as a percentage of total energy are 33·3, 14·0, 13·6, 5·6 and 0·5 %, respectively. Total fat, SFA and trans fat intakes since 2005 remained largely stable over time with all displaying minor decreases of <1 %. Adherence to SFA recommendations remains inadequate, with only 7 % of the population complying. Insufficient compliance with PUFA (71 %) and EPA and DHA (DHA; 16 %) recommendations was also noted.

Children in Ireland continue to meet the total fat and trans fat target goals. Adherence to MUFA and PUFA recommendations has also significantly improved. However, deviations for some fats remain, in particular SFA. These findings are useful for the development of dietary strategies to improve compliance with current recommendations.

36% the over 50s in Ireland are obese based on body mass index (BMI: reflective of fat store peripherally) while 52% are ‘centrally obese’ based on waist circumference (indicative of fat located viscerally).(1) Visceral fat is thought to be a major site for inflammatory cytokine production and has been linked to other vascular risk factors such as hypertension and diabetes,(2) potentially providing a mechanism for brain atrophy.(3) The aim of the present work was to examine associations between obesity and grey matter (GM)/white matter (WM) perfusion as measured using pseudo-continuous arterial spin labelling (pCASL) MRI.

This study was embedded within the Irish Longitudinal Study on Ageing (TILDA), a nationally representative sample of > 8,000 older adults.(4) At wave three, 561 participants underwent brain MRI using a 3T scanner (Achieva, Philips, Netherlands); after exclusions, 484 participants data were included for this analysis. Cerebral blood flow (CBF [ml/100g/min]) values were calculated and their associations with BMI and waist-to-hip ratio (WHR) measures modelled using multiple linear regression. We also examined 6 groups: ‘normal’, ‘overweight’, and ‘obese’ as defined by BMI, with and without central obesity, as defined by WHR.(5) Models were adjusted for age, sex, smoking, alcohol consumption, physical activity, education, heart disease, hypertension, anti-hypertensive use, and depression.

The mean age was 69 years (± 7.2 years); 52% were female. Higher BMI and WHR were both related to lower GM and WM CBF: BMI per 1 SD (GM: β:-1.451, 95%CI:-2.300 to -0.607, P < 0.001; WM: β:-0. 575, 95%CI:-0. 939 to -0.210, P = 0.002) and WHR (GM: β:−1.667, 95%CI:−2.856 to −0.477, P = 0.006; WM: β:−0.688, 95%CI:−1.178 to −0.197, P = 0.006). The combination of overall obesity (BMI ≥ 30 kg/m2) and central obesity (WHR > 0.85[female], > 0.90[male]) was associated with lower CBF (GM: β:-4.303, 95%CI:-7.015 to -1.591, P = 0.002; WM: β:-2.029, 95%CI:-3.185 to -0.873, P < 0.001) compared to subjects without central obesity (GM: β:-0.959, 95%CI:-6.490 to 4.572, P = 0.733; WM:β:-0.051, 95%CI:-2.060 to 1.958, P = 0.960).

Our results show that central adiposity is a risk factor for impaired cerebral perfusion independent of BMI. Recent studies have shown that accumulation of fat in this area is a risk factor for cognitive impairment(6) and thus this study could partly explain the vascular origins.

Milk is widely recognised as a nutrient dense food, supporting the growth and development of children. Nevertheless some milk types such as whole milk can consist of high levels of saturated fat, which is recognised for its association with chronic disease risk in adults when intakes are elevated. In Ireland, current dietary guidelines recommend that children from two years onwards should consume low fat milk. Previous research has shown low levels of compliance with this guideline. Therefore the aim of this study is to review the current consumption of milk and non-dairy milk-based alternatives among Irish children and compare these with previous intakes.

Analyses are based on data from the nationally representative National Children's Food Survey (NCFS, 2003–2004) and the National Children's Food Survey II (NCFSII 2017–2018) (www.iuna.net). The NCFS and NCFS II collected detailed food and beverage intake data from 7-d and 4-d weighed food diaries respectively, of Irish children aged 5–12 years (NCFS, n594; NCFS II, n600). Dietary intakes were analysed using WISP© in NCFS and Nutritics V5.02 (Nutritics, Dublin, Ireland) in NCFS II. Milk intakes were categorised into three food groups: ‘Whole milk’, ‘reduced fat milk’, and ‘non-dairy milk alternatives’. Mean daily intakes (MDIs) were calculated for the total population and consumers only using SPSS© V24.0.

Dietary intakes of ‘whole milk’ decreased over time from 232 ± 186g/d to current intakes of 131 ± 154g/d. In contrast, increases were noted in ‘reduced fat milks’ (26 ± 86g/d to 52 ± 110g/d) and ‘non-dairy alternatives’ (0.2 ± 4g/d to 3 ± 19g/d). A total of 68% of children were classified as consumers of whole milk (193 ± 151g/d) compared to 90% (257 ± 178g/d) previously. ‘Reduced fat milk’ consumers increased from 17% to 31% and ‘non-dairy alternatives’ consumers also increased from < 1% to 3%.

Our preliminary results indicate that the number of Irish children consuming whole milk have decreased over the last number of years. In contrast consumers of ‘reduced fat milks’ have significantly increased, indicating potential improvement to healthy eating guidelines adherence. Further analysis to examine current intakes and sources of saturated fat is warranted to establish additional changes in dietary patterns and compliance with recommendations within this age group.