Stakeholder perceptions of non-regulatory bovine health issues in Ireland: past and future perspectives.

BACKGROUND: In recent years, there have been multiple (political, environmental, cultural) drivers of change in Irish agriculture, including the establishment of Animal Health Ireland (AHI) in 2009, to provide leadership of non-regulatory livestock health issues (diseases and conditions of livestock that are endemic in Ireland but which are not currently subject to international legislation). In this study, we describe the opinion of stakeholders (farmers, veterinary practitioners and agricultural industry professional service providers), elicited by means of a survey, on their perceptions of changes in selected non-regulatory bovine health issues over the last 10 years and priority issues relevant to non-regulatory bovine health to be tackled over the next 10 years. RESULTS: A total of 673 individuals participated in the online questionnaire. For the majority of the non-regulatory bovine health issues, most participants felt there had been improvements over the last 10 years. However, professional service providers were generally more conservative in their response to improvements on-farm compared to farmers. Several issues, particularly BVD and udder health/milk quality, were viewed more positively by all relevant respondents. There was reasonable agreement between responses from different respondent types and sectors regarding the top three priorities relevant to non-regulatory bovine animal health for the next 10 years in Ireland, which included antimicrobial resistance (highlighting measures to reduce both on-farm usage and resistance), anthelmintic resistance, greenhouse emissions and calf welfare. CONCLUSIONS: The results are encouraging, demonstrating a perception of improvement in a number of non-regulatory bovine health issues in Ireland over the last ten years. With respect to the next 10 years, stakeholders prioritised antimicrobial and anthelmintic resistance, greenhouse gas emissions and calf welfare, which aligns closely with broader societal concerns. This information is useful to AHI, particularly with respect to future priorities. However, these concerns are broad in scope and will require further considerations, including collaborations, between AHI and partnering organisations. Given that there were differences between farmers and professional service providers in responses, it is useful to consider how the aims and the benefits of future AHI programmes are framed and communicated to all stakeholders.

Examining the media portrayal of obesity through the lens of the Common Sense Model of Illness Representations.

This study examined the Irish media discourse on obesity by employing the Common Sense Model of Illness Representations. A media sample of 368 transcripts was compiled from newspaper articles (n = 346), radio discussions (n = 5), and online news articles (n = 17) on overweight and obesity from the years 2005, 2007, and 2009. Using the Common Sense Model and framing theory to guide the investigation, a thematic analysis was conducted on the media sample. Analysis revealed that the behavioral dimensions of diet and activity levels were the most commonly cited causes of and interventions in obesity. The advertising industry was blamed for obesity, and there were calls for increased government action to tackle the issue. Physical illness and psychological consequences of obesity were prevalent in the sample, and analysis revealed that the economy, regardless of its state, was blamed for obesity. These results are discussed in terms of expectations of audience understandings of the issue and the implications of these dominant portrayals and framings on public support for interventions. The article also outlines the value of a qualitative analytical framework that combines the Common Sense Model and framing theory in the investigation of illness narratives.

Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer.

BACKGROUND: This is an update of a Cochrane review first published in The Cochrane Library in Issue 2, 2002 and previously updated in 2004, 2007 and 2010.Radiotherapy, open surgery and endolaryngeal excision (with or without laser) are all accepted modalities of treatment for early-stage glottic cancer. Case series suggest that they confer a similar survival advantage, however radiotherapy and endolaryngeal surgery offer the advantage of voice preservation. There has been an observed trend away from open surgery in recent years, however equipoise remains between radiotherapy and endolaryngeal surgery as both treatment modalities offer laryngeal preservation with similar survival rates. Opinions on optimal therapy vary across disciplines and between countries. OBJECTIVES: To compare the effectiveness of open surgery, endolaryngeal excision (with or without laser) and radiotherapy in the management of early glottic laryngeal cancer. SEARCH METHODS: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL 2014, Issue 8); PubMed; EMBASE; CINAHL; Web of Science; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 18 September 2014. SELECTION CRITERIA: Randomised controlled trials comparing open surgery, endolaryngeal resection (with or without laser) and radiotherapy. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS: We identified only one randomised controlled trial, which compared open surgery and radiotherapy in 234 patients with early glottic laryngeal cancer. The overall risk of bias in this study was high.For T1 tumours, the five-year survival was 91.7% following radiotherapy and 100% following surgery and for T2 tumours, 88.8% following radiotherapy and 97.4% following surgery. There were no significant differences in survival between the two groups.For T1 tumours, the five-year disease-free survival rate was 71.1% following radiotherapy and 100.0% following surgery, and for the T2 tumours, 60.1% following radiotherapy and 78.7% following surgery. Only the latter comparison was statistically significant (P value = 0.036), but statistical significance would not have been achieved with a two-sided test.Data were not available on side effects, quality of life, voice outcomes or cost.We identified no randomised controlled trials that included endolaryngeal surgery. A number of trials comparing endolaryngeal resection and radiotherapy have terminated early because of difficulty recruiting participants. One randomised controlled trial is still ongoing. AUTHORS' CONCLUSIONS: There is only one randomised controlled trial comparing open surgery and radiotherapy but its interpretation is limited because of concerns about the adequacy of treatment regimens and deficiencies in the reporting of the study design and analysis.

Weight stigma and narrative resistance evident in online discussions of obesity.

This study sampled 2872 obesity-relevant comments from three years of interest from a multi-topic online message board. An inductive thematic analysis was conducted and three themes were evident: reactions and responses to obesity and obese bodies, diminished status of overweight/obese persons, and narrative resistance to an overweight/obese identity. Obesity stigma was pervasive and the discussion of the issue revealed it to be highly acceptable. Consistent with previous research, dominant representations of obese persons as lazy and unintelligent with poor self-control were evident. The analysis provided valuable insight into experiences of explicit stigma, the social and psychological repercussions of overt stigma and norms regarding the perception of obese bodies. There was a prevailing notion that the opinions and insights of overweight and obese persons on the issue of weight were not credible and were perceived as biased. Furthermore, individuals sought to distance themselves from the undesirable labels of 'overweight' and 'obese' by enacting narrative resistance to negotiate the social meaning of excess weight and endeavouring to place themselves on the 'safe' side of this boundary. These results highlight the pervasive nature of weight stigma and the social acceptability of such attitudes and beliefs. Furthermore, it highlights the richness of data that may be obtained by examining social media interactions as a window into the naturally-occurring discourse on obesity and stigma.

Farmers' self-reported perceptions and behavioural impacts of a welfare scheme for suckler beef cattle in Ireland.

BACKGROUND: To date, there have been a limited number of studies on the impact of government-incentivised farm animal welfare programmes or 'schemes', and on farmers' attitudes regarding such schemes. In this study, focus groups were used to gain insight into Irish farmers' perceptions of such a scheme for suckler cattle and its behavioural impacts on farmers. RESULTS: The findings were categorised into 46 codes and ultimately yielded two Global themes: 1) Beliefs and Evidence and 2) Logic and Logistics. The former theme covered farmers' attitudes and observations regarding the Scheme. The latter dealt with factors such as workload and costs. The Global themes allowed for comprehensive reporting of the strongest messages from focus groups. There was consensus that Scheme measures for the minimum calving age and for weaning had a positive impact on welfare. Two aspects criticized by participants were firstly disbudding, due to the logistics for anaesthetic application, and secondly the administrative workload associated with data capture and utilisation. The majority anticipated that data being collected via the Scheme would help to inform farm management decisions in future. CONCLUSIONS: Farm animal welfare schemes, which incentivise participants to implement certain practices, aspire to long-term behavioural change after scheme conclusion. Our research showed that this Scheme increased farmer awareness of the benefits of certain practices. It also demonstrated the importance of stakeholder participation in the design stages of welfare initiatives to ensure scheme measures are practical and relevant, to address any perceived controversial measures, and to plan for training and adding value to schemes.

"Fat is your fault". Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity.

We investigated the representation of obesity in the Irish media by conducting an inductive thematic analysis on newspaper articles (n=346) published in 2005, 2007 and 2009 sampled from six major publications. The study analysed the media's construction of gender in discussions of obesity and associated attributions of blame. Three dominant themes are discussed: the caricatured portrayal of gender, women as caregivers for others, and emotive parent-blaming for childhood obesity. Men were portrayed as a homogenous group; unaware and unconcerned about weight and health issues. Dieting and engaging in preventative health behaviours were portrayed as activities exclusively within the female domain and women were depicted as responsible for encouraging men to be healthy. Parents, specifically mothers, attracted much blame for childhood obesity and media messages aimed to shame and disgrace parents of obese children through use of emotive and evocative language. This portrayal was broadly consistent across media types and served to reinforce traditional gender roles by positioning women as primarily responsible for health. This analysis offers the first qualitative investigation into the Irish media discourse on obesity and indicates a rather traditional take on gender roles in diet and nutrition.

Tissue banking: relationship with blood donor and organ donor card status.

Understanding the relationships among altruistic health acts may serve to aid therapeutic research advances. In this paper, we report on the links between two such behaviours-donating blood and carrying an organ donor card-and willingness to donate urological tissue to a tissue bank. Reasons for the differential willingness to do so are examined in this paper. A systematic sample of 259 new and returning attendees at a tertiary urology referral clinic in Ireland completed a self-report questionnaire in an outpatient setting. In addition to demographic details, details of known diagnosis of malignancy and family history of cancer; attitudes to tissue donation for research purposes were gauged using a 5-point Likert scale. Both blood donors and organ donor card carriers were more likely to be willing to donate tissue for research purposes. Blood donors were more likely want to know their overall results in comparison to nonblood donors and want their samples to be used for nonprofit research. Our hypothesis that being a blood donor would be a better predictor to donate urological tissue than being an organ donor card carrier borne out by the trends reported above.

The emergence and portrayal of obesity in The Irish Times: content analysis of obesity coverage, 1997-2009.

Both global obesity prevalence rates and media attention to obesity have increased significantly in recent years. The current study examined the representation of obesity in The Irish Times, from 1997 to 2009. A quantitative content analysis was conducted on 479 articles to examine how the causes, consequences, and solutions to obesity have been portrayed and how obesity has been described. A frame analysis was also conducted to examine the dominant frames over time. It was found that attention to obesity was positively correlated with time, indicating coverage has increased significantly over the period examined. Regarding reported causes and solutions, the behavioral frame has been dominant, though environmental and mixed-frame stories have become more frequent. The presence of the genetic frame was consistently low. The study provides an overview of how the issue is being represented in Ireland's paper of record and informs health communicators of the dominant and trending messages and the implications for individuals' formation of illness representations.

Patients attending tertiary referral urology clinics: willingness to participate in tissue banking.

OBJECTIVE: To examine attitudes of male patients attending urology clinics to the donation of prostate tissue samples for research purposes, to compare attitudes in relation to age, educational attainment, previous hospitalization and experience of cancer, and to evaluate attitudes to the duration of storage of tissue samples. PATIENTS AND METHODS: A systematic sample of 259 male patients aged 20-75 years, attending the urology clinics in two busy tertiary referral urological centres, completed a self-reported questionnaire in an outpatient setting. RESULTS: Most (84.5%) respondents strongly agreed/agreed that they would be willing to donate prostate tissue for research purposes if undergoing invasive investigation or treatment. After adjusting for other factors, being aged >55 years and having a positive attitude to new discoveries in genetics and cancer remained independently associated with the willingness to donate. There were significantly fewer agreeing with the statement 'I would like my samples to be used for profit-making research' (39.3%) than with the statement 'I would like my samples to be used for non-profit research' (88.8%; P < 0.001). While most respondents trusted researchers to act in an ethical way, the proportions agreeing with the statement 'In regard to extra research studies I would trust medical researchers to act in an appropriate and ethical way' was significantly lower in those on a first visit rather than subsequent visit to urology outpatients and significantly higher in those with a family history of serious disease or a previous cancer. CONCLUSIONS: This study indicates that patients want to support research and become willing partners in the battle against cancer.

The distribution of wellbeing in Ireland.

OBJECTIVES: There is a substantial knowledge gap about the distribution of mental health in community populations. The European Social Survey is particularly useful as it contains information on over 40,000 individuals, including 2,286 Irish adults. The objective of this study is to conduct a large scale statistical analysis to examine the distribution and determinants of mental wellbeing in a large representative sample of the Irish population. METHOD: Analysis of the European Social Survey using robust multiple linear and non-linear regression techniques. The data-set contains WHO-Five scores and subjective wellbeing for a sample of 2,286 Irish people interviewed in their homes in 2005. RESULTS: Ireland has the second highest average WHO-Five score among the 22 countries in the European Social Survey. Multiple linear regression analysis across the distribution of WHO-Five reveals a wellbeing gradient largely related to education and social capital variables. A probit model examining the determinants of vulnerability to psychiatric morbidity reveals that a similar set of factors predict scores below the threshold point on the WHO-Five scale. CONCLUSIONS: The results are consistent with marked differences in mental wellbeing across education levels and variables relating to social capital factors. Such indicators provide a useful index for policy-makers and researchers. However, much further work is needed to identify causal mechanisms generating observed differences in mental health across different socioeconomic groups.