Provision of smoking cessation support for patients following a diagnosis of cancer in Ireland.

There is growing evidence that smoking cessation (SC) improves outcomes following diagnosis of cancer. Notwithstanding adverse outcomes, a significant number of those diagnosed with cancer continue to smoke. Our objective was to document the SC services provided for patients with cancer by specialist adult cancer hospitals across Ireland, a country with a stated tobacco endgame goal. A cross-sectional survey based on recent national clinical guidelines was used to determine SC care delivery across eight adult cancer specialist hospitals, and one specialist radiotherapy centre. Qualtrics was used. The response rate was 88.9% with data reported from seven cancer hospitals and one specialist radiotherapy centre, all indicating they had some SC related provision (100%). Stop smoking medications were provided to cancer inpatients in two hospitals, at outpatients and attending day ward services in one hospital. Smokers with cancer were referred automatically to the SC service in two hospitals at diagnosis. While stop smoking medications were available 24 h a day in five hospitals, most did not stock all three (Nicotine Replacement Therapy, Bupropion, Varenicline). One hospital advised they had data on uptake of SC services for smokers with cancer but were unable to provide detail. There is considerable variation in SC information and services provided to cancer patients across adult cancer specialist centres in Ireland, reflecting the suboptimal practice of smoking cessation for patients with cancer found in the limited international audits. Such audits are essential to demonstrate service gaps and provide a baseline for service improvement.

Public beliefs about the consequences of living with obesity in the Republic of Ireland and Northern Ireland.

BACKGROUND: This study aimed to capture public beliefs about living with obesity, examine how these beliefs have changed over time and to explore whether certain characteristics were associated with them in a nationally representative sample of adults from the Republic of Ireland (RoI) and Northern Ireland (NI). METHODS: A cross-sectional survey employed a random quota sampling approach to recruit a nationally representative sample of 1046 adults across NI and RoI. Telephone interviews captured information on demographics; health behaviours & attitudes; and beliefs about the consequences of obesity (measured using the Obesity Beliefs Scale). Univariable analyses compared beliefs about the consequences of living with obesity between participants with a self-reported healthy weight and those living with overweight or obesity, and non-responders (those for whom weight status could not be ascertained due to missing data). Multiple linear regression examined associations between obesity-related beliefs and socio-demographics, self-rated health and perceived ability to change health behaviours. Multiple linear regression also compared changes in obesity-related beliefs between 2013 and 2020 in the RoI. RESULTS: Higher endorsement of the negative outcomes of obesity was significantly associated with living with a healthy weight, higher self-rated health, dietary quality and perceived ability to improve diet and physical activity. Those who lived with overweight, with obesity and non-responders were less likely to endorse the negative consequences of obesity. Those living with obesity and non-responders were also more likely to support there is an increased cost and effort in maintaining a healthy weight. Comparison with survey data from 2013 showed that currently, there is a greater endorsement of the health benefits of maintaining a healthy weight (p < 0001), but also of the increased costs associated with it (p < 0001). CONCLUSION: Beliefs about the consequences of maintaining a healthy body weight are associated with individuals' weight, self-rated health, diet and perceived ease of adoption of dietary and exercise-related improvements. Beliefs about the health risks of obesity and perceived greater costs associated with maintaining a healthy weight appear to have strengthened over time. Present findings are pertinent to researchers and policy makers involved in the design and framing of interventions to address obesity.

Experience of discrimination and engagement with mental health and other services by Travellers in Ireland: findings from the All Ireland Traveller Health Study (AITHS).

OBJECTIVES: Irish Travellers are an indigenous ethnic minority population in Ireland, with poor life expectancy. This study aims to identify factors associated with reported discrimination and how this affects their experiences of accessing and quality of health services, including mental health. METHODS: The All Ireland Traveller Health Study was a cross-sectional census study in 2010. All Traveller families completed a survey questionnaire (n = 6540), and at random an adult selected from the family completed either a health status (health status study = 1547) or health services utilisation survey (HSU = 1576). Experience of discrimination (EOD) from the census was analysed in relation to HSU data on services used in the previous 12 months and reported experiences of access and quality of that health service. Census variables were analysed in relation to EOD and perceived discrimination (PD). RESULTS: In the final models, EOD and PD were significantly associated with socio-demographic, socio-cultural and living conditions. The multivariate odds of reporting EOD ranged from OR 1.84 to 2.13 and were significant for those reporting worse opportunities in accessing health services, mental health (p = 0.001), hospitals (p < 0.001) and public health nurses (p < 0.001). The multivariate odds of reporting EOD ranged from OR 1.95 to 2.71 and remained significant for those who reported they had poorer experiences than others when using health services, quality of experience (OR 2.18, p =< 0.001), trust in providers (OR 1.95, p =< 0.001) and appropriate information (OR 2.71, p =< 0.001). CONCLUSIONS: Travellers experience high levels of discrimination which negatively affects their engagement with health services. Culturally competent services need to be developed.

A rapid review of Irish Traveller mental health and suicide: a psychosocial and anthropological perspective.

INTRODUCTION: Irish Travellers are an indigenous ethnic minority (IEM) with poor health outcomes. Whilst they constitute less than 1% of the Irish population, they account for 10% of national young adult male suicide statistics. METHODS: A rapid review of scientific publications related to mental health and suicide in Irish Travellers was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Searches of PubMed, PsycINFO and Google Scholar were performed. Eligibility criteria included: (i) Irish Travellers/Gypsy Travellers; (ii) information on mental health/suicide/self-harm; (iii) psychosocial anthropological perspectives of mental health; (iv) publications in english. Data on studies including design, methods, participants and key findings were extracted using a spreadsheet template. RESULTS: From 5160 scientific references over the past 20 years, 19 papers made reference to Traveller mental health, and only 5 papers made specific data-based reference to suicide in Travellers. It was only when we qualified Travellers as being 'Irish Travellers' in our scientific review did we detect meaningful references to their existence as an IEM, and their health and well-being. Due to sample sizes and heterogeneity in design, results were synthesised narratively. DISCUSSION: This paper draws together strands from the disciplines of psycho/socio/anthropological perspectives to gain deeper insights into mental health and suicide in Irish Travellers. In a knowledge vacuum, it behoves the scientific community to explain the value of scientific research and rigour to both policymakers as well as Travellers, shifting the existing discourse towards new knowledge and understanding around mental health and suicide in Travellers.

Relative information from thermal infrared imagery via unoccupied aerial vehicle informs simulations and spatially-distributed assessments of stream temperature.

Stream temperature is a measure of water quality that reflects the balance of atmospheric heat exchange at the air-water interface and gains or losses of water along a stream reach. In urban areas, stormwater sewers deliver water with varying magnitude and temperature to streams at variable timescales. Understanding the impacts of stormwater through space and time is therefore difficult to do with conventional approaches like in situ sensors. To study the impacts of stormwater on creek water temperatures, we combined in situ water temperature observations with thermal infrared (TIR) imagery collected via unoccupied aerial vehicle (UAV). Imagery was collected in May, June, and July of 2017. As ongoing work with UAV-based TIR suggests that this imagery is prone to poor accuracy, we focused on creating several data products beyond absolute water temperatures that can be used to assess temporal and spatial water temperature variations. In particular, TIR data products were used to extract the length of the observed stormwater plume as well as the width of the creek cross-section impacted by stormwater. From these values, we conclude that relatively narrow stormwater plumes affecting a small fraction of creek width can alter creek water temperatures for considerable distances downstream. We also applied TIR data to constrain results of a deterministic stream temperature model (HFLUX 3.0) that simulates the physical processes affecting stream heat exchanges. Stormwater plume lengths obtained from TIR imagery were used to refine spatially-distributed simulations, demonstrating that relative temperature information obtained from UAV imagery can provide useful calibration targets for stream temperature models. Overall, our work demonstrates the added value of UAV datasets for understanding urban stream temperatures, calibrating water quality models, and for modeling and monitoring of the impact of spatially explicit hydrologic processes on stream temperature.

Childhood central adiposity at ages 5 and 9 shows consistent relationship with that of the maternal grandmother but not other grandparents.

BACKGROUND: The importance of a life course approach to childhood obesity has been emphasized; however, few studies can prospectively investigate relationships in three-generation families. OBJECTIVE: To prospectively investigate the relationship between grandparental and grandchild waist circumference (WC) at ages 5 and 9 down maternal and paternal lines. METHODS: At baseline in the Lifeways Cross-Generation Cohort, 1094 children were born to 1082 mothers; 585 were examined at age 5 and 298 at age 9. Of the total 589 children with measured WC, data were also available from 745 grandparents. Child WC was standardized for age and sex, and theory-based hierarchical linear regression was used. RESULTS: Maternal grandmother (MGM) WC was predictive of grandchild WC at both time points. At age 5, grandchild's standardized birth weight (B = 0.266, p = 0.001), mother's means tested eligibility for free medical care (B = 1.029, p = 0.001) and grandchild seeing maternal grandparents daily (B = 0.312, p = 0.048) were significant alongside MGM WC (B = 0.015, p = 0.019). At age 9, only MGM WC (B = 0.022, p = 0.033) and mother's WC (B = 0.032, p = 0.005) were significant. Mediation analysis with mother's WC showed significant direct relationship of MGM and grandchild WC. CONCLUSIONS: This prospective cross-generational cohort shows consistent patterns of association between MGM and grandchild WC, not seen in other grandparental lineages.

Predictors of adults' body mass index and the association with index child's infant birth weight, in the Lifeways Cross-Generation Cohort Study of a thousand families in the Republic of Ireland.

The Lifeways study is novel in having information on three generations of the same families. It is well established that infant birth weight (IBW) predicts individuals' risk of adult chronic disease and more recently studies report cross-generation transmission of risk patterns. The aims of this analysis were to examine whether adults' birth weights were associated with measures of own health status or social position and to relate adults' birth weights to that of the index child's IBW. Finally, we assessed whether birth weight of either adults or children was associated with adult body mass index (BMI) of parents and grandparents. We included 1075 children whose IBW was recorded at recruitment from hospital records and 2546 adult cohort members followed from 2001 until 2014. At baseline, a sub-group of 920 adults had reported own birth weight (RBW). Results showed male adults' RBW were significantly higher than females' (P=0.001). Mothers' RBW was significantly correlated with IBW (r=0.178, P<0.001). In mixed effects linear models with BMI as the outcome variable, of all adults, and in sub-groups of adults with RBW and of mothers only, the IBW was associated with adult BMI adjusting for other predictors. Adults' BMI was positively associated with age (P=0.013), index child's IBW (P=0.001), gender (P<0.001) but not own RBW, adjusting for family identification number. When mothers were removed from the adult models however, IBW ceased to be associated with BMI, a final model showed RBW being associated with adult BMI (P=0.04). There are cross-generational associations in the Lifeways cohort, the maternal association being stronger.

Total HDL cholesterol efflux capacity in healthy children - Associations with adiposity and dietary intakes of mother and child.

BACKGROUND AND AIMS: High-density lipoprotein (HDL) cholesterol efflux capacity in adults may be a measure of the atheroprotective property of HDL. Little however, is known about HDL cholesterol efflux capacity in childhood. We aimed to investigate the relationship between HDL cholesterol efflux capacity and childhood anthropometrics in a longitudinal study. METHODS AND RESULTS: Seventy-five children (mean age = 9.4 ± 0.4 years) were followed from birth until the age of 9 years. HDL cholesterol efflux capacity was determined at age 9 by incubating serum-derived HDL-supernatants with 3H-cholesterol labeled J774 macrophages and percentage efflux determined. Mothers provided dietary information by completing food frequency questionnaires in early pregnancy and then 5 years later on behalf of themselves and their children. Pearson's correlations and multiple regression analyses were conducted to confirm independent associations with HDL efflux. There was a negative correlation between HDL cholesterol efflux capacity and waist circumference at age 5 (r = -0.3, p = 0.01) and age 9 (r = -0.24, p = 0.04) and BMI at age 5 (r = -0.45, p = 0.01) and age 9 (r = -0.19, p = 0.1). Multiple regression analysis showed that BMI at age 5 remained significantly associated with reduced HDL cholesterol efflux capacity (r = -0.45, p < 0.001). HDL-C was negatively correlated with energy-adjusted fat intake (r = -0.24, p = 0.04) and positively correlated with energy-adjusted protein (r = 0.24, p = 0.04) and starch (r = 0.29, p = 0.01) intakes during pregnancy. HDL-C was not significantly correlated with children dietary intake at age 5. There were no significant correlations between maternal or children dietary intake and HDL cholesterol efflux capacity. CONCLUSIONS: This novel analysis shows that efflux capacity is negatively associated with adiposity in early childhood independent of HDL-C.

The association between weight perception and BMI: report and measurement data from the growing up in Ireland Cohort Study of 9-year olds.

BACKGROUND: The gold standard for categorisation of weight status is clinically measured body mass index (BMI), but this is often not practical in large epidemiological studies. OBJECTIVES: To determine if a child's weight perception or a mother's perception of a child's weight status is a viable alternative to measured height and weight in determining BMI classification. Secondary outcomes are to determine the influence of a mother's BMI on her ability to categorise the child's BMI and a child's ability to recognise his/her own BMI. METHODS: Cross-sectional analysis of the growing up in Ireland cohort study, a nationally representative cohort of 8568 9-year-old children. The variables considered for this analysis are the child's gender, BMI (International Obesity Taskforce grade derived from measured height and weight) and self-perceived weight status, and the mother's weight perception of the child, BMI (derived from measured height and weight) and self-perceived weight status. Cohen's weighted-kappa was used to evaluate the strength of the agreement between pairwise combinations of the BMI variables. Cumulative and adjacent categories logistic regression were used to predict how likely a person rates themselves as under, normal or overweight, based on explanatory variables. RESULTS: Mothers are more accurate at correctly classifying their child's BMI (κ=0.5; confidence intervals (CI) 0.38-0.51) than the children themselves (κ=0.25; CI 0.23-0.26). Overweight mothers are better raters of their child's BMI (κ=0.51; CI 0.49-0.54), compared with normal (κ=0.44; CI 0.41-0.47) or underweight mothers (κ=0.4; CI 0.22-0.58), regardless of whether the mother's BMI is derived from measured height and weight or self-perceived. The mother's perception of the child's weight status is not an influencing factor on the child's ability to correctly classify him/herself, but the child's self-perceived weight status influences the mother's ability to correctly classify the child. CONCLUSIONS: A mother's BMI classification of her child is a viable alternative to BMI measurement in large epidemiological studies.

Combination treatment with mirabegron and solifenacin in patients with overactive bladder: exploratory responder analyses of efficacy and evaluation of patient-reported outcomes from a randomized, double-blind, factorial, dose-ranging, Phase II study (SYMPHONY).

PURPOSE: This large dose-ranging study explored the benefits of different combinations of mirabegron and solifenacin on health-related quality of life (HRQoL), based on patient-reported outcomes (PROs), and patients ('responders') achieving clinically meaningful improvements in efficacy and HRQoL. METHODS: SYMPHONY (NCT01340027) was a Phase II, placebo- and monotherapy-controlled, dose-ranging, 12-week trial. Adult patients with overactive bladder (OAB) for ≥3 months were randomized to 1 of 12 groups: 6 combination (solifenacin 2.5/5/10 mg + mirabegron 25/50 mg), 5 monotherapy (solifenacin 2.5/5/10 mg, or mirabegron 25/50 mg), or placebo. Change from baseline to end of treatment was assessed, versus placebo and solifenacin 5 mg in: PROs (OAB-q [Symptom Bother/total HRQoL] and Patient Perception of Bladder Condition score), and responders achieving minimally important differences (MIDs) in PROs and predetermined clinically meaningful improvements in efficacy (e.g. <8 micturitions/24 h). Changes in PROs and responders were analysed using an ANCOVA model and logistic regression, respectively. RESULTS: The Full Analysis Set included 1278 patients. Combination therapy of solifenacin 5/10 mg + mirabegron 25/50 mg significantly improved PROs versus solifenacin 5 mg and placebo, and significantly more responders achieved MIDs in PROs and efficacy. Micturition frequency normalization was approximately twofold greater with 10 + 25 mg (OR 2.06 [95 % CI 1.11, 3.84; p = 0.023]) and 5 + 50 mg (OR 1.91 [95 % CI 1.14, 3.21; p = 0.015]) versus solifenacin 5 mg. CONCLUSION: Combining mirabegron 25/50 mg and solifenacin 5/10 mg improves objective and subjective efficacy outcomes compared with placebo or solifenacin 5 mg.

A Prospective Analysis of the Relationship between Chronic Diseases and Adiposity in older adults: Findings from the Lifeways Cross-Generation Cohort Study of a Thousand Families 2001-2014.

This study assesses the relationship between body mass index (BMI) and adult chronic diseases (diabetes mellitus type 2 [DM2], cardiovascular diseases [CVD] and cancers), in grandparents in the Lifeways Cross-Generation Cohort Study. BMI was either measured or reported, at baseline or 10-year follow-up, in 1,244 grandparents. Cumulative morbidity data were recorded at baseline, 3 and 10-year follow-up through questionnaires, General Practice note search, or both. Just over 42% of grandparents were overweight and 32.1% obese. In the multivariate analysis BMI showed a strong linear association with both DM2 (ptrend <0.001) and CVD (ptrend <0.001). There were no significant associations with cancers, but case numbers were small. Results were similar for waist circumference. This prospective study presents novel Irish data and confirms other recent Irish cross-sectional reports on adiposity and adult chronic disease, highlighting the need for effective health promotion interventions in older adults.

Is there a link between overactive bladder and the metabolic syndrome in women? A systematic review of observational studies.

OBJECTIVES: To conduct a systematic review to determine whether there is an association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) or overactive bladder (OAB) in women. METHODS: We systematically reviewed English language observational studies on the effect of MetS (or component factors) on the presence of OAB or LUTS in women. We searched PubMed, Web of Science and The Cochrane Library with no date restrictions, checked reference lists and undertook citation searches in PubMed and Google Scholar. Studies were assessed for risk of bias. Because of heterogeneity, results were not pooled, but are reported narratively. RESULTS: Of 27 included studies, only three looked at the link between MetS and OAB. The rest looked at links between OAB and components of MetS such as obesity or insulin resistance (n = 10), between MetS and urinary symptoms (n = 3) and between urinary symptoms and components of MetS, such as obesity (n = 14). Evidence is currently limited, but it does suggest that there may be important links between MetS and OAB and components of MetS such as obesity. CONCLUSIONS: The literature on MetS and OAB or LUTS in women is limited, and poor quality. However, the evidence available on obesity appears to support MetS as a contributor and predictor of LUTS in women. Many of the women with LUTS will be overweight and will have features of the MetS, if looked for. This provides not only an opportunity to encourage weight loss as an adjunct to therapy for the OAB symptoms but also a window of opportunity to address cardiovascular risk factors and prevent future cardiovascular morbidity and mortality.

Demographic trends in suicide in the UK and Ireland 1980-2010.

BACKGROUND: Ireland has the 17th highest suicide rate in the EU and the 4th highest among 15-24-year-old males (WHO 2012). Suicide is the leading cause of death in this age group; death by hanging accounted for 69 % of suicides in 2010. METHODS: This study examines youth suicide rates from 1980 to 2010 in Ireland and compares them to the rates in Northern Ireland, Scotland, England and Wales. Irish data were obtained from the Central Statistics Office and their annual reports on Vital Statistics. Northern Irish data were obtained from the Northern Ireland Statistics and Research Agency website; Scottish data were from the General Register Office for Scotland and English/Welsh data from the Office for National Statistics website. RESULTS: There has been a threefold increase in young male suicide in Ireland over the past three decades (8.9-29.7 per 100,000). In contrast, there has been approximately a threefold reduction in deaths by road traffic accidents in young men in the same period (42.7-16.2 per 100,000). Suicide rates in young men are similar in Scotland and Northern Ireland for the same period but are 50 % lower in England and Wales. Despite the rates of hanging as a method of suicide increasing in all jurisdictions, the overall rate in England and Wales has continued to decline. CONCLUSION: The suicide rate in Ireland remains very high and strategies to address this are urgently required. Our study indicates that national suicide prevention strategies can be effective.

Investigating the potential of under-utilised plants from the Asteraceae family as a source of natural antimicrobial and antioxidant extracts.

Antimicrobial properties of ethanol and water extracts from eight Asteraceae species were investigated against three Gram positive (Staphylococcus aureus, MRSA and Bacillus cereus) and two Gram negative (Escherichia coli and Salmonella typhimurium) bacterial strains. Ethanol extracts from Centaurea scabiosa, Arctium minus, Taraxacum officinale, Centaurea nigra and Cirsium palustre demonstrated antimicrobial activity against strains of S. aureus, MRSA and B. cereus (MIC=187.5-365µg/ml). Ethanol extracts also had higher antioxidant activities and phenolic content demonstrating a link between these compounds and the bioactivity of these extracts. Further investigation into the phenolic content of ethanol extracts using UPLC-MS/MS lead to the identification and quantification of numerous phenolic compounds in all species including; 18 from Cirsium arvense, 16 from Cirsium vulgare, 19 from C. palustre, 15 from C. nigra, 17 from C. scabiosa, 14 from Sonchus asper, 17 from A. minus and 11 from T. officinale.

Urgency and pain in patients with overactive bladder and bladder pain syndrome. What are the differences?

BACKGROUND: The Overactive Bladder Syndrome (OAB) and the Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) are different urological conditions sharing 'urgency' as a common symptom. The aim of this review is to address our existing knowledge and establish how these symptoms are interrelated and to determine whether or not there is a common link between both symptoms complexes that help to distinguish one from the other. METHODS: Pubmed was used to obtain references for this non-systematic review aiming to discuss differences between OAB and BPS/IC. Guidelines of several professional associations and discussions based on expert opinion from the authors were implemented. RESULTS: Whilst in BPS the hallmark symptom is pain on bladder filling, urgency is the defining symptom of OAB. Whilst it is likely that the pain in BPS/IC arises from local inflammation in the bladder wall, the nature of urgency as a symptom, its origin, and the relationship between urgency and pain, as well as the different afferent mechanisms associated with the genesis of these sensory symptoms, remains unknown. Although the aetiology of both OAB and PBS/IC is unclear, the influence of environmental factors has been suggested. Both are chronic conditions with very variable symptom resolution and response to therapy. The relationship with voiding dysfunction, gynaecological causes of chronic pelvic pain or the possible alteration of the hypothalamic-pituitary-adrenal axis and psychological disorders has not been established. Inflammation has been suggested as the common link between OAB and BPS/IC. CONCLUSIONS: OAB and BPS/IC are different symptoms complexes that share urgency as a common symptom. None of them have a specific symptom although pain on bladder filling is the hallmark symptom in BPS/IC. Bladder pain with urgency should be a trigger for referral to the provider with appropriate knowledge and expertise in this disease state, whereas the management of OAB should be part of normal routine care in the community.

Does pain mediate or moderate the relationship between physical activity and depressive symptoms in older people? Findings from The Irish Longitudinal Study on Ageing (TILDA).

Background. Depression is an increasing problem in older adults, which is exacerbated by under diagnosis and ineffective treatment options. Broadly speaking, as people age, their levels of regular physical activity (PA) decrease, while their experience of chronic pain increases. PA has been shown to be an effective, yet under-utilised, treatment for depression in this age-cohort although the influence of pain on the relationship between PA and depressive symptoms has not been considered. Methods. Secondary analysis of national data from The Irish Longitudinal Study on Ageing (TILDA, 2011) (n = 8163 participants aged 50 years and older) examined the mediating or moderating role of pain in the relationship between depressive symptoms and PA, and the impact of PA, pain and depressive symptoms on health-care utilisation. Results. Approximately 8.5% TILDA older adults were depressed. No mediating or moderating effects of pain were found in the association between PA and depressive symptoms. Higher levels of PA were found to be independently associated with lower depressive symptoms, while higher levels of pain significantly increased the likelihood of depressive symptoms supporting previous findings. Depressive symptoms and higher levels of pain were also found to significantly increase health-care utilisation. Conclusions. Consistent with previous findings in this field, both PA and pain were found to be independently associated with depressive symptoms in Irish older adults. Furthermore, pain does not play a mediating or moderating role in the relationship between PA and depressive symptoms. Continued support for ongoing initiatives in this area aimed at increasing PA in older adults as a means to improve both physical and mental well-being is advised. The absence of any synergistic effect between PA and pain suggests that clinicians and health service providers should continue to promote PA as a treatment for depression, irrespective of the pain levels of their patients.

Smoking in vehicles is lower than mobile telephone use while driving, but is socially patterned.

Legislation is being considered which bans smoking in cars carrying children under the age of 16. This was an observational survey of smoking by drivers and passengers and mobile phone use by drivers in 2,230 cars over three time periods in two Dublin locations. The observed prevalence of mobile telephone use (2.56%) was higher than smoking (1.39%) (p < 0.01), but was low in both. There was no significant variation according to time of day. There was an inverse pattern according to car value for smoking drivers (p = 0.029). Eight adult passengers and just one child were observed as being exposed to a smoking adult driver. In conclusion, the public health importance of regulating passive smoke exposure is clear but the resources required to police such a ban in vehicles may be labour intensive for the yield in detection or prevention.

Maternal macronutrient intake during pregnancy and 5 years postpartum and associations with child weight status aged five.

BACKGROUND/OBJECTIVES: Animal models have demonstrated that maternal overnutrition during pregnancy influences offspring adiposity. Few human studies of normal pregnancy have replicated these findings. We examined the association between child body mass index at age 5 years and maternal nutrient intake during pregnancy and 5 years postpartum. SUBJECTS/METHODS: Five-year-old children (n=585) and their mothers were recruited during pregnancy from two maternity hospitals in Ireland. Data are from the Lifeways Cross-Generation Cohort study with detailed dietary information obtained during pregnancy and postpartum using a food frequency questionnaire. Nutrient intake was adjusted for energy intake (EI) and expressed in quartiles. Heights and weights were measured when the children were aged 5 years. We performed multivariate logistic regression analyses to examine the independent associations of macronutrients (protein, fat and carbohydrate) and their components (saturated fatty acid (SFA)/monounsaturated fatty acid/polyunsaturated fatty acid and sugar/starch) with child overweight/obesity. Associations were examined for nutrient intake during pregnancy (T1), at 5 years postpartum (T2) and the change in nutrient intake between T1 and T2. RESULTS: Total mean (s.d.) EI was significantly higher during pregnancy (2548 ± 1239 kcal) than 5 years postpartum (2084 ± 718 kcal). Increased odds of overweight/obesity were found in mothers with higher intakes of sugar at T1 (Q4 odds ratio (OR): 4.57, 95% confidence interval (CI): 1.01-20.69) and high intakes of SFA at T2 (Q4 OR: 3.35, 95% CI: 0.97-11.57). Mothers with persistently high intakes of SFA and those who reduce their sugar intake between T1 and T2 were more likely to have overweight/obese children. CONCLUSION: Maternal prenatal sugar and pre/postnatal SFA was associated with offspring adiposity.