Rasharkin Health Initiative

This project will build on previous work carried out over the last 3 years. There are 4 main aspects: - intergenerational work focusing on the development of a vegetable garden with pharmacy input on health advice - develop and promote the lunch club which has been very successful to date and has targeted people previously not accessing support or community services in the village - annual health fair - local carer’s advice centre to provide practice information and signposting services. This last aspect is the result of ongoing identification of the need to support carers over the last 2 years of the BCPP project. This project will be driven forward by a lay health worker working closely with the pharmacist Outcome: The project built on previous work. Some of the work included: health fayre, intergenerational garden, and luncheon club. Results from questionnaires showed that the project increased people's awareness of the causes of ill-health and how they might deal with them. People now see the pharmacist as a local and not just as someone dispensing medicine.

Consumer Focused Review of Fruit and Vegetables

This review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. It focuses on ready-to-eat (RTE) fresh fruit and vegetables which are consumed raw, whether whole or prepared, and includes products packaged under vacuum or in a modified atmosphere that have not undergone any treatment (chemical, physical or biological) to ensure preservation, other than chilling. The key finding was that 75% of Irish consumers are now able to identify that they should eat five portions of fruit and vegetables a day, but only a third (36%) of consumers say they are doing so. The average intake of fruit and vegetables is currently less than half that recommended, at 2.4 portions per day. Issues to do with cost, shelf life, preparation time and habit were seen by consumers as barriers to buying and consuming more fruit and vegetables. his review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. - See more at: http://www.safefood.eu/Publications/Research-reports/Consumer-Focused-Review-of-Fruit-and-Vegetables.aspx#sthash.T98zN2UU.dpuf This review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. It focuses on ready-to-eat (RTE) fresh fruit and vegetables which are consumed raw, whether whole or prepared, and includes products packaged under vacuum or in a modified atmosphere that have not undergone any treatment (chemical, physical or biological) to ensure preservation, other than chilling. The key finding was that 75% of Irish consumers are now able to identify that they should eat five portions of fruit and vegetables a day, but only a third (36%) of consumers say they are doing so. The average intake of fruit and vegetables is currently less than half that recommended, at 2.4 portions per day. Issues to do with cost, shelf life, preparation time and habit were seen by consumers as barriers to buying and consuming more fruit and vegetables. This review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. It focuses on ready-to-eat (RTE) fresh fruit and vegetables which are consumed raw, whether whole or prepared, and includes products packaged under vacuum or in a modified atmosphere that have not undergone any treatment (chemical, physical or biological) to ensure preservation, other than chilling. The key finding was that 75% of Irish consumers are now able to identify that they should eat five portions of fruit and vegetables a day, but only a third (36%) of consumers say they are doing so. The average intake of fruit and vegetables is currently less than half that recommended, at 2.4 portions per day. Issues to do with cost, shelf life, preparation time and habit were seen by consumers as barriers to buying and consuming more fruit and vegetables. - See more at: http://www.safefood.eu/Publications/Research-reports/Consumer-Focused-Review-of-Fruit-and-Vegetables.aspx#sthash.T98zN2UU.dpuf This review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. It focuses on ready-to-eat (RTE) fresh fruit and vegetables which are consumed raw, whether whole or prepared, and includes products packaged under vacuum or in a modified atmosphere that have not undergone any treatment (chemical, physical or biological) to ensure preservation, other than chilling. The key finding was that 75% of Irish consumers are now able to identify that they should eat five portions of fruit and vegetables a day, but only a third (36%) of consumers say they are doing so. The average intake of fruit and vegetables is currently less than half that recommended, at 2.4 portions per day. Issues to do with cost, shelf life, preparation time and habit were seen by consumers as barriers to buying and consuming more fruit and vegetables. - See more at: http://www.safefood.eu/Publications/Research-reports/Consumer-Focused-Review-of-Fruit-and-Vegetables.aspx#sthash.T98zN2UU.dpuf This review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. It focuses on ready-to-eat (RTE) fresh fruit and vegetables which are consumed raw, whether whole or prepared, and includes products packaged under vacuum or in a modified atmosphere that have not undergone any treatment (chemical, physical or biological) to ensure preservation, other than chilling. The key finding was that 75% of Irish consumers are now able to identify that they should eat five portions of fruit and vegetables a day, but only a third (36%) of consumers say they are doing so. The average intake of fruit and vegetables is currently less than half that recommended, at 2.4 portions per day. Issues to do with cost, shelf life, preparation time and habit were seen by consumers as barriers to buying and consuming more fruit and vegetables. - See more at: http://www.safefood.eu/Publications/Research-reports/Consumer-Focused-Review-of-Fruit-and-Vegetables.aspx#sthash.T98zN2UU.dpuf This review provides an update on the fruit and vegetable review conducted in 2007. It collates and considers the information available – academic, regulatory, public health – on the health and food safety implications of fruit and vegetables. - See more at: http://www.safefood.eu/Publications/Research-reports/Consumer-Focused-Review-of-Fruit-and-Vegetables.aspx#sthash.T98zN2UU.dpuf

CHIP-Community Health Improvement Programme (Group-Based)

This intervention aims to: - Increase fruit and vegetable intake - Increase activity levelsInitiate weight loss - Reduce health risks - Provide effective weight loss tools - Increase participant behaviour change skills

Fakenham Weight Management Service

Tier 3 weight management service for clients with BMI>40, or >30 plus co-morbidities. The service aims for 5% weight loss in 6 months, and to increase fruit and vegetable intake and activity levels. It also aims to set up hub and spoke model with 3 satellite sites to deliver local services in a rural area, and to develop a North Norfolk Obesity Pathway and to make only appropriate bariatric surgery referrals as per East of England guidelines.

Health at a glance: Europe 2012.

This second edition of Health at a Glance: Europe presents a set of key indicators of health and health systems in 35 European countries, including the 27 European Union member states, 5 candidate countries and 3 EFTA countries. The selection of indicators is based largely on the European Community Health Indicators (ECHI) shortlist, a list of indicators that has been developed by the European Commission to guide the development and reporting of health statistics. It is complemented by additional indicators on health expenditure and quality of care, building on the OECD expertise in these areas. Contents: Introduction 12 Chapter 1. Health status 15 1.1. Life expectancy and healthy life expectancy at birth 1.2. Life expectancy and healthy life expectancy at age 65 1.3. Mortality from all causes 1.4. Mortality from heart disease and stroke 1.5. Mortality from cancer 1.6. Mortality from transport accidents 1.7. Suicide 1.8. Infant mortality 1.9. Infant health: Low birth weight 1.10. Self-reported health and disability 1.11. Incidence of selected communicable diseases 1.12. HIV/AIDS 1.13. Cancer incidence 1.14. Diabetes prevalence and incidence 1.15. Dementia prevalence 1.16. Asthma and COPD prevalence Chapter 2. Determinants of health 49 2.1. Smoking and alcohol consumption among children 2.2. Overweight and obesity among children 2.3. Fruit and vegetable consumption among children 2.4. Physical activity among children 2.5. Smoking among adults 2.6. Alcohol consumption among adults 2.7. Overweight and obesity among adults 2.8. Fruit and vegetable consumption among adults Chapter 3. Health care resources and activities 67 3.1. Medical doctors 3.2. Consultations with doctors 3.3. Nurses 3.4. Medical technologies: CT scanners and MRI units 3.5. Hospital beds 3.6. Hospital discharges 3.7. Average length of stay in hospitals 3.8. Cardiac procedures (coronary angioplasty) 3.9. Cataract surgeries 3.10. Hip and knee replacement 3.11. Pharmaceutical consumption 3.12. Unmet health care needs Chapter 4. Quality of care 93 Care for chronic conditions 4.1. Avoidable admissions: Respiratory diseases 4.2. Avoidable admissions: Uncontrolled diabetes Acute care 4.3. In-hospital mortality following acute myocardial infarction 4.4. In-hospital mortality following stroke Patient safety 4.5. Procedural or postoperative complications 4.6. Obstetric trauma Cancer care 4.7. Screening, survival and mortality for cervical cancer 4.8. Screening, survival and mortality for breast cancer 4.9. Screening, survival and mortality for colorectal cancer Care for communicable diseases 4.10. Childhood vaccination programmes 4.11. Influenza vaccination for older people Chapter 5. Health expenditure and financing 117 5.1. Coverage for health care 5.2. Health expenditure per capita 5.3. Health expenditure in relation to GDP 5.4. Health expenditure by function. 5.5. Pharmaceutical expenditure 5.6. Financing of health care 5.7. Trade in health services Bibliography 133 Annex A. Additional information on demographic and economic context 143 Most European countries have reduced tobacco consumption via public awareness campaigns, advertising bans and increased taxation. The percentage of adults who smoke daily is below 15% in Sweden and Iceland, from over 30% in 1980. At the other end of the scale, over 30% of adults in Greece smoke daily. Smoking rates continue to be high in Bulgaria, Ireland and Latvia (Figure 2.5.1). Alcohol consumption has also fallen in many European countries. Curbs on advertising, sales restrictions and taxation have all proven to be effective measures. Traditional wine-producing countries, such as France, Italy and Spain, have seen consumption per capita fall substantially since 1980. Alcohol consumption per adult rose significantly in a number of countries, including Cyprus, Finland and Ireland (Figure 2.6.1).This resource was contributed by The National Documentation Centre on Drug Use.

WALK Community Garden

WALK operate a Community Garden in Dublin 12 which promotes the growing of fresh fruit, vegetable, salad leaves and flowers which change seasonally. The garden helps create a sense of community and advocates the benefits of growing healthy food, environmental awareness and sustainability. It offers an opportunities for people to take part in hand-on, activity based learning with some formal training offered to local groups and individuals with varying levels of skill and ability. This outdoor space fosters an interest in growing and guides people in learning new skills which can be transferred to their own gardens or allotments. Dublin City Council Initiative Type Community Food Growing Projects Location Dublin 12 Funding Dublin City Council Partner Agencies Dublin City Council Dublin Mainstream Access Project Scoil Colm

Daisy Roots Garden Project

In the summer of 2009 a local Men’s group that met in St Helena’s thought that it might be a good idea to sow a wild garden on the site.  Then came the raised beds – 2 were placed in the garden area opposite the front door of the house and as it was winter there was not much happening and they were quickly renamed the ‘coffins’.  This was the start of ‘Daisy Roots’. Dublin City Council provided top soil and water butts.  An Taisce funded the start up phase of the project and now continue to provide funds for insurance and some development work.  At the right hand side of St Helena’s there is, what was the old stable yard of the ‘big house’.  This had been used to house a large ‘lock up container and a porta-cabin.  These have been now removed and this is where the main part of the garden is. Following a conference of Business in the Community Ireland, DX Ltd expressed an interest in getting involved in a local project.  Together DX staff and the volunteers reclaimed the old stables and gave them new roofs and new doors.  Paths were put in between the raised vegetable beds and new raised beds were built.  A seating area was developed.  The garden is now wheelchair accessible and there are wheelchair accessible flowerbeds in the garden also.  The newest projects in the garden are a memorial flowerbed and a propagator. Dublin City Council via Cherry Orchard Regeneration Board Initiative Type Community Food Growing Projects Location Dublin 11 Funding Dublin City Council via Cherry Orchard Regeneration Board Partner Agencies An Taisce Dublin City Council HSE Tolka Area Partnership

Ballina Eat Wise Project

The Mayo North East Ballina Eat Wise project will proactively engage with disadvantaged communities, including migrant and Traveller groups, in Ballina to encourage and support people to make informed decisions regarding their diet and that of their families. The project aims to empower people with the resources, skills and knowledge to improve their physical and mental wellbeing through affordable healthy eating. A steering group comprising local stakeholders will be established to co-ordinate and inform the CFI’s work and to ensure it is fully addressing the needs of the target group. The CFI will begin by developing a training module to equip a group of peer researchers to carry out a needs analysis. The information gathered will inform the practical aspects of the project ensuring participation and a sense of ownership from the local community. Young people will be targeted through local schools and youth organisations. Training will be provided for both adults and young people in vegetable/fruit growing, nutrition, cooking, preventing food wastage, smart shopping and budgeting. Practical cookery demonstrations coupled with advice on healthy eating will take place in the target areas. The project will also engage with local supermarkets and takeaways to encourage the provision of healthy affordable options. Other options to increase the availability of healthy food in the target areas will be explored. Part of theCFI Programme 2013-2015 Initiative Type Nutrition Education and Training Programmes Location Mayo Target Groups Children (13-18 years) Families Partner Agencies safefood

Bash Street Kids

Primary school teachers will find materials, advice and suggestions here to help them give pupils aged 7 to 11 (Key Stage 2 or P7 in Scotland) greater opportunities both to learn about and have access to fruit and vegetable choices. There are also details of how these materials fit with the school curriculum. The aims of 5-a-day the Bash Street way are to: - encourage children to eat more fruit and vegetables each day - help them to feel more positive about fruit and vegetables, which can genuinely promote their good health - help establish the 5-a-day habit for a lifetime

Cross-immunoreactivity between anti-potato apyrase antibodies and mammalian ATP diphosphohydrolases: potential use of the vegetal protein in experimental schistosomiasis

We have previously showed that Schistosoma mansoni ATP-diphosphohydrolase and Solanum tuberosum potato apyrase share epitopes and the vegetable protein has immunostimulatory properties. Here, it was verified the in situ cross-immunoreactivity between mice NTPDases and anti-potato apyrase antibodies produced in rabbits, using confocal microscopy. Liver samples were taken from Swiss Webster mouse 8 weeks after infection with S. mansoni cercariae, and anti-potato apyrase and TRITC-conjugated anti-rabbit IgG antibody were tested on cryostat sections. The results showed that S. mansoni egg ATP diphosphohydrolase isoforms, developed by anti-potato apyrase, are expressed in miracidial and egg structures, and not in granulomatous cells and hepatic structures (hepatocytes, bile ducts, and blood vessels). Therefore, purified potato apyrase when inoculated in rabbit generates polyclonal sera containing anti-apyrase antibodies that are capable of recognizing specifically S. mansoni ATP diphosphohydrolase epitopes, but not proteins from mammalian tissues, suggesting that autoantibodies are not induced during potato apyrase immunization. A phylogenetic tree obtained for the NTPDase family showed that potato apyrase had lower homology with mammalian NTPDases 1-4, 7, and 8. Further analysis of potato apyrase epitopes could implement their potential use in schistosomiasis experimental models.

Detection of IgG1 and IgG4 subtypes reactive against potato apyrase in schistosomiasis patients

In this paper, we showed for the first time that the conserved domains within Schistosoma mansoni ATP diphosphohydrolase isoforms, shared with potato apyrase, possess epitopes for the IgG1 and IgG4 subtypes, as 24 (80%) of the 30 schistosomiasis patients were seropositive for this vegetable protein. The analyses for each patient cured (n = 14) after treatment (AT) with praziquantel revealed variable IgG1 and IgG4 reactivity against potato apyrase. Different antigenic epitopes shared between the vegetable and parasite proteins could be involved in susceptibility or resistance to S. mansoni AT with praziquantel and these possibilities should be explored.

Análisis de la Morfología del Raquis Torácico y Lumbar en Mujeres Trabajadoras de una Cooperativa Hortofrutícola

The aim of this study was to analyze the sagittal spinal morphology of thoracic and lumbar spine in standing and sitting in women workers from a cooperative in the production, handling and marketing business of vegetable and fruit products. A total of 50 women (mean age: 43.62±8.43 years old) were evaluated. The Spinal Mouse system was used to mesasure the sagittal thoracic and lumbar curvatures in standing and relaxed sitting. The values for thoracic and lumbar curvatures were 32.74±8.76 and -21.66±19.12 in standing and 36.32±10.55 and -1.08±18.14 in sitting. A high frequency (86.0% and 68.3%) of normal thoracic kyphosis and lumbar lordosis were found in standing posture. While sitting the 74.0% and 20.0% presented thoracic hyperkyphosis and lumbar kyphosis. In conclusion, a high percentaje of women workers presented normality values in standing posture, although a high percentage of women were found with thoracic hyperkyphosis and lumbar flexed while sitting relaxed. It is recommended that these women carry out a program to improve their actitudinal postures in their work place.

Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC).

BACKGROUND Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. METHODOLOGY/PRINCIPAL FINDINGS After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. CONCLUSIONS/SIGNIFICANCE Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

Social inequalities and mortality in Europe-results from a large multi-national cohort

BACKGROUND Socio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans. METHODS A total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC) was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES). Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII) was calculated as measure of relative inequality. RESULTS Total mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52-0.61); among women by 29% (HR 0.71, 95% C.I. 0.64-0.78). The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women) by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake) (3% in men and 5% in women). Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries. DISCUSSION In this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported.

Avaluació de vitamines i antioxidants en aliments vegetals mitjançant tècniques HPLC-DAD i UPLC-MS/MS

El programa experimental s’ha portat a terme dins el marc de les activitats del projecte TRUEFOOD, finançat per la UE per als anys 2007-2010. L’objectiu principal d’aquesta activitat ha estat l’avaluació dels continguts en àcid ascòrbic (vitamina C), polifenols totals, àcids fenòlics i flavonoides en mostres de tomàquet i enciam, produïts sota diferents condicions de camp (producció ecològica i convencional). Per aconseguir els resultats s’han utilitzat mètodes analítics basats en tècniques de cromatografia líquida d’alta eficàcia (HPLC) i d’ultra-alta eficàcia (UHPLC) acoblades a sistemes de detecció de diode array (DAD) i espectrometria de masses (MSn). Per a l’àcid ascòrbic, s’ha desenvolupat un mètode ràpid que ha permès la determinació d’aquest compost en diferents matrius vegetals amb el mínim pretractament de les mostres, utilitzant una fase estacionària HILIC (Fluorinated Stationary Phase). Els mètodes desenvolupats d’anàlisi de compostos fenòlics han permès realitzar les anàlisi de forma ràpida, a fi de processar el màxim nombre de mostres per a obtenir resultats representatius. S’ha realitzat una completa caracterització dels extractes de tomàquet i enciam, ampliant el coneixement descrit en la bibliografia sobre la seva composició fenòlica. En el cas de l’enciam, s’ha identificat quatre compostos fenòlics que mai abans han estat descrits i quantificats en aquesta hortalissa. La definició, amb precisió, dels continguts en vitamina C i compostos fenòlics en les mostres analitzades ha permès comparar els efectes de diferents tècniques de cultiu sobre les característiques nutricionals dels vegetals objecte de l’estudi. Els mètodes d’anàlisi desenvolupats i els resultats derivats del projecte seran publicats properament en revistes científiques de reconegut prestigi.