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Background: Engaging people in advance care planning is a challenging systemic problem that requires a social innovation approach and a conceptual framework to guide behavioural and social change efforts. Aim: To identify stakeholders' perspectives on barriers to advance care planning engagement, options for overcoming these barriers, and user needs. The findings will inform the design of a health behaviour change intervention for engaging older adults (50+) in advance care planning. Design: To advance co‐production and intervention design goals, the study used collective intelligence and scenario‐based design methods. Methods: Following a systematic stakeholder analysis, 22 participants were recruited to three online collective intelligence sessions. The socioecological perspective informed framing of integrated findings and specifying factors at the individual, interpersonal, service, and system levels. Results: Identified barriers (n = 109) were grouped into seven categories: (i) Psychological, (ii) Advance Care Planning Literacy, (iii) Interpersonal and Interprofessional, (iv) Service‐Related, (v) Resources and Supports, (vi) Advance Care Planning Process and Methods, (vii) Cultural and Societal. Stakeholders generated 222 options for overcoming these barriers and specified 230 service user needs. The need to change perceptions of advance care planning, increase psychological readiness, and target advance care planning literacy was highlighted (individual‐level). Timely, focused, and meaningful interaction between the key ACP actors must be facilitated using creative strategies (interpersonal‐level). Need‐ and value‐based services, including high quality resources, support systems, and infrastructure, should be co‐designed (service‐level). Cultural and societal transformation is required (system‐level). Conclusion: Findings integration offered insight into the complexity of the design context and problem situation and identified directions for context‐specific advance care planning intervention development. The use of design thinking methodologies is recommended for the next phase of complex intervention development. Implications: The study presents a roadmap of actions required from policy‐makers, practitioners, and researchers to ensure the design of adequate advance care planning interventions. Reporting Method: Quality of reporting was assured by adherence to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (International Journal for Quality in Health Care, 19, 2007, 349). Patient or Public Contribution: Patient and public representatives participated in the collective intelligence sessions. Members of the All Ireland Institute of Hospice and Palliative Care Voices4Care facilitated that process. Findings from the first CI session (involving patients and caregivers) informed the content, format, and methods used in subsequent CI sessions. [ABSTRACT FROM AUTHOR]

Drawing on conceptual and empirical work in geographies of ageing and environmental gerontology, this study's aim is to explore the generation and maintenance of enabling places from the perspective of older community dwellers in the context of COVID‐19. Findings are drawn from a qualitative thematic analysis of written submissions (n = 17), narrative interviews (n = 44) and go‐along interviews (n = 5) with people ageing‐in‐place in Irish communities during the pandemic. The mean age of participants was 74.9 (SD = 7; range 65–96), 53% were female, 46% lived alone, and 86% lived in areas with high urban influence. Our results indicate that the COVID‐19 public health restrictions curtailed participants' usual activities and influenced how they related to their homes, and a variety of public spaces where they had previously pursued valued activities. Transitions in their everyday geographies led to a wide array of affective and embodied experiences, and participants described diverse material and social emplaced‐resources as enabling or hindering their health and well‐being during COVID‐19. Our core findings are summarised across three themes: (1) somewhere old, relates to emplacement in familiar places and the role of familiarity with place resources; (2) somewhere new, comprises the emergence of digital spaces and possible pathways to build place insideness; and (3) somewhere green, describes the negotiation and (re)turn to natural and outdoor environments during the pandemic. Results from this study contribute to identify the pathways through which enabling places for diverse older people may be generated and/or maintained, and provide evidence to support the development of enabling environments during times of social upheaval and beyond. [ABSTRACT FROM AUTHOR]

Smoking prevalence remains high in Europe and widening socioeconomic group differences are driving health inequalities. While plain packaging policies disrupt tobacco industry tactics that sustain smoking, evidence of their equity impact is sparse. This study evaluated the implementation of plain packaging in Ireland in 2018 on consumer responses, overall and by the socioeconomic group. Consecutive nationally representative cross-sectional surveys (2018, n  = 7701 and 2019, n  = 7382) measured changes in 13 consumer responses among respondents who smoked across three domains: product appeal, health warnings effectiveness, and perceived harmfulness of smoking. Multiple logistic regression-derived adjusted odds ratios with 95% confidence intervals to compare responses post- versus pre-implementation adjusting for age, gender, educational level, and heaviness of smoking. A stratified analysis examined changes by socioeconomic group indexed using educational level. There were statistically significant changes in consumer responses to plain packaging policy implementation across 7/13 outcomes studied. Five changes were aligned with expected policy impacts (2/6 product appeal outcomes and 3/4 health warning effectiveness outcomes). Two responses were also observed which were not expected policy impacts (1 appeal-related and 1 perceived harm-related outcome). There was no change in five outcomes. Differences in consumer responses between educational groups were generally small, mixed in nature, and indistinguishable when interval estimates of effect were compared. Implementation of plain packaging in Ireland had intended impacts on consumer responses. Including plain packaging requirements in revising the European Union's legislative frameworks for tobacco control will help build progress towards a Tobacco-Free Europe without exacerbating smoking inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Financial incentives to stop smoking (FISS) programs have been implemented internationally to encourage people who smoke to quit smoking. However, such programs require that the financial reward structure and its resulting effects on smoking quit rates are considered. We analyzed a number of scenarios for FISS reward schedules for current smoking individuals in Ireland, with a view to identify the potential implications in terms of financial consequences and expected effects. Methods: Using national QuitManager services data 2021–2023, we defined smoking quit rates for smokers currently using the national Health Services Executive stop smoking services in Ireland. Smoking quit rates at 4, 12 and 52 weeks were defined, and additionally defined by sex, age and education level. Using scenarios assuming different FISS reward sizes, structures and targeted population sub-groups, we estimated the number of additional quitters, budget impact, and incremental costeffectiveness ratio. Results: A FISS program, if implemented for a cohort of 3500 smokers can result in a budget impact ranging €250000 – €870000. The cost-effectiveness trade-off between different payment schedules and the expected effect size suggested that FISS are cost-effective even at a moderate effect size. A FISS program implemented to approximately 20000 smokers nationally would cost between €2.0 million and €4.8 million, subject to the chosen reward schedule. Across social groups, FISS is more cost-effective for females, individuals in the youngest age group, and individuals with a medium level of education. Conclusions: This analysis highlights the importance of considering different FISS schedules and potential quit effects, when designing such programs. We highlight that FISS programs should be targeted at certain social groups to achieve highest long-term smoking cessation rates. We also identified important challenges that decision-makers face when designing the reward structure of FISS programs. The acceptability or otherwise of the FISS structures may differ among stakeholders and should be explored. [ABSTRACT FROM AUTHOR]

Fertilization is a common practice, as it improves plant yields. In many areas, biosolids (remains from treated wastewater) are used instead of chemical fertilizers owing to multi-year nutrient release and positive changes in soils and water retention. Little is known about whether biosolids affect animal consumers. Here, we examine diets and nesting sites of American Kestrels (Falco sparverius Linnaeus, 1758) in British Columbia, Canada. Our major study area was a large cattle ranch that has been grazed for over a century and where biosolids were applied in the previous 1-3 years. Kestrels selected nests in areas with higher Northern Flicker (Colaptes auratus (Linnaeus, 1758)) nest density and with a higher proportion of pastures with biosolids applications, but with less forest. Kestrels were observed more often on biosolids-amended pastures than in untreated areas. Kestrels primarily ate voles (genus Microtus Schrank, 1798), but also consumed grasshoppers (Orthoptera) late in the breeding season when grasshoppers were abundant. Kestrel diets were slightly more varied on a nearby control area than on the ranch. Our results suggest that biosolids applications improve prey availability for Kestrels, thus potentially acting as a restoration tool in areas with degraded habitats or where Kestrels have declined. Key words: Falco sparverius, foraging behavior, nest sites, nest cavities, biosolids, British Columbia, grasslands, American Kestrel. La fertilisation est une pratique courante parce qu'elle ameliore le rendement des cultures. Dans de nombreuses regions, des biosolides (residus de traitement des eaux usees) sont utilises plutot que des engrais chimiques parce qu'ils relachent des elements nutritifs sur plusieurs annees et engendrent des changements positifs dans les sols et sur le plan de la retention d'eau. Les connaissances sur d'eventuels effets des biosolides sur des animaux consommateurs sont tres limitees. Nous examinons les regimes alimentaires et sites de nidification de crecerelles d'Amerique (Falco sparverius Linnaeus, 1758) en ColombieBritannique (Canada). Notre principale region d'etude est un grand ranch bovin ou paissent des animaux depuis plus d'un siecle et ou des biosolides ont ete appliques au cours des 1-3 annees precedant l'etude. Les crecerelles choisissaient des nids dans des secteurs de densite relativement elevee de nids de pics flamboyants (Colaptes auratus (Linnaeus, 1758)) et presentant une plus grande proportion de paturages sur lesquels des biosolides avaient ete appliques, mais avec moins de foret. Des crecerelles etaient observees plus souvent dans des paturages amendes avec des biosolides que dans des secteurs non traites. Les crecerelles se nourrissaient principalement de campagnols (genre Microtus Schrank, 1798), mais egalement de sauterelles (orthopteres) tard dans la periode de reproduction, quand ces dernieres etaient abondantes. Les regimes alimentaires des crecerelles etaient legerement plus varies dans un secteur temoin situe a proximite que dans le ranch. Nos resultats donnent a penser que les applications de biosolides ameliorent la disponibilite de proies pour les crecerelles et qu'ils pourraient ainsi servir d'outil de restauration dans des secteurs ou les habitats sont degrades ou l'abondance des crecerelles a diminue. [Traduit par la Redaction] Mots-cles : Falco sparverius, comportement d'approvisionnement, sites de nidification, cavites de nidification, biosolides, Colombie-Britannique, prairie, crecerelle d'Amerique., Introduction Grasslands in North America have suffered from habitat conversion, grazing, and agricultural intensification over the last century (Matson et al. 1997). This shift towards crops and less diverse grassland [...]

BackgroundmicroRNAs (miRNAs) are approximately 21 nucleotide non-coding transcripts capable of regulating gene expression. The most widely studied mechanism of regulation involves binding of a miRNA to the target mRNA. As a result, translation of the target mRNA is inhibited and the mRNA may be destabilized. The inhibitory effects of miRNAs have been linked to diverse cellular processes including malignant proliferation, apoptosis, development, differentiation, and metabolic processes. We asked whether endogenous fluctuations in a set of mRNA and miRNA profiles contain correlated changes that are statistically distinguishable from the many other fluctuations in the data set.Methodology/principal findingsRNA was extracted from 12 human primary brain tumor biopsies. These samples were used to determine genome-wide mRNA expression levels by microarray analysis and a miRNA profile by real-time reverse transcription PCR. Correlation coefficients were determined for all possible mRNA-miRNA pairs and the distribution of these correlations compared to the random distribution. An excess of high positive and negative correlation pairs were observed at the tails of these distributions. Most of these highest correlation pairs do not contain sufficiently complementary sequences to predict a target relationship; nor do they lie in physical proximity to each other. However, by examining pairs in which the significance of the correlation coefficients is modestly relaxed, negative correlations do tend to predict targets and positive correlations tend to predict physically proximate pairs. A subset of high correlation pairs were experimentally validated by over-expressing or suppressing a miRNA and measuring the correlated mRNAs.Conclusions/significanceSufficient information exists within a set of tumor samples to detect endogenous correlations between miRNA and mRNA levels. Based on the validations the causal arrow for these correlations is likely to be directed from the miRNAs to the mRNAs. From these data sets, we inferred and validated a tumor suppression pathway linked to miR-181c.