Hepatitis A virus (HAV) infection is a notifiable disease in Ireland, with national coverage of clinical and laboratory surveillance. In December 2020, a cluster of 11 HAV cases among the Irish Traveller community was detected. The outbreak investigation identified 61 total HAV cases from September 2020 to November 2021. Sequenced isolates were sub-genotype IA with identical genome sequence. Case-patients were predominantly aged under 18 (77%), hospitalised (46%) and lived on communal residential sites. Mass onsite HAV vaccination was employed following failure of initial ring vaccination to contain the outbreak. This is the largest outbreak of HAV described in Ireland, involving spillover to the UK and Netherlands. We recommend mass HAV vaccination and tailored communication for outbreak control in migratory subpopulations.

Food portion sizes routinely consumed by children have increased over time and consumption of larger portion sizes is associated with higher weight status. Parents often have the critical role of deciding portion sizes of foods to serve their children. It is not well understood, however, how parents decide the amount of food to serve. This research aimed to investigate parental views on portion sizes of foods and beverages served to children.

A purposive sample of preschools and primary schools geographically located in either urban or rural areas of Northern Ireland and the Republic of Ireland, and classified as either high or low deprivation were recruited. Selected schools were invited to facilitate this research. Parents with at least one child aged 2–12 years attending a recruited school were then invited to participate in a focus group. A maximum of three groups were scheduled with interested parents at each school. One researcher moderated the focus groups, assisted by another researcher in all groups where possible. A semi-structured discussion guide was followed, using probes to stimulate discussion. The guide explored practices in portioning foods and beverages for children, factors influencing portioning and views on portion sizes of foods and beverages served to children. Discussions were audio-recorded, transcribed verbatim and data was analysed thematically. Nvivo software was used to manage the coded data.

Focus groups (n = 24) ranging in size from 3–12 parents were conducted across 19 schools. The response rate from parents at recruited schools ranged from 1–16%. A total of 144 parents (86% female, mean age 46y) participated, of which 60% had a child attending a high deprivation school and 64% had a child attending a rural school. Factors influencing parental portioning included seven themes comprised of sub-themes: parent knowledge (portion size knowledge, serving a learned amount), parent motivations (ensure child is fed, encourage healthier food), child-related factors (appetite, body size, food preferences, eating patterns), family influence (spouses and grandparents serving), food retail and other settings (restaurants, takeaways, special occasions), socio-cultural influences (parent childhood experiences, parents’ portion size norms) and portioning resources used (serve ware, utensils, hand sizes).

Parents’ main concern regarding the amount they feed their children was to ensure that they are fed a sufficient amount to feel full. Parents learned this amount through experience and felt it was specific to each child's appetite. These findings will inform future interventions and information campaigns to help parents understand child portion sizes.

Few studies have investigated the relative validity of FFQ in young children and no study has investigated the relative validity of changes in children's food intake in a longitudinal context. The aim of the present study was to compare the FFQ of the longitudinal Family Influences on Food Intake study, assessing children's food intake in the previous 3 months, with a 3 d online food record when children were 3 and 7 years old, as well as to investigate the relative validity of changes in food group intake over a 4-year period. Parents (n 89) completed the FFQ and an online food record over three non-consecutive days on two separate occasions (January–April 2008 and 2012). Wilcoxon signed-rank tests and Spearman's correlations were used to compare food group intake and changes in intake assessed using both methods. In 2008, the intake of eleven of the twenty-two food groups was overestimated and that of four food groups underestimated in the FFQ in comparison with the online tool; in 2012, the intake of four food groups was overestimated and that of seven food groups underestimated. Nevertheless, changes in intake did not differ significantly between the two methods for eighteen food groups. Correlations in 2008 and 2012 were, on average, 0·47; correlations between the changes in dietary intake were, on average, 0·26. The results suggest that despite the significant differences between the two methods for a number of food groups at both baseline and/or follow-up, the FFQ can be used to monitor changes in dietary intake for groups of young children.

Diets high in monounsaturated fatty acids (MUFA) are increasingly being recommended as a highly-effective cholesterol-lowering strategy in populations at risk of CHD. However, the need for a re-appraisal of the benefits of diets rich in MUFA became apparent as a result of recent studies showing that meals high in olive oil cause greater postprandial activation of blood coagulation factor VII than meals rich in saturated fatty acids. The present review evaluates the evidence for the effects of MUFA-rich diets on fasting and postprandial measurements of haemostasis, and describes data from a recently-completed long-term controlled dietary intervention study. The data show that a background diet high in MUFA has no adverse effect on fasting haemostatic variables and decreases the postprandial activation of factor VII in response to a standard fat-containing meal. Since the same study also showed a significant reduction in the ex vivo activation of platelets in subjects on the high-MUFA diet, the overall findings suggest that there is no reason for concern regarding adverse haemostatic consequences of high-MUFA diets.

Parental feeding style, as measured by the Child Feeding Questionnaire (CFQ), may be an important influence on child feeding behaviour and weight status in early to mid childhood, but more evidence on parental feeding style is required from samples outside the USA. We aimed to use the CFQ in a sample of 117 Scottish children (boys n 53, girls n 64 mean age 4·6 (sd 0·5) years) to: characterise gender differences and changes over time (in forty of the 117 children studied over 2 years); test associations between parental feeding style, free-living energy intake (measured over 3 days using the multiple pass 24-h recall), and weight status (BMI sd score). No dimensions of parental feeding style changed significantly over 2 years in the longitudinal study (P>0·05 in all cases). No aspects of parental feeding style as measured by the CFQ differed significantly between the sexes (P>0·05 in all cases). Parental perceptions of child weight status were generally significantly positively correlated with child weight status as measured by the BMI sd score. In this sample and setting, measures of parental control over child feeding were generally not associated with child energy intake or weight status.

Accurate measurement of energy intake (EI) is essential in studies of energy balance in all age groups. Reported values for EI can be validated against total energy expenditure (TEE) measured using doubly labelled water (DLW). Our previous work has indicated that the use of the standardized 24 h multiple pass recall (24 h MPR) method produces slight overestimates of EI in pre-school children which are inaccurate at individual level but acceptable at group level. To extend this work, the current study validated EI by 24 h MPR against TEE by DLW in sixty-three (thirty-two boys) school-aged children (median age 6 years). In both boys and girls, reported EI was higher than TEE, although this difference was only significant in the girls (median difference 420 kJ/d, P=0·05). On analysis of agreement between TEE and EI, the group bias was an overestimation of EI by 250 kJ/d with wide limits of agreement (−2880, 2380 kJ/d). EI was over-reported relative to TEE by 7 % and 0·9 % in girls and boys, respectively. The bias in the current study was lower than in our previous study of pre-school children, suggesting that estimates of EI become less inaccurate as children age. However, the current study suggests that the 24 h MPR is inaccurate at the individual level.

The aim of the present study was to compare the response of a range of atherogenic and thrombogenic risk markers to two dietary levels of saturated fatty acid (SFA) substitution with monounsaturated fatty acids (MUFA) in students living in a university hall of residence. Although the benefits of such diets have been reported for plasma lipoproteins in high-risk groups, more needs to be known about effects of more modest SFA-MUFA substitutions over the long term and in young healthy adults. In a parallel design over 16 weeks, fifty-one healthy young subjects were randomised to one of two diets: (1) a moderate-MUFA diet in which 16 g dietary SFA/100 g total fatty acids were substituted with MUFA (n 25); (2) a high-MUFA diet in which 33 g dietary SFA/100 g total fatty acids were substituted with MUFA (n 26). All subjects followed an 8-week run-in diet (reference diet), with a fatty acid composition close to the UK average values. There were no differences in plasma lipid responses between the two diets over 16 weeks of the study with similar reductions in total cholesterol (P <0·001) and LDL-cholesterol (P<0·01) in both groups; a small but significant reduction in HDL-cholesterol was also observed in both groups (P<0·01). Platelet responses to ADP (P<0·01) and arachidonic acid (P<0·05) differed with time on the two diets; at 16 weeks, platelet aggregatory response to ADP was significantly lower on the high-MUFA than the moderate-MUFA (P<0·01) diet; ADP responses were also significantly lower within this group at 8 (P<0·05) and 16 (P<0·01) weeks compared with baseline. There were no differences in fasting factor VII activity (factors VIIc and VIIag), fibrinogen concentration or tissue-type plasminogen activator activity between the diets. There were no differences in postprandial factor VIIc responses to a standard meal (area under the curve) between the diets after 16 weeks, but postprandial factor VIIc response was lower than on the high-MUFA diet compared with baseline (P<0·01). In conclusion, a high-MUFA diet sustains potentially beneficial effects on platelet aggregation and postprandial activation of factor VII. Moderate or high substitution of MUFA for SFA achieves similar reductions in fasting blood lipids in young healthy subjects.