Taste is influenced by several factors. However, whether habitual exercise level is associated with differences in taste perception has received little investigation. The aim of this study was to determine if habitual exercise is associated with differences in taste perception in men. Active (n = 16) and inactive (n = 14) males, between ages 18–55, underwent two days of sensory testing, using prototypical taste stimuli of high and low concentrations for sweet, salt, bitter, sour, umami, and carbohydrate (maltodextrin). Mean perceived intensity and hedonic ratings were recorded. Eating behaviour was assessed by the three factor eating questionnaire and food intake by EPIC food frequency questionnaire (FFQ). There were moderate to large differences between the two groups in perceived intensity for sweet taste at the high concentration and umami taste at both high and low concentrations, with active males recording a higher perceived intensity (p < 0.05 for all). The active group also recorded a greater dislike for umami low and carbohydrate low concentration (p < 0.01). Salt, bitter and sour perception did not significantly differ between the two groups. FFQ analysis showed no difference in % energy from macronutrients between the groups. Eating behaviour traits correlated with sweet taste intensity and umami taste liking, independent of activity status. Results indicated that sweet and umami taste perception differ in active compared to inactive males. Habitual exercise level should be considered in taste perception research and in product development. Whether differences in taste perception could be one factor influencing food intake and thus energy balance with habitual exercise warrants further investigation.

BackgroundHepatitis B (HBV), hepatitis C (HCV), and HIV blood-borne viruses (BBV) are associated with chronic ill health and mortality. Early diagnosis reduces disease transmission, delays progression, and improves outcomes. Routine opt-out testing for BBV in primary care may be viable in identifying unknown disease. AimTo assess the viability and yield of routine optout testing for BBV. Design and settingA multicentre, prospective, routine opt-out testing study of BBV in primary care between September 2014 and February 2015 across four sites in Dublin, Ireland. MethodAll adult patients attending for routine blood tests were offered an additional BBV test during a 6-month period. All individuals were given an information leaflet before phlebotomy and were given the choice to opt out of BBV testing. ResultsIn total, 1188 patients were invited to participate in the study and 1063 (89.5%) opted to be tested (95% confidence interval [CI] = 87.7% to 91.2%). A total of 125 patients (10.5%) opted out. There were 10 positive results, four new diagnoses, and six previously known. There were two new HBV and two new HCV diagnoses, a yield of four per 1000 (95% CI = 0.9 to 7.5 cases per 1000). No new HIV cases were diagnosed. ConclusionThis study indicates that testing for BBV in patients presenting for routine blood tests in primary care is viable. The yield of HBV and HCV suggests that opt-out testing should be considered in primary care to increase detection rates of BBV.

Access to existing services must be increased, and significant resources must be put into the development of dedicated primary care services.

<b><i>Background:</i></b> This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiology, assessment, and treatment of obesity. <b><i>Summary:</i></b> It shifts the focus of obesity management toward improving patient-centred health outcomes, functional outcomes, and social and economic participation, rather than weight loss alone. It gives recommendations for care that are underpinned by evidence-based principles of chronic disease management; validate patients’ lived experiences; move beyond simplistic approaches of “eat less, move more” and address the root drivers of obesity. <b><i>Key Messages:</i></b> People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of body weight. Education is needed for all healthcare professionals in Ireland to address the gap in skills, increase knowledge of evidence-based practice, and eliminate bias and stigma in healthcare settings. We call for people living with obesity in Ireland to have access to evidence-informed care, including medical, medical nutrition therapy, physical activity and physical rehabilitation interventions, psychological interventions, pharmacotherapy, and bariatric surgery. This can be best achieved by resourcing and fully implementing the Model of Care for the Management of Adult Overweight and Obesity. To address health inequalities, we also call for the inclusion of obesity in the Structured Chronic Disease Management Programme and for pharmacotherapy reimbursement, to ensure equal access to treatment based on health-need rather than ability to pay.

Objectives: Real-world evidence (RWE) is increasingly considered alongside trial data to estimate relative effectiveness of treatments. However, using RWE reliably can be challenging. We examined the feasibility of using RWE to assess relative clinical effects of left atrial appendage closure (LAAC) with the WATCHMAN device and oral anticoagulants (OACs) for stroke risk reduction in nonvalvular atrial fibrillation to inform decisions on conducting a cost effectiveness analysis. Methods: A systematic literature review identified potential RWE sources for OACs, which were compared to EWOLUTION, a prospective registry on LAAC with the WATCHMAN device, to assess the feasibility of conducting a statistical indirect comparison. Homogeneity of the evidence base was evaluated on study design, patient characteristics, endpoint derivation and reported results. Published risk equations were used to re-estimate event rates within studies to determine the feasibility of adjusting for differences in patient characteristics across studies using reported aggregate data. Results: We identified three meta-analyses, three prospective registries and five retrospective data analyses. Patients enrolled in EWOLUTION were older (25.6% $80) and had higher stroke risk (73.1% with CHA 2 DS 2 -VASc $4) and more comorbidities than OAC patients. Inclusion criteria and endpoint definitions across studies were importantly different. Calculated risks using published equations did not sufficiently reproduce observed event rates. Compared to observed rates, predicted annual stroke rates differed by .50%, death rates were underestimated by .15% and major bleeding rates were underestimated by .20%. Conclusions: Risk adjustment analyses using aggregate data yielded low levels of reproducibility, which led to widely different estimates of clinical effect. Coupled with differences in study designs, it is inadvisable to compare the real-world safety and effectiveness of WATCHMAN to OACs using existing real-world studies, even when adjusting for differences in patient characteristics. Attempts should be made to improve consistency of reporting to fully realize the value of RWE in clinical and health economic evaluations.

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