BackgroundThere is emerging evidence that the supplementation of omega-3 contributes to a decrease in aggressive behaviour in prison populations. A challenge of such research is achieving statistical power against effect sizes which may be affected by the baseline omega-3 index. There are no published data on the blood omega-3 index with studies of this kind to assess the variability of the blood omega-3 index in conjunction with aggression and attention deficit assessments.ObjectiveTo determine if the variance of the omega-3 index is correlated with aggressive and attention deficit behaviour in a prison population.Design136 adult male prisoners were recruited from South Coast Correctional Centre (SCCC), NSW Australia. A 7 point categorisation was used to quantify levels of aggressive behaviour (4 weeks) from individual SCCC case notes, whereby higher scores correspond to increasingly aggressive behaviour. Study participants completed the Aggression Questionnaire (AQ) and the Brown’s Attention Deficit Disorder Scales (BADDS), provided a blood sample for erythrocyte fatty acid analysis using gas chromatography and the omega-3 index was calculated.ResultsThe baseline omega-3 index ranged from 2.3% to 10.3%, indicating that some participants already had substantial omega-3 intake, however a median of 4.7% indicated a lower overall omega-3 intake than the general Australian population. Assessment of aggressive and attention deficit behaviour shows that there were negative correlations between baseline omega-3 index and baseline aggression categorisation scores (r = −0.21, P = 0.016); total AQ score (r = −0.234, P = 0.011); Anger (r = -0.222 p = 0.016); Hostility AQ (r = −0.239, P = 0.009); indirect aggression (r = −0.188 p = 0.042); total BADDS (r = −0.263, p = 0.005); Activation (r = −0.224, p = 0.016); Attention (r = −0.192, p = 0.043); Effort (r = −0.253, p = 0.007); Affect (r = −0.330, p = 0.000) and Memory (r = −0.240, p = 0.010).ConclusionsThere is a high variability in omega-3 status of a NSW prison population, and inmates with lower omega-3 index were more aggressive and had higher ADD scores.

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This study aimed to assess the feasibility of conducting a nutrition trial in adult male prisoners. Adult male prisoners were recruited for a 16-week randomised control trial comparing the effect of ingestion of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) and multivitamin supplements versus placebo on aggressive behaviour. The baseline and post-intervention assessments from the participant blood samples were the erythrocyte n-3 LCPUFA levels as well as measures of aggressive behaviour determined through institutional records of misconduct (IRM), the Inmate Behaviour Observation Scale (IBOS), and questionnaires. A total of 136 adult male prisoners consented to the study with a retention rate of 60%, and 93% of blood samples were successfully collected. The IRM and IBOS scores were collected for 100% of participants, whilst 82–97% of participants completed the questionnaires. From the baseline data, the Odds Ratio shows that prisoners are 4.3 times more likely to have an IBOS >2 if they are below the 6% cut off on the omega-3 index. Both groups improved across all outcome measures and, at the current sample size, no significant differences were seen between them. A power calculation suggests a total sample size of 600 participants is required to detect the effects of this dietary supplementation, and that this supplementation study is feasible in a Correctional Centre. Important criteria for the exclusion and consideration of logistics and compliance are presented.

Farmworkers contribute significantly to North Carolina's communities and economy; however, they incur significant occupational risks with limited workplace protections. Many barriers complicate their access to health care services. Recommendations include increased number of outreach workers, extended clinic hours, strengthening workplace protections, and inclusion of farmworkers in community needs assessments. N orth Carolina is among the most diversified agricultural states in the nation with approximately 50,200 farmers growing over 80 different commodities [1]. It is the nation's largest producer of tobacco and sweet potatoes, the second largest producer of Christmas trees, and ranks eighth nationally for the total value of agricultural products sold [2]. Farmworkers are an integral part of North Carolina's economy, helping to respond to the demand for seasonal labor to plant, cultivate, harvest, and pack the state's varied agricultural products. However, farmworkers remain an often invisible, underserved population. The North Carolina Department of Commerce estimates that there were approximately 80,000 migrant and seasonal farmworkers (MSFW) in our state in 2017 (North Carolina Department of Commerce, unpublished data, 2017). Although farmworkers reside in all of North Carolina's 100 counties, 60% of the MSFW population lives in just 16 counties (see Figure 1). Farmworkers are classified as seasonal (living in North Carolina year round but working in agriculture on a seasonal basis) or migrant (moving to North Carolina on a temporary basis to work in agriculture). Migrant workers come to North Carolina with family or friends or are recruited through the federal H2A visa program. The H2A program provides temporary visas for agricultural workers after recruiters demonstrate that there are no US citizens willing to be hired. This program supplies 27% of all of North Carolina farmworkers, with the majority of H2A workers recruited from Mexico. Although estimates indicate that the overall farmworker population in North Carolina has decreased by 5% between 2014 and 2017 (North Carolina Department of Commerce,

Farmworker health outreach workers have not traditionally been involved in the prioritization and design of research studies. This report from the field shares the results of a survey administered to outreach workers providing health services to farmworkers in North Carolina. Priority areas of research and best practices for engaged research are presented from the perspective of the outreach worker community. The purposeful involvement of outreach workers can make farmworker health research more meaningful and solution-oriented.