Healthy eating supports optimal growth, development, and academic achievement. Yet, the diet quality of school-aged children is poor. Food insecurity and chronic disease are concerns, as are ...unsustainable agricultural practices. Sustainable food systems have a low environmental impact and can address both dietary and sustainability concerns. This multi-case study was conducted in two Community Schools in a mid-sized Canadian city. Data was collected through interviews, observations, a checklist, and curriculum and policy review. The purpose of this study was to understand the capacity of local elementary schools to implement sustainable food systems strategies in curriculum, policy, and practice. Teachers were doing some cooking and gardening with students, and schools were doing some recycling. There were no specific food policies. Infrastructure challenges varied by school. Insufficient funding and curriculum resources were seen as barriers to implementing sustainable food systems. Staff characteristics and relationships were seen as facilitators.
Schools can be positioned to be strong leaders in the area of school food by prioritizing food literacy and sustainable food system strategies and developing supportive policies, including community members and students in programming, and including experiential food production opportunities for all students.
Healthy eating in school-aged children supports optimal growth and learning; however, diet quality and food insecurity are a source of concern for many school-aged children in Canada. Canadian ...school-aged children’s diets are a concern. In 2019 the Canadian federal government announced the intention to work towards a National School Food Program. A nationally organized program can evolve and meet the needs of children if there is a national evaluation strategy developed along with the program. A scoping review published in 2019 consisted of reports of school food programs in Canada evaluating nutritional impacts and food system sustainability. Food system sustainability recognizes the full impact that school food programs can have on individual, community, and environmental health by integrating social determinants of health, food systems, and economic sustainability. We conducted a content analysis of the evaluation strategies of these programs. Of the 17 peer-reviewed and 18 grey literature publications in the initial scoping review, 12 peer-reviewed and seven grey literature publications contained an evaluation component. Components assessed social determinants of health, including changes in food intake, knowledge about local foods, educational and behavioural outcomes, general knowledge, intention to eat, and willingness to try new foods. An evaluation template for school food programs including categories for social systems, environmental and economic sustainability would capture elements contributing to program impact.
Objectives
This scoping review aims to describe factors that facilitate consumer-level transitions to more environmentally sustainable diets.
Methods
Using scoping review methods, four databases were ...searched for articles published in English examining facilitators to consuming an environmentally sustainable diet and focused on consumers, using data collected in Western countries, and were published between 2012 and 2022. Researchers extracted study characteristics and factors influencing adoption or uptake of sustainable foods or dietary patterns. Using this data, researchers conducted a thematic analysis to determine five main themes describing leverage points (modifiable) for dietary transitions.
Results
Results are reported per PRISMA guidelines: 21 studies were included with data from the U.K., U.S., Australia, and Europe. The results of this review indicate that values, knowledge, marketing, consumer-product relationships, and support networks, along with their respective subthemes, may be central drivers of consumer adoption of sustainable dietary patterns. Consumers are more likely to purchase and consume products which are familiar and appealing and align with their values. Cost, lack of knowledge, and lack of social support act as barriers to dietary change to more sustainable food choices. Income, education, ethnicity, sex, and employment were common individual-level characteristics identified as influential over likelihood of adopting environmentally sustainable dietary patterns. Individual-level characteristics create nuances in both likelihood to adopt, and the experience of barriers to adopting, sustainable dietary patterns.
Conclusion
Knowledge of leverage points and individual-level nuances is useful in informing strategies to facilitate transitions to more sustainable diets.
Over the last 70 years, Canadian agriculture has shifted from many small farms that supplied local residents, to fewer large farms designed to maximize production, reduce cost, and target ...international markets. At present, small local food chains exist as a small fraction of the Canadian food system. However, during the COVID-19 pandemic, the role of local producers was valued by Canadians. The purpose of this study was to gain insight into the role that local producers played in maintaining food system resilience during the early part of the COVID-19 pandemic. We were particularly interested in identifying adaptation strategies and factors that contributed to (enabled) or worked against (constrained) increasing local food system resilience (i.e. the perseverance of farms and farm production). We also examined the accessibility and sufficiency of current agriculture supports. Eight semi-structured interviews were conducted with Antigonish Farmers’ Market (AFM) producers. Challenges identified include system bottlenecks, increased costs, increased demand, changes in sales, and the need for online literacy. In response to these challenges, AFM producers demonstrated a high degree of adaptability. Half of the study participants accessed agriculture-support related to COVID-19. Other participants expressed discontent with the suitability and accessibility of current support programs available. Opportunities to increase local food system resilience include increasing local support, promoting AFM collaboration, and tailoring agriculture support for small, diversified, local farmers.
Over the last 70 years, Canadian agriculture has shifted from many small farms that supplied local residents, to fewer large farms designed to maximize production, reduce cost, and target ...international markets. At present, small local food chains exist as a small fraction of the Canadian food system. However, during the COVID-19 pandemic, the role of local producers was valued by Canadians. The purpose of this study was to gain insight into the role that local producers played in maintaining food system resilience during the early part of the COVID-19 pandemic. We were particularly interested in identifying adaptation strategies and factors that contributed to (enabled) or worked against (constrained) increasing local food system resilience (i.e. the perseverance of farms and farm production). We also examined the accessibility and sufficiency of current agriculture supports. Eight semi-structured interviews were conducted with Antigonish Farmers’ Market (AFM) producers. Challenges identified include system bottlenecks, increased costs, increased demand, changes in sales, and the need for online literacy. In response to these challenges, AFM producers demonstrated a high degree of adaptability. Half of the study participants accessed agriculture-support related to COVID-19. Other participants expressed discontent with the suitability and accessibility of current support programs available. Opportunities to increase local food system resilience include increasing local support, promoting AFM collaboration, and tailoring agriculture support for small, diversified, local farmers.
In Canada, childhood obesity is increasing while 16% of children are food insecure. Schools provide an opportunity to promote healthy eating, yet, there is no national school food program. The ...purpose of this scoping review is to determine promising practices for Canadian school food programs. Using peer reviewed and gray literature in English and French published after 1970, we examined 35 publications for evidence of nutritional intake, nutrition education, improved educational attainment, promotion of health equity, and cultural awareness. Interest in school food programs is growing. Programs should address social determinants of health, food systems, and environmental and economic sustainability.
Diet quality and food security are a concern in school-aged children in Canada. In 2019, the Canadian federal government announced the intention to work towards a national school food program. ...Understanding the factors that impact school food program acceptability can inform planning to ensure that students are willing to participate. A scoping review of school food programs in Canada completed in 2019 identified 17 peer-reviewed and 18 grey literature publications. Of these, five peer-reviewed and nine grey literature publications included a discussion of factors that impact the acceptance of school food programs. These factors were thematically analyzed into categories: stigmatization, communication, food choice and cultural considerations, administration, location and timing, and social considerations. Considering these factors while planning can help to maximize program acceptability.
Dietitians (RDs) are well-positioned to promote sustainable food systems and diets. This research aims to review the literature for how RDs in Canada define sustainability and determine the types of ...relevant activities that exist in practice as described in published literature.
Using standardised scoping review methods, researchers searched CINAHL, ACASP, PubMed and ENVCOM databases to identify peer-reviewed articles and conducted a grey literature search to locate other publications related to sustainability in Canadian dietetic practice. Qualitative, thematic coding methods were used to examine definitions and existing practice. The PRISMA extension for scoping reviews guided reporting.
The search resulted in 1059 documents and, after screening, 11 peer-reviewed and 16 grey literature documents remained. Ten unique definitions were used, the most common being Sustainable Diets. Definitions were multidimensional, including environmental, social, economic and health dimensions, and 31 unique subtopics. However, existing practice activities appear to reduce actions to one to two dimensions. Existing practice areas well-reflected include Food and Nutrition Expertise, Management and Leadership, Food Provision and Population Health Promotion. Notable gaps include action in Professionalism and Ethics and Nutrition Care.
No single definition supports all professional contexts, and agency in choice of language to define the work is helpful for contextual clarity. Strengthening practitioners' ability to analyse issues using systems thinking and applying this in practice will help to address challenges and reduce risks of trade-offs. Updates to competency standards that reflect the breadth of existing activities, as well as curricular supports or practice standards, are needed.
Diabetes is a chronic disease in which the body is unable to control blood sugar. It can cause many serious complications such as blindness, kidney failure, lower limb amputations, and heart attack ...or stroke. It is treated through lifestyle modifications including eating healthy and being physically active. First Nations people are at higher risk of diabetes due, in part, to dietary and physical activity changes since European contact. Diabetes education programs provide education to encourage lifestyle modifications to control blood sugar in order to minimize or prevent complications. Traditionally, First Nations people had effective health and education strategies; however, after European contact and attempted assimilation, First Nations people lost many of these practices. This qualitative research project uses a needs assessment process, using focus groups and interviews, to determine the educational content and method of delivery that are seen as useful in supporting people with diabetes in a First Nations community. One surprising finding is that many people requested "white" ways of teaching and learning. This may be because culturally biased methods were used to collect data or because, through assimilation pressures, First Nations people have lost traditional learning strategies.
Background:
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is often required to support infants with congenital defects, congenital heart disease, and other causes of reversible ...cardiopulmonary insufficiency. Although ECMO can be a life-saving modality, bleeding, inflammation, and thrombosis are well-described complications of ECMO. Adult porcine models of ECMO have been used to recapitulate the physiology and hematologic consequences of ECMO cannulation. However, these models lack the unique physiology and persistence of fetal forms and quantities of coagulation proteins and fibrinogen found in human infants. Furthermore, anticoagulation and hemostatic strategies developed for adults or using adult porcine models are often extrapolated to infants without specific considerations for developmental hemostasis. Therefore, development of an animal model of ECMO that faithfully reproduces both the physiology and coagulation profile of human infants is important to improving anticoagulation strategies and gaining a better mechanistic understanding of hemostatic challenges in infants. We hypothesized that an infant porcine mode (piglets) supported with VA-ECMO would closely recapitulate the physiology and hematology of human infants on ECMO.
Methods:
Four healthy piglets (5.7-6.4 kg) were cannulated via the jugular vein and carotid artery and supported for 20 hours or until adult whole blood for transfusion was exhausted. Heparin was used with a goal activated clotting time (ACT) of 180-220 seconds. Blood gas (ABG) was performed hourly, and blood was transfused from an adult donor to maintain hematocrit ≥24%. Rotational thromboelastometry (ROTEM) assays were performed at each of seven time points. Specifically, EXTEM, INTEM, and FIBTEM were used to determine the coagulation time (CT) and maximum clot firmness (MCF) of the extrinsically-mediated, intrinsically-mediated, and acellular fibrin clots, respectively.
Results:
All animals (n=4) had slow but significant hemorrhage at cannulation, arterial line, and bladder catheter sites. All animals required the maximum blood transfusion volume available. All animals became anemic after exhaustion of blood for transfusion, and two required sacrifice before the 20-hour endpoint for critical anemia. ABG showed progressively declining hematocrit and adequate oxygenation. ROTEM demonstrated decreasing FIBTEM clot firmness with preservation of EXTEM and INTEM coagulation times. Histology was overall unremarkable.
Conclusion:
Our infant porcine model faithfully reproduces the physiology and hematostatic profile of human infants during VA-ECMO, including transfusion dependence and heparin-induced coagulopathy. Weak whole-blood clot firmness by ROTEM suggests defects in fibrinogen. This model serves as an important means to study the complex derangements in hemostasis during VA ECMO in infants, including subtle derangements due to adult blood product transfusions, as well as to investigate novel approaches to anticoagulation and hemostasis during extracorporeal life support.
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Arepally:Veralox Therapeutics: Membership on an entity's Board of Directors or advisory committees; Apotex Pharmaceuticals: Consultancy; Biokit: Patents & Royalties.
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