Capturing Voices in the Heat of the Moment: Election Reflections 2016

At Utah State University Libraries, we have a tradition of community-driven oral history efforts aimed at bringing the voices of the underserved and underheard communities into our Special Collections & Archives for preservation and presentation. This effort is called Northern Utah Speaks

Exposed: Discrimination Against Breastfeeding Workers

https://repository.uchastings.edu/wll/1000/thumbnail.jp

A Baby-Led approach to complementary feeding: Adherence and infant food and nutrient intakes at seven months of age

Baby-Led Weaning (BLW) is an alternative approach to complementary feeding. Parents offer ‘whole’ (baby-fist size) pieces of food, allow infants to feed themselves, include infants at family meal times and offer family foods when practical. There is virtually no information on BLW infants’ food and nutrient intakes, and there have been no randomised studies with participants who were not self-motivated to choose a Baby-Led approach. The aim of this thesis was to investigate the extent to which families are able to adhere to a Baby-Led approach to complementary feeding, and the impact a Baby-Led approach has on infant food group and nutrient intakes at seven months of age. The Baby-Led Introduction to SolidS (BLISS) study was a two-arm randomised controlled trial. Women from Dunedin, New Zealand, were recruited during pregnancy and randomised to the Usual Care (n=101) or the BLISS Intervention (n=101) group. The Intervention group used a modified Baby-Led approach to complementary feeding which focused on inclusion of high-iron and high-energy foods at each meal, and reduction of infants’ choking risk. The BLISS group received five intervention contacts before seven months: an antenatal education session, three Lactation Consultant contacts, and a BLISS advice visit. This thesis used the BLISS study Maternal Baseline Questionnaire, Feeding Questionnaires collected at two, four, six, seven and eight months postpartum and a three-day Weighed Food Record, modified to collect adherence data for the Baby-Led approach to infant feeding, completed at seven months. Parents reported who fed the infant each food (parent-fed only, infant and parent-fed together, infant self-fed only) as well as the foods and amounts offered and consumed. Participants were classified as adherent to a Baby-Led approach if ≤ 10% of foods were solely parent-fed, ≤ 15% of foods were infant and parent-fed together, and at least 75% of foods were infant self-fed only. This meant that the infant contributed to feeding ≥ 90% of their food. Weighed Food Records were returned by 80% of participants (n=162). Two-thirds of the BLISS group (n=48) were classified as adherent, as were eight Usual Care infants. A significantly greater proportion of the energy intake of infants in the Usual Care group was supplied by ‘Fruit’ (median: 30.7% vs. 18.3% (p=0.001)) and ‘Vegetables’ (median: 10.8% vs. 6.3% (p<0.001)) compared to the BLISS group. BLISS infants were more likely to have eaten ‘Sweet foods’ (Odds Ratio (OR): 4.08; 95% Confidence Interval (95%CI): 2.05, 10.52 (p<0.001)) and ‘Powdered infant cereal’ (OR: 2.69; 95%CI: 1.32, 5.50 (p=0.006)). However, the Usual Care group were more likely to have consumed ‘Ready-to-eat commercial infant foods’ (OR: 2.78; 95%CI: 1.41, 5.56 (p=0.003)), and they also had a higher energy intake from these foods (median: 15.8% vs. 0% (p<0.001)). There was no difference between the study groups in terms of mean energy intakes, or percentage of energy contributed by fat, protein or carbohydrate. Infants in the BLISS group had a significantly lower intake of vitamin A (-12%, 95%CI: -20%, -3% (p=0.0013)), and significantly higher intakes of selenium (11%, 95%CI: 4%, 8% (p=0.002)) and sodium (38%, 95%CI: 20%, 59 (p<0.001)) than the Usual Care group. These results indicate that, with support, families are able to adhere to the principles of a Baby-Led approach, as presented by BLISS, including infant self-feeding of complementary foods. The food group and nutrient intakes of infants following a modified Baby-Led approach showed some differences compared to infants being introduced to complementary foods conventionally. Intake of ‘Fruit’ and ‘Vegetables’ was lower for BLISS infants and consumption of sodium was higher. Longitudinal follow-up is needed to determine whether these differences will dissipate, or become more pronounced, as Usual Care group infants are introduced to family-foods later in infancy

“The System is Well Intentioned, but Complicated and Fallible” Interviews with Caregivers and Decision Makers About Palliative Care in Canada

Background: Canadian palliative care (PC) philosophy seeks to support individuals in a person-centered and sensitive manner. Unfortunately, philosophy does not necessarily translate into practice and this divide may leave patients without appropriate care at the end of life, causing distress for some families. The primary goal of the study was to identify key factors affecting perceptions of quality PC from the perspective of informal caregivers and decision makers (e.g., program managers) and to understand how their experiences within the health care system may have influenced their perceptions. Methods: Nine caregivers and 11 decision makers from Yukon Territory, British Columbia, Alberta, Ontario, & Nova Scotia shared their experiences in PC via interview or focus group. Audio recordings were transcribed verbatim and qualitatively analyzed for themes. Results: Three themes emerged, including the Caregiver as Anchor, Bewildering System, and Patient, Caregiver, and Family-Centered Care. While these results resembled other studies on caregivers and individuals receiving PC, the present study also uncovered systemic concerns. There was agreement between the two participant groups across most subthemes, however only caregivers reported feelings of being trapped by the health care system and a general lack of respect from health care professionals. Additionally, caregivers stressed the importance of preserving some sort of normalcy in daily life despite the individual\u27s illness. Conclusions: Caregivers are critical. The health care system expects them to help a great deal, but they often do not feel supported or respected and the system is lacking the capacity and resources to meet their needs while they are grieving loss and struggling to meet demands

Cultural competency and mental health training for medical students: Learning from refugees and asylum seekers

Objective: Studies suggest that healthcare professionals often feel unprepared to deal with mental health issues in refugees and asylum seekers. The aim of this qualitative study was to examine the experiences of refugees and asylum seekers in relation to mental health and healthcare, to inform cultural competency training for undergraduate medical students. Method: Focus groups were conducted with 16 refugees and asylum seekers and staff from relevant charity organisations in Wales. We explored participants’ experiences in relation to mental health and healthcare, and training for healthcare professionals. The data were thematically analysed using an inductive approach. Results: Three overarching themes were identified: (1) recognition of the specific mental health needs of refugees and asylum seekers, (2) barriers preventing effective mental healthcare delivery for refugees and asylum seekers and (3) authentic learning experiences for medical students. Conclusion: To our knowledge, this is the first study to actively involve refugees and asylum seekers, along with individuals who work closely with this population, in considering the development of cultural competency training for healthcare students and professionals in relation to mental health. If we are to reduce the risks of exclusion from healthcare for refugees and asylum seekers, training in this area is essential. Findings from this study have informed the development of a guide for healthcare educators with a focus on refugee and asylum seeker mental health

Highly Relevant Mentoring (HRM) as a Faculty Development Model for Web-­Based Instruction

This paper describes a faculty development model called the highly relevant mentoring (HRM) model; the model includes a framework as well as some practical strategies for meeting the professional development needs of faculty who teach web-based courses. The paper further emphasizes the need for faculty and administrative buy-in for HRM and examines relevant theories that may be used to guide HRM in web-based teaching environments. Of note is that HRM was conceived by the instructional design staff who contributed to this paper before the concept of high impact mentoring appeared in the recent literature (2009). While the model is appropriate in various disciplines and professions, the examples and scenarios provided are drawn from a Canadian university’s experience of using HRM, in conjunction with a pedagogical approach called ICARE, in a variety of nursing courses and programs

Assessment of urinary deoxynivalenol biomarkers in UK children and adolescents

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Deoxynivalenol (DON), the mycotoxin produced mainly by Fusarium graminearum and found in contaminated cereal-based foodstuff, has been consistently detected in body fluids in adults. Available data in children and adolescents are scarce. This study assessed urinary DON concentrations in children aged 3–9 years (n = 40) and adolescents aged 10–17 years (n = 39) in the UK. Morning urine samples were collected over two consecutive days and analysed for free DON (un-metabolised form), DON-glucuronides (DON-GlcA), deepoxy deoxynivalenol (DOM-1), and total DON (sum of free DON, DON-GlcA, and DOM-1). Total DON was detected in the urine of > 95% of children and adolescents on both days. Mean total DON concentrations (ng/mg creatinine) were 41.6 and 21.0 for children and adolescents, respectively. The greatest total DON levels were obtained in female children on both days (214 and 219 ng/mg creatinine on days 1 and 2, respectively). Free DON and DON-GlcA were detected in most urine specimens, whereas DOM-1 was not present in any sample. Estimation of dietary DON exposure suggested that 33–63% of children and 5–46% of adolescents exceeded current guidance regarding the maximum provisional tolerable daily intake (PMTDI) for DON. Although moderate mean urinary DON concentrations were shown, the high detection frequency of urinary DON, the maximum biomarker concentrations, and estimated dietary DON exposure are concerning