The Association between Perceived Adequacy and Capacity for School Food Policy Implementation with Food Availability and Policy Adherence in Nova Scotia, Canada.

Supporting the implementation of school food and nutrition policies is an international priority to encourage healthier eating among children and youth. Schools are an important intervention setting to promote childhood nutrition, and many jurisdictions have adopted policies, guidelines, and programs to modify the school nutrition environment and promote healthier eating. The purpose of this study was to explore the association between perceived adequacy of facilities or equipment and capacity of staff to support policy implementation with food availability and policy adherence in the province of Nova Scotia (NS), Canada, one of the first regions in Canada to launch a comprehensive school food and nutrition policy (SFNP). A cross-sectional online survey was conducted in 2014-2015 to provide a current-state assessment of policy implementation and adherence. Adequacy and capacity for food policy implementation was used to assess policy adherence through the availability of prohibited 'minimum' nutrition foods. An exploratory factor analysis was conducted on a selection of available foods, and 'slow'- and 'quick'-service food composition measures were dichotomized for food availability. Schools with above-average perceived adequacy and capacity for policy implementation had greater odds (OR = 3.62, CI = 1.56, 8.40) of adhering to a lunch policy, while schools that adhered to a snack and lunch policy had lower odds (OR = 0.48, CI = 0.23, 1.01 and OR = 0.18, CI = 0.08, 0.41) of serving quick-service foods. This study identified the need for appropriate adequacy of facilities or equipment and capacity of staff for policy implementation to ensure policy adherence and improve the school food environment. These findings highlight the relationship between school food and nutrition policies, suggesting that better supporting their implementation could increase the likelihood of their success

The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children

AbstractObjectiveThe objective of this study is to assess population-level trends in children's dietary intake and weight status before and after the implementation of a provincial school nutrition policy in the province of Nova Scotia, Canada.MethodSelf-reported dietary behavior and nutrient intake and measured body mass index were collected as part of a population-level study with grade 5 students in 2003 (n=5215) and 2011 (5508), prior to and following implementation of the policy. We applied random effects regression methods to assess the effect of the policy on dietary and health outcomes.ResultsIn 2011, students reported consuming more milk products, while there was no difference in mean consumption of vegetables and fruits in adjusted models. Adjusted regression analysis revealed a statistically significant decrease in sugar-sweetened beverage consumption. Despite significant temporal decreases in dietary energy intake and increases in diet quality, prevalence rates of overweight and obesity continued to increase.ConclusionThis population-level intervention research suggests a positive influence of school nutrition policies on diet quality, energy intake and healthy beverage consumption, and that more action beyond schools is needed to curb the increases in the prevalence of childhood obesity

Understanding System-Level Intervention Points to Support School Food and Nutrition Policy Implementation in Nova Scotia, Canada.

Supporting the implementation of school food and nutrition policies (SFNPs) is an international priority to encourage healthier eating among children and youth. Such policies can improve equitable access, resources, and supports for healthy eating. However, despite the potential impact of SFNPs, several implementation barriers have been reported. This study sought to examine the system-level intervention points within a school food system using a complex systems framework. We conducted semi-structured interviews with various stakeholders working to influence the school food system in Nova Scotia, Canada. We sought to understand their roles and experiences with the SFNP by applying the Intervention Level Framework (ILF), a novel, solutions-oriented approach to better understand how complex systems function. Participants (n = 33) included teachers, parents, cafeteria workers, public health staff and non-profit organizations. Interview transcripts were first coded, then themed and finally analyzed using the ILF, resulting in three intervention points within the school food system. These were defined as: (1) Actors and Elements, (2) System Regulation and Interconnections and (3) Purpose and Values. We concluded that understanding the interactions between these system levels and stakeholder roles can help to inform the development of relevant policy strategies that better support healthier school food environments in this jurisdiction

A Call for Change in the Public Education System in Nova Scotia

The United Nation’s International Decade for People of African Descent and Nova Scotia’s Ministry of African Nova Scotian Affairs recognize that students of African descent continue to experience inequities. As previous studies indicate, parents of Black learners identified that many educators lack knowledge and experience in understanding students of African descent.This study explored student achievement from the perspective of parents of children of African descent attending public schools in Nova Scotia. Participants included individual interviews and focus groups with parents from rural and urban areas. Based on Bronfenbrenner’s ecological theory framework, a thematic analysis of the data was conducted, a dominant storyline related to the families’ experiences in school and subsequent themes emerged: we are treated differently; we don’t feel connected; we know there are challenges: the resistance of parents; and we deal with injustices but persevere. These findings provide recommendations to improve the educational success for Black learners. Keywords: African Canadian, academic achievement and success, Black students, education, schooling challenges, students of African descentLa déclaration des Nations Unies de la Décennie internationale des personnes d’ascendance africaine et le Ministre des affaires Afro-néo-écossaises reconnaissent que les élèves d’ascendance africaine continuent à vivre des inégalités. Des études antérieures démontrent que les parents d’apprenants Noirs ont identifié que plusieurs éducateurs manquent de connaissances et d’expérience quant à la compréhension d’élèves d’ascendance africaine. Cette étude explore la réussite scolaire de la perspective des parents d’enfants d’ascendance africaine fréquentant des écoles publiques en Nouvelle-Écosse. Les participants incluent des entretiens individuels et des groupes de discussion avec des parents provenant de régions rurales et urbaines en Nouvelle-Écosse. Basée sur le cadre théorique écologique de Bronfenbrenner, une analyse thématique des données a été entreprise, un fil conducteur dominant lié aux expériences scolaires des familles, et des thèmes résolutoires ont émergé : nous sommes traités différemment ; et nous ne nous sentons pas connectés ; nous sommes conscients qu’il y a des défis ; la résistance des parents ; et nous font face à des injustices mais nous persistons. Ces constats fournissent des recommandations pour améliorer le succès académique des apprenants Noirs. Mots-clés : Afro-canadiens, performance et succès académique, élèves noirs, éducation, défis scolaires, élèves d’ascendance Africain

Newcomer families' experiences with programs and services to support early childhood development in Canada: A scoping review

It can be difficult for families with young children to navigate early childhood development supports. In particular, newcomer families often encounter additional barriers and require resources, programs, and services that are tailored to their unique assets, experiences, and needs. We conducted a scoping review of the literature published between 2000 and 2019 to explore what is known about newcomer families’ experiences with programs and services to support early childhood development in Canada. We searched 12 databases, screened 2390 articles, and included 34 articles for synthesis and analysis. Three common and connected themes were identified: 1) effective intercultural understanding, responsiveness, and communication are critical to ensuring full access to meaningful programs and services; 2) some newcomer families face systemic barriers exacerbated by their immigration status, and; 3) feelings and perceptions of families and service providers, as well as social supports, networks, and relationships influence how programs and services are accessed and experienced. Our review identifies the requirement for additional, participatory research that centres the voices and perspectives of newcomer children and their families and the need to expand that research to less populated and rural areas of the country to inform meaningful and culturally relevant policies, programs, and services for newcomer families to support their children’s well-being

How an early learning and child care program embraced outdoor play: A case study

Research indicates outdoor play influences children’s physical, cognitive and social-emotional well-being, but there are barriers to implementation in early learning settings. This study explores an early learning and child care (ELCC) program achieving success with outdoor play to identify strategies that may help overcome barriers and support outdoor play in similar contexts. Focus groups and interviews were conducted with ELCC program Early Childhood Educators (ECEs) and facilitators, school teachers and principal, and government staff. Data also included relevant documentation and photographs of the outdoor play spaces. Thematic analysis of all data was completed, resulting in a description of the ELCC program’s outdoor play space and practices and factors that may be influencing these identified practices. Six themes or influencing factors were identified: 1) outdoor play, including loose parts and risky play, is valued; 2) outdoor play is promoted and engaged in by others; 3) space and resources are available; 4) communication and engagement happens; 5) leaders are integral; and 6) partnerships and collaboration are essential. Using Bronfenbrenner’s ecological systems model, this research identifies outdoor play implementation strategies that may provide guidance to ELCC stakeholders such as ECEs and policymakers. To overcome outdoor play challenges, considerations should be made to purposefully target and engage multiple subsystems and stakeholders as described in this study for greatest impact

Association of Over-The-Counter Pharmaceutical Sales with Influenza-Like-Illnesses to Patient Volume in an Urgent Care Setting

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round. © 2013 Liu et al

Evaluation of a health promoting schools program in a school board in Nova Scotia, Canada.

A Health promoting schools (HPS) approach aims to make schools a healthy place through a holistic approach that promotes a supportive 'school ethos' and emphasizes improvements in physical, social, and emotional well-being and educational outcomes. A HPS initiative in rural Nova Scotia (Canada) provided an opportunity for a population-level natural experiment. This study investigated student well-being and health behaviours between schools with and without HPS implementation and schools with high and low school ethos scores. Student well-being, nutrition, and physical activity were examined in a cross-sectional survey of elementary students in Nova Scotia, Canada in 2014. Multiple regression was used to assess the relationship with student well-being using the Quality of Life in School (QoLS) instrument and health behaviours. The main exposure was attending one of the 10 HPS schools; secondary exposure was the school ethos score. The overall QoLS score and its subdomain scores in the adjusted models were higher in students attending HPS schools compared to those in non-HPS schools, but the differences were not statistically significant and the effect sizes were small. Students in schools that scored high on school ethos score had higher scores for the QoLS and its subdomains, but the difference was only significant for the teacher-student relationship domain. Although this study did not find significant differences between HPS and non-HPS schools, our results highlight the complexity of evaluating HPS effects in the real world. The findings suggest a potential role of a supportive school ethos for student well-being in school

Management for the Children with Otitis Media with Effusion in the Tertiary Hospital

ObjectivesRecently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study.MethodsEighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months.ResultsThirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05).ConclusionIn the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals