Procurement from local producers for food service in primary and secondary school settings: A scoping review

Issue addressed: Australian school canteen guidelines do not broadly incentivise procuring food from local producers, despite evidence of this occurring abroad. This scoping review aims to investigate what is known about local food procurement for school foodservice. Methods: A scoping review of peer-reviewed articles published since 2000 was undertaken using MEDLINE, CINAHL and Scopus. Results: Twenty-one studies met the inclusion criteria. Local food was generally perceived as fresher and more nutritious. Small, positive impacts on fruit and vegetable intake have been demonstrated when food is procured locally. Challenges identified included concerns around food safety, varied availability, time spent coordinating food supply, lack of incentive from regional or national guidelines, inadequate kitchen facilities and budget constraints. Conclusions: There is no universal definition or standard for procuring ‘local food’. The main motivation for local food procurement was a sense of social responsibility, however there are barriers, including cost, facilities and food safety. Purchasing food locally holds potential to benefit the local economy but government funding and policy supporting local and small-scale producers is an important enabler. So what?: Government support to build stakeholder capacity is important in establishing and maintaining these programmes and would be crucial in achieving change in Australian schools. Investigating feasibility of a national school lunch service would be beneficial, as these programmes may have merit not just in feeding children but also in supporting the local economy. Further research is warranted in this area

Taking the alternative route: Women's experience of intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia

© 2017 Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Objective To compare women’s experience of receiving either intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia. Design A content analysis was undertaken as part of the third phase of a larger randomised controlled trial, using the per-protocol dataset to examine women’s experiences of treatment received. Healthy women birthing at term, who received intranasal fentanyl (n=41), subcutaneous fentanyl (n=37) and/or intramuscular pethidine (n=38) for labour analgesia, were contacted at 6 weeks postpartum to complete a phone questionnaire. Setting A tertiary and regional maternity unit in South Australia. Findings Over 80% of women who received intranasal or subcutaneous fentanyl reported that they would use the treatment again compared to 44.8% of women who had received pethidine (self-administered intranasal fentanyl provided more expressive responses emphasising the route provided a strong sense of control and enablement. Key conclusions Route of administration influenced the women’s experience, more women who self-administered intranasal fentanyl reported positive emotional responses, with women reporting increased autonomy and satisfaction. Whereas, women who relied on the midwife to administer subcutaneous fentanyl or intramuscular pethidine, were more often focused on the physical effect of the drug. Pethidine was the least preferred option due to adverse effects. Implications for practice For women requesting parenteral analgesia, fentanyl administered by less invasive routes offers women additional options that may better meet their emotional, cognitive and physical needs than the current practice of administering intramuscular pethidine

Defective Fas expression exacerbates neurotoxicity in a model of Parkinson's disease

Fas (CD95), a member of the tumor necrosis factor-receptor superfamily, has been studied extensively as a death-inducing receptor in the immune system. However, Fas is also widely expressed in a number of other tissues, including in neurons. Here, we report that defects in the Fas/Fas ligand system unexpectedly render mice highly susceptible to neural degeneration in a model of Parkinson's disease. We found that Fas-deficient lymphoproliferative mice develop a dramatic phenotype resembling clinical Parkinson's disease, characterized by extensive nigrostriatal degeneration accompanied by tremor, hypokinesia, and loss of motor coordination, when treated with the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) at a dose that causes no neural degeneration or behavioral impairment in WT mice. Mice with generalized lymphoproliferative disease, which express a mutated Fas ligand, display an intermediate phenotype between that of lymphoproliferative and WT mice. Moreover, Fas engagement directly protects neuronal cells from MPTP/1-methyl-4-phenylpyridinium ion toxicity in vitro. Our data show that decreased Fas expression renders dopaminergic neurons highly susceptible to degeneration in response to a Parkinson-causing neurotoxin. These findings constitute the first evidence for a neuroprotective role for Fas in vivo