Search

Purpose: The healthcare sector is an important area for sustainable food initiatives, given its inherent mission to heal and its substantial impact on the food system. Foodservice managers can take part in these initiatives by using sustainable menu practices (SMPs). This study aimed to explore managerial perceptions of barriers and facilitators to adopting SMPs in Québec healthcare institutions. Methods: Seventeen foodservice managers were recruited through purposeful sampling to participate in a qualitative semi-structured interview. The Diffusion of Innovations theory was used to assess the main determinants of the diffusion of an innovation (SMPs) through a complex social system (healthcare organization). Results: Participants reported more barriers than facilitators. Lack of support at many levels was recognized as a major hindrance to SMP adoption, as were shortfalls in political directives. Increased collaboration between all food system actors and better communication in healthcare were perceived as needed for increased SMP adoption. Conclusions: This research contributes to an in-depth understanding of managerial experiences in SMP adoption in various regional and healthcare settings. Findings suggest the need for support and strategies that would remove important barriers for foodservice managers and contributed to the development of a guide to support foodservice managers in implementing SMPs.

Cardiac ATP-sensitive K

Fossil frogs of North America have been reviewed by Holman (2003), and records from the middle and late Miocene of North America are relatively numerous. Nonetheless, frog fossils from the late Miocene Clarendonian North American Land Mammal Age time period (ca. 12.5-9 Ma) are rare and biogeographically poorly represented. There is a single record of a bufonid from the Clarendonian Land Mammal Age (LMA) of South Dakota (Holman, 1973), but most of our knowledge of Clarendonian LMA frogs comes from a single local fauna, the Wakeeney Lo cal Fauna (L.F.) of Kansas (Wilson, 1968; Holman, 1975, 2003). In this report we describe an important collection of middle to late Clarendonian (ca. 11-9 Ma; time scale of Woodburne, 2004) frog fossils recovered from the Whisenhunt Quarry fossil site of Beaver County, Oklahoma. The mammals of the Whisenhunt Quarry fossil site have been discussed previously by Dalquest et al. (1996) and, to a lesser degree, by Smith (2005). The Whisen hunt Quarry frogs represent the first lower vertebrates reported from the local fauna, but more importantly they provide new and noteworthy information that improves our knowledge about the diversity and distribution of North American midcontinental frogs from this time period. Fossil Locality?The Whisenhunt Quarry fossil site is located approximately 10 km south of Gate, Beaver County, Oklahoma, in the Laverne Formation at T3N, R28E, Sec. 9, SE 1/4, NW 1/4 (Dalquest et al., 1996; see Fig. 4 for the general location of the site). Late Miocene mammals from this Great Plains formation have been known to science since at least the late 19th century (see discussion in Tedford et al, 2004). Fossils from the Whisen hunt Quarry site were obtained by Dalquest et al. (1996) by pro cessing matrix collected at the quarry in the early 1990s. The ma terial was derived from a stratum of sand and diatomaceous clay, which they (Dalquest et al., 1996:133) believed represented an ancient "still-water pool or lake in a marsh or swamp." No ra diometric date (numerical date) is available for the Whisenhunt Quarry, but on the basis of a detailed study of the Whisenhunt Quarry mammals, Dalquest et al. (1996) assigned the local fauna a biochronological age of middle to late Clarendonian LMA. They suggested that the Whisenhunt Quarry L.F. best correlated with the well-documented late Clarendonian Wakeeney L.F. of Kansas. On the basis of megaand micromammal components of the Whisenhunt Quarry and mammals from other nearby Lav erne Formation sites, Tedford et al. (2004) suggested a medial Clarendonian age for the local fauna.

The Pratt Slide fossil site of Brown County, Nebraska, has yielded the largest and most diverse Clarendonian North American Land Mammal Age (late Miocene; approximately 10.5-9.5 Ma) snake fauna thus far known. The overall composition of the snake fauna consists of extinct taxa from older Miocene times, temporally isolated taxa, and modern taxa. More specifically, the fauna includes at least two extinct erycine boids, 14 colubrids of which five genera are extinct, and possibly three extant viperid genera. The fossil site yielded additional evidence (three vertebrae) of the unique late Clarendonian erycine Tregophis brevirachis and vertebrae of a new distinctive tiny natricine colubrid. Additional vertebrae of a Paleoheterodon-Heterodon snake(s) further support the suggestions by others that these two xenodontine colubrids are indistinguishable at the vertebral level. Overall, the composition of the Pratt Slide snake fauna provides supportive evidence of a North American late Miocene transition from an archaic to a modern snake fauna with most of the modernization taking place during Clarendonian to Hemphillian time (approximately 10-6 Ma).

This paper describes the experiences of volunteers who have been trained to deliver the Stanford Chronic Disease Self-Management Program course. In Queensland, Australia, Leaders usually work in pairs (a Health Professional Leader (HPL) and a Peer Leader (PL)). Qualitative data were collected to explore volunteers' experiences as Leaders and their opinions about working together to deliver self-management courses. The data were collected from September 2005 to December 2005. In-depth, semistructured telephone interviews were conducted with a purposive sample of 34 Leaders (17 PL, 17 HPLs). Thematic analysis revealed two core themes that described Leaders' perceptions and experiences of working relationships between HPLs and PLs: (i) The Value of Working Together and (2) Relationship Tensions. Both HPLs and PLs believed that working together represented 'the best of both worlds' and that the combination of peers and health professionals enhanced the sustainability of the approach. However, a number of tensions were revealed that undermined the development and sustainability of these working relationships. From HPLs' perspective, the benefits of working with volunteer PLs did not always justify the 'burden'. Finding the 'right person' for the PL role was difficult and a higher value was often placed on the contribution of professionals. The tensions that were most prominent for PLs were grounded in the disparity between their status and that of HPLs, their lack of ownership over courses coupled with lack of a strong voice in the co-Leader relationship, and the absence of connection and engagement among Leaders. Working relationships between HPLs and PLs have potential to deliver positive outcomes for people with chronic disease, but the current study has highlighted the necessity of developing a culture of mutual respect and a system that values both forms of knowledge and expertise (i.e. experiential and professional).

This study obtained input from Australian student smokers approximately 15 years old, which may be useful in designing school-based smoking cessation programs. The sample was analyzed by previous quitting experience and intentions to quit. The order of preference for assistance options and incentives for quitting was similar across all groups; however, those who previously attempted to quit (previous quitters) and those who intended to quit (intenders) in the future were significantly more likely than non-quitters and non-intenders to find assistance options for quitting acceptable. The potential for saving money emerged as an important variable in convincing all groups of smokers not to smoke, and using personal willpower and cutting down slowly were identified as important in actual attempts to quit. The need for programs to be free and for friends to be supportive also was evident across all groups.

The Ottawa Charter for Health Promotion supported the empowerment of individuals to participate in their health care and have control over their health. For older adults with chronic conditions, the Chronic Disease Self-Management Program has been widely adopted as an adjunct to existing healthcare options. A growing body of literature has supported the positive impact of self-management programs on outcomes for people with a range of chronic conditions. However, evidence also suggests that participation in these programs is biased. This paper draws on pilot data to describe the profile of those people who inquire, enrol, attend, and complete CDSM courses in Queensland, Australia. As expected, there was evidence that males, Indigenous people, people of non-English speaking background, and those with multiple responsibilities were less likely to participate. Most importantly, participation was affected by a self-selection bias associated with health status. Those who were either unwell or well at the time of the course were unlikely to attend, minimising the preventative value of the CDSM program. Further, CDSM evaluation studies are likely to be inherently flawed and the distribution of health resources can become inequitable.