Search

Schools are recognized as important locales for education and action to change food-related environmental and health behaviours. Research shows the potential for a whole school systems approach to integrate educational activities, food in school, and wider food-related interactions. However, little attention has been given to how theory is put into practice in terms of reforming school food practices in the everyday routines and commitments of schooling. This study aimed to identify how school practitioners operationalise whole systems approaches. The context was an exchange programme involving schools and national school food non-governmental organisations in England, Denmark, and the Czech Republic. Using case study design, the research involved school practitioner interviews and critical group reflection. Participants adopted perspectives and identified actions to create solutions in real-world practice settings, such as themes around, 'persistence, passion and belief'; 'bending the rules' 'supportive, respectful, and united teams'; 'having a holistic vision', 'resistance', and 'making-do'. Drawing upon a conceptual framework concerned with taking an integrated approach, we suggest that these 'everyday practices' have a critical role in food systems reform in schools.

If people want to be healthy they need to eat. However, food poverty (the inability to afford or access food to make up a healthy diet) is just one of the consequences of climate change. For many children in UK schools, food poverty is their everyday experience. The UK's food poverty rate is suggested to be among the highest in Europe; despite the UK being the sixth richest country in the world, millions are struggling to access the food they need. In this article, the authors describe how education is the key to leaving food poverty behind.

Global food security and sustainability, animal welfare, dietary health, and socially just relations of food production have become prominent societal issues. They are of particular concern for young people as their lives progress towards becoming independent consumers and citizens with the capacity to shape food systems of the future. This paper examined the role of the Food for Life Partnership programme in promoting young people's engagement with food-related citizenship education in secondary schools. The research consisted of a two stage study of 24 English schools. We surveyed experiences and attitudes of students and staff, and recorded programme activities. The results presented a mixed picture. Staff reports and monitoring evidence showed much successful implementation of programme activities across the whole school. However, there was less evidence of positive student behavioral change. Amongst a range of possibilities to account for the findings, one explanation is the organizational challenges of delivering a complex and ambitious programme in the secondary school setting. This suggests the need to develop food citizenship programmes that combine long term institutional reforms alongside focused interventions with specific groups of students. It also highlights the case for ensuring a place for food related citizenship on the educational policy agenda.

Purpose: The quality of voluntary sector-led community health programmes is an important concern for service users, providers and commissioners. Research on the fidelity of programme implementation offers a basis for assessing and further enhancing practice. The purpose of this paper is to report on the fidelity assessment of Living Well Taking Control (LWTC)--a voluntary sector-led, community-based education programme in England focussing on the prevention and management of type 2 diabetes. Design/methodology/approach: This fidelity of implementation (FoI) study was conducted with the Devon-based LWTC programme. A fidelity checklist was developed to analyse audio records of group-based lifestyle education sessions--implementation was rated in terms of adherence to protocol and competence in delivery; the influence of wider contextual factors was also assessed. Kappa statistics (?) were used to test for inter-rater agreement. Course satisfaction data were used as a supplementary indicator of facilitator competence. Findings: Analysis of 28 sessions, from five diabetes prevention and two diabetes management groups (total participants, n = 49), yielded an overall implementation fidelity score of 77.3 per cent for adherence (moderate inter-rater agreement, ? = 0.60) and 95.1 per cent for competence (good inter-rater agreement, ? = 0.71). The diabetes prevention groups consistently achieved higher adherence scores than the diabetes management groups. Facilitator competence was supported by high participant satisfaction ratings. Originality/value: An appropriate level of implementation fidelity was delivered for the LWTC group-based education programme, which provides some confidence that outcomes from the programme reflected intervention effectiveness. This study demonstrates the viability of assessing the FoI in a voluntary sector-led public health initiative and the potential of this method for assuring quality and informing service development.

Microgrant schemes are used in many contexts relevant to community development, but there are few detailed accounts of their operation and effects. This study explored a four-year microgrant scheme in Bristol, UK. The research analyzed 141 awards and collected qualitative and quantitative data on 233 individuals. The research found that the diversity of activities, local embeddedness, skills and capacity development, social connection and volunteering features of the scheme offered routes to community development goals. Microgrant schemes are likely to benefit from designated staff to conduct outreach work, facilitate stakeholder engagement, and provide ongoing support. Coordination with other community development activities enhanced the scheme's impact while weaknesses in local infrastructure, caused by funding cuts, impeded delivery. Microgrant schemes should be understood as an intervention that complements and works alongside other community development activities. To enhance their role in community development, attention needs to be paid to scheme design, implementation and integration. [ABSTRACT FROM AUTHOR]

Breastfeeding rates in the UK remain persistently low, with a rapid fall off during the first 6–8 weeks. The work of healthcare and public health practitioners impacts on mothers' experiences of infant feeding. Support, promotion and protection of breastfeeding are a national priority. Semi-structured qualitative interviews were undertaken with mothers who had experience of breastfeeding. Participants were engaged with a local Children's Centre (indicating engagement with public health provision) and their babies were up to 6-month old (to increase recall of early experiences). Twenty-four participants were recruited and interviews thematically analysed. Mothers identified matters significant in relation to public health provision for breastfeeding, including three stages of time of significance for breastfeeding impact. These interlinked critical stages impact on a mother's experiences. Joined up public health practice providing breastfeeding support and information before birth, around the time of the birth, and once home is significant in mother's accounts. Breastfeeding support, in both healthcare and public health contexts, needs to be highly attuned to different stages in the experiences of mothers. Breastfeeding continuation is influenced by support experienced antenatally, perinatally, and in early weeks. To enhance the initiation and retention of breastfeeding, public health practice must pay attention to these stages. Breastfeeding support needs to begin prior to birth and be given throughout the postnatal period and beyond. [ABSTRACT FROM AUTHOR]

BackgroundLow back pain (LBP) is the leading cause of years lived with disability worldwide. Most people with LBP receive the diagnosis of nonspecific LBP or sciatica. Medications are commonly prescribed but have limited analgesic effects and are associated with adverse events. A novel treatment approach is to target neurotrophins such as nerve growth factor (NGF) to reduce pain intensity. NGF inhibitors have been tested in some randomized controlled trials (RCTs) in recent years, showing promise for the treatment of chronic LBP; however, their efficacy and safety need to be evaluated to guide regulatory actions. ObjectiveThe aim of this study is to evaluate the efficacy and safety of medicines targeting neurotrophins in patients with LBP and sciatica. MethodsIn this systematic review, we will include published and unpublished records of parallel RCTs and the first phase of crossover RCTs that compare the effects of medicines targeting neurotrophins with any control group. We will search the CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, EU Clinical Trials Register, and WHO International Clinical Registry Platform databases from inception. Pairs of authors will independently screen the records for eligibility, and we will independently extract data in duplicate. We will conduct a quantitative synthesis (meta-analysis) with the studies that report sufficient data and compare the medicines of interest versus placebo. We will use random-effects models and calculate estimates of effects and heterogeneity for each outcome. We will assess the risk of bias for each study using the Cochrane Collaboration tool, and form judgments of confidence in the evidence according to GRADE recommendations. We will use the PRISMA statement to report the findings. We plan to conduct subgroup analyses by condition, type of medication, and time point. We will also assess the impact of a potential new trial on an existing meta-analysis. Data from studies that meet inclusion criteria but cannot be included in the meta-analysis will be reported narratively. ResultsThe protocol was registered on the Open Science Framework on May 19, 2020. As of December 2020, we have identified 1932 records. ConclusionsThis systematic review and meta-analysis will assess the evidence for the efficacy and safety of NGF inhibitors for pain in patients with nonspecific LBP and sciatica. The inclusion of new studies and unpublished data may improve the precision of the effect estimates and guide regulatory actions of the medications for LBP and sciatica. Trial RegistrationOpen Science Framework; https://osf.io/b8adn/ International Registered Report Identifier (IRRID)DERR1-10.2196/22905