Reducing coronary heart disease in the Australian Coalfields: evaluation of a 10-year community intervention

Coronary heart disease is a leading cause of death in Australia with the Coalfields district of New South Wales having one of the country's highest rates. Identification of the Coalfields epidemic in the 1970's led to the formation of a community awareness program in the late 1980's (the healthy heart support group) followed by a more intense community action program in 1990, the Coalfields Healthy Heartbeat (CHHB). CHHB is a coalition of community members, local government officers, health workers and University researchers. We evaluate the CHHB program, examining both the nature and sustainability of heart health activities undertaken, as well as trends in risk factor levels and rates of coronary events in the Coalfields in comparison with nearby local government areas. Process data reveal difficulties mobilising the community as a whole; activities had to be selected for interested subgroups such as families of heart disease patients, school children, retired people and women concerned with family nutrition and body maintenance. Outcome data show a significantly larger reduction in case fatality for Coalfields men (although nonfatal heart attacks did not decline) while changes in risk factors levels were comparable with surrounding areas. We explain positive responses to the CHHB by schools, heart attack survivors and women interested in body maintenance in terms of the meaning these subgroups find in health promotion discourses based on their embodied experiences. When faced with a threat to one's identity, health discourse suddenly becomes meaningful along with the regimens for health improvement. General public disinterest in heart health promotion is examined in the context of historical patterns of outsiders criticising the lifestyle of miners, an orientation toward communal lather than individual responsibility for health (i.e, community 'owned' emergency services and hospitals) and anger about risks from environmental hazards imposed by industrialists. (C) 1999 Elsevier Science Ltd. All rights reserved.

Use of the web to provide learning support for a large metabolism and nutrition class

To support student learning in a large Metabolism and Nutrition class, we have introduced a web-based package, using a commercially available program, WebCT. The package was developed at a minimal cost and with limited resources. In addition to downloadable (PDF) versions of lecture Powerpoint presentations, tutorial outlines and a practical class exercise, web-based self-directed learning exercises were included to reinforce and extend lecture material in an active learning environment. The web-site also contained a variety of formative and summative assessment tasks that examined both factual recall and higher order thinking Detailed course information, timetables and a bulletin board were also readily accessible. Student usage of the site was generally high, but varied widely between individual students. Students who achieved a high overall score for the course completed on average three times as many formative assessment items and achieved a higher score for all tests than students who did poorly. Student feedback about the site was very positive with the majority of students reporting that the course material and assessment items that were available were useful to their learning. Administration of the course was also facilitated. (C) 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.

Development and current use of parenteral nutrition in critical care - an opinion paper.

Critically ill patients depend on artificial nutrition for the maintenance of their metabolic functions and lean body mass, as well as for limiting underfeeding-related complications. Current guidelines recommend enteral nutrition (EN), possibly within the first 48 hours, as the best way to provide the nutrients and prevent infections. EN may be difficult to realize or may be contraindicated in some patients, such as those presenting anatomic intestinal continuity problems or splanchnic ischemia. A series of contradictory trials regarding the best route and timing for feeding have left the medical community with great uncertainty regarding the place of parenteral nutrition (PN) in critically ill patients. Many of the deleterious effects attributed to PN result from inadequate indications, or from overfeeding. The latter is due firstly to the easier delivery of nutrients by PN compared with EN increasing the risk of overfeeding, and secondly to the use of approximate energy targets, generally based on predictive equations: these equations are static and inaccurate in about 70% of patients. Such high uncertainty about requirements compromises attempts at conducting nutrition trials without indirect calorimetry support because the results cannot be trusted; indeed, both underfeeding and overfeeding are equally deleterious. An individualized therapy is required. A pragmatic approach to feeding is proposed: at first to attempt EN whenever and as early as possible, then to use indirect calorimetry if available, and to monitor delivery and response to feeding, and finally to consider the option of combining EN with PN in case of insufficient EN from day 4 onwards.

A good practice guide for community food initiatives

Food and nutrition are key determinants of health. What people eat, and how much they eat, influences how healthy they are, and even how long they live. Food poverty arises when people lack the money or other resources needed to eat a healthy diet. The overarching objective of Healthy Food for All is to end food poverty on the island of Ireland.

WALK Community Garden

WALK operate a Community Garden in Dublin 12 which promotes the growing of fresh fruit, vegetable, salad leaves and flowers which change seasonally. The garden helps create a sense of community and advocates the benefits of growing healthy food, environmental awareness and sustainability. It offers an opportunities for people to take part in hand-on, activity based learning with some formal training offered to local groups and individuals with varying levels of skill and ability. This outdoor space fosters an interest in growing and guides people in learning new skills which can be transferred to their own gardens or allotments. Dublin City Council Initiative Type Community Food Growing Projects Location Dublin 12 Funding Dublin City Council Partner Agencies Dublin City Council Dublin Mainstream Access Project Scoil Colm

Westside Community Garden

The New Community Garden is a community initiative aiming to promote social inclusion and peoples participation in the community. Initiative Type Community Food Growing Projects Location Galway

Portadown Blossom Surestart Community Food Initiative

A group devised by our families for our families. Southern Trust Initiative Type Nutrition Education and Training Programmes Location Armagh Target Groups Families Funding Southern Trust Partner Agencies Early Years

Kilkenny Allotments and Community Gardens Association

Our aim is to provide affordable sites for growing food across the city of Kilkenny and to provide education to families, individuals and community groups around growing food. Kilkenny Local Authorities Initiative Type Community Food Growing Projects Location Kilkenny Funding Kilkenny Local Authorities Partner Agencies Carlow Kilkenny Leader Partnership Future Proof Kilkenny GIY Kilkenny Local Authorities

Colin Glen Community Gardens and Allotments

This project forms part of Groundwork NIâ?Ts Sharing our Space programme, which aims to transform derelict, unwelcoming & underused sites into shared facilities. Peace III, SEUPB Initiative Type Community Food Growing Projects Location Antrim Funding Peace III, SEUPB Partner Agencies Colin Neighbourhood Partnership

Muck & Magic Community Garden

Sustainable organic vegetables, fruit and herb production for distribution to the participants of the community garden. All Age Groups, throughout the Ballymun community Global Action Plan Initiative Type Community Food Growing Projects Location Dublin 11 Funding Global Action Plan Partner Agencies Ballymun Regeneration Ltd.

Gortin Community Seasonal Eating

Gortin Community Seasonal Eating is based within Owenkillew Development Company in the rural village of Gortin. They are establishing a community garden which will help to develop sustainable living through encouraging growing their own food, developing healthy options which are available locally and educating both providers and consumers in healthy food options. Their aims are to improve access to and availability of healthy food options through community growing and harvesting of fruit and vegetables and eating locally produced and procured ingredients. They will educate parents through targeting both the children and parents of local schools and play/toddler groups. They will use community networking of social media such as facebook, twitter and community newspaper to promote messages and events etc. They will promote awareness of healthy eating and will aim to challenge public policy on food poverty at regional and national levels. Part of theCFI Programme 2013-2015 Initiative Type Community Food Growing Projects Location Tyrone Partner Agencies safefood

Building a Transition Community

Footprints is developing a Transition Community Initiative which will be another distinct area of work within the Healthy Living Project, as part of the group's ongoing endeavours to influence change within the Colin community, tackling health inequalities. The Building a Transition Community Initiative oversees the development of the grounds at Footprints Women's Centre and offers food growing training to local residents who will be encouraged to volunteer in the garden. A local gardener has been hired and oversees the development and training of the volunteers. The project will grow fruit and vegetables within the grounds of Footprints Women's Centre and this produce will be used within the Footprints Catering Services. Any supplies surplus to requirements will be used in schools in the neighbourhood. Skills learned by the volunteers will also be transferred to their gardens at home throughout the Colin neighbourhood. The aim is also to demonstrate how participation in this project will increase and improve the physical activity levels and mental wellbeing of residents. Part of theDemonstration Programme 2010-2012 Initiative Type Community Food Growing Projects Location Antrim Target Groups Women Partner Agencies safefood

Musgrave Park Community Garden

Musgrave Park Community Garden includes a Community Garden Area, Group and Individual allotment plots. Musgrave Park, Stockmans Lane, Belfast, BT9. Conservation Volunteers NI Initiative Type Community Food Growing Projects Location Antrim Funding Conservation Volunteers NI Partner Agencies Public Health Agency

WTID Nutrition and Cooking Classes

In partnership with the VEC WTID has delivered Nutrition Level 5 FETAC to a group of 24 learners, 4 being members of the Travelling community.  This module was also delivered to 5 Childcare staff at WTIDs pre-school service. Staff of the Harmony Afterschool Service undertakes baking activities each week with the children. Group work has been facilitated with 16 men who were on a BTEI on salt, sugar, caffeine and fibre, as well as with a young girls group on food tasting of various fruits, cheeses and how to make healthy potato wedges and other healthy snacks. WTID as part of the local Traveller Interagency Group are writing a well-being manual to be used with community groups working with Travellers- Healthy Eating is a module of this manual. Plans are in place to run a First Instincts Men's Health programme which will run over an 8 week period with workshops, weigh ins and provision of a healthy breakfast on each morning. HSE West; FAS CE scheme; Involve: Senior Youth Worker; Department of Children and Youth Affairs: Childcare Service; Pobal Initiative Type Community Food Centres Nutrition Education and Training Programmes Location Galway Target Groups At risk youth Children ( 4-12 years) Children (0-4 years) Children (13-18 years) Families Lone parents Men Older people People with mental health difficulties Travellers Unemployed Women Funding HSE West; FAS CE scheme; Involve: Senior Youth Worker; Department of Children and Youth Affairs: Childcare Service; Pobal Partner Agencies Equal Ireland FÁS Galway County Council GCCCC GRD HSE Involve RAPID VEC Adult Education Service