Participatory Approaches to Understand Dietary Behaviours of Adolescents in the Secondary School Setting.

Acknowledgement of wider socio-ecological factors that influence dietary behaviours needs greater consideration in nutrition research with young people. Additionally, children and adolescents have a right to have their voices heard in research that concerns them. The aim of this methods paper is to describe and evaluate participatory methodologies undertaken as part of a dietary behaviour study with adolescents in the school setting in Ireland. Photovoice and peer-led focus groups were the key participatory methodologies, undertaken alongside food diaries and anthropometry. These methodologies were evaluated through discussion with peer researchers, qualitative surveys and in the context of the wider study process and outcomes. Peer researchers reported learning new skills including research, facilitation, listening and social skills and many felt they gained confidence, as well as an awareness about healthy and unhealthy practices at school. The findings were found to be authentic according to students, except for two limitations. Students believed body image was not adequately represented in the findings, and alternative focus group compositions could have influenced discussion content. Youth participants were afforded genuine opportunities to have their voices heard as part of a diet and nutrition research and the methodologies were acceptable and enjoyable. They demonstrated agency in valuable contributions at project design, data collection, analysis and interpretation stages of the research process. Furthermore, the participatory methodologies complemented quantitative data by providing environmental, behavioural, and socio-cultural insights into food choice in the school setting.

'We know what we should eat but we don't ': a qualitative study in Irish secondary schools.

Healthy eating opportunities for young people need to be provided in the school setting. Links between formal education and local policies and practices, and active involvement of students are emphasized in whole school approaches to health promotion. In many jurisdictions, schools struggle to provide nutritious food that is acceptable to students. The aim of this study was to conduct an in-depth exploration of school food and students' food choice with students, teachers and principals in six Irish secondary schools. Students conducted their own focus groups with peers, and a researcher conducted focus groups with teachers and one-to-one interviews with principals. Students, teachers and principals expressed dissatisfaction with food provision within their respective schools and reported unhealthy dietary behaviours among the student body as the norm. Divergent views, however, emerged regarding education, knowledge and the primary drivers of food choice. Teachers and principals saw a role for more education modules and students believed environmental infrastructures, practices and policies needed to be addressed to improve behaviours. This consultation with students, teachers and principals highlight that, in addition to education, the social and environmental aspects of food choice and eating at school deserve attention in future research and policy.

Put a Frog in Your Mouth: Toothache 'Cures' from Nineteenth- and Twentieth-Century Ireland.

During the late nineteenth and early twentieth centuries, toothache must have been a common complaint in Ireland, to judge from the number of toothache 'cures' reported as part of The Schools' Collection (SC) or 'Bailiúchán na Scol', a folklore-collecting scheme that was undertaken in the Irish Republic in 1937 and 1938, and upon which this article is based. These cures range from quasi-medical treatments, such as packing the affected tooth with tobacco, to more folkloric, or magico-religious cures, such as licking a frog or pulling out a tooth from a corpse, as well as herbal and mineral remedies.

School lunches in the Republic of Ireland: a comparison of the nutritional quality of adolescents' lunches sourced from home or purchased at school or 'out' at local food outlets.

OBJECTIVE: To compare the energy, nutrient and food group compositions of three sources of school-day lunches among students in five secondary schools in the Republic of Ireland (ROI). DESIGN: Cross-sectional study conducted between October 2012 and March 2013. Students completed self-report food diaries over two school days. The energy, nutrient, nutrient density and food group composition of school-day lunches from home, school and 'out' in local food outlets were compared using ANCOVA and Tukey's Honest Significant Difference post hoc analysis. SETTING: Five secondary schools in the ROI. SUBJECTS: Male and female students aged 15-17 years (n 305). RESULTS: Six hundred and fifteen lunches (376 home lunches, 115 school lunches and 124 lunches sourced 'out' in the local environment) were analysed. School and 'out' purchased lunches were significantly higher than packed lunches from home in energy (2047 kJ (489 kcal), 2664 kJ (627 kcal), 1671 kJ (399 kcal), respectively), total fat (23·5 g, 30·1 g, 16·6 g, respectively) and free (added) sugars (12·6 g, 19·3 g, 7·4 g, respectively). More home lunches contained more fruit, wholemeal breads, cheese and red meat than lunches from school or 'out'. Meat products, chips and high-calorie beverages were sourced more frequently at school or 'out' than home. Fibre and micronutrient contents of lunches from all sources were low. CONCLUSIONS: Home-sourced lunches had the healthiest nutritional profile in terms of energy and macronutrients. Foods high in energy, fat and free sugars associated with school and local food outlets are of concern given the public health focus to reduce their consumption. While school food should be improved, all sources of lunches need to be considered when addressing the dietary behaviours of secondary-school students.

Outcomes of comprehensive heart care programs in high-risk women.

OBJECTIVE: The purpose of this study was to improve the fund of knowledge, reduce cardiovascular disease (CVD) risk, and attain Healthy People 2010 objectives among women in model women's heart programs. METHODS: A 6-month pre/post-longitudinal educational intervention of high-risk women (n = 1310) patients at six U.S. women's heart programs consisted of comprehensive heart health counseling and use of American Heart Association/American College of Cardiology (AHA/ACC) Evidence-Based Guidelines as enhancement to usual care delivered via five integrated components: education/awareness, screening/risk assessment, diagnostic testing/treatment, lifestyle modification/rehabilitation, and tracking/evaluation. Demographics, before and after knowledge surveys, clinical diagnoses, laboratory parameters, and Framingham risk scores were also determined. Changes in fund of knowledge, awareness, and risk reduction outcomes and Healthy People 2010 objectives were determined. RESULTS: At 6 months, there were statistically significant improvements in fund of knowledge, risk awareness, and clinical outcomes. Participants attained or exceeded >90% of the Healthy People 2010 objectives. Proportions of participants showing increased knowledge and awareness of CVD as the leading killer of women, of all signs and symptoms of a heart attack, and calling 911 increased significantly (11.1%, 25.4%, and 34.6%, respectively). Health behavior counseling for physical activity, diet, and diabetes as CVD risk factors increased significantly (28.3%, 28.2%, and 12.5%, respectively). There was a statistical 4.1% increase in participants with systolic blood pressure (SBP) <140/90 mm Hg, a 4.7% decrease in participants with total cholesterol (TC) >240 mg/dL, a 4.5% decrease in participants with TC >200 mg/dL, a 5.9% decrease in participants with high-density lipoprotein cholesterol (HDL-C) <50 mg/dL, a 4.4% decrease in participants with HDL-C <40 mg/dL, and an 8.8% increase in diabetics with low-density lipoprotein cholesterol (LDL-C) <100 mg/dL. CONCLUSIONS: CVD prevention built around a comprehensive heart care model program and AHA/ACC Evidence-Based Guidelines can be successful in improving knowledge and awareness, CVD risk factor reduction, and attainment of Healthy People 2010 objectives in high-risk women. Thus, these programs could have a dramatic and lasting impact on the health of women.

Prevalence rates and comparisons of obesity levels in Ireland.

This article compares the prevalence of the overweight and obesity levels in Irish school children aged 4-13 years from data collected by one of the authors in 2007, with data collected from a previous Irish study in 2002 by Whelton et al (2007). Both data sets were analyzed using the International Obesity Taskforce (IOTF) international cut-off points for body mass index (BMI). From the data collected in 2007 the overall prevalence of the overweight was 17.8% and the rate of obesity was 6.8%. The prevalence of the overweight and obese was 24.6%. No correlation was found between gender and BMI, however a positive and significant correlation was observed between age and BMI, indicating that as age increased so too did BMI (R = 0.35, p < 0.001). Comparing results with data from 2002 (Whelton et al, 2007), no statistically significant changes in the proportions of overweight and obese children were observed within this age group in the 5-year period from 2002 to 2007. While the results of our data suggest that rates of being overweight or obese among Irish children in this age group may be stabilizing, larger and preferably longitudinal Irish studies are required if this assertion is to be fully validated in the Irish context.

"The Child's World": a creative and visual trigger to stimulate student enquiry in a problem based learning module.

Despite the abundance of literature on problem based learning (PBL) [Murray, I., Savin-Baden, M., 2000. Staff development in problem-based learning. Teaching in Higher Education 5 (1), 107-126; Johnson, A.K., Tinning, R.S., 2001. Meeting the challenge of problem-based learning: developing the facilitators. Nurse Education Today 21 (3), 161-169; McCourt, C., Thomas, G., 2001. Evaluation of a problem based curriculum in midwifery. Midwifery 17 (4), 323-331; Cooke, M., Moyle, K., 2002. Students' evaluation of problem-based learning. Nurse Education Today 22, 330-339; Haith-Cooper, M., 2003a. An exploration of tutors' experiences of facilitating problem-based learning. Part 1--an educational research methodology combining innovation and philosophical tradition. Nurse Education Today 23, 58-64; Haith-Cooper, M., 2003b. An exploration of tutor' experiences of facilitating problem-based learning. Part 2--implications for the facilitation of problem based learning. Nurse Education Today 23, 65-75; Rowan, C.J., Mc Court, C., Beake, S., 2007. Problem based learning in midwifery--The teacher's perspective. Nurse Education Today 27, 131-138; Rowan, C.J., Mc Court, C., Beake, S., 2008. Problem based learning in midwifery--The students' perspective. Nurse Education Today 28, 93-99] few studies focus on describing "triggers", the process involved in their development and their evaluation from students' perspective. It is clearly documented that well designed, open ended, real life and challenging "triggers" are key to the success of PBL implementation [Roberts, D., Ousey, K., 2004. Problem based learning: developing the triggers. Experiences from a first wave site. Nurse Education in Practice 4, 154-158, Gibson, I., 2005. Designing projects for learning. In: Barrett, T., Mac Labhrainn, I., Fallon, H., (Eds.), Handbook of Enquiry and Problem-based Learning: Irish Case Studies and International Perspectives. AISHE & CELT: NUI Galway. , Barrett, T., 2005. Understanding problem-based learning. In: Barrett, T. Mac Labhrainn, I., Fallon, H., (Eds.), Handbook of Enquiry and Problem-based Learning: Irish Case Studies and International Perspectives. AISHE & CELT, NUI Galway. ]. This paper outlines the planning, implementation and evaluation of a "trigger" developed for a first year undergraduate nursing module. To meet specific module learning outcomes and to stimulate student inquiry through the learning strategy of PBL, a bright and colourful collage, was constructed. This tool was then evaluated using focus group interviews. Students' perspectives centered round a core theme, 'finding a focus and taking control'. Four categories were identified illustrating students progress from 'initial confusion' to engaging with the 'trigger diversity' before confidently 'exploring their own line of inquiry', thus leading to the 'stimulation of their learning'. Consistent with previous research, we also suggest it is customary for students to experience an initial period of ambiguity as they switch from teacher led to student centered learning [Biley, F., 1999. Creating tension: under graduate students nurses' response to a problem-based learning curriculum. Nurse Education Today 19 (7), 586-589]. One challenge in developing "triggers" is that the process is primarily controlled by lecturers. We suggest that a possible way forward would be to also engage students in the development of "triggers".

Education for asthma care: lessons from Ireland.

Despite the increase in prevalence of asthma among children and the importance of appropriate professional training in asthma management, no programme of study in children's asthma care was available to nurses in Ireland. A professional development module was designed to meet the education needs of nurses caring for children with asthma and their families. The module has theoretical and practical elements that are reflected in both module delivery and assessment. It was evaluated using a Likert scale questionnaire and focus group interviews with 15 students. The results indicate a high degree of student satisfaction with the module. Students reported changes in practice as a result of greater confidence, increased knowledge and improved skills. Future evaluation should include the ongoing impact on practice as well as the perspectives of service users and managers.