ABSTRACT
This paper has two main aims: (1) to describe the design, implementation, and testing of a protocol to assess longitudinal changes in F&V plate waste conducted as part of a quasi-experimental study, (2) to provide baseline descriptive data on school demographics and study participants. This paper describes the protocol development and implementation, and presents baseline data of a longitudinal fruit and vegetable (F&V) plate waste study. The protocol was developed to determine the preliminary impact of Brighter Bites, a 16-week school-based nutrition intervention, on F&V wasted and nutrients wasted from school lunches. We measured plate waste using a quasi-experimental design (n = 2 intervention schools receiving Brighter Bites, n=1 comparison school; n = 115 4th and 5th grade children). We measured plate waste for five days at each of four time points over the 2017-2018 academic year (baseline prior to intervention, three additional time points). Data collectors measured lunch F&V waste using digital scales and recorded weights on a data collection app. This study was conducted in three central Texas public elementary schools serving predominantly low-income families (>89% of children on free/reduced lunch program). On average, at baseline, 59.1% of all F&V were wasted and children tried <1 F&V at meals. Foods most wasted were legumes and foods least wasted were par-fried baked potatoes. Final retention rate across the four time points was 75.70%. Measurement inter-rater reliability was 100% (r = 0.99). Our study presents a protocol for detailed, individual-level, longitudinal plate waste assessment in elementary schools.
ABSTRACT
During April 2009, a novel H1N1 influenza A virus strain was identified in Mexico and the USA. Within weeks the virus had spread globally and the first pandemic of the 21st Century had been declared. It is unlikely to be the last and it is crucial that real lessons are learned from the experience. Asia is considered a hot spot for the emergence of new pathogens including past influenza pandemics. On this occasion while preparing for an avian, highly virulent influenza virus (H5N1 like) originating in Asia in fact the pandemic originated from swine, and was less virulent. This discrepancy between what was planned for and what emerged created its own challenges. The H1N1 pandemic has tested national health-care infrastructures and exposed shortcomings in our preparedness as a region. Key health challenges include communication throughout the region, surge capacity, access to reliable information and access to quality care, health-care worker skills, quality, density and distribution, access to essential medicines and lack of organizational infrastructure for emergency response. Despite years of preparation the public health and clinical research community were not ready to respond and opportunities for an immediate research response were missed. Despite warm words and pledges efforts to engage the international community to ensure equitable sharing of limited resources such as antivirals and vaccines fell short and stockpiles in the main remained in the rich world. This manuscript with authors from across the region describes some of the major challenges faced by Asia in response to the pandemic and draws lessons for the future.
