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There is paucity of data assessing levels of food/beverage waste in long-term care (LTC) facilities, especially in Ontario. Observations in the Veteran's Centre (VC) at Sunnybrook Health Sciences Centre (Sunnybrook) indicated food/beverage waste may be high, potentially impacting sustainability efforts within our institution. Before proceeding with waste reduction efforts, we conducted a comprehensive 3-day waste-audit of food/beverage items provided to VC residents with the goal of understanding the extent of food/beverage waste at VC, items wasted, and any other factors that may inform future changes. Our results indicate that 28% of items served to residents were wasted. Lunch was the meal with greatest waste at 31% and waste of solid items was 12% higher than that of liquids. We observed a large variability in waste between residents and within each resident, with 15% of residents wasting >50% of items provided. This study provides a deeper insight into the magnitude of food/beverage waste in a LTC population and highlights the importance of considering individualized strategies to address waste to avoid negative impact on residents.

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Introduction. In 2022, the World Health Organization (WHO) predicted that climate change would cause thousands of additional deaths per year from malnutrition, malaria, diarrhea, and heat stress alone between the years of 2030 and 2050. With such health consequences and environmental changes, climate change is impacting human occupations globally. However, there is a gap in the literature regarding the occupational therapists' role in climate change, particularly in the Canadian context. Objectives. Our research aimed to explore what is the perceived role of occupational therapists in climate change and climate action from the perspective of Canadian occupational therapists and international experts. Methods. This qualitative study used interpretive description methodology. We recruited 12 occupational therapists, including 4 research experts in the field. We conducted semi-structured interviews with each participant. Data were analyzed thematically. Results. This study uncovered three themes that focused on the complex interconnections between climate challenges and climate actions that occupational therapists are wrestling with personally, clinically, and professionally. Specifically, this study emphasized the importance of supporting individual occupational therapists with their personal challenges, integrating climate actions into clinical practices, and incorporating climate change and climate justice into occupational therapy curricula and professional advocacy. Conclusions. The environment, including the planet's ecosystem, is a fundamental component in many models of occupational therapy practice. This research provides a rich understanding in the themes of occupational therapists' perceptions of climate change and climate actions, particularly within a Canadian context.

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The healthcare system and the practice of health care have unprecedented impacts on our environment. High carbon footprint, pollution and its consequences on health, the picture is not glorious. Even if they rarely identify themselves as such, healthcare professionals are key actors in the drive towards more sustainable practices. Their numbers, skills and activities give them privileged access to the population, communities and individuals of all ages and backgrounds. Thanks to their increasingly specialized training, they are in a position to accompany people on their health journey, prevent illness and promote healthy behaviours. These aspects are central to sustainability in healthcare.

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Background. Many occupational therapists make home modification recommendations; however, it is unknown if sustainability considerations (i.e., economic, social, and environmental) are contemplated during this process. Purpose. To understand occupational therapists' perceptions regarding the sustainability of home modifications. Method. This study adopted a qualitative description approach. Researchers utilized semistructured interviews as the primary means of data collection. Findings. The ten female occupational therapists interviewed had three or more years of experience working with home modifications. The analysis identified three themes: It's not easy being green: environmental sustainability, stretching a dollar: financial inequities, and barriers and benefits in the home modification process. Implications. Findings suggest OTs have a varied and a general understanding of how to implement sustainability concepts in their practice. There is also a need to make access to home modifications more equitable. Further research is needed to build a more robust understanding of how OT recommended home modifications can contribute to sustainability.

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INTRODUCTION: A large variety of pet feeds is commercially available for pet herbivores; these feeds may differ in nutrient composition from the natural diet, and may trigger different feeding behaviours than observed in natural habitats. Here, we surveyed literature on the natural diet and activity budget of rabbits (Oryctolagus cuniculus), guinea pigs (Cavia porcellus), chinchilla (Chinchilla lanigera) and degus (Octodon degus), as well as 260 compound feeds commercially available for these species between 1982 and 2020. The species are classified as herbivores, with available data on natural diets suggesting a crude fibre (CF) level of approximately 250 g/kg dry matter (DM), natural feeding activity at a magnitude of 4-7 h per day, with distinctively shorter feeding when fed on compound pet feeds. Only for a minority of feeds did the first 5 listed ingredients not include a starchy ingredient, or only ingredients not considered suitable for human consumption. The percentage of feeds whose CF level was less than 150 g/kg DM was 22 % for production rabbits, 18 % for pet rabbits, 26 % for guinea pigs, 18 % for chinchillas and 14 % for degus; in other words, a majority of currently marketed products have CF levels in accord with published recommendations, even if that means a discrepancy to natural diets. Screening the producers' feeding instructions suggests they should generally not be followed uncritically. No temporal trends in the CF levels of these diets was evident. There is no consensus whether only products resembling natural diet items should be included in pet feeds, or whether vegetable byproducts not edible by humans should also be included. The observed practice of pet feed composition largely did not follow either concept, questioning the general rationale of pet feed composition. Whole forage like hay is recommended as the main diet component for these species, and 76 % of pet feed products noted that hay should be fed in the feeding instructions.

INTRODUCTION: Une grande variété d'aliments pour animaux de compagnie est disponible dans le commerce pour les herbivores de compagnie; ces aliments peuvent différer du régime naturel dans leur composition en nutriments et peuvent déclencher des comportements alimentaires différents de ceux observés dans les habitats naturels. Nous avons étudié la littérature sur le régime alimentaire naturel et le budget d'activité des lapins (Oryctolagus cuniculus), des cochons d'Inde (Cavia porcellus), des chinchillas (Chinchilla lanigera) et des dégus (Octodon degus), ainsi que 260 aliments composés disponibles dans le commerce pour ces espèces entre 1982 et 2020. Les espèces sont classées comme herbivores et les données disponibles sur leurs régimes alimentaires naturels suggèrent une teneur en fibres brutes (FB) d'environ 250 g/kg de matière sèche (MS), une activité alimentaire naturelle de l'ordre de 4 à 7 heures par jour, avec une durée d'alimentation nettement plus courte lorsque l'animal est nourri avec des aliments composés pour animaux de compagnie. Ce n'est que pour une minorité d'aliments que les cinq premiers ingrédients énumérés ne comprenaient pas d'ingrédient amylacé, ou seulement des ingrédients considérés comme impropres à la consommation humaine. Le pourcentage d'aliments dont la teneur en FB était inférieure à 150 g/kg MS était de 22 % pour les lapins de production, 18 % pour les lapins de compagnie, 26 % pour les cochons d'Inde, 18 % pour les chinchillas et 14 % pour les dégus ; en d'autres termes, la majorité des produits actuellement commercialisés ont des teneurs en FB conformes aux recommandations publiées, même si cela signifie une divergence par rapport aux régimes naturels. L'examen des instructions d'alimentation des producteurs suggère qu'elles ne doivent généralement pas être suivies sans discernement. Aucune évolution temporelle dans les teneurs en FB de ces régimes n'a été mise en évidence. Il n'y a pas de consensus sur la question de savoir si seuls les produits ressemblant à des aliments naturels doivent être inclus dans les aliments pour animaux de compagnie ou si des sous-produits végétaux non comestibles pour l'homme doivent également être inclus. La pratique observée en matière de composition des aliments pour animaux de compagnie n'a en grande partie respecté aucun de ces deux concepts, ce qui remet en question la logique générale de la composition de ces aliments. Les fourrages entiers, comme le foin, sont recommandés comme principale composante de l'alimentation de ces espèces et 76 % des produits alimentaires pour animaux de compagnie indiquent, dans les instructions d'alimentation, que du foin doit être donné.

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BACKGROUND: Transcatheter aortic valve replacement is an established treatment for high- or intermediate-risk patients with symptomatic aortic valve stenosis. As more low-risk patients are being treated, transcatheter heart valve durability is gaining importance. Data on structural valve deterioration beyond 8 years after transcatheter aortic valve replacement is limited. AIM: To evaluate the outcomes of transcatheter aortic valve replacement in high-risk patients with a follow-up of ≥10 years, focusing on survival and structural valve deterioration, according to the European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology/European Association for Cardio-Thoracic Surgery definitions. METHODS: Only patients with a follow-up of ≥ 10 years were included in this study (n=510). Using serial echocardiographic data, the cumulative incidences of structural valve deterioration and bioprosthetic valve failure were analysed. Receiver operating characteristic analysis was used for predictor assessment. RESULTS: Mean age was 79.6±6.7 years, with a mean logistic EuroSCORE of 19.8±12.7%. Immediate procedural mortality was 2.9%, and 30-day mortality was 7.8%. Kaplan-Meier-estimated survival at 10 years was 10.3±1.5%. At 10 years, the cumulative incidences of severe and moderate structural valve deterioration were 4.3% and 13%, respectively, for the total population. The cumulative incidence of bioprosthetic valve failure at 10 years was 9.0%. There was a significant difference in the rates of structural valve deterioration and bioprosthetic valve failure depending on valve type: structural valve deterioration, SAPIEN 8.9% vs CoreValve 2.2% at 10 years (P=0.001); bioprosthetic valve failure, SAPIEN 13.9% vs CoreValve 6.7% at 10 years (P=0.021). CONCLUSIONS: Structural valve deterioration and bioprosthetic valve failure of early transcatheter heart valves was low at 10 years. The identified differences between valve types must be validated using current-generation devices in younger patients.

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Current food systems drive environmental damage, social injustices, and undermine health, and these challenges are complex and seemingly intractable. Collaboration is required to transition to more sustainable food systems (SFS). Registered Dietitians and Nutritionists (RDs) are an under-leveraged and well-positioned group to contribute to addressing food systems challenges because of their locations in the system and their existing skillsets. Drawing on research with dietitians, this perspective paper presents both a theoretical proposal as well as collective expertise in supporting sustainable development of the global food system. It highlights where RDs work in food systems with the aim to reveal multiple points of entry where RDs can and do contribute to SFS across food systems, approaches to apply, as well as opportunities for collaboration within and beyond the profession. Educational and societal barriers exist that prevent systematic RD engagement; however, examples of established work provide models to follow.

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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.

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Resumo Este estudo apresenta uma análise semântica do termo sustentabilidade, procurando identificar se seria possível extrair do seu uso estratégico um projeto social. Parte-se da hipótese de que existe uma vacuidade conceitual em seu uso, de modo que suas projeções semânticas não são suficientes para estruturá-lo como conceito organizador de processos sociais compatíveis. Sob o enfoque deste trabalho, o termo sustentabilidade se constituiria no interior da atividade psicológica imanente ao sujeito, que busca interpretar seu mundo e explicar suas ordens de conservação e transformação. O método da pesquisa envolve a construção de um sistema de interpretação do termo sustentabilidade que designa forças semânticas presentes no seu emprego. Observou-se que não é possível extrair do seu uso um conceito de organização social, mas de construções teóricas transformacionistas que se impõem como necessidades lógicas com resignado apelo às referências tecnocientíficas e, ao mesmo tempo, como elemento intersubjetivo regulador de processos socioambientais não revolucionários.

Abstract This study presents a semantic analysis of the term 'sustainability,' seeking to identify whether one could draw a social project from its use. Assuming the existence of a conceptual vacuity in its use, its semantic projections would be insufficient to structure 'sustainability' as an organizing concept of compatible social processes. Hence, sustainability would be constituted within the psychological activity immanent to the historical subject that seeks to interpret their world and explain its preservation and transformation. The research method involved constructing a system of interpretation to designate the semantic forces present when the term is employed. It is not possible to extract a concept of social organization from its use, only transformational theoretical constructions that impose themselves as logical needs that appeal to technoscientific references, as well as a regulating intersubjective element of non-revolutionary socio-environmental processes.

Resumen Este estudio presenta un análisis semántico del término sostenibilidad, buscando identificar si es posible extraer un proyecto social de su uso estratégico. Se parte de la hipótesis de que existe un vacío conceptual en el uso de este término, una vez que sus proyecciones semánticas no son suficientes para estructurarlo como un concepto organizador de procesos sociales compatibles. Bajo el enfoque de este trabajo, el término sostenibilidad se constituiría a través de la actividad psicológica del sujeto que busca interpretar el mundo y explicar sus órdenes de conservación y transformación. El método de investigación implica la construcción de un sistema de interpretación de este término que designa las fuerzas semánticas presentes en su uso. Se observó que no es posible extraer de su uso un concepto de organización social, sino construcciones teóricas transformacionalistas que se imponen como necesidades lógicas con apelación a referencias tecnocientíficas, al mismo tiempo como elemento intersubjetivo de procesos socioambientales no revolucionarios.

Résumé Cette étude présent une analyse sémantique du terme « durabilité ¼, cherchant à identifier s'il est possible d'extraire de son utilisation un projet social. On suppose qu'il existe une vacuité conceptuelle dans son usage, de sorte que ses projections sémantiques ne sont pas suffisant pour le structurer en tant que concept organisateur de processus sociaux compatibles. Ici, le terme « durabilité ¼ se constituerait au sein de l'activité psychologique immanente au sujet qui cherche à interpréter son monde et à expliquer ses ordres de conservation et de transformation. La méthode de recherche implique la construction d'un système d'interprétation du terme qui désigne les forces sémantiques présentes dans son emploi. On a observé qu'il est impossible d'extraire de son utilisation un concept d'organisation sociale, juste des constructions théoriques transformationnelles qui s'imposent comme des besoins logiques, ainsi qu'un élément intersubjectif régulateur de processus socio-environnementaux non révolutionnaires.

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The word given to the teams, caregivers and patients who, in the field, carry out reflections and initiatives in favor of sustainable development reflects their commitment. It is an educational and institutional challenge and a strong individual and collective awareness that is expressed.

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The world's population is expected to grow to almost 10 billion by 2050, placing unprecedented demands on agriculture and natural resources. The risk in food security is also aggravated by climate change and land degradation, which compromise agricultural productivity. In recent years, our understanding of the role of microbial communities on ecosystem functioning, including plant-associated microbes, has advanced considerably. Yet, translating this knowledge into practical agricultural technologies is challenged by the intrinsic complexity of agroecosystems. Here, we review current strategies for plant microbiome manipulation, classifying them into three main pillars: (i) introducing and engineering microbiomes, (ii) breeding and engineering the host plant, and (iii) selecting agricultural practices that enhance resident soil and plant-associated microbial communities. In each of these areas, we analyze current trends in research, as well as research priorities and future perspectives.

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Until recently, transcatheter aortic valve implantation was restricted to high-risk and inoperable patients. The updated 2017 European Society of Cardiology Guidelines has widened the indication to include intermediate-risk patients, based on two recently published trials (PARTNER 2 and SURTAVI). Moreover, two other recent trials (PARTNER 3 and EVOLUT LOW RISK) have demonstrated similar results with transcatheter aortic valve implantation in low-risk patients. Thus, extension of transcatheter aortic valve implantation to younger patients, who are currently treated by surgical aortic valve replacement, raises the crucial question of bioprosthesis durability. In this translational review, we propose to produce a state-of-the-art overview of the durability of transcatheter aortic valve implantation by integrating knowledge of the basic science of bioprosthesis degeneration (pathophysiology and biomarkers). After summarising the new definition of structural valve deterioration, we will present what is known about the pathophysiology of aortic stenosis and bioprosthesis degeneration. Next, we will consider how to identify a population at risk of early degeneration, and how basic science with the help of biomarkers could identify and predict structural valve deterioration. Finally, we will present data on the differences in durability of transcatheter aortic valve implantation compared with surgical aortic valve replacement.

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Quality improvement initiatives in neonatology have yielded positive results; however, few programs have demonstrated sustainability. We evaluated an ongoing, national quality improvement initiative (Evidence-based Practice for Improving Quality Phase 3 (EPIQ-3)) on outcomes of preterm neonates with a gestational age (GA) of 220-286 weeks (i.e., from 22 weeks and 0 days of gestation to 28 weeks and 6 days of gestation). Data from 7459 neonates admitted to 25 Canadian centers between 2013 and 2017 were studied. Trends in mortality and major morbidities were evaluated. The number of neonates with a GA of 220-236 weeks increased from 90 in 2013 to 139 in 2017 without a significant change in any other GA categories. In the entire cohort, the odds of composite outcome of mortality or any major morbidity (adjusted odds ratio (AOR) 0.72, 95% confidence interval (CI) 0.61-0.84) and of necrotizing enterocolitis (AOR 0.66, 95% CI 0.49-0.89) were lower in 2017 than in 2013. When calculated per year, the odds of composite outcome (AOR 0.93, 95% CI 0.89-0.97) and odds of necrotizing enterocolitis (AOR 0.89, 95% CI 0.82-0.96) decreased significantly. Among the subgroup of neonates with a GA of 260-286 weeks, the odds of composite outcome (AOR 0.63, 95% CI 0.51-0.79), necrotizing enterocolitis (AOR 0.44, 95% CI 0.26-0.73), and nosocomial infection (AOR 0.64, 95% CI 0.49-0.84) were reduced. The collaborative, multidisciplinary, nationwide EPIQ-3 program improved outcomes of preterm neonates, and the improvement was sustainable over 5 years.

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Biosurfactants are important in many areas; however, costs impede large-scale production. This work aimed to develop a global sustainable strategy for the production of biosurfactants by a novel strain of Bacillus amyloliquefaciens. Initially, Bacillus sp. strain 0G was renamed B. amyloliquefaciens subsp. plantarum (syn. Bacillus velezensis) after analysis of the gyrA and gyrB DNA sequences. Growth in modified Landy's medium produced 3 main recoverable metabolites: surfactin, fengycin, and acetoin, which promote plant growth. Cultivation was studied in the presence of renewable carbon (as glycerol) and nitrogen (as arginine) sources. While diverse kinetics of acetoin production were observed in different media, similar yields (6-8 g·L-1) were obtained after 72 h of growth. Glycerol increased surfactin-specific production, while arginine increased the yields of surfactin and fengycin and increased biomass significantly. The specific production of fengycin increased ∼10 times, possibly due to a connecting pathway involving arginine and ornithine. Adding value to crude extracts and biomass, both were shown to be useful, respectively, for the removal of p-xylene from contaminated water and for biodiesel production, yielding ∼70 mg·g-1 cells and glycerol, which could be recycled in novel media. This is the first study considering circular bioeconomy to lower the production costs of biosurfactants by valorisation of both microbial cells and their primary and secondary metabolites.

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Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers. This article describes the authors' experiences in facilitating Child-Parent Psychotherapy (CPP) training and explores the role of reflective clinical consultation as an active process that supports the implementation of a rich, but complex, model that requires sophisticated knowledge and skills from practitioners. It examines the intricate range of the CPP consultant's functions, which ultimately support clinicians' reflective practice as they learn and adopt this EBT. Reflective consultation is proposed as an essential component for the integration of knowledge, experience, and emotions in practitioners and as a catalyst for organizational change. Using their voices as trainers-consultants and those of their trainees, the authors discuss the implications of reflective consultation for the effective implementation and sustainability of CPP. Reflections are offered on lessons learned.

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