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Upgrading the food at VGH for patient and planetary health

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There are no sirens or flashing lights in the kitchen at Vancouver General Hospital, but their staff — and several key people — are addressing an emergency: the food.

Not the food that visitors and staff buy, but rather the food that is delivered to VGH’s hundreds of patients daily, each of whom is healing from any number of conditions covering a wide spectrum of nutritional needs.

Hospital food, with its rep for being boring, basic and bland, has been a long-overlooked component of patient care.

“We cannot afford to not talk about it,” says Ned Bell.

The Vancouver-based chef, known for his commitment to fresh, seasonal ingredients, including sustainable seafood, has been working with VGH for the past few years by way of a pilot program to modernize the hospital’s food program.

Patients said they wanted more diverse and meatless options

While VGH has always served healthy food that meets nutritional requirements, over the years, patients have expressed a wish for the hospital’s roster of largely Western-based meals to better reflect the diversity of its diners. That means more plant-based options and more global flavours, all in the name of health.

Bell didn’t have the state of hospital food on his plate for most of his culinary career until his wife began spending more time at VGH as she underwent cancer treatment. The timing was crucial, as conversations were in the beginning stages of implementing a pilot program to study how food could be improved and factor in cultural and dietary diversity, as well as more eco-friendly choices.

And, of course, being a chef, Bell was keen to find out if hospital food could actually taste great.

Joining a team led by Dr. Annie Lalande, surgical resident and PhD student in the Institute for Resources, Environment and Sustainability at the University of British Columbia (UBC), and Tiffany Chiang, director of food service transformation and strategic projects at Vancouver Coastal Health (VCH), Bell, along with key VGH staff like registered dietitian in acute care Elaine Eppler, got to work on developing new recipes.

Though the pandemic put a hold on the fieldwork, in 2022 the team regrouped to get the Planetary Health menu pilot up and running.

Revamping hospital food menu not the same as in a restaurant

Given the scope of the hospital’s food program, and its limitations, as well as the highly specified nutritional requirements each meal has to meet, tackling the menu at VGH wasn’t anything like revamping a restaurant menu.

“I had to learn a ton,” shares Bell during an in-person menu tasting and info session. “My learning curve was steep.”

Starting with an initial batch of 53 recipes, Bell explored all the ways by which he could dial up the flavour, sustainability, and overall deliciousness of existing dishes in the VGH food program.

The working list was narrowed down to about 20 or so lunch and dinner dishes (the team soon realized breakfast items needed the least attention for the time being) and Bell sought ways to make minor adjustments, asking question after question along the way.

Where could ground beef be subbed for ground turkey or lentils? Which ingredients could be sourced from within B.C. at a lower price point, to boot? What could be made in-house rather than brought in packaged? Could a sauce or dressing import offer more flavour in a meal?

Adding garnish a game-changer

But it was the simple addition of garnish to the pilot program’s dishes, a practice often reserved for restaurants, that emerged as a game-changer.

What might seem like a minor detail to some has proven to be a significant catalyst in transforming not only the visual appeal of hospital meals but also the overall satisfaction and well-being of patients.

“Sauce and a bit of garnish made a good dish better,” explains Lalande.

Lalande explains that the pilot program began by gauging patient feedback through multiple means to discover what people most wanted to see improved. “More flavour,” was the dominant response, recalls Lalande, adding that patients spoke up about wanting the ingredients to be fresher and the recipes “more culturally diverse,” with more seasoning and texture.

Recognizing that crafting scratch-made meals for six to 700 patients a day is no small feat, Lalande says it was essential for the pilot program to look at meaningful solutions with significant impact.

“Unless we take this time to stop and embrace the complexity, it’s hard to come up with something that isn’t a band-aid solution,” she adds, noting that change in hospital systems is so often reactive and not proactive.

Looking at hospital food programs in North America and even as far away as Lebanon for inspiration on how to be more plant-forward and eco-conscious, the changes in the works at VGH are likely “the most progressive in Canada,” attests Lalande.

Subbing in plant-based proteins for meat – without shouting about it

While cost is, of course, a factor, the pilot program made certain to keep ingredient choices within the budget, even finding ways to save by using a plant-based protein source over an animal one. Chickpeas, generally, are cheaper than chicken.

“Plant-based proteins do tend to be less expensive,” says Lalande.

Oftentimes, offering a meatless version of a familiar dish didn’t yield objections.

“We don’t scream from the rooftop that the Sloppy Joe is vegetarian,” says Bell.

It simply is vegetarian, which makes it an option for more patients than a beef version.

Popular new meals include a chickpea curry and trout with tomato miso dressing

A not-so-coincidental side effect of embracing more plants, whether it be fresh vegetables alongside a moist piece of fish or lentils in a Sloppy Joe, is that the impact on the environment is lessened. Even shifting to leaner animal proteins, like turkey or trout, are lower-impact options.

It’s not exactly an off-label use of the food program, but it’s a way VGH has of “giving the planet a seat at the table,” explains Lalande.

Bell, who has long championed a “globally inspired, locally sourced” approach to his cooking, says he’s never worked so hard on perfecting so many recipes in his career.

Some of Bell’s dishes that have emerged as popular favourites have been the Steelhead Trout with Tomato Miso Dressing; Creamy Coconut Chickpea Curry with Cauliflower and Cashews with Mango Chutney; and the Korean Gochujang Bowl.

During the study, patients answered surveys about the meal, and the team kept an eye on how empty the plates were when they came back to the kitchen.

Eppler calls the Planetary Health pilot program “probably the most exciting thing I’ve ever worked on in my 36-year career.”

Food is more than nutrients: ‘there’s also the emotional feeling’

The longtime dietitian describes the constant and nuanced challenges of working with patients who not only have specific dietary needs but also various struggles to eat. Many hospital patients are unmotivated to eat or do not have the strength for rigorous chewing.

However, having food that looks appetizing and hints at the taste and care of home, can go a long way in getting a patient excited about meal time.

What Bell calls those “little touches of home-made,” can wind up “encouraging people to eat,” describes Lalande.

“Nutrients help with the physical — but there’s also the emotional feeling,” elaborates Eppler. Food encompasses so much, she continues: “It’s comfort, memory, healing, companionship, building relationships, respecting culture.”

With the pilot program concluded, VGH is preparing to implement a variety of improvements to its food system in the facility, starting with adjustments to its meal ordering and distribution system to work on a hub or satellite model to shorten the distance between patients and their food.

The plan is to continue “with a few of the recipes right away and introducing [some of the] recipes to other VGH hospitals,” explains Chiang.

“This work matters,” says Bell, who adds he is extremely proud of the recipes he and the team have produced. “There is an opportunity for us to make changes and that is so incredibly powerful.”

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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