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Objective To describe the traditional food (TF) systems of First Nations in Canada, including intake, barriers and promoters. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults below the 60 th parallel that obtained data for communities excluded from other national studies. A food frequency questionnaire was used to establish frequency of TF intake (number of days in a year) to allow comparisons across ecozones/regions in Canada. Grams of TF intake were also calculated using frequency multiplied by average portions from 24-h recalls. Closed- and open-ended questions attempted to identify some of the key barriers and concerns regarding TF access and use. Multivariable analyses were run to determine what factors are associated with increased TF consumption. Results Across communities, there is a strong preference by adults to have TF in the diet more often. Consumption of land animals was most frequently reported in most ecozones except for the Pacific Maritime and Mixedwood Plains, where fish and plants, respectively, were more frequently consumed. First Nations identified structural and environmental challenges such as development, government regulations and climate change, along with household barriers such as insufficient capital for equipment and transportation, lack of time and absence of a hunter in the household. Multivariable analyses revealed that the highest intake of TF occurred in the Taiga Plains ecozone, and for older individuals and men. Conclusion Identifying solutions that empower First Nations at all levels is required to overcome the multiple challenges to the inclusion of TF in the diet.

Objective To investigate the relationships between fish/seafood consumption patterns and food security status among First Nations (FN) communities in Canada. We estimated the contribution of fish/seafood to daily nutrient requirements. Barriers to traditional food (TF) access including fish were summarized. Methods Data were collected by the First Nations Food, Nutrition and Environment Study (2008–2018). The sample of this participatory study comprised 6258 randomly selected FN adults. Fish/seafood consumption was estimated with a food frequency questionnaire. Food security status was assessed with the Household Food Security Survey Module. The contribution of fish/seafood to protein, n-3 fatty acid, vitamin (A, B12, D, niacin) and mineral (selenium, zinc) requirements was assessed by comparison to Dietary Reference Intakes. Results Regional differences were observed in fish/seafood consumption patterns and their relationship with food security status. In the eastern regions (Ontario, Quebec/Labrador and the Atlantic region), consumption of fish/seafood and other TF was significantly higher among food insecure compared with food secure FN participants. Severely food insecure men (particularly in British Columbia, Alberta, Quebec/Labrador and the Atlantic region) tended to eat a higher amount of TF, including fish/seafood, compared with food secure and moderately food insecure men, while no difference was observed in women. Fish/seafood provided good sources of selected nutrients. However, the high cost of harvesting equipment, industry-related activities and climate change reduce access to fish/seafood and other wildlife. Conclusion Fish/seafood continues to be vital to the diet of FN communities. Focusing on policies that support FN increased access to fish/seafood has the potential to decrease food insecurity and support sustainable livelihoods. Future policies should focus on socio-economic determinants of food insecurity and support traditional harvesting and sustainable fisheries among FN communities.

Objective To describe the rationale, the participatory nature of the methodology, and the lessons learned during the First Nations Food, Nutrition and Environment Study (FNFNES), a community-based participatory research project implemented in eight Assembly of First Nations regions, which includes the entirety of Canada south of the 60 th parallel. Methods FNFNES respected the First Nations principles of Ownership, Control, Access and Possession (OCAP®) ( https://fnigc.ca/ocap ). A random sampling strategy based on an ecosystem framework comprising 11 ecozones was adopted to collect representative nutritional and environmental health results for all First Nations adults living on-reserve south of the 60 th parallel. Data collection occurred during the fall months from 2008 to 2016. Respective First Nations were involved in the planning and implementation of data collection for the five principal components: household interviews, tap water sampling for metals, surface water sampling for pharmaceuticals, hair sampling for mercury, and traditional food sampling for contaminants. Results A total of 6487 adults from 92 First Nations participated in the Study (participation rate 78%). A higher percentage of females (66%) participated than males (34%). The average age of males and females was similar (44 and 45 years, respectively). This study offers a novel body of coherent and regionally representative evidence on the human dimension of the ongoing environmental degradation affecting First Nations. Conclusion FNFNES serves as a good example of participatory research. We encourage public health professionals to develop policy and programs building on the participatory dimension of the research as well as on its results. The information collected by the FNFNES is also important for community empowerment, environmental stewardship and the general promotion of good health by and for First Nations peoples in Canada.

This quantitative study examines whether employees in the fields of intensive care or acute and emergency medicine experience psychological distress because of their daily work. In addition, it was examined if self-stigmatization tendencies can significantly influence the willingness to seek help, and therefore psychological problems are not being treated adequately. These problems lead to various difficulties in professional and private contexts and ultimately endanger patient safety. From May to June 2021, an online questionnaire survey was conducted. This questionnaire combined two validated measuring instruments (PHQ-D and SSDS). To ensure high participation, the departments of anesthesia and/or intensive care medicine in 68 German hospitals were contacted, of which 5 responded positively. A total of 244 people participated in the questionnaire survey. On average, depressive symptoms were of mild severity. At the same time, self-stigmatization regarding depressive symptoms was high. These results highlight the practical need to prepare staff who work in the field of intensive care or acute and emergency medicine at the early onset for potentially traumatic and emotionally demanding events during their university education or studies. Adequate, evaluated, and continuously available support services from the psychosocial field should become an integral part of every staff care structure.

Objectives First Nations may have a higher risk of contaminant exposure from the consumption of traditional foods. The objective of this study was to measure concentrations of metals and organochlorines in traditional foods commonly consumed by First Nations in Canada and estimate the risk from dietary exposure. Methods Data were collected from the participatory First Nations Food, Nutrition and Environment Study (2008–2018). Traditional food samples were collected by community members and concentrations of metals and organochlorines were measured. The population-weighted mean daily contaminant intake from traditional food items was estimated. Hazard quotients (HQs) were calculated by dividing contaminant intake with the toxicological reference values (TRVs). Results A total of 2061 food samples (different parts and organs) from 221 species were collected. The highest concentrations of cadmium were found in the kidneys of land mammals: moose kidney was the most significant contributor to intake. The meat of land mammals and birds had the highest lead concentrations and were the most significant contributors to intake. Arsenic was highest in seaweed, and prawn was the most significant contributor. Mercury and methyl mercury were highest in harp seal meat, with walleye/pickerel contributing most to intake. Harp seal meat also had the highest p,p′-DDE and PCB concentrations, and ooligan grease and salmon were the most significant contributors to intake. The percentage of adults eating traditional food who exceeded the TRVs was 1.9% for cadmium, 3.7% for lead, 13.6% for arsenic, 0.7% for mercury, and 0% for p,p′-DDE and PCBs. All median HQs, and most 95th percentile HQs, were less than 1. Conclusion These results can be used as a baseline of contaminant levels and exposure in traditional foods for future monitoring programs and to support risk assessment programs.

Objectives To identify food sources of nutrients in First Nations adults in Canada and to establish whether these populations are meeting their nutrient requirements and whether traditional foods (TF) contribute to better nutrient intake. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults living south of the 60 th parallel. Twenty-four-hour recalls were conducted in 92 First Nations communities from 2008 to 2016. Repeat recalls were attempted with 20% of participants to adjust for within-person variation and estimate the proportion of individuals below recommendations according to Institute of Medicine guidelines. Nutrients from days with and without TF were compared. The main food sources of select nutrients were identified, including TF. Results Mean energy intakes among women and men ranged from 1664 to 1864 and from 1761 to 2298 kcal/day respectively. Most macronutrients were within the acceptable macronutrient diet range except for fat in most age groups and carbohydrates in men 71 years of age and older. Saturated fat was above recommendations for all ages. Only niacin was identified as above recommendations in all age and sex categories. Days where TF were eaten showed greater intakes of key nutrients. Conclusion It is imperative that we find culturally appropriate ways to improve the quality and nutritional value of First Nations Peoples food intake by improving TF access and use on the one hand and conversely providing better quality store-bought foods. For success in this, we must empower First Nations communities and health practitioners to collaboratively overcome these challenges.

Objectives The First Nations Food, Nutrition and Environment Study (FNFNES), a community-based participatory research project, measured the levels of metals of health concern and the levels of metals that have operational guidance (OG) and aesthetic objectives (AO) in drinking water of First Nations (FN) south of the 60 th parallel. Methods Both stagnant (first draw) and flushed tap water samples were collected from participating households in 91 FN representing 11 ecozones. The concentrations of metals were quantified and compared to Health Canada’s Guidelines for Canadian Drinking Water Quality (GCDWQ). Results In total, 1516 FN households participated in this study component. Exceedances of the 2019 GCDWQ for the health-based maximum acceptable concentration (MAC) were found for five metals: lead 8.4% of households (first draw), manganese 4.0%, uranium 1.6%, aluminum 1.3%, and copper 0.2% (flushed). Flushing taps resulted in a decrease to 0.7% of households exceeding the lead MAC. Exceedances of the current OG for aluminum were found in 14.2% and the exceedances of the proposed OG were found in 18.1% of households (flushed). Exceedances of the AO (flushed) were as follows: manganese 12.8%, sodium 5.1%, iron 3.5%, and copper 0.4%. Results of the study were compared to provincial surveys where the data were available. Taste and colour were reported to be the main reasons for limiting the use of tap water. Conclusion Overall, the quality of drinking water with respect to trace metals of human health concern is satisfactory. However, elevated lead levels were found in some FN communities. Until appropriate action can take place, it was recommended to flush the water before use to reduce the lead levels.

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci ( P  < 5 × 10 −8 ), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis. A genome-wide association study and Metabochip meta-analysis of body mass index (BMI) detects 97 BMI-associated loci, of which 56 were novel, and many loci have effects on other metabolic phenotypes; pathway analyses implicate the central nervous system in obesity susceptibility and new pathways such as those related to synaptic function, energy metabolism, lipid biology and adipogenesis. Genetic correlates of obesity In the second of two Articles in this issue from the GIANT Consortium, Elizabeth Speliotes and collegues conducted a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), commonly used to define obesity and assess adiposity, to find 97 BMI-associated loci, of which 56 were novel. Many of these loci have significant effects on other metabolic phenotypes. The 97 loci account for about 2.7% of BMI variation, and genome-wide estimates suggest common variation accounts for more than 20% of BMI variation. Pathway analyses implicate the central nervous system in obesity susceptibility including synaptic function, glutamate signaling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

Objective We previously examined the associations between dietary dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyls (PCBs) intake from fish consumption and type 2 diabetes (T2D) prevalence in Ontario and Manitoba. This study aims to further explore the relationship in a regionally representative sample of First Nations adults living on-reserve across Canada. Methods Dietary, health and lifestyle data collected by the cross-sectional First Nations Food, Nutrition and Environment Study (2008–2018) were analyzed. This participatory study included 6091 First Nations adult participants who answered questions on T2D. The consumption of locally caught fish was estimated with a food frequency questionnaire. A total of 551 samples from 96 fish species were collected and analyzed for the presence of DDE and PCBs. The associations between fish and dietary DDE/PCBs intake with self-reported T2D were investigated using multiple logistic regression models adjusted for confounders. Results Dietary exposure to DDE (>2.11 ng/kg/bw) and PCBs (>1.47 ng/kg/bw) vs no exposure was positively associated with T2D with ORs of 2.33 (95% CI: 1.24–4.35) for DDE and 1.43 (95% CI: 1.01–3.59) for PCBs. The associations were stronger among females (DDE OR = 3.11 (1.41–6.88); PCBs OR = 1.76 (1.10–3.65)) and older individuals (DDE OR = 2.64 (1.12–6.20); PCBs OR = 1.44 (1.01–3.91)) as compared with males and younger participants. Also, significant dose-response relationships were found for fish consumption in females only. Conclusion This study confirms our previous findings that dietary DDE/PCBs exposure may increase the risk of T2D. The effect of DDE/PCBs from fish consumption is driven by geographical differences in DDE/PCBs concentrations in fish and by the amount of fish consumed, and is more prominent in females than in males.

Improving university teamwork performance is essential, especially due to the worldwide pandemic. This study examined a model for enhancing university performance by increasing friendship prevalence, work engagement, and Organizational Citizenship Behavior (OCB) among employees. This study used a quantitative design by distributing online questionnaires to 132 employees of universities in Indonesia. Then, the data were analyzed using Structural Equation Modeling (SEM)-Amos version 23. The study found a significant and positive effect among the variables: 1) Friendship prevalence has a significant positive effect on work engagement and OCB; 2) Work engagement also has a significant positive effect on OCB and team performance; and 3) OCB also has a significant positive effect on team performance. Moreover, the relationships between friendship prevalence and OCB, and friendship prevalence and team performance were mediated by work engagement. However, this study found that OCB could not mediate the relationship between work engagement and team performance. The study indicated that friendship prevalence is the predictor of work engagement. Thus, it is recommended for universities to build and improve good friendship among employees. Poboljšanje timskog rada na sveučilištima od suštinske je važnosti, osobito u vrijeme svjetske pandemije. Cilj ove studije bio je ispitati model za poboljšanje uspješnosti sveučilišta povećanjem prevalencije prijateljstva, radnog angažmana i organizacijskog građanskog ponašanja (OCB) među zaposlenicima. Ova studija koristila je kvantitativni dizajn distribuiranjem online upitnika za 132 zaposlenika sveučilišta u Indoneziji. Zatim su podaci analizirani pomoću strukturnih modela jednadžbi (SEM – Structural Equation Modeling) – Amos verzije 23. Istraživanjem je potvrđen značajan i pozitivan učinak među sljedećim varijablama: 1) Prevalencija prijateljstva ima značajan pozitivan učinak na radnu angažiranost i OCB; 2) Radna angažiranost ima značajan pozitivan učinak na OCB i na uspješnost timskog rada; i 3) OCB ima također značajan pozitivan učinak na timsku izvedbu. Štoviše, odnosi između prevalencije prijateljstva i OCB-a, te prevalencije prijateljstva i uspješnosti timskog rada nastaju posredstvom radnog angažmana. Međutim, ovo istraživanje potvrđuje da OCB ne može posredovati u odnosu između radnog angažmana i uspješnosti timskog rada. Studija je pokazala da je prevalencija prijateljstva prediktor radnog angažmana. Stoga se sveučilištima preporuča graditi i unapređivati dobro prijateljstvo među zaposlenicima.