Saturday, December 29, 2012

What's This All Been Working Toward?

I have been contemplating writing a book intended as a support for people experiencing challenges with eating as a result of changed health status. Because I want to share my learnings about this topic more speedily than the time it takes to write and publish a book, after much thought, I have decide to  launch a new blog, the content of which will, one day I hope, become the book I dream of creating. In thinking through and in doing some preparation for this blog/book idea,  I felt a little pang that 'Summer In Chawton' was left hanging. I felt the need to bring it to a close and to let interested readers know how to connect with my ongoing work on the application of learnings about the history of feeding the sick to address present-day issues of eating and feeding with changed health status, and optimizing the nutritional status of people in hospital.

'Summer In Chawton' was created in July 2010 to help keep my friends and family in touch with my studies as a Visiting Fellow at Chawton House Library (CHL). It served the same purpose again in May 2012 when I returned to CHL as a Visiting Researcher. This final post serves as a sum up of how I have used the work I did at CHL, and an invitation to follow my work on a soon-to-be-launched blog entitled 'Eating With Changed Health Status' ( 

I presented the findings from the 2010 visit to CHL as the 'sample class' during my interview for a tenure-track professor position at Acadia University. The focus of this presentation was my belief that present-day transitional diets (the transition from nothing-by-mouth (NPO or NBM) to clear fluids to full fluids to 'light diet') are holdovers from beliefs in the four humours. This view is aided by two observations; that there is no evidence of physiological benefit of these diets, and that early ad lib feeding (feeding a person what they want when they want it) post surgery results in improved and faster recovery, greater patient and family satisfaction, and earlier hospital discharge. I got the position at Acadia U in 2011, and have since received two grants to further this line of inquiry.

An Acadia University Research Award funded my return to CHL in 2012; the purpose of that trip was to gather additional evidence that there was some truth to the idea that transitional diets had their origins in feeding to balance the humours or to convince myself that I was totally mistaken. The result was reaffirmation of my earlier belief - I felt as though I had cracked a code. Everything I read from the period seemed to relate to this idea. Words such a 'nourishing' and 'wholesome' took on new meaning; their use in medical books in Jane Austen's time was in connection with the supposed effects of foodstuffs on the humours. Jane used these words herself in the character of Mr. Woodhouse in Emma.

The second grant, a SSHRC Small Institution Grant, is funding a project to track the evolution of the use of clear fluids, full fluids, and light or soft diets from 1840 to the present. 1840 is the date of the last cookery book I studied at CHL so the search carries on from there. Our findings completely  support the 'holdover' idea.

I framed this line of inquiry as 'Feeding In Hospitals As Though Recovery Matters', and have made several presentations to garner support for the notion of collective efforts to optimizing nutritional status of people in hospital, and to encourage additional research. The result, I happily report, has been the emergence of some spin-off research projects.

I presented locally to clinical dietitian colleagues in Yarmouth and Kentville, Nova Scotia to encourage collaboration on research projects. The result was that Renee Racine, a dietetic intern at Annapolis Valley Health, conducted a project to ascertain surgeon, dietitian, and nurse perspectives on the rationale for the use of transitional diets. Another intern, Allana Kerr, will continue this work in 2013.

I presented my research on the historical antecedents to present day hospital feeding practices as part of a panel entitled 'Feeding In Hospitals As Though Recovery Matters: High Time For Evidence-based Practice' at the International Congress of Dietetics in Sydney, Australia in September along with two dietitians who work and conduct research in surgery nutrition, Kate Willcutts (USA) and Sharon Casey (Australia). There was a standing room only crowd and enthusiastic reception of our ideas. Our international trio has had a proposal accepted to present a workshop on this topic at the Dietitians of Canada conference in Victoria, British Columbia in June. We are pleased we have the opportunity to further our work together. 

Alas, this post draws 'Summer In Chawton' to a close. I don't imagine I'll return again to study at Chawton (although one never knows). This blog served its original purpose and attracted the attention of more than my family and friends (as I note from the readership stats). My thanks to all who took the time to read it.

Thanks all!

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