Agriculture Policy Is Health Policy.

The Farm Bill is meant to supplement and secure farm incomes, ensure a stable food supply, and support the American farm economy. Over time, however, it has evolved into a system that creates substantial health impacts, both directly and indirectly. By generating more profit for food producers and less for family farmers; by effectively subsidizing the production of lower-cost fats, sugars, and oils that intensify the health-destroying obesity epidemic; by amplifying environmentally destructive agricultural practices that impact air, water, and other resources, the Farm Bill influences the health of Americans more than is immediately apparent. In this article, we outline three major public health issues influenced by American farm policy. These are (1) rising obesity; (2) food safety; and (3) environmental health impacts, especially exposure to toxic substances and pesticides

Beliefs and attitudes of Australian learner drivers toward driving and avoiding driving through floodwater

Introduction: Driving through floodwater is a significant cause of flood-related injury and mortality, and opportunities exist to embed safe driving messages regarding floodwaters to novice drivers in graduated driver licensing schemes. To inform future educational efforts, we investigated the beliefs and attitudes of Australian learner drivers about driving and avoiding driving through floodwaters. Methods: The study adopted a cross-sectional correlational design with measures drawn from the theory of planned behaviour and administered within an online survey. Phase 1 (N = 44 learner drivers) aimed to identify the core beliefs associated with driving through floodwater. Phase 2 (N = 250 learner drivers) tested these beliefs predicting willingness to drive through floodwater as well as the social psychological factors that predict learner drivers’ willingness to drive and avoid driving through floodwater using a pre-tested scenario. Analyses comprised descriptive statistics, linear regression, and structural equation models. Results: Ten key beliefs were identified as predicting willingness to drive through floodwater. These included perceived advantages and disadvantages, perceived social approval from important others, and perceived facilitators and barriers regarding driving through floodwater in the presented scenario. Structural equation models of social cognition constructs of the theory of planned behaviour revealed attitude, subjective norm, and perceived behavioural control predicted both willingness to drive and avoid driving through floodwater. Past experience as a passenger also predicted these social cognition constructs, although this differed across models. Discussion: Results highlight the importance of modelling safe driving behaviour for young passengers. The strong association between subjective norm and willingness to drive through floodwater further highlights the importance of those supervising learner drivers to establish expectations around avoiding driving through the floodwater if it is encountered on a driving route. Conclusion: Social cognition factors from the theory of planned behaviour predict willingness to drive and avoid driving though floodwater. Theory-based targets should be considered for the development of intervention programs for novice drivers, such as those holding learner licenses

The Science of Behavior Change : The Road Ahead

Peer reviewe

Psychometric properties of the Stress Control Mindset Measure in University students from Australia and the UK.

Introduction: Beliefs about the consequences of stress, stress mindsets, are associated with health and performance outcomes under stress. This article reports the development and examination of the psychometric properties of a measure of stress mindset: The Stress Control Mindset Measure (SCMM). The measure is consistent with theory on mindsets about self-attributes and conceptualizes stress mindset as the extent to which individuals endorse beliefs that stress can be enhancing. Methods: The study adopted a correlational cross-sectional survey design in two student samples. Undergraduate students from an Australian university (Sample 1, N=218) and a UK university (Sample 2, N=214) completed the SCMM and measures of health and well being outcomes. Results: Confirmatory factor analyses supported a four-factor structure and strict measurement invariance across samples(ΔCFI <.01). Reliability, convergent validity, discriminant validity, and concurrent validity of the overall SCMM was supported in both samples. Incremental validity was supported for most outcomes, accounting for significantly more variance (between 2.2% and 5.9%) in health and wellbeing outcomes than an existing measure. Conclusions: Current data provide preliminary support for the SCMM as a reliable and valid measure with good psychometric properties and theoretically consistent relations with health outcomes under stress. Findings provide initial evidence supporting the potential utility of the SCMM in future research examining relations between stress mindsets and health and performance outcomes

Adolescent sugar-sweetened beverage consumption: An extended Health Action Process Approach.

OBJECTIVE:Consumption of excess added sugar in the form of sugar-sweetened beverages (SSBs) contributes to a wide range of health concerns in adolescents. Identification of modifiable determinants of SSB consumption based on behavioral theory may inform development of interventions aimed at reducing SSB consumption. The aim of the current study was to test the efficacy of an extended version of the Health Action Process Approach to predict adolescent SSB consumption. METHODS:Using a prospective design, adolescent students (N = 450) self-reported their outcome expectancies, perceived behavioral control, intentions, habit, action, maintenance, and recovery self-efficacy, action and coping planning, perceived affordability, and past behavior with respect to SSB consumption. One month later, participants self-reported their SSB consumption. RESULTS:A structural equation model revealed significant direct effects of action self-efficacy, outcome expectancies, and perceived behavioral control on intentions to reduce SSB consumption. Significant direct effects of action self-efficacy on maintenance self-efficacy, and maintenance self-efficacy on recovery self-efficacy, were also identified. There were significant direct effects of intentions and maintenance self-efficacy on action and coping planning. Only intentions and perceived affordability had significant direct effects on SSB consumption. There were also indirect effects of outcome expectancy and perceived behavioral control on SSB consumption mediated by intentions. Inclusion of past behavior attenuated model effects, with past behavior the only remaining predictor of SSB consumption. CONCLUSIONS:Findings indicate that adolescent SSB consumption is predicted by intentions and perceived affordability, but effects were extinguished by the inclusion of past behavior. The pervasive effects of past behavior point to the importance of identifying potential mediators of past behavior in future research, and that interventions targeting non-conscious rather than intentional processes may be most effective in reducing SSB consumption

Predictors of correct technique in patients using pressurized metered dose inhalers

Background: Correct inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. Methods: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical. Results: 23.1% of patients had no errors in inhaler technique and 32.2% had no critical errors. Patients had a median of 10 correct steps (IQR9-11), and 3(IQR2-4) correct critical steps. Using binary logistic regression the predictors of 10 correct steps were, other healthcare professional (pharmacist, nurse, physiotherapist) explained OR 3.73(1.63–8.54, p = 0.001), male gender 2.70(1.35–5.39, p = 0.004), self-score 1–10 1.21(1.05–1.39, p = 0.007), spacer use 0.38(0.19–0.79, p = 0.007), inhaled steroid 3.71(1.34–10.25, p = 0.01), heart disease 0.31(0.13–0.77, p = 0.01), pneumococcal vaccine 2.48(1.0–6.15, p = 0.043), education level 1–4 1.44(1.00–2.06, p = 0.05) and respiratory physician explained 0–7 times, 1.11(0.99–1.26, p = 0.08). Using ordinal logistic regression, predictors for correct critical steps 0–4, were: technique self-score 1–10 1.2(1.05–1.42, p = 0.006), inhaled corticosteroid use 2.78(1.1–7.31, p = 0.03) and education level 1–4 1.41(1.02–1.95, p = 0.03 Times respiratory physician explained inhaler technique 0–7 1.1(0.98–1.24, p = 0.1), married status 1.55(0.85–2.82, p= 0.15), hypercholesterolaemia 0.52(0.25–1.01, p = 0.054) and male gender 1.76(0.97–3.18, p = 0.06). Conclusions: Known predictors of correct pMDI use, such as gender and education level were confirmed, while age and concomitant use of dry powder inhaler were not. Pneumococcal vaccination and awareness of steroid side effects were possible novel positive predictors, while the use of a spacer and co-morbidity with heart disease were found to be negative predictors. Patients’ self-assessment correlated well with actual performance. This information may be useful in defining approaches to optimize inhaler techniques which are so susceptible to human error.peer-reviewe

Trait Self‐Control, Social Cognition Constructs, and Intentions : Correlational Evidence for Mediation and Moderation Effects in Diverse Health Behaviours

Background We examined effects of trait self‐control, constructs from social cognition theories, and intentions on health behaviours. Trait self‐control was expected to predict health behaviour indirectly through theory constructs and intentions. Trait self‐control was also predicted to moderate the intention–behaviour relationship. Methods Proposed effects were tested in six datasets for ten health‐related behaviours from studies adopting prospective designs. Participants (N = 3,249) completed measures of constructs from social cognition theories and self‐control at an initial time point and self‐reported their behaviour at follow‐up. Results Results revealed indirect effects of self‐control on behaviour through social cognition constructs and intentions for eight behaviours: eating fruit and vegetables, avoiding fast food, dietary restrictions, binge drinking, physical activity, walking, out‐of‐school physical activity, and pre‐drinking. Self‐control moderated the intention–behaviour relationship in four behaviours: dietary restriction, and alcohol‐related behaviours. Conclusions Mediation effects suggest that individuals with high self‐control are more likely to hold beliefs and intentions to participate in future health behaviour, and more likely to act. Moderation effects indicate that individuals with high self‐control are more likely to enact healthy intentions and inhibit unhealthy intentions, but findings were restricted to few behaviours. Training self‐control and managing contingencies that derail goal‐directed action may be effective intervention strategies.Peer reviewe

Membrane remodelling triggers maturation of excitation–contraction coupling in 3D-shaped human-induced pluripotent stem cell-derived cardiomyocytes

The prospective use of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) for cardiac regenerative medicine strongly depends on the electro-mechanical properties of these cells, especially regarding the Ca$^{2+}$-dependent excitation–contraction (EC) coupling mechanism. Currently, the immature structural and functional features of hiPSC-CM limit the progression towards clinical applications. Here, we show that a specific microarchitecture is essential for functional maturation of hiPSC-CM. Structural remodelling towards a cuboid cell shape and induction of BIN1, a facilitator of membrane invaginations, lead to transverse (t)-tubule-like structures. This transformation brings two Ca$^{2+}$ channels critical for EC coupling in close proximity, the L-type Ca$^{2+}$ channel at the sarcolemma and the ryanodine receptor at the sarcoplasmic reticulum. Consequently, the Ca$^{2+}$-dependent functional interaction of these channels becomes more efficient, leading to improved spatio-temporal synchronisation of Ca$^{2+}$ transients and higher EC coupling gain. Thus, functional maturation of hiPSC-cardiomyocytes by optimised cell microarchitecture needs to be considered for future cardiac regenerative approaches

Predictors of school students’ leisure-time physical activity : An extended trans-contextual model using Bayesian path analysis

The present study aimed to examine effects of motivational and social cognition constructs on children’s leisure-time physical activity participation alongside constructs representing implicit processes using an extended trans-contextual model. The study adopted a correlational prospective design. Secondary-school students (N = 502) completed self-report measures of perceived autonomy support from physical education (PE) teachers, autonomous motivation in PE and leisure-time contexts, and social cognition constructs (attitudes, subjective norms, perceived behavioral control), intentions, trait self-control, habits, and past behavior in a leisure-time physical activity context. Five weeks later, students (N = 298) self-reported their leisure-time physical activity participation. Bayesian path analyses supported two key premises of the model: perceived autonomy support was related to autonomous motivation in PE, and autonomous motivation in PE was related to autonomous motivation in leisure time. Indirect effects indicated that both forms of autonomous motivation were related to social cognition constructs and intentions. However, intention was not related to leisure-time physical activity participation, so model variables reflecting motivational processes did not account for substantive variance in physical activity participation. Self-control, attitudes, and past behavior were direct predictors of intentions and leisure-time physical activity participation. There were indirect effects of autonomous motivation in leisure time on intentions and physical activity participation mediated by self-control. Specifying informative priors for key model relations using Bayesian analysis yielded greater precision for some model effects. Findings raise some questions on the predictive validity of constructs from the original trans-contextual model in the current sample, but highlight the value of extending the model to incorporate additional constructs representing non-conscious processes.Peer reviewe