Examining the Influence of Farmers\u27 Market Motivations on Access to Healthful Foods and Business Opportunities for Farms

Farmers’ markets are increasingly promoted as mechanisms for improving access to healthful foods for low-income households, as they are relatively inexpensive to establish and they can provide affordable food for low-income households by offering Supplemental Nutrition Assistance Program Electronic Benefit Transfer (SNAP/EBT). SNAP/EBT at markets also expands revenue opportunities for participating farmers. Market mangers provide a critical role in overseeing SNAP/EBT at markets and influencing business opportunities for farmers. Using a mixed-method approach, this study aimed to evaluate how managers’ motivations influence SNAP/EBT availability and participation at markets and business opportunities for small- and moderate- sized farms. To develop a survey measuring managers’ attitudes and behaviors and farmers’ market outcomes, focus groups were conducted with farmers’ market managers (n=8) in Western North Carolina, East Tennessee, and Southwest Virginia, and interviews were conducted with farmers in the same region (n=8). Eight themes were identified in the manager focus groups, and 5 were identified in the farmer interviews. Qualitative data yielded insight on how managers influence market outcomes. A survey incorporating qualitative findings was distributed to 271 NC farmers’ market managers in May 2014. Multiple regression models were used to examine the influence of mangers’ motivations to improve access to healthful food and support business opportunities on SNAP/EBT availability and participation and indicators of market vitality. Sixty managers completed the survey. There was no significant association between food access motivation and SNAP/EBT participation. A significant, positive association was found between business motivation and customer count, total vendor count, and average weekly vendor count. More research is needed to understand how managers’ motivations interplay with environmental and organizational characteristics to influence food access for low-income households and business opportunities for farmers. Findings from this study offer a starting point for developing interventions that maximize managers’ impact on these outcomes

Depression, physical activity and mental health: an interpretative phenomenological analysis of healthcare professionals’ attitudes to exercise referral schemes

Depression is, today more than ever, a profoundly serious public health concern in the UK, impacting upon the lives of individuals from all social backgrounds and strata (Yohannes & Caton, 2010). Moreover, and contrary to the often-held stereotype of a relatively simple disorder of mood, the condition manifests in an additional array of psychological and somatic symptoms such as “…loss of interest and pleasure, loss of appetite, weight loss/gain, sleep disturbance, psychomotor agitation or retardation, energy decrease, sense of worthlessness, guilt, difficulty in concentrating, or thoughts of suicide.” (Legrand & Heuze, 2007, p.348). In recent years a body of research has emerged dedicated to exploring the value and impacts of exercise in assisting individuals suffering from depression (see Callaghan, Khalil, Morres, & Carter, 2011; Carter, Callaghan, Khalil, & Morres, 2012), and Exercise Referral Schemes (ERS) have been developed to provide access to structured programmes of physical activity. Robust evidence indicates that such physical activity can have strong positive impacts upon the rehabilitation process, not least in terms of enhancing happiness with physical appearance and providing venues for social interaction (Daley, MacArthur, & Winter, 2007; Johnson & Taliaferro, 2011). Despite the well-documented success of various ERSs, and the relative affordability thereof when compared to CBT or pharmaceutical options, however, rates of such referral in cases of mild to moderate depression are low (Callaghan, Khalil, Morres, & Carter, 2011). The research reported in this paper stems from a high-definition investigation of the attitudes of a small number of General Practioners in the North West (N=4), utilising Interpretative Phenomenological Analysis (Pringle, Drummond, McLafferty, & Hendry, 2011; Smith, Flowers, & Larkin, 2009) to reveal how such attitudes are embedded in first- and second-hand experience of ERSs, with a view to illuminating why progress toward their wider use remains slow in the locale. References: Callaghan, P., Khalil, E., Morres, I., & Carter, T. (2011). Pragmatic randomised controlled trial of preferred intensity exercise in women living with depression. BMC Public Health, 11, 465-465. Carter, T., Callaghan, P., Khalil, E., & Morres, I. (2012). The effectiveness of a preferred intensity exercise programme on the mental health outcomes of young people with depression: A sequential mixed methods evaluation. BMC Public Health, 12, 187-187. Daley, A. J., MacArthur, C., & Winter, H. (2007). Brief report: The role of exercise in treating postpartum depression: A review of the literature. Journal of Midwifery and Women's Health, 52, 56-62. Johnson, K. E., & Taliaferro, L. A. (2011). Relationships between physical activity and depressive symptoms among middle and older adolescents: A review of the research literature. Journal for Specialists in Pediatric Nursing, 16(4), 235-251. Legrand, F., & Heuze, J. P. (2007). Antidepressant effects associated with different exercise conditions in participants with depression: A pilot study. Journal of Sport & Exercise Psychology, 29(3), 348-364. Pringle, J., Drummond, J., McLafferty, E., & Hendry, C. (2011). Interpretative phenomenological analysis: A discussion and critique. Nurse Researcher, 18(3), 20-24. Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. London: Sage. Yohannes, A. M., & Caton, S. (2010). Management of depression in older people with osteoarthritis: A systematic review. Aging & Mental Health, 14(6), 637-651

Long-Term Dietary Nitrate Supplementation Does Not Prevent Development of the Metabolic Syndrome in Mice Fed a High-Fat Diet

Background. Nitric oxide (NO) is an important vascular signaling molecule that plays a role in vascular homeostasis. A reduction in NO bioavailability is thought to contribute to endothelial dysfunction, an early risk factor for both cardiovascular disease and type 2 diabetes. Dietary nitrate, through the nitrate-nitrite-NO pathway, may provide an alternate source of NO when the endogenous eNOS system is compromised. In addition to a role in the vascular system, NO may also play a role in the metabolic syndrome including obesity and glucose tolerance. Aim. To investigate the effect of long-term dietary nitrate supplementation on development of the metabolic syndrome in mice fed a high-fat diet. Methods. Following 1 week of acclimatisation, male (6-8 weeks) C57BL6 mice were randomly assigned to the following groups (10/group) for 12 weeks: (i) normal chow + NaCl (1 mmol/kg/day), (ii) normal chow + NaNO3 (1 mmol/kg/day), (iii) high-fat diet + NaCl (1 mmol/kg/day), and (iv) high-fat diet + NaNO3 (1 mmol/kg/day). Body weight and food consumption were monitored weekly. A subset of mice (5/group) underwent running wheel assessment. At the end of the treatment period, all mice underwent fasting glucose tolerance testing. Caecum contents, serum, and tissues (liver, skeletal muscle, white and brown adipose, and kidney) were collected, frozen, and stored at -80°C until analysis. Results. Consumption of the high-fat diet resulted in significantly greater weight gain that was not affected by dietary nitrate. Mice on the high-fat diet also had impaired glucose tolerance that was not affected by dietary nitrate. There was no difference in adipose tissue expression of thermogenic proteins or energy expenditure as assessed by the running wheel activity. Mice on the high-fat diet and those receiving dietary nitrate had reduced caecum concentrations of both butyrate and propionate. Conclusions. Dietary nitrate does not prevent development of the metabolic syndrome in mice fed a high-fat diet. This may be due, in part due, to reductions in the concentration of important short-chain fatty acids

Meter- to Millimeter Emission from Cool Stellar Systems : Latest Results, Synergies Across the Spectrum, and Outlook for the Next Decade

Splinter session summary, to appear in the proceedings of the 20th Cambridge Workshop on Cool Stars, Stellar Systems, and the Sun (ed. S. J. Wolk)Radio observations of cool stellar systems provide unique information on their magnetic fields, high-energy processes, and chemistry. Buoyed by powerful new instruments (e.g. ALMA, JVLA, LOFAR), advances in related fields (e.g., the Gaia astrometric revolution), and above all a renewed interest in the relevant stellar astrophysics, stellar radio astronomy is experiencing a renaissance. In this splinter session, participants took stock of the present state of stellar radio astronomy to chart a course for the field's future

Disparities in Healthy Food Zoning, Farmers\u27 Market Availability, and Fruit and Vegetable Consumption Among North Carolina Residents

Background: Context and purpose of the study. To examine (1) associations between county-level zoning to support farmers\u27 market placement and county-level farmers\u27 market availability, rural/urban designation, percent African American residents, and percent of residents living below poverty and (2) individual-level associations between zoning to support farmers\u27 markets; fruit and vegetable consumption and body mass index (BMI) among a random sample of residents of six North Carolina (NC) counties. Methods: Zoning ordinances were scored to indicate supportiveness for healthy food outlets. Number of farmers\u27 markets (per capita) was obtained from the NC-Community Transformation Grant Project Fruit and Vegetable Outlet Inventory (2013). County-level census data on rural/urban status, percent African American, and percent poverty were obtained. For data on farmers\u27 market shopping, fruit and vegetable consumption, and BMI, trained interviewers conducted a random digit dial telephone survey of residents of six NC counties (3 urban and 3 rural). Pearson correlation coefficients and multilevel linear regression models were used to examine county-level and individual-level associations between zoning supportiveness, farmers\u27 market availability, and fruit and vegetable consumption and BMI. Results: At the county-level, healthier food zoning was greater in more urban areas and areas with less poverty. At the individual-level, self-reported fruit and vegetable consumption was associated with healthier food zoning. Conclusions: Disparities in zoning to promote healthy eating should be further examined, and future studies should assess whether amending zoning ordinances will lead to greater availability of healthy foods and changes in dietary behavior and health outcomes

Farmers\u27 market use is associated with fruit and vegetable consumption in diverse southern rural communities

Background While farmers’ markets are a potential strategy to increase access to fruits and vegetables in rural areas, more information is needed regarding use of farmers’ markets among rural residents. Thus, this study’s purpose was to examine (1) socio-demographic characteristics of participants; (2) barriers and facilitators to farmers’ market shopping in southern rural communities; and (3) associations between farmers’ market use with fruit and vegetable consumption and body mass index (BMI). Methods Cross-sectional surveys were conducted with a purposive sample of farmers’ market customers and a representative sample of primary household food shoppers in eastern North Carolina (NC) and the Appalachian region of Kentucky (KY). Customers were interviewed using an intercept survey instrument at farmers’ markets. Representative samples of primary food shoppers were identified via random digit dial (RDD) cellular phone and landline methods in counties that had at least one farmers’ market. All questionnaires assessed socio-demographic characteristics, food shopping patterns, barriers to and facilitators of farmers’ market shopping, fruit and vegetable consumption and self-reported height and weight. The main outcome measures were fruit and vegetable consumption and BMI. Descriptive statistics were used to examine socio-demographic characteristics, food shopping patterns, and barriers and facilitators to farmers’ market shopping. Linear regression analyses were used to examine associations between farmers’ market use with fruit and vegetable consumption and BMI, controlling for age, race, education, and gender. Results Among farmers’ market customers, 44% and 55% (NC and KY customers, respectively) reported shopping at a farmers’ market at least weekly, compared to 16% and 18% of NC and KY RDD respondents. Frequently reported barriers to farmers’ market shopping were market days and hours, “only come when I need something”, extreme weather, and market location. Among the KY farmers’ market customers and NC and KY RDD respondents, fruit and vegetable consumption was positively associated with use of farmers’ markets. There were no associations between use of farmers’ markets and BMI. Conclusions Fruit and vegetable consumption was associated with farmers’ market shopping. Thus, farmers’ markets may be a viable method to increase population-level produce consumption

Farmers’ market use is associated with fruit and vegetable consumption in diverse southern rural communities

Background While farmers’ markets are a potential strategy to increase access to fruits and vegetables in rural areas, more information is needed regarding use of farmers’ markets among rural residents. Thus, this study’s purpose was to examine (1) socio-demographic characteristics of participants; (2) barriers and facilitators to farmers’ market shopping in southern rural communities; and (3) associations between farmers’ market use with fruit and vegetable consumption and body mass index (BMI). Methods Cross-sectional surveys were conducted with a purposive sample of farmers’ market customers and a representative sample of primary household food shoppers in eastern North Carolina (NC) and the Appalachian region of Kentucky (KY). Customers were interviewed using an intercept survey instrument at farmers’ markets. Representative samples of primary food shoppers were identified via random digit dial (RDD) cellular phone and landline methods in counties that had at least one farmers’ market. All questionnaires assessed socio-demographic characteristics, food shopping patterns, barriers to and facilitators of farmers’ market shopping, fruit and vegetable consumption and self-reported height and weight. The main outcome measures were fruit and vegetable consumption and BMI. Descriptive statistics were used to examine socio-demographic characteristics, food shopping patterns, and barriers and facilitators to farmers’ market shopping. Linear regression analyses were used to examine associations between farmers’ market use with fruit and vegetable consumption and BMI, controlling for age, race, education, and gender. Results Among farmers’ market customers, 44% and 55% (NC and KY customers, respectively) reported shopping at a farmers’ market at least weekly, compared to 16% and 18% of NC and KY RDD respondents. Frequently reported barriers to farmers’ market shopping were market days and hours, “only come when I need something�, extreme weather, and market location. Among the KY farmers’ market customers and NC and KY RDD respondents, fruit and vegetable consumption was positively associated with use of farmers’ markets. There were no associations between use of farmers’ markets and BMI. Conclusions Fruit and vegetable consumption was associated with farmers’ market shopping. Thus, farmers’ markets may be a viable method to increase population-level produce consumption

Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis

Background People who inject drugs (PWID) experience a high prevalence of incarceration and might be at high risk of HIV and hepatitis C virus (HCV) infection during or after incarceration. We aimed to assess whether incarceration history elevates HIV or HCV acquisition risk among PWID. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, and PsycINFO databases for studies in any language published from Jan 1, 2000 until June 13, 2017 assessing HIV or HCV incidence among PWID. We included studies that measured HIV or HCV incidence among community-recruited PWID. We included only studies reporting original results and excluded studies that evaluated incident infections by self-report. We contacted authors of cohort studies that met the inclusion or exclusion criteria, but that did not report on the outcomes of interest, to request data. We extracted and pooled data from the included studies using random-effects meta-analyses to quantify the associations between recent (past 3, 6, or 12 months or since last follow-up) or past incarceration and HIV or HCV acquisition (primary infection or reinfection) risk among PWID. We assessed the risk of bias of included studies using the Newcastle-Ottawa Scale. Between-study heterogeneity was evaluated using the I2 statistic and the P-value for heterogeneity. Findings We included published results from 20 studies and unpublished results from 21 studies. These studies originated from Australasia, western and eastern Europe, North and Latin America, and east and southeast Asia. Recent incarceration was associated with an 81% (relative risk [RR] 1·81, 95% CI 1·40–2·34) increase in HIV acquisition risk, with moderate heterogeneity between studies (I2=63·5%; p=0·001), and a 62% (RR 1·62, 95% CI 1·28–2·05) increase in HCV acquisition risk, also with moderate heterogeneity between studies (I2=57·3%; p=0·002). Past incarceration was associated with a 25% increase in HIV (RR 1·25, 95% CI 0·94–1·65) and a 21% increase in HCV (1·21, 1·02–1·43) acquisition risk. Interpretation Incarceration is associated with substantial short-term increases in HIV and HCV acquisition risk among PWID and could be a significant driver of HCV and HIV transmission among PWID. These findings support the need for developing novel interventions to minimise the risk of HCV and HIV acquisition, including addressing structural risks associated with drug laws and excessive incarceration of PWID