Exercise self-regulation among older women participating in a heart disease-management intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.     

Government Capital,Intimate and Community Social Capital,and Food Security Status in Older Adults with Different Income Levels

Whether government‐based forms of food assistance such as the Supplemental Nutrition Assistance Program (SNAP), communal efforts including food pantries, aid from friends and family, or alternative means such as gardening are the appropriate means to reduce the prevalence of household food insecurity is a continuous source of policy contention. To inform this debate, we examine the relative importance of these forms of food assistance and acquisition to a sample of U.S. older adults from the 2010 Brazos Valley Health Assessment of central Texas households that have been stratified by income eligibility for SNAP, low‐income SNAP ineligibility, and above low income status. To identify how membership in these socioeconomic groups constrains household capacity to acquire sufficient food to maintain an adequate and healthy diet, we explore the varied associations of assets received from government; communal and intimate social networks; and alternative food sources such as gardening, hunting, and fishing with household food security across socioeconomic status, while examining the importance of place of residence on the use of capital assets. SNAP participation was the only specific capital asset associated with all levels of food insecurity for both SNAP‐eligible and ineligible low‐income groups, thus emphasizing the continued importance of food assistance among poverty‐level older adults.     

Linking Local Food Systems and the Social Economy? Future Roles for Farmers' Markets in Alberta and British Columbia*

Often organized as grassroots, nonprofit organizations, many farmers' markets serve as strategic venues linking producers and consumers of local food while fulfilling multiple social, economic, and environmental objectives. This article examines the potential of farmers' markets to play a catalyst role in linking local food systems to the social economy in western Canada. We used the Delphi method of inquiry to solicit and synthesize perspectives on the future role of farmers' markets within local food systems and the social economy from farmers' market vendors, market managers, and policy and government representatives in each province. We found that negotiations over the definition of local food systems, the dynamics of supply and demand relationships, and perceptions of “authenticity” affect the positionality of farmers' markets in relation to other marketing channels within regional food systems. Stakeholders engaged in this Delphi inquiry strategized ways to scale up local food systems beyond current limits while also maintaining the “authentic experience” offered by farmers' markets that has helped to fuel increased consumer interest, demand, and growth. Results confirm the need for further investigation of the relationship between the social economy, infrastructure, and authenticity in the development of local food systems.     

Process evaluation of an environmental walking and healthy eating pilot in small rural worksites

Small Steps are Easier Together (SS) was a pilot environmental intervention in small rural worksites in Upstate New York in collaboration with Extension educators. Worksite leaders teamed with co-workers to select and implement environmental changes to increase walking steps over individual baseline and to choose healthy eating options over 10 weeks. Participants were 226 primarily white, women employees in 5 sites. A mixed methods process evaluation, conducted to identify determinants of intervention effectiveness and to explain differences in outcomes across worksites, included surveys, self-reports of walking and eating, interviews, focus groups, and an intervention log. The evaluation assessed reach, characteristics of recruited participants, dose delivered, dose received, and context and compared sites on walking and eating outcomes. Emergent elements of participant-reported dose received included: active leadership, visible environmental changes, critical mass of participants, public display of accomplishments, accountability to co-workers, and group decision making. Participants at sites with high reach and dose were significantly more likely than sites with low reach and dose to achieve intervention goals. Although this small pilot needs replication, these findings describe how these evaluation methods can be applied and analyzed in an environmental intervention and provide information on trends in the data.     

The Elephant Is Not Pink: Talking About White, Black, and Brown to Achieve Excellence in Clinical Practice

Incorporating issues of race and racism can improve clinical engagement and the therapeutic alliance. Assessing, understanding, and responding to experiences related to racial identity and racism related stress can be an important factor in a clinician??s ability to be culturally responsive. A vignette of client treatment presents common dilemmas in clinical treatment. Responses to questions about race from focus groups are presented to frame the experiences of women of color who struggle with poverty and social-emotional issues. A framework of multicultural antiracist practice highlights the skills necessary for clinicians, supervisors, and managers.     

The incidence of metabolic risk factors in an inpatient psychiatric setting

Our study examines risk factors for metabolic syndrome on admission to an acute psychiatric facility and the incidence of medical referrals at discharge. Data on demographics, risk factors for metabolic syndrome, other health risk factors, medications, related diagnoses, and primary care providers and referrals were collected from 125 psychiatric patient charts. Comparison analysis was done for two groups: those with two or more risk factors for metabolic syndrome and those with less than two risk factors. Differences between groups were statistically significant for age, waist circumference, body mass index, high-density lipoprotein, triglycerides, and fasting glucose levels. Few patients were referred to their primary care provider for follow-up care. This study has clinical implications for improving assessment of psychiatric patients at risk for developing metabolic syndrome, for designing interventions to help patients adopt lifestyle changes to mitigate these risks, and for working toward fuller integration of psychiatric and primary care.     

Changing attitudes about self-injury prevention management: lessons learned

In the behavioral health environment, nurses often use continuous staff monitoring and, at times, physical restraints, to manage the severity of patients' self-injury. Both options put staff in control, are the most restrictive in nature, and can be financially draining on the hospital's budget. This can result in negative reactions by both patients and staff. It is important to develop a program that will empower patients to control their behavior and allow staff to be aware of their perceptions and attitudes toward patients who self-injure. This article describes the leadership initiative that drove the development, training, and implementation of a self-injury prevention project and the lessons learned by staff.     

Can a Knowledge Sanctuary also be an Economic Engine? The Marketization of Higher Education as Institutional Boundary Work

Universities, particularly research‐intensive ones, have responded to a variety of external and internal influences by retooling their missions, culture, and organizational structures to generate revenue from market opportunities. This has resulted in the marketization of higher education: organizational practices that blur the boundary between knowledge‐driven and profit‐driven institutions. This blurring has spurred debates and uncertainties over the scope and boundaries of the 21st century university. We argue that these debates spring from institutional boundary work at the intersection of the three main missions of the contemporary academy: knowledge production, student learning, and satisfying the social charter. These missions can sometimes create areas of synergy, but also tensions that are particularly acute where market logics and business‐oriented practices contradict academic values. Within knowledge production, a key dilemma is the extent to which knowledge advancement should aim for transcendence versus revenue generation. Within student learning, the dilemma involves incommensurability between the ideals of democratic citizenship and demonstrable return on investment. Within the social charter mission, the dilemma is over whether the university can serve the public welfare while also facilitating the growth of local and national economies.     

Walking in the shoes of others: Experimental testing of dual-interest and empathy in environmental choice

This paper further tests dual interest theory and the metaeconomics approach to environmental choice, recognizing a possible role for empathy–sympathy (the basis for an internalized, shared other-interest) in tempering and conditioning the more fundamental tendency to pursue self-interest. To test, we focus on rivers flowing through agricultural areas carrying sediments, chemicals, and fertilizers which are making their way into downstream rivers and lakes. We conduct a framed laboratory experiment modeling this problem: farmers decide on the usage of conservation technology to lessen impacts on the water quality (i.e. on the commons, the capacity to absorb these wastes) in downstream areas, which is more costly than the alternative intensive technology. The results confirm our hypotheses, demonstrating that Upstream Farmers who practice conservation are tempering profit maximization with empathy-based, environmentally conscious behavior. Such behavior better serves the farmers’ own-interest, and also helps Downstream Water Users. Environmental economics models need to explicitly include empathy–sympathy and the moral–ethical context it produces, providing a more scientific basis for conservation policy and programs.