Can environmental traffic light warning labels reduce meat meal selection? A randomised experimental study with UK meat consumers.

An important area for tackling climate change and health improvement is reducing population meat consumption. Traffic light labelling has successfully been implemented to reduce the consumption of unhealthy foods and sugary drinks. The present research extends this work to meat selection. We tested 1,300 adult UK meat consumers (with quotas for age and gender to approximate a nationally representative sample). Participants were randomised into one of four experimental groups: (1) a red traffic light label with the text 'High Climate Impact' displayed on meat meal options only; (2) a green traffic light label with the text 'Low Climate Impact' displayed on vegetarian and vegan meal options only; (3) red/orange/green (ROG) traffic light labels displayed on relevant meals; and (4) control (no label present). Participants made meal selections within their randomised group across 20 meal trials. A beta-regression was performed to ascertain the change in primary outcome (proportion of meat meals selected across the 20 trials) across the different groups. The red-only label and ROG labels significantly reduced the proportion of meat meals selected compared to the unlabelled control group, by 9.2% and 9.8% respectively. The green-only label did not differ from control. Negatively framed traffic light labels seem to be effective at discouraging meat selection. The labels appeared to be moderately acceptable to meat eaters, who did not think the labels impacted the appeal of the products. These encouraging findings require replication in real-life settings.

Characterizing restrictions on commercial advertising and sponsorship of harmful commodities in local government policies: a nationwide study in England.

BACKGROUND: Commercial advertising and sponsorship drive the consumption of harmful commodities. Local authorities (LAs) have considerable powers to reduce such exposures. This study aimed to characterize local commercial policies across all English LAs. METHODS: We conducted a census of all English LAs (n = 333) to identify local commercial policies concerning advertising and sponsorship of tobacco, alcohol, less healthy foods and gambling, through online searches and Freedom of Information requests. We explored policy presence, commodity frequency and type, and associations with LA characteristics (region, urban/rural and deprivation). RESULTS: Only a third (106) of LAs in England had a relevant policy (32%). These included restrictions on tobacco (91%), gambling (79%), alcohol (74%) and/or less healthy foods (24%). Policy prevalence was lowest in the East of England (22%), North East (25%) and North West (27%), higher in urban areas (36%) than rural areas (28%) and lower in the least (27%) compared with the most (38%) deprived areas. Definitions in policies varied, particularly for alcohol and less healthy foods. CONCLUSIONS: English LAs currently underutilize their levers to reduce the negative impacts of harmful commodity industry marketing, particularly concerning less healthy foods. Standardized guidance, including clarity on definitions and application, could inform local policy development.

Impact of pictorial warning labels on meat meal selection: A randomised experimental study with UK meat consumers.

Meat consumption has been linked to adverse health consequences, worsening climate change, and the risk of pandemics. Meat is however a popular food product and dissuading people from consuming meat has proven difficult. Outside the realm of meat consumption, previous research has shown that pictorial warning labels are effective at curbing tobacco smoking and reducing the consumption of sugary drinks and alcohol. The present research extends this work to hypothetical meat meal selection, using an online decision-making task to test whether people's meal choices can be influenced by pictorial warning labels focused on the health, climate, or pandemic risks associated with consuming meat. Setting quotas for age and gender to approximate a UK nationally representative sample, a total of n = 1001 adult meat consumers (aged 18+) were randomised into one of four experimental groups: health pictorial warning label, climate pictorial warning label, pandemic pictorial warning label, or control (no warning label present). All warning labels reduced the proportion of meat meals selected significantly compared to the control group, with reductions ranging from -7.4% to -10%. There were no statistically significant differences in meat meal selection between the different types of warning labels. We discuss implications for future research, policy, and practice.

Simultaneous Administration of Hyperbaric Oxygen Therapy and Antioxidant Supplementation with Filipendula ulmaria Extract in the Treatment of Thermal Skin Injuries Alters Nociceptive Signalling and Wound Healing.

Background and Objectives: Thermal skin injuries are a prevalent cause of skin damage, potentially leading to severe morbidity and significant mortality. In this study, we intended to estimate the effects of HBO (hyperbaric oxygen treatment) and antioxidant supplementation with Filipendula ulmaria extract, individually and simultaneously, in the treatment of thermal skin injuries. Materials and Methods: As a thermal skin injury experimental model, we used two-month-old male Wistar albino rats. Thermal injuries were made with a solid aluminium bar at a constant temperature of 75 °C for 15 s. Hyperbaric oxygen treatment was performed in a specially constructed hyperbaric chamber for rats (HYB-C 300) for seven consecutive days (100% O2 at 2.5 ATA for 60 min). Antioxidant supplementation was performed with oral administration of Filipendula ulmaria extract dissolved in tap water to reach a final concentration of 100 mg/kg b.w. for seven consecutive days. Results: Simultaneous administration of hyperbaric oxygen therapy and antioxidant supplementation with Filipendula ulmaria extract significantly ameliorated the macroscopic and histopathological characteristics of the wound area and healing. Also, this therapeutic approach decreased the local expression of genes for proinflammatory mediators and increased the expression of the µ-opioid receptor and the MT1 and MT2 receptors in the wound area and spinal cord, with a consequent increase in reaction times in behavioural testing. Conclusions: In conclusion, the presented results of our study allow evidence for the advantages of the simultaneous employment of HBO and antioxidant supplementation in the treatment of thermal skin injuries, with special reference to the attenuation of painful sensations accompanied by this type of trauma.

Implementing alcohol screening and brief interventions in primary health care: study protocol for a pilot cluster randomized controlled trial.

BACKGROUND: Alcohol is one of the most important risk factors contributing to the global burden of disease. Screening and brief interventions in primary care settings are effective in reducing alcohol consumption. However, implementation of such interventions in routine practice has been proven difficult. Most programmes in practice and research have lacked a theoretical rationale for how they would change practitioner behaviour. OBJECTIVE: To determine whether a theory-based behaviour change intervention delivered to primary care practices significantly increases delivery of alcohol screening. METHODS: We will conduct a two-arm, cluster-randomized controlled, parallel, open trial. Twelve primary care practices will be randomized to one of two groups: training and support; and waiting-list control. Family physicians, nurses and receptionists will be eligible to participate. The intervention will be a training and support programme. The intervention will be tailored to the barriers and facilitators for implementing alcohol screening and brief interventions following the principles of the Behaviour Change Wheel approach. The primary outcome will be the proportion of patients screened with the Alcohol Use Disorders Identification Test. CONCLUSION: This study will test whether a theory-driven implementation programme increases alcohol screening rates in primary care. Results from this trial will provide a useful addition to existing evidence by informing implementation researchers what areas of behaviour change are critical to increasing alcohol screening rates. TRIAL REGISTRATION: clinicaltrials.gov NCT02968186.

Impact of increasing the proportion of healthier foods available on energy purchased in worksite cafeterias: A stepped wedge randomized controlled pilot trial.

Increasing the proportion of healthier foods available could encourage healthier consumption, but evidence to date is limited in scope and quality. The current study aimed to: (a) examine the feasibility and acceptability of intervening to change product availability in worksite cafeterias; and (b) estimate the impact on energy purchased of increasing the proportion of healthier (i.e. lower energy) cooked meals, snacks, cold drinks and sandwiches. Six English worksite cafeterias increased the proportion of healthier foods available, aiming to keep the total number of options constant, in a stepped wedge randomized controlled pilot trial conducted between January and May 2017. The intervention was generally successfully implemented and acceptable to clientele. Generalized linear mixed models showed a reduction of 6.9% (95%CI: -11.7%, -1.7%, p = 0.044) in energy (kcal) purchased from targeted food categories across all sites. However, impact varied across sites, with energy purchased from targeted categories significantly reduced in two sites (-10.7% (95%CI: -18.1% to -2.6%, p = 0.046); -18.4% (95%CI: -26.9% to -8.8%, p = 0.013)), while no significant differences were seen in the other four sites. Overall, increasing the proportion of healthier options available in worksite cafeterias seems a promising intervention to reduce energy purchased but contextual effects merit further study.

What is the impact of increasing the prominence of calorie labelling? A stepped wedge randomised controlled pilot trial in worksite cafeterias.

BACKGROUND: Calorie labelling may help to reduce energy consumption, but few well-controlled experimental studies have been conducted in real world settings. In a previous randomised controlled pilot trial we did not observe an effect of calorie labelling on energy purchased in worksite cafeterias. In the present study we sought to enhance the effect by making the labels more prominent, and to address the operational challenges reported previously by worksites. METHODS: Three worksite cafeterias were randomised in a stepped wedge design to start the intervention at one of three fortnightly periods between March and July 2018. The intervention comprised introducing prominent calorie labelling for all cafeteria products for which calorie information was available (on average 87% of products offered across the three sites were labelled). Calorie content was displayed in bold capitalised Verdana typeface with a minimum font size of 14 e.g.120 CALORIES. Feasibility and acceptability were assessed using post-intervention surveys with cafeteria patrons and semi-structured interviews with managers. Effectiveness was assessed using total daily energy (kcal) purchased from intervention items across the three sites, analysed using semi-parametric GAMLSS models. RESULTS: Recruitment and retention of worksite cafeterias proved feasible: all three randomised sites successfully completed the study. Post-intervention feedback suggested high levels of intervention acceptability: 87% of responding patrons wanted calorie labelling to remain in place. No effect of the intervention on daily energy purchased was observed: -0.6% (95%CI -2.5 to 1.2, p = .487). By-site analyses showed similar null effects at each of the three sites, all ps > .110. CONCLUSIONS: There was no evidence that prominent calorie labelling changed daily energy purchased across three English-based worksite cafeterias. The intervention was feasible to implement and acceptable to patrons and managers.

Impact of reducing portion sizes in worksite cafeterias: a stepped wedge randomised controlled pilot trial.

BACKGROUND: Reducing the portion sizes of foods available in restaurants and cafeterias is one promising approach to reducing energy intake, but there is little evidence of its impact from randomised studies in field settings. This study aims to i. examine the feasibility and acceptability, and ii. estimate the impact on energy purchased, of reducing portion sizes in worksite cafeterias. METHODS: Nine worksites in England were recruited to reduce by at least 10% the portion sizes of foods available in their cafeterias from targeted categories (main meals, sides, desserts, cakes). In a stepped wedge randomised controlled pilot trial, each site was randomised to a date of implementation, staggered fortnightly, following a baseline period of four weeks. Impact on energy purchased was analysed using generalised linear mixed modelling. We also assessed feasibility, acceptability, and fidelity of intervention implementation. RESULTS: Data from six of the nine randomised sites were analysed, with three sites excluded for not providing sufficient data and/or not implementing the intervention. The extent to which the intervention was implemented varied by site, with between 6 and 49% of products altered within targeted categories. Feedback following the intervention suggested it was broadly acceptable to customers and cafeteria staff. For the primary outcome of daily energy (kcal) purchased from intervention categories, there was no statistically significant change when data from all six sites were pooled: percentage change - 8.9% (95% CI: -16.7, - 0.4; p = 0.081). Each of these six sites showed reductions in energy purchased, ranging from - 15.6 to - 0.3%, which were borderline statistically significant at two sites (respective percentage changes (95% CIs): - 15.6% (- 26.7, - 2.8); - 14.0% (- 25.0, - 1.2)). Secondary outcome data are suggestive of a compensatory increase in energy purchased from food categories not targeted by the intervention, with no overall effect observed on energy purchased across all categories. CONCLUSIONS: The results of this pilot trial suggest that reducing portion sizes could be effective in reducing energy purchased and consumed from targeted food categories, and merits investigation in a larger trial. Future studies will need to address factors that prevented optimal implementation including site dropout and application across a limited range of products. TRIAL REGISTRATION: ( ISRCTN52923504 ). Registered on 20th September 2016.

Impact of calorie labelling in worksite cafeterias: a stepped wedge randomised controlled pilot trial.

BACKGROUND: For working adults, about one-third of energy is consumed in the workplace making this an important context in which to reduce energy intake to tackle obesity. The aims of the current study were first, to identify barriers to the feasibility and acceptability of implementing calorie labelling in preparation for a larger trial, and second, to estimate the potential impact of calorie labelling on energy purchased in worksite cafeterias. METHODS: Six worksite cafeterias were randomised to the intervention starting at one of six fortnightly periods, using a stepped wedge design. The trial was conducted between August and December 2016, across 17 study weeks. The intervention comprised labelling all cafeteria products for which such information was available with their calorie content (e.g. "250 Calories") displayed in the same font style and size as for price. A post-intervention survey with cafeteria patrons and interviews with managers and caterers were used to assess the feasibility and acceptability of the intervention. Intervention impact was assessed using generalised linear mixed modelling. The primary outcome was the total energy (kcal) purchased from intervention items in each cafeteria each day. RESULTS: Recruitment and retention of worksite cafeterias proved feasible, with post-intervention feedback suggesting high levels of intervention acceptability. Several barriers to intervention implementation were identified, including chefs' discretion at implementing recipes and the manual recording of sales data. There was no overall effect of the intervention: -0.4% (95%CI -3.8 to 2.9, p = .803). One site showed a statistically significant effect of the intervention, with an estimated 6.6% reduction (95%CI -12.9 to - 0.3, p = .044) in energy purchased in the day following the introduction of calorie labelling, an effect that diminished over time. The remaining five sites did not show robust changes in energy purchased when calorie labelling was introduced. CONCLUSIONS: A calorie labelling intervention was acceptable to both cafeteria operators and customers. The predicted effect of labelling to reduce energy purchased was only evident at one out of six sites studied. Before progressing to a full trial, the calorie labelling intervention needs to be optimised, and a number of operational issues resolved. TRIAL REGISTRATION: ISRCTN52923504 ; Registered: 22/09/2016; retrospectively registered.

Marketing messages accompanying online selling of low/er and regular strength wine and beer products in the UK: a content analysis.

BACKGROUND: Increased availability of low/er strength alcohol products has the potential to reduce alcohol consumption if they are marketed as substitutes for higher strength products rather than as additional products. The current study compares the main marketing messages conveyed by retailers and producers for low/er and regular strength wine and beer products. METHODS: A content analysis of the marketing messages stated (in text) or depicted (in image) for low/er and regular strength wines and beers sold online on the websites of the four main UK retailers (Tesco, ASDA, Sainsbury's, and Morrisons), and the producers of these products between February-March 2016. RESULTS: Four themes were identified: (a) suggested occasions for consumption, (b) health-related associations, (c) alcohol content, and (d) taste. Compared with regular strength products, low/er strength equivalents were more often marketed in association with occasions deemed to be suitable for their consumption including lunchtimes [wine: X 2 (1, n = 172) = 11.75, p = .001], outdoor events/barbeques [beer: X 2 (1, n = 96) = 11.16, p = .001] and on sport/fitness occasions [beer: X 2 (1, n = 96) = 7.55, p = .006]. Compared with regular strength wines and beers, low/er strength equivalents were more frequently marketed with images or text associated with health. These included images of fruit [wine: X 2 (1, n = 172) = 7.78, p = .005; beer: X 2 (1, n = 96) = 22.00, p < .001] and the provision of their energy (calorie) content [wine: X 2 (1, n = 172) = 47.97, p < .001; beer: X 2 (1, n = 96) = 15.10, p < .001]. Low/er strength products were also more often marketed with information about their alcohol content. There were few differences in the marketing messages regarding taste. CONCLUSIONS: Low/er strength wines and beers appear to be marketed not as substitutes for higher strength products but as ones that can be consumed on additional occasions with an added implication of healthiness.

Stuck in the heat or stuck in the hierarchy? Power relations explain regional variations in violence.

We contend that an ecological account of violence and aggression requires consideration of societal and cultural settings. Focusing on hierarchical relations, we argue countries with higher (vs. lower) power distance are, on average, located closer to the equator, have more challenging climates (e.g., higher temperature; lower temperature variation), and have a greater prevalence of violence and aggression (e.g., higher homicide rates).

Boosting Belligerence: How the July 7, 2005, London Bombings Affected Liberals' Moral Foundations and Prejudice.

Major terrorist events, such as the recent attacks in Ankara, Sinai, and Paris, can have profound effects on a nation's values, attitudes, and prejudices. Yet psychological evidence testing the impact of such events via data collected immediately before and after an attack is understandably rare. In the present research, we tested the independent and joint effects of threat (the July 7, 2005, London bombings) and political ideology on endorsement of moral foundations and prejudices among two nationally representative samples (combined N = 2,031) about 6 weeks before and 1 month after the London bombings. After the bombings, there was greater endorsement of the in-group foundation, lower endorsement of the fairness-reciprocity foundation, and stronger prejudices toward Muslims and immigrants. The differences in both the endorsement of the foundations and the prejudices were larger among people with a liberal orientation than among those with a conservative orientation. Furthermore, the changes in endorsement of moral foundations among liberals explained their increases in prejudice. The results highlight the value of psychological theory and research for understanding societal changes in attitudes and prejudices after major terrorist events.

Impact of advertisements promoting candy-like flavoured e-cigarettes on appeal of tobacco smoking among children: an experimental study.

BACKGROUND: There are concerns that the marketing of e-cigarettes may increase the appeal of tobacco smoking in children. We examined this concern by assessing the impact on appeal of tobacco smoking after exposure to advertisements for e-cigarettes with and without candy-like flavours, such as, bubble gum and milk chocolate. METHODS: We assigned 598 English school children (aged 11-16 years) to 1 of 3 different conditions corresponding to the adverts to which they were exposed: adverts for flavoured e-cigarettes, adverts for non-flavoured e-cigarettes or a control condition in which no adverts were shown. The primary endpoint was appeal of tobacco smoking. Secondary endpoints were: appeal of using e-cigarettes, susceptibility to tobacco smoking, perceived harm of tobacco, appeal of e-cigarette adverts and interest in buying and trying e-cigarettes. RESULTS: Tobacco smokers and e-cigarette users were excluded from analyses (final sample=471). Exposure to either set of adverts did not increase the appeal of tobacco smoking, the appeal of using e-cigarettes, or susceptibility to tobacco smoking. Also, it did not reduce the perceived harm of tobacco smoking, which was high. Flavoured e-cigarette adverts were, however, more appealing than adverts for non-flavoured e-cigarettes and elicited greater interest in buying and trying e-cigarettes. CONCLUSIONS: Exposure to adverts for e-cigarettes does not seem to increase the appeal of tobacco smoking in children. Flavoured, compared with non-flavoured, e-cigarette adverts did, however, elicit greater appeal and interest in buying and trying e-cigarettes. Further studies extending the current research are needed to elucidate the impact of flavoured and non-flavoured e-cigarette adverts.

Making food labels social: The impact of colour of nutritional labels and injunctive norms on perceptions and choice of snack foods.

Recent studies report that using green labels to denote healthier foods, and red to denote less healthy foods increases consumption of green- and decreases consumption of red-labelled foods. Other symbols (e.g. emoticons conveying normative approval and disapproval) could also be used to signal the healthiness and/or acceptability of consuming such products. The present study tested the combined effects of using emoticons and colours on labels amongst a nationally representative sample of the UK population (n = 955). In a 3 (emoticon expression: smiling vs. frowning vs. no emoticon) × 3 (colour label: green vs. red vs. white) ×2 (food option: chocolate bar vs. cereal bar) between-subjects experiment, participants rated the level of desirability, healthiness, tastiness, and calorific content of a snack bar they had been randomised to view. At the end they were further randomised to view one of nine possible combinations of colour and emoticon labels and asked to choose between a chocolate and a cereal bar. Regardless of label, participants rated the chocolate as tastier and more desirable when compared to the cereal bar, and the cereal bar as healthier than the chocolate bar. A series of interactions revealed that a frowning emoticon on a white background decreased perceptions of healthiness and tastiness of the cereal bar, but not the chocolate bar. In the explicit choice task selection was unaffected by label. Overall nutritional labels had limited effects on perceptions and no effects on choice of snack foods. Emoticon labels yielded stronger effects on perceptions of taste and healthiness of snacks than colour labels. Frowning emoticons may be more potent than smiling emoticons at influencing the perceived healthiness and tastiness of foods carrying health halos.

How, when, and why is social class linked to mental health and wellbeing? A systematic meta-review.

RATIONALE: Meta-reviews synthesising research on social class and mental health and wellbeing are currently limited and focused on specific facets of social class (e.g., social capital) or mental health and wellbeing (e.g., mental health disorders), and none sought to identify mechanisms in this relationship. OBJECTIVES: The present meta-review sought to (1) assess the overall relationship between social class and mental health and wellbeing, (2) determine the mechanisms that act in this relationship, and (3) evaluate the strength of evidence available. METHODS: The protocol was prospectively registered on PROSPERO (CRD42021214731). We systematically searched twelve databases in September 2022 and identified 149 eligible reviews from 38,257 records screened. Quality of evidence was assessed with the JBI levels of evidence and risk of bias with the ROBIS tool. RESULTS: A large but low-quality evidence base points to class-based inequalities in mental health and wellbeing, with the strongest available evidence linking lower social positions to an increased risk of depression. In terms of different facets of stratification, the best available evidence suggests that deprivation (e.g., poverty), socioeconomic status, income, and subjective social status are consequential for individuals' mental health and wellbeing. However, high-quality evidence for the roles of education, occupation, other economic resources (e.g., wealth), and social capital is currently limited. Most reviews employed individual-level measures (e.g., income), as opposed to interpersonal- (e.g., social capital) or community-level (e.g., neighbourhood deprivation) measures. Considering mechanisms, we found some evidence for mediation via subjective social status, sense of control, and experiences of stress and trauma. There was also some evidence that higher socioeconomic status can provide a buffer for neighbourhood deprivation, lower social capital, and lower subjective social status. CONCLUSIONS: Future research employing experimental or quasi-experimental methods, and systematic reviews with a low risk of bias, are necessary to advance this area of research.

Socioeconomic inequalities in mental health and wellbeing among UK students during the COVID-19 pandemic: Clarifying underlying mechanisms.

Universities are seeing growing numbers of students with poor mental health and wellbeing. Given that lower socioeconomic status (SES) students typically have poorer mental health and wellbeing than their peers, this may be, in part, caused by an increase in the number of students attending university from lower SES backgrounds. However, less is known about how socioeconomic inequalities in mental health and wellbeing persist within university communities. Research investigating psychosocial factors that contribute to socioeconomic disparities in mental health and wellbeing suggests perceived control, inclusion, and perceived worth to be important underlying mechanisms. However, another strand of research suggests perceived competence may also play a mediating role in this relationship. Consequently, the present research seeks to examine fulfilment of perceived control, inclusion, perceived worth, and competence needs as potential mediators in the relationship between subjective SES and mental health and wellbeing in university students. Below, we report the results of a cross-sectional survey conducted among university students (n = 811) in the UK during a period of COVID-19 restrictions. In line with prior research, we found evidence of socioeconomic inequalities in mental health and wellbeing among students. Further, we found subjective SES predicted perceptions of control, inclusion, and competence. In turn, perceived control and competence predicted both positive and negative mental health and wellbeing, whilst inclusion predicted positive mental health and wellbeing only. Unexpectedly, we found no evidence that perceived worth acts as a mediator in this relationship, independently of perceived control, inclusion, and competence. As academic institutions continue to pursue policies to 'widen participation', they also have a responsibility to understand how socioeconomic inequalities in mental health and wellbeing are perpetuated within the university community. Research in this area marks a first step to improve socioeconomic equality within Higher Education.

Understanding the implementation of 'Making Every Contact Count' (MECC) delivered by healthcare professionals in a mental health hospital: protocol for a pragmatic formative process evaluation.

Background: 'Making Every Contact Count' (MECC) is a public health strategy supporting public-facing workers to use opportunities during routine contacts to enable health behaviour change. A mental health hospital in the North East of England is currently implementing a programme to embed MECC across the hospital supporting weight management ('A Weight Off Your Mind'). Bespoke MECC training has been developed to improve staff confidence in discussing physical activity, healthy eating, and related behaviour change with service users. This article describes the protocol for a pragmatic formative process evaluation to inform the implementation plan for MECC and facilitate successful implementation of the bespoke MECC training at scale. Methods/Design: An 18-month, mixed method pragmatic formative process evaluation, including qualitative research, surveys, document review and stakeholder engagement. This project is conducted within a mental health inpatient setting in the North East of England. Programme documents will be reviewed, mapped against MECC national guidelines, Behaviour Change Techniques (BCTs) and intervention functions within the Behaviour Change Wheel. A cross-sectional survey (n = 365) and qualitative semi-structured interviews (n = 30) will be conducted with healthcare practitioners delivering MECC to assess capability, opportunity and motivation. Data collection and fidelity procedures will be examined, including design, training and delivery dimensions of fidelity. Interviews with service users (n = 20) will also be conducted. Discussion: Anticipated outcomes include developing recommendations to overcome barriers to delivery of and access to MECC, including whether to either support the use of the existing MECC protocol or tailor the MECC training programme. The findings are anticipated to improve fidelity of MECC training within mental health inpatient settings as well as provide evidence for MECC training at a national level. We also expect findings to influence strategic plans, policy, and practice specific to MECC and inform best practice in implementing wider brief intervention programmes.

Typology of how 'harmful commodity industries' interact with local governments in England: a critical interpretive synthesis.

INTRODUCTION: Industries that produce and market potentially harmful commodities or services (eg, tobacco, alcohol, gambling, less healthy foods and beverages) are a major influence on the drivers of behavioural risk factors for non-communicable diseases. The nature and impact of interactions between public bodies and 'harmful commodity industries' (HCIs) has been widely recognised and discussed at national and international levels, but to date little is known about such interactions at local or regional government levels. This study aimed to identify and characterise actual and potential interactions and proposes a typology of interactions between HCIs and English local authorities (LAs). METHODS: Five electronic databases covering international literature (PubMed, EBSCO, OVID, Scopus and Web of Science) were searched up to June 2021. We also performed online searches for publicly available, web-based grey literature and documented examples of interactions in an English LA context. We conducted a critical interpretive synthesis of the published and grey literature to integrate and conceptualise the data in the context of English LAs. RESULTS: We included 47 published papers to provide the frame for the typology, which was refined and contextualised for English LAs through the available grey literature. Three categories were developed, describing the medium through which interactions occur: (1) direct involvement with LAs, (2) involvement through intermediaries and (3) involvement through the local knowledge space. Within these, we grouped interactions into 10 themes defining their nature and identified illustrative examples. CONCLUSION: Our typology identifies complex inter-relationships and characterises interactions between HCIs and LAs, with illustrative examples from English LAs. Drawn from well-established theories and frameworks in combination with contextual information on English LAs, this typology explores the LA perspective and could help local decision-makers to maximise population health while minimising negative impacts of HCIs. PROSPERO REGISTRATION NUMBER: CRD42021257311.

Just an anger synonym? Moral context influences predictors of disgust word use.

Are verbal reports of disgust in moral situations specific indicators of the concept of disgust, or are they used metaphorically to refer to anger? In this experiment, participants read scenarios describing a violation of a norm either about the use of the body (bodily moral) or about harm and rights (socio-moral). They then expressed disgust and anger on verbal scales, and through facial expression endorsement measures. The use of disgust words in the socio-moral condition was largely predicted by anger words and only secondarily by disgust faces, whereas in the bodily moral condition the use of disgust words was predicted to a similar extent by disgust faces and anger words. Angry faces, however, never predicted disgust words independently of anger words. These results support a middle-ground position in which disgust words concerning socio-moral violations are not entirely a metaphor for anger, but bear some relationship to other representations of disgust. In the case of socio-moral violations, however, the use of disgust language is more strongly related to anger language, and less strongly to facial representations of disgust than in the case of bodily moral violations.