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1.
J Immunol ; 212(9): 1457-1466, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38497668

RESUMEN

Increased receptor binding affinity may allow viruses to escape from Ab-mediated inhibition. However, how high-affinity receptor binding affects innate immune escape and T cell function is poorly understood. In this study, we used the lymphocytic choriomeningitis virus (LCMV) murine infection model system to create a mutated LCMV exhibiting higher affinity for the entry receptor α-dystroglycan (LCMV-GPH155Y). We show that high-affinity receptor binding results in increased viral entry, which is associated with type I IFN (IFN-I) resistance, whereas initial innate immune activation was not impaired during high-affinity virus infection in mice. Consequently, IFN-I resistance led to defective antiviral T cell immunity, reduced type II IFN, and prolonged viral replication in this murine model system. Taken together, we show that high-affinity receptor binding of viruses can trigger innate affinity escape including resistance to IFN-I resulting in prolonged viral replication.


Asunto(s)
Coriomeningitis Linfocítica , Internalización del Virus , Ratones , Animales , Ratones Noqueados , Virus de la Coriomeningitis Linfocítica/fisiología , Replicación Viral , Ratones Endogámicos C57BL , Inmunidad Innata
2.
Front Neuroendocrinol ; 66: 100998, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35597328

RESUMEN

Differential HPA axis function has been proposed to underlie sex-differences in mental disorders; however, the impact of fluctuating sex hormones across the menstrual cycle on HPA axis activity is still unclear. This meta-analysis investigated basal cortisol concentrations as a marker for HPA axis activity across the menstrual cycle. Through a systematic literature search of five databases, 121 longitudinal studies were included, summarizing data of 2641 healthy, cycling participants between the ages of 18 and 45. The meta-analysis showed higher cortisol concentrations in the follicular vs. luteal phase (dSMC = 0.12, p =.004, [0.04 - 0.20]). Comparisons between more precise cycle phases were mostly insignificant, aside from higher concentrations in the menstrual vs. premenstrual phase (dSMC = 0.17, [0.02 - 0.33], p =.03). In all included studies, nine samples used established cortisol parameters to indicate HPA axis function, specifically diurnal profiles (k = 4) and the cortisol awakening response (CAR) (k = 5). Therefore, the meta-analysis highlights the need for more rigorous investigation of HPA axis activity and menstrual cycle phase.


Asunto(s)
Hidrocortisona , Sistema Hipotálamo-Hipofisario , Adolescente , Adulto , Femenino , Humanos , Hidrocortisona/análisis , Sistema Hipotálamo-Hipofisario/fisiología , Ciclo Menstrual/fisiología , Persona de Mediana Edad , Sistema Hipófiso-Suprarrenal/fisiología , Saliva/química , Adulto Joven
3.
Int J Eat Disord ; 56(6): 1254-1268, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37076868

RESUMEN

OBJECTIVE: CBT-T is a brief (10-week) cognitive-behavioral therapy for non-underweight eating disorders. This report describes the findings from a single center, single group, feasibility trial of online CBT-T in the workplace as an alternative to health service settings. METHOD: This trial was approved by the Biomedical and Scientific Research Ethics committee, University of Warwick, UK (reference 125/20-21) and was registered with ISRCTN (reference number: ISRCTN45943700). Recruitment was based on self-reported eating and weight concerns rather than diagnosis, potentially enabling access to treatment for employees who have not previously sought help and for those with sub-threshold eating disorder symptoms. Assessments took place at baseline, mid-treatment (week 4), post-treatment (week 10), and follow-up (1 and 3 months post-treatment). Participant experiences following treatment were assessed using quantitative and qualitative approaches. RESULTS: For the primary outcomes, pre-determined benchmarks of high feasibility and acceptability were met, based on recruiting >40 participants (N = 47), low attrition (38%), and a high attendance rate (98%) over the course of the therapy. Participant experiences revealed low previous help-seeking for eating disorder concerns (21%). Qualitative findings indicated a wide range of positive impacts of the therapy and the workplace as the therapeutic setting. Analysis of secondary outcomes for participants with clinical and sub-threshold eating disorder symptoms showed strong effect sizes for eating pathology, anxiety and depression, and moderate effect sizes for work outcomes. DISCUSSION: These pilot findings provide a strong rationale for a fully powered randomized controlled trial to determine the effectiveness of CBT-T in the workplace. PUBLIC SIGNIFICANCE: This study demonstrates the feasibility of implementing an eating disorders intervention (online CBT-T) in the workplace as an alternative to traditional healthcare settings. Recruitment was based on self-reported eating and weight concerns rather than diagnosis, potentially enabling access to treatment for employees who had not previously sought help. The data also provide insights into recruitment, acceptability, effectiveness, and future viability of CBT-T in the workplace.


Asunto(s)
Terapia Cognitivo-Conductual , Trastornos de Alimentación y de la Ingestión de Alimentos , Humanos , Estudios de Factibilidad , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Lugar de Trabajo , Autoinforme , Resultado del Tratamiento
4.
BMC Health Serv Res ; 23(1): 942, 2023 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-37660008

RESUMEN

BACKGROUND: Managing long-term sickness absence is challenging in countries where employers and managers have the main responsibility to provide return to work support, particularly for workers with poor mental health. Whilst long-term sick leave and return to work frameworks and guidance exist for employers, there are currently no structured return to work protocols for employers or for their workers encompassing best practice strategies to support a positive and timely return to work outcome. PURPOSE: To utilise the intervention mapping (IM) protocol as a framework to develop return to work toolkits that are underpinned by relevant behaviour change theory targeting mental health to promote a positive return to work experiensce for workers on long-term sick leave. METHODS: This paper provides a worked example of intervention mapping (IM) to develop an intervention through a six-step process to combine theory and evidence in the development of two toolkits - one designed for managers and one to be used by workers on long-term sick leave. As part of this process, collaborative planning techniques were used to develop the intervention. A planning group was set up, through which researchers would work alongside employer, worker, and mental health professional representatives to develop the toolkits. Additionally, feedback on the toolkits were sought from the target populations of workers and managers and from wider employer stakeholders (e.g., human resource specialists). The implementation and evaluation of the toolkits as a workplace intervention were also planned. RESULTS: Two toolkits were designed following the six steps of intervention mapping. Feedback from the planning group (n = 5; psychologist, psychiatrist, person with previous experience of poor mental health, employer and charity worker) and participants (n = 14; employers = 3, wellbeing director = 1; human resources = 2, managers = 2, employees with previous experience of poor mental health = 5) target populations indicated that the toolkits were acceptable and much needed. CONCLUSIONS: Using IM allowed the development of an evidence-based practical intervention, whilst incorporating the views of all the impacted stakeholder groups. The feasibility and acceptability of the toolkits and their supporting intervention components, implementation process and methods of assessment will be evaluated in a feasibility pilot randomised controlled trial.


Asunto(s)
Ausencia por Enfermedad , Lugar de Trabajo , Humanos , Organizaciones de Beneficencia , Personal de Salud , Salud Mental
5.
BMC Med Inform Decis Mak ; 23(1): 271, 2023 11 27.
Artículo en Inglés | MEDLINE | ID: mdl-38012655

RESUMEN

BACKGROUND: Depression is one of the most significant health conditions in personal, social, and economic impact. The aim of this review is to summarize existing literature in which machine learning methods have been used in combination with Electronic Health Records for prediction of depression. METHODS: Systematic literature searches were conducted within arXiv, PubMed, PsycINFO, Science Direct, SCOPUS and Web of Science electronic databases. Searches were restricted to information published after 2010 (from 1st January 2011 onwards) and were updated prior to the final synthesis of data (27th January 2022). RESULTS: Following the PRISMA process, the initial 744 studies were reduced to 19 eligible for detailed evaluation. Data extraction identified machine learning methods used, types of predictors used, the definition of depression, classification performance achieved, sample size, and benchmarks used. Area Under the Curve (AUC) values more than 0.9 were claimed, though the average was around 0.8. Regression methods proved as effective as more developed machine learning techniques. LIMITATIONS: The categorization, definition, and identification of the numbers of predictors used within models was sometimes difficult to establish, Studies were largely Western Educated Industrialised, Rich, Democratic (WEIRD) in demography. CONCLUSION: This review supports the potential use of machine learning techniques with Electronic Health Records for the prediction of depression. All the selected studies used clinically based, though sometimes broad, definitions of depression as their classification criteria. The reported performance of the studies was comparable to or even better than that found in primary care. There are concerns with generalizability and interpretability.


Asunto(s)
Depresión , Registros Electrónicos de Salud , Humanos , Depresión/diagnóstico , Depresión/epidemiología , Aprendizaje Automático
6.
Psychol Sci ; 33(4): 579-594, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35298316

RESUMEN

People make subjective judgments about the healthiness of different foods every day, and these judgments in turn influence their food choices and health outcomes. Despite the importance of such judgments, there are few quantitative theories about their psychological underpinnings. This article introduces a novel computational approach that can approximate people's knowledge representations for thousands of common foods. We used these representations to predict how both lay decision-makers (the general population) and experts judge the healthiness of individual foods. We also applied our method to predict the impact of behavioral interventions, such as the provision of front-of-pack nutrient and calorie information. Across multiple studies with data from 846 adults, our models achieved very high accuracy rates (r2 = .65-.77) and significantly outperformed competing models based on factual nutritional content. These results illustrate how new computational methods applied to established psychological theory can be used to better predict, understand, and influence health behavior.


Asunto(s)
Etiquetado de Alimentos , Juicio , Adulto , Conducta de Elección , Comportamiento del Consumidor , Etiquetado de Alimentos/métodos , Preferencias Alimentarias , Humanos
7.
Int J Eat Disord ; 55(5): 723-730, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35289953

RESUMEN

OBJECTIVE: CBT-T is a brief (10 sessions) version of cognitive behavioral therapy for non-underweight eating disorders. This report describes the protocol for a single center, single group, feasibility trial of online CBT-T in the workplace as an alternative to the health-service setting. By offering mental health services for eating disorders in the workplace, greater accessibility and increased help-seeking behaviors could be achieved. METHOD: Treatment will be delivered online over 10 weeks and offered to employees based on self-referral rather than meeting diagnostic criteria, making treatment available to employees with sub-threshold eating disorder symptoms. RESULTS: Assessments will be conducted at baseline, mid-treatment (week 4), posttreatment (week 10) and at follow-up (1 month and 3 months posttreatment). For the primary outcome, measures will include recruitment, attrition and attendance data using pre-set benchmarks to determine high, medium or low feasibility and acceptability. Qualitative participant experiences data will be analyzed using thematic analysis. Impact on work engagement and effect sizes will be determined from secondary outcome measures; the latter enabling sample size calculations for future study. DISCUSSION: These pilot data will provide insights to recruitment, acceptability, effectiveness and viability of a future fully powered clinical trial of online CBT-T in the workplace. PUBLIC SIGNIFICANCE STATEMENT: This study will present feasibility data from an eating disorders intervention (online CBT-T) using the workplace as an alternative to the healthcare setting to recruit and treat workers. Recruitment will be based on self-reported eating and weight concerns rather than diagnosis potentially enabling treatment to employees who have not previously sought help. The data will also provide insights to recruitment, acceptability, effectiveness, and future viability of CBT-T in the workplace.


Asunto(s)
Terapia Cognitivo-Conductual , Trastornos de Alimentación y de la Ingestión de Alimentos , Terapia Cognitivo-Conductual/métodos , Estudios de Factibilidad , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Humanos , Resultado del Tratamiento , Lugar de Trabajo
8.
Appetite ; 175: 106078, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35533790

RESUMEN

The current research examines the relationships between mothers' experiences of the ways in which they were provided food as a child, their current eating behaviours, and their use of coercive food parenting practices with their own child. Mothers (N = 907 (M = 37 years, SD = 7.7)) completed an online/paper survey that included validated measures of food parenting practices and eating behaviours. Regression analyses show that mothers' experiences of being provided food as a child, and their current eating behaviours are significant unique predictors of engagment in coercive food-related parenting practices with their child. Exploratory mediation analyses further show that the relationship between mothers' experiences of being provided food as a child and use of coercive food-related parenting practices with their child is partially mediated by mothers' eating behaviours. The findings indicate concordance between mothers' experiences of being provided food as a child and use of the same coercive food-related parenting practices with their child. Furthermore, maternal experiences of food-related parenting practices as a child are the strongest predictors of use coercive food parenting practices with their own child. There may be value in focussing on the food-related experiences mothers had as a child in addition to their existing eating behaviours prior to food-related parenting practice intervention. Longitudinal research is needed to strengthen the current findings and to further understand the links identified.

9.
Matern Child Nutr ; 18(3): e13346, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35294102

RESUMEN

Family mealtimes can be important for supporting children's healthy development, yet the emotional context of mealtimes can vary considerably, likely impacting their overall success and enjoyment. Yet, despite having an important role, little is known about how parents emotionally experience mealtimes with their family. The first aim of the current study was to assess the factor structure of a novel self-report measure to assess parents' emotional responses experienced during family mealtimes (Mealtime Emotions Measure for Parents; MEM-P). The second aim was to examine relationships between maternal mealtime emotions and their food parenting practices. Mothers of children aged between 1.5 and 6 years participated in this study. Mothers were invited to complete an online questionnaire measuring family mealtime emotions, anxiety, depression and food parenting practices. Exploratory factor analysis produced a three-factor solution comprising both positive and negative emotion subscales: MEM-P Efficacy; MEM-P Anxiety; MEM-P Stress and Anger. Mothers' positive mealtime emotions (mealtime efficacy) were related to greater use of practices promoting autonomy, providing a healthy home food environment, and modelling healthy eating. Higher anxiety about mealtimes was related to greater reports of child control over eating, and mealtime stress and anger was associated with greater use of food to regulate emotions. These findings highlight novel relationships between how mothers emotionally experience family mealtimes and the food parenting practices they use with their children. It is important to develop resources to help promote positive maternal experiences of family mealtimes and food-based interactions.


Asunto(s)
Madres , Responsabilidad Parental , Niño , Conducta Infantil/psicología , Preescolar , Emociones , Conducta Alimentaria/psicología , Femenino , Humanos , Lactante , Comidas/psicología , Madres/psicología , Responsabilidad Parental/psicología , Padres , Encuestas y Cuestionarios
10.
BMC Psychiatry ; 21(1): 369, 2021 07 23.
Artículo en Inglés | MEDLINE | ID: mdl-34301226

RESUMEN

BACKGROUND: About half of Swedish eating disorder patients report exercising compulsively and compulsive exercise (CE) is prevalent in all diagnoses and both genders. Yet there are no systematic treatments targeting CE in specialist care. This study aims to evaluate the effects of The CompuLsive Exercise Activity TheraPy (LEAP) - a promising group treatment targeting compulsive exercise, in Swedish eating disorder patients. METHOD: One hundred twenty-eight adult females and males suffering from anorexia nervosa, bulimia nervosa or other specified feeding and eating disorders (type 1, 2, or 4) with CE will be recruited via four specialist eating disorder treatment units. Participants will be randomized to receive treatment as usual (control group) or treatment as usual plus LEAP (intervention group). The groups will be assessed on key variables (e.g., BMI, eating disorder symptoms, exercise cognitions and behaviors) at three occasions: initially, after 3 months and after 6 months. DISCUSSION: The project takes place in a clinical setting, including both male and female patients with different eating disorder diagnoses with CE, enabling a good indication of the efficacy of LEAP. If our results are positive, LEAP has the potential of benefiting about half of the eating disorder population, with remission and recovery hopefully improving as a result. TRIAL REGISTRATION: The trial is registered with the ISRCTN registry (registration date 2020-03-25), trial ID: ISRCTN80711391 .


Asunto(s)
Anorexia Nerviosa , Bulimia Nerviosa , Terapia Cognitivo-Conductual , Trastornos de Alimentación y de la Ingestión de Alimentos , Adulto , Bulimia Nerviosa/terapia , Cognición , Ejercicio Compulsivo , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Femenino , Humanos , Masculino , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto
11.
Int J Eat Disord ; 53(3): 404-411, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31762064

RESUMEN

OBJECTIVE: Using calorie-counting and fitness-tracking technologies is concerning in relation to eating disorders. While studies in this area typically assess one aspect of use (e.g., frequency), engagement with a device or application is more complex. Consequently, important relationships between the use of these technologies and the eating disorder symptomatology might remain undetected. The current study therefore used comments from online eating disorder-related forums to generate comprehensive qualitative insights into engagement with a popular calorie-counting and fitness-tracking application, MyFitnessPal. METHOD: First, we extracted every comment mentioning MyFitnessPal made on three eating disorder-related forums between May 2015 and January 2018 (1,695 comments from 920 commenters). Then, we conducted an inductive thematic analysis using these comments to identify important aspects of engagement with MyFitnessPal. RESULTS: The analyses resulted in three themes: Preventing misuse, describing ways in which MyFitnessPal attempts to prevent pathological use and actions taken by users to circumvent its interventions; Accuracy, outlining distrust of MyFitnessPal's accuracy and ways in which perceived inaccuracy is reduced or compensated for; and Psychosocial factors, comprising cognitive, behavioral, and social factors that influence, or are influenced by, engagement with MyFitnessPal. DISCUSSION: The qualitative insights provide a detailed overview of how people with high levels of eating disorder symptomatology likely engage with MyFitnessPal. The insights can be used as a basis to develop valid, quantitative assessment of pathological patterns of engagement with calorie-counting and fitness-tracking technologies. The findings can also provide clinicians with insight into how their patients likely engage with, and are affected by, these devices and applications.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Aplicaciones Móviles/normas , Femenino , Humanos , Internet , Masculino , Investigación Cualitativa
12.
Appetite ; 147: 104525, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-31756411

RESUMEN

BACKGROUND: Current evidence indicates that to prevent the intergenerational transfer of overweight and obesity from parent to child, interventions are needed across the early life stages, from preconception to early childhood. Maternal body image is an important but often overlooked factor that is potentially implicated in both short- and long-term maternal and child health outcomes, including maternal gestational weight gain, postpartum weight retention, obesity, child feeding practices and early parenting. AIM: The aim of this paper is to propose a conceptual model of the relationship between maternal body image (with a specific focus on body dissatisfaction) and maternal and child excess body weight risk across the pregnancy, postpartum and early childhood periods, as well as to highlight opportunities for intervention. CONCLUSION: Our conceptual model proposes factors that mediate the associations between antenatal and postpartum maternal body dissatisfaction and maternal and childhood obesity risk. Pregnancy and postpartum present key risk periods for excess weight gain/retention and body dissatisfaction. Psychosocial factors associated with maternal body dissatisfaction, including psychopathology and disordered eating behaviours, may increase maternal and child obesity risk as well as compromise the quality of mother-child interactions underpinning child development outcomes, including physical weight gain. Our conceptual model may be useful for understanding modifiable psychosocial factors for preventing the intergenerational transfer of obesity risk from mothers to their children, from as early as pregnancy, and highlights next steps for multidisciplinary research focused on combatting maternal and child obesity during critical risk periods.


Asunto(s)
Insatisfacción Corporal , Hijo de Padres Discapacitados/psicología , Madres/psicología , Obesidad/psicología , Responsabilidad Parental/psicología , Complicaciones del Embarazo/psicología , Adulto , Imagen Corporal/psicología , Niño , Preescolar , Conducta Alimentaria/psicología , Femenino , Ganancia de Peso Gestacional , Humanos , Relaciones Madre-Hijo , Periodo Posparto/psicología , Embarazo
13.
Eur Eat Disord Rev ; 28(1): 3-25, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31793151

RESUMEN

OBJECTIVE: The theoretical model by Petrie and Greenleaf (2007, 2012) is an admirable attempt to collate the causal factors of disordered eating in athletes. The aims of this systematic review are (a) to provide an overview of the findings from the relevant literature, (b) to assess whether the model is supported by the existing research, (c) to evaluate the different designs, methods, and measures used to test the mediators in the model, and (d) to highlight areas for improvements and future research. METHOD: A systematic review of four major online databases identified 37 relevant papers on risk factors of disordered eating in athletes, which were reviewed and critically compared with the theoretical model. RESULTS: There is a lack of longitudinal research with the relevant mediators in athlete populations, which makes it difficult to determine whether the potential mediators described by Petrie and Greenleaf are causal risk factors rather than simply correlates of disordered eating for athletes. Findings for all the potential mediators are inconsistent, and the range of measures used makes it problematic to draw conclusions. CONCLUSIONS: Future research needs to use gold standard measures and longitudinal designs in order to fully test and possibly update the model.


Asunto(s)
Atletas/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Atletas/estadística & datos numéricos , Humanos , Modelos Teóricos , Psicopatología , Factores de Riesgo
14.
Int J Eat Disord ; 51(11): 1270-1276, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30508261

RESUMEN

OBJECTIVE: To explore the relationships between the use of food intake and activity monitoring tools with compulsive exercise, eating psychopathology, and psychological wellbeing. METHOD: Participants (N = 352; mean age 21.90 years) indicated their use of activity and food intake monitoring tools, and completed the Compulsive Exercise Test (CET), Eating Disorders Examination Questionnaire (EDE-Q), and the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). RESULTS: Users of monitoring tools reported significantly higher CET and EDE-Q scores than nonusers. Positive associations were detected between the frequency of activity monitoring tool use with CET and EDE-Q scores. Participants who reported using monitoring tools primarily to manage weight and shape reported higher levels of eating and compulsive exercise psychopathology than those who reported using tools to improve health and fitness. DISCUSSION: Features of compulsive exercise and eating psychopathology are elevated among users of food intake and activity monitoring tools; and particularly among those who report using the tools for weight and shape purposes. Longitudinal and experimental research is needed to further our understanding of these observed associations, and specifically to explore the prospective relationships between monitoring tool use, eating psychopathology, and compulsive exercise.


Asunto(s)
Conducta Compulsiva/psicología , Ejercicio Físico/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Psicopatología , Encuestas y Cuestionarios , Adulto Joven
15.
Int J Eat Disord ; 51(7): 647-655, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29734478

RESUMEN

OBJECTIVE: Text-mining offers a technique to identify and extract information from a large corpus of textual data. As an example, this study presents the application of text-mining to assess and compare interest in fitness tracking technology across eating disorder and health-related online communities. METHOD: A list of fitness tracking technology terms was developed, and communities (i.e., 'subreddits') on a large online discussion platform (Reddit) were compared regarding the frequency with which these terms occurred. The corpus used in this study comprised all comments posted between May 2015 and January 2018 (inclusive) on six subreddits-three eating disorder-related, and three relating to either fitness, weight-management, or nutrition. All comments relating to the same 'thread' (i.e., conversation) were concatenated, and formed the cases used in this study (N = 377,276). RESULTS: Within the eating disorder-related subreddits, the findings indicated that a 'pro-eating disorder' subreddit, which is less recovery focused than the other eating disorder subreddits, had the highest frequency of fitness tracker terms. Across all subreddits, the weight-management subreddit had the highest frequency of the fitness tracker terms' occurrence, and MyFitnessPal was the most frequently mentioned fitness tracker. DISCUSSION: The technique exemplified here can potentially be used to assess group differences to identify at-risk populations, generate and explore clinically relevant research questions in populations who are difficult to recruit, and scope an area for which there is little extant literature. The technique also facilitates methodological triangulation of research findings obtained through more 'traditional' techniques, such as surveys or interviews.


Asunto(s)
Minería de Datos , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Monitores de Ejercicio , Internet , Algoritmos , Recolección de Datos , Bases de Datos Factuales , Humanos , Factores de Riesgo
16.
Int J Eat Disord ; 51(8): 999-1004, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-30051623

RESUMEN

OBJECTIVE: To compare the efficacy of the compuLsive Exercise Activity theraPy (LEAP) programme integrated with manualized cognitive behavioral therapy for anorexia nervosa (CBT-AN) compared to CBT-AN alone. METHOD: Seventy-eight adults were randomized to CBT-AN, delivered with or without eight embedded sessions of LEAP, for a total of 34 individual outpatient sessions. Participants were assessed at baseline, the end of the first phase of CBT-AN (which included LEAP), mid-therapy, end of therapy, and at 3 and 6 months follow-up. Linear mixed effects modelling was used for comparing trajectories over time by group in primary outcomes of pathological exercise cognitions and secondary outcomes of exercise frequency, BMI, eating disorder (ED) symptoms, AN stage of change, anxiety/depression, and health related quality of life. RESULTS: There were significant improvements over time in all outcomes. There were no significant differences between treatment groups in primary outcome measures. Fidelity and end-of-treatment participant satisfaction were satisfactory across both conditions. DISCUSSION: CBT-AN and LEAP added to CBT-AN resulted in improved attitudes and beliefs toward exercise and general improvements in BMI and ED psychopathology in people with AN.


Asunto(s)
Anorexia Nerviosa/complicaciones , Terapia Cognitivo-Conductual/métodos , Conducta Compulsiva/psicología , Terapia por Ejercicio/métodos , Calidad de Vida/psicología , Adulto , Femenino , Humanos , Masculino , Resultado del Tratamiento
17.
Infant Ment Health J ; 39(4): 410-422, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29953641

RESUMEN

Despite widespread use of behavioral observations to evaluate child feeding behaviors in research and clinical practice, few studies have comprehensively characterized mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Mealtime observations were conducted for 18 children with avoidant restrictive food intake disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Most behaviors were observed across both clinical and nonclinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviors relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. The comparability of behaviors across clinical and nonclinical groups suggests that eating behaviors exist on a continuum from "normal" to "abnormal," with group differences relating to frequency rather than type of behavior. The behavioral differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape-maintained behaviors will lead to underrecognition of families in need of clinical support.


Asunto(s)
Conducta Infantil/fisiología , Desarrollo Infantil/fisiología , Conducta Alimentaria/fisiología , Trastornos de Ingestión y Alimentación en la Niñez/fisiopatología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino
18.
Int J Eat Disord ; 50(4): 433-436, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28393398

RESUMEN

OBJECTIVE: Examine relationships between parental mealtime strategies used in the family meal session of family-based treatment (FBT) and adolescent outcomes at EOT (session 20). METHOD: Eighteen families with an adolescent receiving FBT-AN participated. Parental strategies during videoed family meals were assessed using a family mealtime coding system. Change scores were calculated for both adolescent %EBW and EDE scores. RESULTS: Increased use of parental direct and non-direct eating prompts during the family meal was associated with greater adolescent weight gain at EOT. Use of parental mealtime strategies was not associated with any significant change in adolescent eating psychopathology at EOT. DISCUSSION: Parental verbal eating prompts during the family meal may be effective in promoting short-term weight gain. During the family meal session, parents should be encouraged to maintain a direct focus on their adolescent child's eating behaviour which may assist their child with food consumption and potential weight gain. Further research examining food-based interactions among parents and their adolescent child with AN is needed. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:433-436).


Asunto(s)
Anorexia Nerviosa/terapia , Terapia Familiar/métodos , Comidas , Relaciones Padres-Hijo , Padres/psicología , Adolescente , Anorexia Nerviosa/psicología , Ingestión de Alimentos/psicología , Femenino , Humanos , Masculino , Resultado del Tratamiento , Aumento de Peso
19.
Int J Eat Disord ; 50(5): 533-541, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-27696468

RESUMEN

OBJECTIVE: Compulsive exercise is a prominent feature for the majority of patients with Anorexia Nervosa (AN), but there is a dearth of research evaluating assessment instruments. This study assessed the concurrent validity of the exercise items of the Eating Disorder Examination (EDE) and Eating Disorder Examination-Questionnaire (EDE-Q), with the Compulsive Exercise Test (CET) and other self-report exercise measures in patients with AN. We also aimed to perform validation of the CET in an adult clinical sample. METHODS: The sample consisted of 78 adults with AN, recruited for the randomized controlled trial "Taking a LEAP forward in the treatment of anorexia nervosa." At baseline, participants completed the EDE, EDE-Q, CET, Reasons for Exercise Inventory (REI), Commitment to Exercise Scale (CES) and Exercise Beliefs Questionnaire (EBQ). Correlational and regression analyses were performed. RESULTS: EDE exercise days and exercise time per day were positively correlated with each other and with all CET subscales (except Lack of exercise enjoyment), CES mean, EBQ total and REI total. Exercise time per day was associated with a higher EDE global score. The CET demonstrated good concurrent validity with the CES, the REI and the EBQ. Of the self-reports, the CET explained the greatest variance in eating disorder psychopathology and demonstrated good to excellent reliability in this sample. DISCUSSION: The EDE and EDE-Q demonstrated good concurrent validity with the CET. Further research is required to evaluate the CET's factor structure in a large clinical sample. However, the CET has demonstrated strong clinical utility in adult patients with AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:533-541).


Asunto(s)
Anorexia Nerviosa/terapia , Prueba de Esfuerzo/métodos , Ejercicio Físico/psicología , Adulto , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Autoinforme , Encuestas y Cuestionarios
20.
Appetite ; 116: 395-400, 2017 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-28536055

RESUMEN

This study aimed to explore differences between mothers with healthy weight versus overweight/obesity in a wide range of their reported child feeding practices and their reports of their children's eating behaviours. Mothers (N = 437) with a 2-6-year-old child participated. They comprised two groups, based on their BMI: healthy weight (BMI of 18.0-24.9, inclusive) or overweight/obese (BMI of 25.0 or more). All mothers provided demographic information and completed self-report measures of their child feeding practices and their child's eating behaviour. In comparison to mothers with healthy weight, mothers with overweight/obesity reported giving their child more control around eating (p < 0.001), but encouraged less balance and variety around food (p = 0.029). They also had a less healthy home food environment (p = 0.021) and demonstrated less modelling of healthy eating in front of their children (p < 0.001). There were no significant differences in mothers' use of controlling feeding practices, such as pressure to eat or restriction, based on their own weight status. Mothers with overweight/obesity reported their children to have a greater desire for drinks (p = 0.003), be more responsive to satiety (p = 0.007), and be slower eaters (p = 0.034). Mothers with overweight/obesity appear to engage in generally less healthy feeding practices with their children than mothers with healthy weight, and mothers with overweight/obesity perceive their children as more avoidant about food but not drinks. Such findings are likely to inform future intervention developments and help health workers and clinicians to better support mothers with overweight/obesity with implementing healthful feeding practices and promoting healthy eating habits in their children.


Asunto(s)
Conducta Infantil , Dieta , Conductas Relacionadas con la Salud , Obesidad/prevención & control , Sobrepeso/prevención & control , Responsabilidad Parental , Adulto , Índice de Masa Corporal , Peso Corporal , Niño , Preescolar , Dieta Saludable , Femenino , Promoción de la Salud , Humanos , Persona de Mediana Edad , Relaciones Madre-Hijo/psicología , Madres , Encuestas y Cuestionarios , Adulto Joven
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