Exploring the mind-body connection from puberty to the interSEXtion of eating disorders and reproductive health: What mental health providers should know.

Eating disorders have potential to significantly impact growth and sexual development, particularly when associated with malnutrition. The hypothalamic-pituitary-gonadal axis, which dictates puberty and sexual maturation, including bone growth, is sensitive to metabolic changes such as those in eating disorders. Consequences may include pubertal delay/arrest, stunted growth, weakened bones, menstrual changes, impotence, sexual dysfunction, infertility, or adverse pregnancy outcomes. The physical and psychological impacts of eating disorders can also affect intimate relationships and sexual satisfaction. Visits to mental health providers offer an opportunity to assess the development and reproductive health concerns of patients with eating disorders. The purpose of this article is to review the epidemiology, pathophysiology, and morbidities of the reproductive sequelae of eating disorders and to educate mental health providers on when to refer patients for further medical evaluation.

The Campaign for Universal Free Lunch in New York City: Lessons Learned.

The New York City (NYC) Department of Education is the largest public school system in the United States, with an enrollment of >1.1 million students. Students who participate in school meal programs can have higher dietary quality than nonparticipating students. Historically, family income documentation qualifying students in the NYC Department of Education for free or reduced-price meals reimbursed by the National School Lunch Program perpetuated poverty stigma. Additionally, National School Lunch Program qualification paperwork was a deterrent to many vulnerable families to participate and impeded all eligible children's access to nutritious meals, potentially magnifying food insecurity. The Healthy, Hunger-Free Kids Act of 2010 provided a viable option for schools to serve free meals to all students, regardless of income status, as a universal free lunch (UFL) through a Community Eligibility Provision if ≥40% of students already participated in another means-based program, such as the Supplemental Nutrition Assistance Program. In this case study, we describe the processes of (1) strategic coalition building of the Lunch 4 Learning campaign (a coalition of students, parents, school-based unions, teachers, pediatricians, community leaders, and children's advocacy organizations) to bring UFL to all NYC public schools, (2) building political support, (3) developing a media strategy, and (4) using an evidence-based strategy to overcome political, administrative, and procedural challenges. The Lunch 4 Learning campaign successfully brought UFL to all NYC public schools in 2017. This case study informs further advocacy efforts to expand UFL in other school districts across the country and national UFL advocacy.

Meta-analysis: drawing conclusions when study results vary.

Low-dose aspirin has been suggested to positively impact a number of clinical outcomes associated with oxidative stress; however, results of clinical trials surrounding its effect on a woman's ability to achieve and sustain pregnancy have been inconclusive. A meta-analysis is an advantageous tool in this situation. Meta-analyses allow researchers to formally and systematically pool together all relevant research in order to clarify findings and form conclusions based on all currently available information. The purpose of this chapter is to describe how to perform a meta-analysis, clarify the impact of model selection, and provide examples of implementation.

Pooling data when analyzing biomarkers subject to a limit of detection.

The use of biomarkers to assess exposure and investigate biomedical questions is common in epidemiology. The usefulness of biomarker research, however, is contingent upon the ability to achieve a complete understanding of the role they play within a population. In estimating distributional parameters for a particular biomarker, such as oxidative stress or antioxidant markers, scientists face two main challenges: overcoming the cost of performing a large number of assays and dealing with data subject to a limit of detection. While approaches have been suggested to deal with each of these issues individually, pooling is a strategy that can address both problems.