Changes in the eating disorder voice over time and the association of voice characteristics at baseline with clinical symptoms in patients with anorexia nervosa.

OBJECTIVE: Patients with eating disorders report the experience of living with an eating disorder voice, a second- or third-person, negative commentary about eating, weight, shape and their implications for self-esteem. Qualitative and cross-sectional studies suggest that the severity and characteristics of the eating disorder voice might play a role in the maintenance of eating disorder symptoms. The goal of this study was to expand the evidence base as to how the eating disorder voice changes over time and whether the characteristics of the voice are associated with changes in eating disorder symptoms during treatment. METHOD: Seventy-two patients with anorexia nervosa receiving intensive eating disorder treatment were recruited. They completed self-report measures of eating disorder symptoms, psychological distress and eating disorder voice's severity and characteristics (e.g., malevolence, benevolence and omnipotence) at baseline and approximately 6 months later. RESULTS: Over time, patients reported lower levels of eating and weight concern (small effect size), shape concern (large effect size) and anxiety (small effect size). They also reported a reduction in the severity, perceived malevolence (medium effect size) and omnipotence (small effect size) of the eating disorder voice. Greater severity and malevolence of the voice, and lower benevolence at baseline predicted greater reductions in eating disorder symptoms (i.e., restraint and shape concern). CONCLUSION: Beliefs about the eating disorder voice (i.e., malevolence) and severity of the voice appear to be malleable to treatment and are associated with a reduction of eating disorder symptoms. The potential of using dialogical approaches to target the eating disorder voice is discussed.

Effects of exercise and physical activity on gut microbiota composition and function in older adults: a systematic review.

BACKGROUND: The characterization and research around the gut microbiome in older people emphasize microbial populations change considerably by losing the diversity of species. Then, this review aims to determine if there is any effect on the gut microbiota of adults older than 65 that starts an exercise intervention or improves physical activity level. Also, this review describes the changes in composition, diversity, and function of the gut microbiota of older subjects that had improved their physical activity level. METHODS: The type of studies included in this review were studies describing human gut microbiota responses to any exercise stimulus; cross-sectional studies focused on comparing gut microbiota in older adults with different physical activity levels-from athletes to inactive individuals; studies containing older people (women and men), and studies written in English. This review's primary outcomes of interest were gut microbiota abundance and diversity. RESULTS: Twelve cross-sectional studies and three randomized controlled trials were examined. Independently of the type of study, diversity metrics from Alpha and Beta diversity remained without changes in almost all the studies. Likewise, cross-sectional studies do not reflect significant changes in gut microbiota diversity; no significant differences were detected among diverse groups in the relative abundances of the major phyla or alpha diversity measures. Otherwise, relative abundance analysis showed a significant change in older adults who conducted an exercise program for five weeks or more at the genus level. CONCLUSIONS: Here, we did not identify significant shifts in diversity metrics; only one study reported a significant difference in Alpha diversity from overweight people with higher physical activity levels. The abundance of some bacteria is higher in aged people, after an exercise program, or in comparison with control groups, especially at the genus and species levels. There needs to be more information related to function and metabolic pathways that can be crucial to understand the effect of exercise and physical activity in older adults. TRIAL REGISTRATION: PROSPERO ID: CRD42022331551.

A proof-of-concept study for the use of a computerised avatar to embody the eating disorder voice in anorexia nervosa.

PURPOSE: This study assessed (1) the experience of the eating disorder voice in people with anorexia nervosa or in remission, and (2) the feasibility of creating and interacting with a computerised representation (i.e., avatar) of this voice. METHODS: Twenty-one individuals with anorexia nervosa and 18 individuals who were in remission participated in the study. They reported on the characteristics of their eating disorder voice and created a personalised avatar (a visual and auditory representation of the eating disorder voice), using a computerised software. Participants assessed closeness of match between the voice and the avatar, perceived distress and acceptability of re-exposure to the avatar. RESULTS: Patients felt less powerful than their eating disorder voice and unable to disregard the voice's commands. The experience of the voice was associated with negative, as well as some positive emotions, reflecting the prototypical ambivalence towards the illness. Individuals in remission had an opposite pattern of responses. They attributed only negative emotions to the voice, felt more powerful than the voice, and able to disregard its commands. Overall participants reported that there was a good match between the voice and the sound of the avatar. Patients expressed willingness to repeat exposure to the avatar. CONCLUSION: Individuals with anorexia can create personalised digital avatars representing the eating disorder voice and are willing to engage therapeutically with the avatar. The next step is to test the feasibility of repeated exposure to the avatar to address the power and distress associated with the eating disorder voice. LEVEL OF EVIDENCE: Level III.

Morphological and molecular characterization of Castniidae (Lepidoptera) associated to sugarcane in Colombia.

The giant sugarcane borer, Telchin licus, has been reported as an economically important sugarcane pest in Colombia; however, its taxonomic status has been scarcely investigated and previous reports offer an ambiguous characterization of both the immature and adult stages. The objective of this work is to identify Telchin species affecting sugarcane and alternative hosts in different departments of the country by integrating molecular analysis and conventional morphology. To date, T. licus has been found in the departments of Caquetá, Casanare, and Meta, while T. atymnius has been found in Antioquia, Caldas, Nariño, and Valle del Cauca. Sugarcane, Musaceae, and Heliconiaceae have been found to be hosts to both species. Additionally, the species T. cacica has also been registered in the department of Nariño, affecting heliconias and plantains. Genetic variation within the species allowed differentiation at the molecular level of subspecies of T. licus and T. atymnius, confirming that the subspecies present in Colombia are T. licus magdalena, T. atymnius humboldti, and T. atymnius atymnius. The haplotype diversity of populations is closely related to their geographical distribution, indicating low gene flow between populations and possible speciation inside the country. Analysis of genetic variance showed significant differences among and within T. atymnius populations, which may suggest a high genetic structure along the regions where it is found and the possible presence of additional subspecies to those previously reported. To understand the geographical and environmental conditions that determine the pest's distribution in Colombia, this information needs to be complemented with ecological considerations of possible geographical isolation and association of alternative hosts.

Association between physical activity and changes in intestinal microbiota composition: A systematic review.

INTRODUCTION: The intestinal microbiota comprises bacteria, fungi, archaea, protists, helminths and viruses that symbiotically inhabit the digestive system. To date, research has provided limited data on the possible association between an active lifestyle and a healthy composition of human microbiota. This review was aimed to summarize the results of human studies comparing the microbiome of healthy individuals with different physical activity amounts. METHODS: We searched Medline/Ovid, NIH/PubMed, and Academic Search Complete between August-October 2020. Inclusion criteria comprised: (a) cross-sectional studies focused on comparing gut microbiome among subjects with different physical activity levels; (b) studies describing human gut microbiome responses to any type of exercise stimulus; (c) studies containing healthy adult women and men. We excluded studies containing diet modifications, probiotic or prebiotic consumption, as well as studies focused on diabetes, hypertension, cancer, hormonal dysfunction. Methodological quality and risk of bias for each study were assessed using the Risk Of Bias In Non-randomized Studies-of Interventions tool. The results from cross-sectional and longitudinal studies are shown independently. RESULTS: A total of 17 articles were eligible for inclusion: ten cross-sectional and seven longitudinal studies. Main outcomes vary significantly according to physical activity amounts in longitudinal studies. We identified discrete changes in diversity indexes and relative abundance of certain bacteria in active people. CONCLUSION: As literature in this field is rapidly growing, it is important that studies incorporate diverse methods to evaluate other aspects related to active lifestyles such as sleep and dietary patterns. Exploration of other groups such as viruses, archaea and parasites may lead to a better understanding of gut microbiota adaptation to physical activity and sports and its potentially beneficial effects on host metabolism and endurance.

A systematic review of the 'eating disorder voice' experience.

The 'eating disorder voice' experience has been reported by both clinicians and by patients with eating disorders (ED) as an important feature of eating psychopathology, however this has only become an area of research in the last decade. The main aim of this paper was to systematically review and synthesize the available literature on this topic. Systematic searches of seven electronic databases were performed up to June 2018. Thirteen peer-reviewed articles were identified. Findings suggested that the existence of an 'ED voice' is often recognized by patients with eating disorders and that this voice has a powerful, negative and omnipotent nature. Feelings of entrapment and defeat are commonly experienced in response to it and patients appear ambivalent towards it. The negative characteristics and responses to the voice are associated with eating disorder symptoms. Addressing the eating disorder voice using relational and interpersonal approaches has the potential to improve clinical and treatment outcomes for patients with eating disorders.

Transition Care in Anorexia Nervosa Through Guidance Online from Peer and Carer Expertise (TRIANGLE): Study Protocol for a Randomised Controlled Trial.

TRIANGLE is a multicentre trial investigating whether the addition of a novel intervention for patients and carers (ECHOMANTRA) to treatment as usual (TAU) improves outcomes for people with anorexia nervosa (AN). ECHOMANTRA is based on the cognitive interpersonal model of AN and includes assessments, workbooks, videos, online groups and joint Skype sessions for patients and carers. People receiving intensive hospital treatment (N = 380) will be randomised to TAU or TAU plus ECHOMANTRA. Participants will be assessed over an 18-month period following randomisation. The primary outcome is patient psychological well-being at 12 months postrandomisation. Secondary outcomes include (i) patient's weight, eating disorder symptoms, motivation to change, quality of life and number of days in hospital at 12 months postrandomisation and (ii) carer's psychological well-being, burden and skills at 12 months (some outcomes will be assessed at 18 months postrandomisation). The results from this trial will establish the effectiveness of ECHOMANTRA. TRIAL REGISTRATION: ISRCTN registry ISRCTN14644379, 08/12/2016. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Una propuesta attropológica para la comprensiónde la resiliencia en niños: lass virtudes humanas / An anthropologiaal proposal to understand children's resilience: human virtues / Uma proposta antropológica para a compreensão da resiliência nas crianças: as virtudes humanas

El abordaje de la resiliencia ha tenido algunas modificaciones a lo largo de los años. En un principio, se enfocaba en los aspectos negativos que las personas generaban en medio de la adversidad. Posteriormente, se ha centrado en las características positivas que pueden desarrollarse como producto de estas situaciones. El objetivo de este trabajo consistió en generar una reflexión sobre la manera de comprender y conceptualizar la resiliencia desde diferentes perspectivas teóricas y así generar una nueva manera de entenderla de acuerdo con las virtudes humanas desde la antropología filosófica. Para cumplir con este propósito, se llevó a cabo una revisión de la literatura empírico-analítica de los estudios que proponían una manera de evaluar y medir este concepto. Aunque existen algunas propuestas para medir la resiliencia desde diferentes disciplinas, ninguno de los estudios previos tuvo en cuenta las virtudes humanas como indicadores de resiliencia desde la antropología filosófica.

The approach to resilience has undergone several changes over the years. Initially, it concentrated on the negative aspects persons generate in the midst of adversity. Subsequently, the focus has been on the positive characteristics that may develop as a result of these situations. The aim of this study is to reflect on how resilience can be understood and conceptualized from different theoretical perspectives and, thus, to find new ways to understand it based on human virtues from the perspective of philosophical anthropology. To do so, the authors reviewed empirical-analytic literature on studies that propose ways to assess and measure this concept. Although there are some proposals to measure resilience through different disciplines, none of the previous studies took into account human virtues as indicators of resilience from the standpoint of philosophical anthropology.

A abordagem da resiliência vem tendo algumas modificações ao longo dos anos. Em um princípio, enfocava-se nos aspectos negativos que as pessoas geravam em meio da adversidade. Posteriormente, centrou-se nas características positivas que podem se desenvolver como produto dessas situações. O objetivo deste trabalho consiste em gerar uma reflexão sobre a maneira de compreender e conceitualizar a resiliência sob diferentes perspectivas teóricas e, assim, gerar uma nova maneira de entendê-la de acordo com as virtudes humanas a partir da antropologia filosófica. Para atingir este propósito, realizou-se uma revisão da literatura empírico-analítica dos estudos que propunham uma maneira de avaliar e medir este conceito. Embora existam algumas propostas para medir a resiliência desde diferentes disciplinas, nenhum dos estudos prévios considerou as virtudes humanas como indicadores de resiliência a partir da antropologia filosófica.