Appetite awareness treatment to prevent obesity in African-American Women

African-American women have the highest rates of obesity within the United States. Obesity is of public health significance, and is associated with numerous co-morbid conditions, including hypertension, diabetes, and various cancers. Behavioral weight loss interventions have not been as effective in African-American women who are obese. Untreated eating behaviors may contribute toward obesity and poorer outcomes in weight loss treatment. The objective of this study is to evaluate participant satisfaction with Appetite Awareness Treatment (AAT), a cognitive-behavioral intervention for binge eating, and generate information to improve its effectiveness among African-American women. African-American women, aged 18-70, with reported binge, overeating, or loss of control eating behaviors, were invited to attend a focus group discussion, following participation in an eight-week community-based AAT intervention. Session content was recorded using a digital audio recorder, and transcribed. Data was analyzed by use of open coding and constant comparison. Themes were generated to describe the experience of participating in the intervention. Seventeen women participated in three traditional focus group discussions to evaluate their experience in AAT. Pertinent themes include the following: satisfaction, cultural relevance, lessons learned, and things to change. AAT was satisfactory, and participants found it valuable to learn more about listening to biological signals of hunger and satiety, and to receive group support from other African-American women. Suggested changes include improving the paper self-monitoring form, increasing the length of the intervention, and providing food in session as part of the intervention instruction. In conclusion, AAT is acceptable, and provides eating behavior instruction that was culturally relevant to participating African-American women. Future research should examine the potential of AAT to improve disordered eating behaviors, and prevent further weight gain in this population

The Feasibility of a Binge Eating Intervention in African-American Women who are Overweight or Obese

African-American women have the highest rates of obesity in the United States, and are at increased risk for a variety of co-morbid health conditions. A significant number of African-American women may have untreated eating disorders that perpetuate their propensity toward obesity. A specific eating pattern that is of serious concern is binge eating, a condition associated with severe obesity. To our knowledge, no intervention research has attempted to treat binge eating among African-American women. In light of this void in the intervention research literature, the purpose of this study was to investigate the feasibility of Appetite Awareness Treatment (AAT), an 8-week cognitive-behavioral binge eating intervention, to reduce binge-eating episodes among African-American women who are overweight and obese. Using a randomized controlled trial design, adult women were randomized to AAT or a Wait-list control (WLC) AAT condition. The sample (N=31), had a mean (±SD) age of 48.81 ±12.79 years, and a body mass index of 33.70 ± 3.90. Within our sample, 83.8% (n=26) completed assessments at 0 and 8 weeks. Overall retention rates were as follows: AAT (n=14, 87.5%) and WLC (n=12; 80%). Moreover, participants completed an average of 2.73/5, or 55% of all homework assignments. To examine the preliminary effectiveness of the AAT intervention, linear mixed modeling was used to examine the differences between the AAT and WLC, as a function of group, time, and group X time interaction, on the outcome variables of BMI, waist circumference, blood pressure, binge eating, eating self-efficacy, and depressive symptoms. At the end of the 8-week intervention, the women in the AAT group had lower mean binge eating scores and higher eating self-efficacy scores than the women in the WLC group. The results of the study suggest that the AAT may improve the eating behaviors and weight outcomes in African-American women who are overweight or obese. The results of this feasibility study highlight the need for the next phase of treatment – a study with a large enough sample (and the associated statistical power) to investigate the efficacy of the AAT in a sample of African-American women, with increased variability in the BMI

The Feasibility of a Binge Eating Intervention in African-American Women who are Overweight or Obese

African-American women have the highest rates of obesity in the United States, and are at increased risk for a variety of co-morbid health conditions. A significant number of African-American women may have untreated eating disorders that perpetuate their propensity toward obesity. A specific eating pattern that is of serious concern is binge eating, a condition associated with severe obesity. To our knowledge, no intervention research has attempted to treat binge eating among African-American women. In light of this void in the intervention research literature, the purpose of this study was to investigate the feasibility of Appetite Awareness Treatment (AAT), an 8-week cognitive-behavioral binge eating intervention, to reduce binge-eating episodes among African-American women who are overweight and obese. Using a randomized controlled trial design, adult women were randomized to AAT or a Wait-list control (WLC) AAT condition. The sample (N=31), had a mean (±SD) age of 48.81 ±12.79 years, and a body mass index of 33.70 ± 3.90. Within our sample, 83.8% (n=26) completed assessments at 0 and 8 weeks. Overall retention rates were as follows: AAT (n=14, 87.5%) and WLC (n=12; 80%). Moreover, participants completed an average of 2.73/5, or 55% of all homework assignments. To examine the preliminary effectiveness of the AAT intervention, linear mixed modeling was used to examine the differences between the AAT and WLC, as a function of group, time, and group X time interaction, on the outcome variables of BMI, waist circumference, blood pressure, binge eating, eating self-efficacy, and depressive symptoms. At the end of the 8-week intervention, the women in the AAT group had lower mean binge eating scores and higher eating self-efficacy scores than the women in the WLC group. The results of the study suggest that the AAT may improve the eating behaviors and weight outcomes in African-American women who are overweight or obese. The results of this feasibility study highlight the need for the next phase of treatment – a study with a large enough sample (and the associated statistical power) to investigate the efficacy of the AAT in a sample of African-American women, with increased variability in the BMI

Accelerating biosimilar market access: the case for allowing earlier standing

Biosimilars, which are affordable alternatives to biologic medicines, face delays in market entry due to the current patent litigation framework under the Biologic Price Competition and Innovation Act. Currently, biosimilar manufacturers can only initiate patent litigation to attempt to clear weak and invalid patents after submitting their Biologic License Application to the Food and Drug Administration (FDA), which happens after completing extensive, and costly clinical trials. By contrast, generic drug manufacturers can start litigation earlier due to shorter development times and less stringent clinical requirements, allowing them to launch immediately after the primary patent expires. We propose allowing biosimilars to begin patent litigation at the start of phase 3 clinical trials, the final stage of biosimilar development, where the product and manufacturing process and product profile are largely finalized. This change would enable biosimilar firms to resolve patent issues well before the brand biologic\u27s primary patent expiration date, potentially reducing market entry delays by about 1.8 years. This article examines the issues surrounding initiation of biosimilar litigation and suggests litigation reforms to expedite biosimilar market availability

Prevalence and contributing factors to recurrent binge eating and obesity among black adults with food insufficiency: findings from a cross-sectional study from a nationally-representative sample

Background: Living in a food-insecure or food insufficient household may increase risk for binge eating and obesity. Because racial disparities in food access, obesity, and access to treatment for disordered eating exist, it is important to examine these relationships in Black populations. Methods: We conducted a secondary analysis of data from the National Survey of American Life (N = 4553), a nationally- representative sample of Black Americans, including African Americans and Afro-Caribbeans. Logistic regression was used to explore the association of food insufficiency with obesity and binge eating. Results: In the total sample of Black Americans, the prevalence of food insufficiency was 10.9% (95% CI 10.0–11.8%). Food insufficiency was not significantly associated with obesity in Black Americans, but when associations were explored in analyses stratified by ethnicity and sex, food insufficiency significantly predicted an increased odds of obesity in Afro-Caribbeans (odds ratio [OR] = 1.47, 95% CI 1.01, 2.13). Individuals experiencing food insufficiency were more likely to report recurrent binge eating in the last 12 months (3% v 2%, P = 0.02) and a lifetime history of binge eating (6% v 3%, P = 0.004) compared to those who were food sufficient. After adjusting for socio-demographic factors, food insufficiency was not significantly associated with recurrent binge eating in Black Americans or in sex- and ethnicity-stratified analyses. Conclusion: The present study reveals a more complex relation between food insufficiency and binge eating than previously thought—although an association existed, it was attenuated by an array of sociodemographic factors. Our results also underscore the importance of considering ethnicity as different patterns emerged between African American and Afro-Caribbean participant

“You have to continue doing the work”: Black women essential workers coping amidst the dual pandemics of COVID-19 and racism

This study sought to examine the experiences of Black women essential workers and their perspectives on wellbeing and coping during the dual pandemics of COVID-19 and structural racism. We used a qualitative approach and purposive sampling techniques to interview 22 essential workers who identified as Black women. Research took place in a large southeastern portion of the United States. Data collection included a brief demographic questionnaire and individual interviews. Thematic and content analysis were used to identify themes and quantify the types of mechanisms used to cope with the pandemics. Four themes were identified to reflect these essential workers’ experiences coping with the pandemics: pervasive distress; varied responses to emergent events; mechanisms for survival; and the persistent obligation to remain strong. Predominant coping mechanisms included the use of social support, faith and spirituality, and increased food consumption. Despite concerns related to imminent threats to their health, widespread uprisings against police brutality, and shifts in caretaking responsibilities, these women’s narratives demonstrated a persistent obligation to remain strong. Moreover, contextual factors related to their roles as essential workers and caretakers, such as others’ reliance on them, contributed to the necessity for survival and their display of strength during such turbulence. These findings highlight the emotional toll essential workers experienced while managing their work-related responsibilities and navigating caregiving roles. Future research should focus on the development of culturally relevant coping strategies to mitigate unwanted effects from pandemic-related stress and dismantling systems of oppression to improve general wellbeing for essential workers and their families

Measuring linkage quality with hashed identifiers: An example using PAYE - ASHE

Objectives ADR-UK supplied the Wage and Employment Dynamics (WED) research team with Pay as You Earn (PAYE) data linked to Annual Survey of Hours and Earnings (ASHE) data. This presentation explains the methodology taken to link PAYE and ASHE databases together, along with quality assurance and analysis of the linked data. Methods The data were primarily linked using deterministic linkage methods on an encrypted National Insurance Number (NINo) variable. A total of four Pay as You Earn tables were linked to the ASHE data. Where a PAYE table contained an encrypted NINo variable, the PAYE table was linked to the ASHE database using exact matching on NINo. Where a PAYE table did not contain an encrypted NINo variable, the table was linked to another PAYE table with an existing NINo variable first and then linked to the ASHE data. Results As multiple HMRC tables were linked to the ASHE database, the linkage rate for each table varies. However, at least 0.93% of each PAYE table linked to the ASHE database. As the ASHE data is based on a 1% sample of employee jobs taken from HMRC’s PAYE records, these linkage rates are considered relatively high. To compensate for loss of variables needed to calculate linkage quality, the data was filtered into categories on the ‘sex’ and ‘age’ variables and the linkage rates analysed. Bias analysis associated to records with a missing NINo value was also investigated. When the records with a missing NINo value were excluded from calculations, the linkage rate for each table rose to 1%. Conclusion This data will be used to assist research outputs that focus on low-pay labour markets and wage progression, wage inequalities and employment. The presentation will also discuss challenges overcome and lessons learnt from this project, with suggestion of how this information can be used to improve ADR-UK projects going forward

Fine-mapping of the HNF1B multicancer locus identifies candidate variants that mediate endometrial cancer risk.

Common variants in the hepatocyte nuclear factor 1 homeobox B (HNF1B) gene are associated with the risk of Type II diabetes and multiple cancers. Evidence to date indicates that cancer risk may be mediated via genetic or epigenetic effects on HNF1B gene expression. We previously found single-nucleotide polymorphisms (SNPs) at the HNF1B locus to be associated with endometrial cancer, and now report extensive fine-mapping and in silico and laboratory analyses of this locus. Analysis of 1184 genotyped and imputed SNPs in 6608 Caucasian cases and 37 925 controls, and 895 Asian cases and 1968 controls, revealed the best signal of association for SNP rs11263763 (P = 8.4 × 10(-14), odds ratio = 0.86, 95% confidence interval = 0.82-0.89), located within HNF1B intron 1. Haplotype analysis and conditional analyses provide no evidence of further independent endometrial cancer risk variants at this locus. SNP rs11263763 genotype was associated with HNF1B mRNA expression but not with HNF1B methylation in endometrial tumor samples from The Cancer Genome Atlas. Genetic analyses prioritized rs11263763 and four other SNPs in high-to-moderate linkage disequilibrium as the most likely causal SNPs. Three of these SNPs map to the extended HNF1B promoter based on chromatin marks extending from the minimal promoter region. Reporter assays demonstrated that this extended region reduces activity in combination with the minimal HNF1B promoter, and that the minor alleles of rs11263763 or rs8064454 are associated with decreased HNF1B promoter activity. Our findings provide evidence for a single signal associated with endometrial cancer risk at the HNF1B locus, and that risk is likely mediated via altered HNF1B gene expression