Self-Injury and Eating Disorders in Minors: When Should the Human Service Professional Break Confidentiality?

The decision to protect or breach confidentiality is a common ethical dilemma for human service professionals. This decision is further complicated when the client is a child or adolescent. This manuscript examines the issue of confidentiality and minors with two common harmful behaviors in adolescents: self-injury and eating disorders. A continuum of physical and psychological factors are included to help the human service profession in ethical decision making. Two case studies followed by a list of questions to use in the decision making process are also provided

Prioritizing CSR barriers in the Indian Service Industry: A Fuzzy AHP Approach

The present study identifies and prioritizes the barriers pertaining to implementation of corporate social responsibility (CSR) policies in Indian service industries. The 10 most important barriers related to CSR implementation have been first identified and then evaluated for the ranking process using Fuzzy Analytical Hierarchy Process (AHP) based methodology. The outcome of the study clearly presents that lack of top management commitment, lack of significant benefit of CSR, and financial constraints are the most important barriers in effective implementation of sustainable CSR initiatives among organizations belonging to the Indian service industry. These results may be used by decision makers to understand and these barriers, and identify critical success factors for the CSR process, which will help them to ensure that CSR is effectively implemented in their respective organizations.JEL Codes - C35; L80; M1

Study Protocol for a Randomized Controlled Trial Comparing Two Low-Intensity Weight Loss Maintenance Interventions Based on Acceptance and Commitment Therapy or Self-Regulation

Background: Weight regain is common following behavioral obesity treatment and attenuates many of the benefits of initial weight loss. This paper describes a randomized controlled trial that will evaluate the efficacy of two low-contact weight loss maintenance interventions based on Acceptance and Commitment Therapy (ACT) and self-regulation (SR). Potential mechanisms of action and moderators of treatment effects will also be evaluated. Methods: Adults (anticipated N=480)with overweight or obesity will complete an initial 3-monthonline weight loss program (Phase 1). Participants who achieve ≥4 kg weight loss (anticipated N=288) will then be randomized to an ACT or SR weight loss maintenance intervention. Both interventions will entail four2.5 hour, face-to-face, group-based workshop sessions and 6 months of email contact. Assessments will be conducted at phase 1 baseline, phase 1 completion/pre-randomization, and 6, 12, 18, 24, and 30 months post-randomization. The primary outcome will be weight change for the period from randomization to 30 months. Potential process measures including ACT-based constructs (e.g., psychological acceptance, values-consistent behavior), self-weighing frequency, and motivation will be also be assessed, as will potential moderators (e.g., initial weight loss). Conclusions: This study will compare the efficacy of two intervention approaches (ACT and SR) delivered in a scalable workshop format for long-term weight loss maintenance. Future research could examine efficacy and cost-effectiveness of these approaches in real world settings

Wearing the Future-Wearables to Empower Users to Take Greater Responsibility for Their Health and Care:Scoping Review

BACKGROUND: Wearables refer to devices that are worn by individuals. In the health care field, wearables may assist with individual monitoring and diagnosis. In fact, the potential for wearable technology to assist with health care has received recognition from health systems around the world, including a place in the strategic Long Term Plan shared by the National Health Service in England. However, wearables are not limited to specialist medical devices used by patients. Leading technology companies, including Apple, have been exploring the capabilities of wearable health technology for health-conscious consumers. Despite advancements in wearable health technology, research is yet to be conducted on wearables and empowerment. OBJECTIVE: This study aimed to identify, summarize, and synthesize knowledge on how wearable health technology can empower individuals to take greater responsibility for their health and care. METHODS: This study was a scoping review with thematic analysis and narrative synthesis. Relevant guidance, such as the Arksey and O’Malley framework, was followed. In addition to searching gray literature, we searched MEDLINE, EMBASE, PsycINFO, HMIC, and Cochrane Library. Studies were included based on the following selection criteria: publication in English, publication in Europe or the United States, focus on wearables, relevance to the research, and the availability of the full text. RESULTS: After identifying 1585 unique records and excluding papers based on the selection criteria, 20 studies were included in the review. On analysis of these 20 studies, 3 main themes emerged: the potential barriers to using wearables, the role of providers and the benefits to providers from promoting the use of wearables, and how wearables can drive behavior change. CONCLUSIONS: Considerable literature findings suggest that wearables can empower individuals by assisting with diagnosis, behavior change, and self-monitoring. However, greater adoption of wearables and engagement with wearable devices depend on various factors, including promotion and support from providers to encourage uptake; increased short-term investment to upskill staff, especially in the area of data analysis; and overcoming the barriers to use, particularly by improving device accuracy. Acting on these suggestions will require investment and constructive input from key stakeholders, namely users, health care professionals, and designers of the technology. As advancements in technology to make wearables viable health care devices have only come about recently, further studies will be important for measuring the effectiveness of wearables in empowering individuals. The investigation of user outcomes through large-scale studies would also be beneficial. Nevertheless, a significant challenge will be in the publication of research to keep pace with rapid developments related to wearable health technology

Patient-Related Barriers to Timely Dialysis Access Preparation: A Qualitative Study of the Perspectives of Patients, Family Members, and Health Care Providers

Rational & Objective A key aspect of smooth transition to dialysis is the timely creation of a permanent access. Despite early referral to kidney care, initiation onto dialysis is still suboptimal for many patients, which has clinical and cost implications. This study aimed to explore perspectives of various stakeholders on barriers to timely access creation. Study Design Qualitative study. Setting & Participants Semi-structured interviews with 96 participants (response rate, 67%), including patients with stage 4 chronic kidney disease (n = 30), new hemodialysis patients with (n = 18) and without (n = 20) permanent access (arteriovenous fistula), family members (n = 19), and kidney health care providers (n = 9). Analytical Approach Thematic analysis. Results Patients reported differential levels of behavioral activation toward access creation: avoidance/denial, wait and see, or active intention. 6 core themes were identified: (1) lack of symptoms, (2) dialysis fear and practical concerns (exaggerated fear, pain, cost, lifestyle disruptions, work-related concerns, burdening their families), (3) evaluating value against costs/risks of access creation (benefits, threat of operation, viability, prompt for early initiation), (4) preference for alternatives, (5) social influences (hearsay, family involvement, experiences of others), and (6) health care provider interactions (mistrust, interpersonal tension, lack of clarity on information). Themes were common to all groups, whereas nuanced perspectives of family members and health care providers were noted in some subthemes. Limitations Response bias. Conclusions Individual, interpersonal, and psychosocial factors compromise dialysis preparation and contribute to suboptimal dialysis initiation. Our findings support the need for interventions to improve patient and family engagement and address emotional concerns and misperceptions about preparing for dialysis

Compensation Theory: Can Club Soccer Players Appropriately Balance Energy Intake and Output in and out of Season?

Obesity is a worldwide epidemic affecting both adults and children. Obesity and overweight prevalence is increasing, with a corresponding decline in physical fitness and general physical activity level (McHugh, 2010). The college setting presents an important opportunity for health promotion during a critical developmental stage for weight gain (Nelson et al., 2007). While exercising and a balanced diet are the basis of most obesity-prevention campaigns, little research has been done on how physical exercise may increase food consumption. The purpose of this study was to examine whether college club soccer players can appropriately balance energy intake and output in and out of season. A convenience sample of twenty-four college students (14 males and 10 females), at a midsized southeastern university between the ages of 18 and 23 years participated in the study. Self-reported anthropometrics and three-day food logs were obtained. Participants were given accelerometers to be worn under clothes on right side of hip for seven days. Food logs and accelerometers were analyzed one time during season and one month post season to receive normal training week and normal out of season readings for food consumption and activity levels. The average calories consumed increased from 1885 kcal/day in season to 1937 kcal/day out of season. The average calories burned decreased from 479.39 kcal/day in season to 451.46 out of season. There were no significant differences for physical activity besides a significant decrease in Total Vigorous Time in minutes. Coaches and dietitians need to encourage and educate athletes on healthier food choices and knowledge on energy balance, so during the off season athletes do not hinder their performance by being out of shape or overweight. More studies are needed to examine compensatory effects with different populations with both starting and ending exercise programs

Back to Work: The Effects of Goal Conflict on Working Mothers

Why is the rate of depression for women two times that of men? In the “we can do it all” generation, becoming a mother can be one of the most frustrating and rewarding experiences in one’s lifetime. Fulfilling career goals in addition to the demands motherhood can cause psychological distress. In this paper I present literature reviews on mothering, careers, goal conflict and how positive psychology tools can help alleviate depression in women. Based on research, I outlined four topics to build a workshop that will help working mothers bounce back from adversity, develop their signature strengths, avoid negative thinking traps as well as minimize the number of decisions they need to make with a technique called satisficing. This approach will invite organizations to invest in their working mothers, as their well-being is important for both families and the world economy

Pregnancy-related urinary incontinence, does it bother?

Pregnancy-related urinary incontinence is very common and will not resolve by itself in many cases. Pelvic floor muscle exercises are an effective treatment option with equal effectiveness in individual and group therapy. However, uncertainty exists about the effect of pelvic floor muscle exercises in a group for pregnant and post-partum women with urinary incontinence. In the motherfit study, the effect of pelvic floor muscle group therapy for peri-partum women with urinary incontinence is compared with usual care. In addition, more precise data regarding the number of pregnant and up to one year post-partum women and their experienced bother were revealed in literature studies. To acquire more knowledge on experienced bother and help-seeking behaviour of Dutch pregnant and post-partum women, two surveys were distributed. Finally, to gain more in-depth knowledge on urinary incontinence and help-seeking behaviour, peripartum women and health care professionals were interviewed

An Assessment of Panhellenic Sorority Member Meal Consumption Patterns

The purpose of study was to determine sorority members’ frequency of meal consumption versus meals offered in sorority houses at a flagship university in the south and to compare the Body Mass Indices (BMIs) of sorority members who consumed less than six (\u3c6) meals to those who consumed six or more (≥6) meals/week at their sorority houses. Another object of this study was to note the relationship between frequency of sorority meal consumption and adequacy of sorority members’ diets in relation to MyPyramid. The sample consisted of 72 Panhellenic sorority members ages 18-22 year sold at the time of participation. All members completed a “Questionnaire of Eating Behaviors” and a 24-hour dietary recall. Weight, height, and number of servings consumed of each MyPyramid food group were recorded. Members consuming ≥6 meals/week at their sorority houses had greater mean intake of each food group and lower mean BMIs than those consuming \u3c6 meals. According to the results of this study, structured meals and meal times may help sorority members maintain a healthier weight