Silent witnesses: the experience of having a sibling with anorexia nervosa

BACKGROUND: This study explored the experience of having a sibling with anorexia nervosa and the sibling perspectives on service provision. METHOD: Four focus groups were conducted with 14 siblings (8 female, 6 male, age 11–19 years) of adolescents with anorexia nervosa or related restrictive eating disorders. Group discussions were transcribed and analysed using thematic analysis. RESULTS: Four themes and eight sub-themes were generated. These illustrated siblings feel greatly affected by the way the family needs to change to support someone with anorexia nervosa. Feelings of ambivalence and acceptance were also evident. They described silencing their own emotions and needs so as not to trouble others, and distancing themselves from their families in order to cope. Some female (but no male) siblings identified an impact on their own perceptions of eating and body image. Siblings generally felt that services had not attended to their needs, and that they had not been appropriately included in treatment. CONCLUSIONS: Data from this study suggest the sibling experience needs to be more carefully considered and included in treatment. This may include a more explicit invitation to sessions and a more active discussion about their own needs and useful involvement in treatment sessions. Findings point to ways siblings may be better supported, such as peer support groups. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40337-022-00655-1

The role of the dietitian within family therapy for anorexia nervosa (FT-AN): a reflexive thematic analysis of child and adolescent eating disorder clinician perspectives

Background: Despite dietitians being important members of the multidisciplinary team delivering family therapy for anorexia nervosa (FT-AN), their specific responsibilities and roles are unclear and their involvement in the treatment can be a contentious issue. Methodology: Clinicians (n = 20) experienced in the delivery of FT-AN who were working at a specialist child and adolescent eating disorder service responded to an online survey about their experience of including a dietitian in FT-AN and how they understand the role. Both categorical and open-ended questions were used. Reflexive thematic analysis was used to analyse the qualitative free-text responses of clinician perspectives on the role of the dietitian in FT-AN. Results: All clinicians agreed that dietetics had a role within FT-AN and most frequently sought dietetic involvement in the early phases of FT-AN. Reflexive thematic analysis of responses identified three main themes. These were (1) collaboration is key, (2) confidence as a core consideration and (3) case-by-case approach. These themes evidenced the role of the dietitian within FT-AN and highlighted both the benefits and concerns of this involvement. Conclusions: This study demonstrated that dietitians can take a core role as collaborators within therapy-led teams that facilitate joint working and sharing of expertise. However, dietetic input should be considered on a case-by-case basis, given its potential for creating an over-focus on nutrition and potentially diminishing parental confidence in feeding. When indicated for selected cases, nutritional counselling should be offered in joint sessions with the therapist rather than separately. The findings of the study were limited by the small sample size of participants recruited from a single centre and heterogeneity in the professional background of respondents. Although the integration of dietetics within the multidisciplinary team and the ability of dietitians to individualise patient care can enhance FT-AN treatment, potential benefits and disbenefits should be considered for each case

Expressiveness of Temporal Query Languages: On the Modelling of Intervals, Interval Relationships and States

Storing and retrieving time-related information are important, or even critical, tasks on many areas of Computer Science (CS) and in particular for Artificial Intelligence (AI). The expressive power of temporal databases/query languages has been studied from different perspectives, but the kind of temporal information they are able to store and retrieve is not always conveniently addressed. Here we assess a number of temporal query languages with respect to the modelling of time intervals, interval relationships and states, which can be thought of as the building blocks to represent and reason about a large and important class of historic information. To survey the facilities and issues which are particular to certain temporal query languages not only gives an idea about how useful they can be in particular contexts, but also gives an interesting insight in how these issues are, in many cases, ultimately inherent to the database paradigm. While in the area of AI declarative languages are usually the preferred choice, other areas of CS heavily rely on the extended relational paradigm. This paper, then, will be concerned with the representation of historic information in two well known temporal query languages: it Templog in the context of temporal deductive databases, and it TSQL2 in the context of temporal relational databases. We hope the results highlighted here will increase cross-fertilisation between different communities. This article can be related to recent publications drawing the attention towards the different approaches followed by the Databases and AI communities when using time-related concepts

Analyses and Validation of Conditional Dependencies with Built-in Predicates

This paper proposes a natural extension of conditional functional dependencies (CFDS [14]) and conditional inclusion dependencies (CINDS [8]), denoted by CFD(p)s and CIND(p)s, respectively, by specifying patterns of data, values with not equal, <, <=, > and >= predicates. As data quality rules, CFD(p)s and CIND(p)s are able to capture errors that commonly arise in practice but cannot, be detected by CFDS and CINDS. We establish two sets of results for central technical problems associated with CFD(p)s and CIND(p)s. (a) One concerns the satisfiability and implication problems for CFD(p)s and CIND(p)s, taken separately or together. These are important for, e.g., deciding whether data, quality rules are dirty themselves, and for removing redundant rules. We show that despite the increased expressive power, the static analyses of CFD(p)s and CIND(p)s retain the same complexity as their CFDs and CINDs counterparts. (b) The other concerns validation of CFD(p)s and CIND(p)s. We show that given a set Sigma of CFD(p)s and CIND(p)s on a database D, a, set of SQL queries can be automatically generated that, when evaluated against D, return all tuples in D that violate some dependencies in Sigma. This provides commercial DBMS with an immediate capability to detect errors based on CFD(p)s and CIND(p)s.Computer Science, Information SystemsComputer Science, Theory & MethodsEICPCI-S(ISTP)

Incorporating cardinality constraints and synonym rules into conditional functional dependencies

We propose an extension of conditional functional dependencies (CFDs), denoted by CFD(c)s, to express cardinality constraints. domain-specific conventions, and patterns of semantically related constants in a uniform constraint formalism. We show that despite the increased expressive power, the satisfiability and implication problems for CFD(c)s remain NP-complete and coNP-complete, respectively, the same as their counterparts for CFDs. We also identify tractable special cases. (C) 2009 Elsevier B.V. All rights reserved.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000267170300005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Computer Science, Information SystemsSCI(E)EI5ARTICLE14783-78910

Consistent Query Answers in the Presence of Universal Constraints

The framework of consistent query answers and repairs has been introduced to alleviate the impact of inconsistent data on the answers to a query. A repair is a minimally different consistent instance and an answer is consistent if it is present in every repair. In this article we study the complexity of consistent query answers and repair checking in the presence of universal constraints. We propose an extended version of the conflict hypergraph which allows to capture all repairs w.r.t. a set of universal constraints. We show that repair checking is in PTIME for the class of full tuple-generating dependencies and denial constraints, and we present a polynomial repair algorithm. This algorithm is sound, i.e. always produces a repair, but also complete, i.e. every repair can be constructed. Next, we present a polynomial-time algorithm computing consistent answers to ground quantifier-free queries in the presence of denial constraints, join dependencies, and acyclic full-tuple generating dependencies. Finally, we show that extending the class of constraints leads to intractability. For arbitrary full tuple-generating dependencies consistent query answering becomes coNP-complete. For arbitrary universal constraints consistent query answering is \Pi_2^p-complete and repair checking coNP-complete.Comment: Submitted to Information System

Temporal Databases: Beyond Finite Extensions (position paper)

We argue that temporal databases should not be restricted to relations with finite extensions. many temporal events are periodic and have no natural bounds. Moreover, such events have a more compact representation when allowed to be unbounded. We present two formalisms for representing and querying possibly infinite periodic data and discuss some of their properties, including expressiveness and query evaluation complexity. Finally, we turn to implementation issues and argue that significant extensions to existing database systems are necessary in order to implement the frameworks we describe