Eating disorders

Abstract. Therapist competency is fundamental to the success in treating most psychological disorders. However, the skills required to effectively treat eating disorders may be more demanding than many other problems, because competency requires mastery of considerable educational information about physical complications associated with eating-disorder symptoms and chronic weight suppression. The cognitive-behavioral model of treatment has become well-defined in recent years; however, the mark for therapist competency continues to rise as the knowledge base has expanded with the high level of clinical and research interest in eating disorders. The guidelines provided in this paper are intended to provide a springboard for the training and supervision to improve patient care.Key Words: Eating disorders, eating disorders treatment, cognitive-behavioral treatment, clinician competencies.Resumen. La competencia del terapeuta es fundamental para el éxito en el tratamiento de los Trastornos Psicológicos. Sin embargo, las habilidades que se requieren para tratar eficazmente los Trastornos del Comportamiento Alimentarios pueden ser más demandantes que para otros problemas, porque la competencia requiere del dominio de considerable información educativa acerca de las complicaciones físicas asociadas con los síntomas de los Trastornos Alimentarios y la supresión crónica de peso. El modelo de tratamiento  cognitivo-conductual se ha convertido en el mejor definido en recientes  años, sin embargo, el marco de la competencia del terapeuta continúa aumentando, dado que, la base de conocimientos se ha ampliado con el alto nivel de interés en la investigación clínica y en los trastornos alimentarios. Las directrices que proporciona  este artículo tiene objetivo servir de trampolín para la formación y supervisión para mejorar la atención al paciente.Palabras claves: Trastornos alimentarios, tratamiento de trastorno alimentario, tratamiento cognitivo-conductual, competencias clínica

Impact of Hydration Status on Jump Performance in Recreationally Trained Males

International Journal of Exercise Science 13(4): 826-836, 2020. The vertical jump is commonly used as a means of evaluating athlete readiness. Athletes have been shown to arrive to training and competition in a hypohydrated state. Thus, this investigation sought to examine the impact of hydration status on both countermovement (CMJ) and squat jump (SJ) performance. Twenty-five recreationally trained males completed three CMJ and SJ in a euhydrated, hypohydrated and control condition. Conditions were separated by a minimum of 24 hours. Hydration status was assessed using urine specific gravity. Jump performance was evaluated using both kinematic and kinetic data obtained from a force platform. A repeated-measures ANOVA was performed for each variable of interest in both the CMJ and SJ. CMJ peak and mean force values were significantly greater in the euhydrated condition compared to the hypohydrated condition (p \u3c 0.05), with no differences between the control condition and either experimental condition. SJ showed reductions in jump height, peak and mean velocity, peak and mean power and impulse from control and euhydrated conditions (p \u3c 0.05). The findings of this investigation show that when performing jump testing, specifically SJ, that hydration status of the individual may impact commonly used variables to assess the readiness of the individual for a given day

Information Transfer in Gonadotropin-Releasing Hormone (GnRH) Signaling:Extracellular Signal-Regulated Kinase (ERK)-Mediated Feedback Loops Control Hormone Sensing

Cell signaling pathways are noisy communication channels, and statistical measures derived from information theory can be used to quantify the information they transfer. Here we use single cell signaling measures to calculate mutual information as a measure of information transfer via gonadotropin-releasing hormone (GnRH) receptors (GnRHR) to extracellular signal-regulated kinase (ERK) or nuclear factor of activated T-cells (NFAT). This revealed mutual information values <1 bit, implying that individual GnRH-responsive cells cannot unambiguously differentiate even two equally probable input concentrations. Addressing possible mechanisms for mitigation of information loss, we focused on the ERK pathway and developed a stochastic activation model incorporating negative feedback and constitutive activity. Model simulations revealed interplay between fast (min) and slow (min-h) negative feedback loops with maximal information transfer at intermediate feedback levels. Consistent with this, experiments revealed that reducing negative feedback (by expressing catalytically inactive ERK2) and increasing negative feedback (by Egr1-driven expression of dual-specificity phosphatase 5 (DUSP5)) both reduced information transfer from GnRHR to ERK. It was also reduced by blocking protein synthesis (to prevent GnRH from increasing DUSP expression) but did not differ for different GnRHRs that do or do not undergo rapid homologous desensitization. Thus, the first statistical measures of information transfer via these receptors reveals that individual cells are unreliable sensors of GnRH concentration and that this reliability is maximal at intermediate levels of ERK-mediated negative feedback but is not influenced by receptor desensitization

A prospective safety and feasibility study of metered cryospray for patients with chronic bronchitis in COPD

BACKGROUND: No currently approved intervention counteracts airway metaplasia and mucus hypersecretion of Chronic Bronchitis (CB) in COPD. Metered Cryospray (MCS) delivering liquid nitrogen (LN2) to the tracheobronchial airways ablates abnormal epithelium and facilitates healthy mucosal regeneration. The objective of this study was to evaluate the feasibility, efficacy and safety of MCS in CB. METHODS: Patients with a FEV1, 30-80% of expected, taking optimal medication were recruited. Primary outcomes: feasibility - completion of treatments; efficacy - 3-month change in St George's Respiratory Questionnaire (SGRQ); safety - incidence of adverse events (AEs). SECONDARY OUTCOMES: lung function, exercise capacity, additional patient-reported outcomes (PROs). RESULTS: 35 patients, 19 male/16 female, aged 47-76 years, GOLD grade I (3), II (10) and III (22), underwent staggered LN2 treatments to the tracheobronchial tree.34 patients completed three treatments, each lasting 34·3±12·1 min, separated by 4-6 weeks: one withdrew after the first treatment. Approximately 1800 doses of MCS were delivered.Clinically meaningful improvements in PROs were observed at 3-months; ΔSGRQ -6·4 [95% CI -11.4, -1.3; p=0·01], COPD Assessment Test (CAT) -3·8 [95% CI -6.4, -1.3; p<0·01] and Leicester Cough Questionnaire (LCQ) 21·6 [95% CI 7.3, 35.9; p<0·01]. CAT changes were durable to 6-months (-3·4 [95% CI -5.9, -0.9; p=0·01]), SGRQ and LCQ to 9-months (-6·9 [95% CI -13.0, -0.9; p=0·03] and 13·4 [95% 2.1, 24.6; p=0·02], respectively).At 12-months, 14 serious AEs were recorded in 11 (31·4%) subjects, 6 moderate (43%) and 8 severe (57%). 9 were respiratory-related: 6 exacerbations of COPD, 2 pneumonias, and 1, increased coughing, recovered without sequelae. None were serious device or procedure-related AEs. CONCLUSION: MCS is safe, feasible and associated with clinically meaningful improvements in multidimensional PROs

Immune Function and Muscle Adaptations to Resistance exercise in Older Adults: Study Protocol for a Randomized Controlled Trial of a Nutritional Supplement

BACKGROUND: Immune function may influence the ability of older adults to maintain or improve muscle mass, strength, and function during aging. Thus, nutritional supplementation that supports the immune system could complement resistance exercise as an intervention for age-associated muscle loss. The current study will determine the relationship between immune function and exercise training outcomes for older adults who consume a nutritional supplement or placebo during resistance training and post-training follow-up. The supplement was chosen due to evidence suggesting its ingredients [arginine (Arg), glutamine (Gln), and β-hydroxy β-methylbutyrate (HMB)] can improve immune function, promote muscle growth, and counteract muscle loss. METHODS/DESIGN: Veterans (age 60 to 80 yrs, N = 50) of the United States military will participate in a randomized double-blind placebo-controlled trial of consumption of a nutritional supplement or placebo during completion of three study objectives: 1) determine if 2 weeks of supplementation improve immune function measured as the response to vaccination and systemic and cellular responses to acute resistance exercise; 2) determine if supplementation during 36 sessions of resistance training boosts gains in muscle size, strength, and function; and 3) determine if continued supplementation for 26 weeks post-training promotes retention of training-induced gains in muscle size, strength, and function. Analyses of the results for these objectives will determine the relationship between immune function and the training outcomes. Participants will undergo nine blood draws and five muscle (vastus lateralis) biopsies so that the effects of the supplement on immune function and the systemic and cellular responses to exercise can be measured. DISCUSSION: Exercise has known effects on immune function. However, the study will attempt to modulate immune function using a nutritional supplement and determine the effects on training outcomes. The study will also examine post-training benefit retention, an important issue for older adults, usually omitted from exercise studies. The study will potentially advance our understanding of the mechanisms of muscle gain and loss in older adults, but more importantly, a nutritional intervention will be evaluated as a complement to exercise for supporting muscle health during aging. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT02261961, registration date 10 June 2014, recruitment active

The role of motivation to eat in the prediction of weight control behaviors in female and male adolescents

Objective: To examine whether motivation to eat variables predict changes in dieting and weight control behaviors in both gender groups over time. \ud Method: Greek adolescents (n=247), aged 14–18 years, completed questionnaires measuring different \ud dimensions of motivation to eat, dieting, healthy and unhealthy weight control behaviors. Dieting and weight \ud control behaviors were measured five months later. \ud Results: Compliance motivation positively predicted changes in dieting in males and a number of unhealthy \ud weight control behaviors in females. Coping motivation negatively predicted meal skipping in both genders \ud and was associated with a lower risk of vomiting in females. Social motivation positively predicted eating less \ud high fat food in males while pleasure motivation was associated with a reduced likelihood of eating more \ud fruits and vegetables in females and a reduced risk of fasting in males. \ud Conclusion: Intervention programs designed to facilitate healthy and circumvent unhealthy weight control \ud practices in adolescents should attend to gender differences in motivational factors shown to predict dieting \ud and weight control behaviors. For females it may be important to minimize compliance motivation whereas \ud for males, programs that foster social motivation to eat might be appropriate

Differences in Falls and Recovery From a Slip Based On an Individual\u27s Lower Extremity Corrective Response

Background: Slips and falls account for high rates of injury and mortality in multiple populations. The corrective responses during the slip perturbation have been well documented. However, when a fall results from a slip, it is unclear which of these responses were inadequate. Objective: The purpose of this study was to examine differences in lower extremity corrective responses of the slip recovery response between individuals who fall and those who recover. Methodology: Sixty-four participants completed this study (32 males & 32 females). Participant’s gait kinematics and kinetics were collected during normal gait (NG) and an unexpected slip (US). A prediction equation for slip outcome and slip severity were created using a binary logistic regression model. Results: Our findings show an increased time to peak hip extension (OR = 1.006, CI: 1.000-1.011) and ankle dorsiflexion (OR = 1.005, CI: 1.001-1.009) moments increased the odds of falling, while the average ankle moment was negatively associated with falling (OR = 0.001, CI: 0.001-0.005). Conclusions: Rapid lower extremity corrective responses appear critical in arresting the slip and preventing a fall. While there are various strategies for slip recovery, our findings suggest that the primary recovery mechanism at the slipping hip may play a vital role in preventing the fall

Differences in falls and recovery from a slip based on an individual’s lower extremity corrective response

Copyright (c) the author(s). This is an open access article under CC BY license (https://creativecommons.org/licenses/by/4.0/) Background: Slips and falls account for high rates of injury and mortality in multiple populations. The corrective responses during the slip perturbation have been well documented. However, when a fall results from a slip, it is unclear which of these responses were inadequate. Objective: The purpose of this study was to examine differences in lower extremity corrective responses of the slip recovery response between individuals who fall and those who recover. Methodology: Sixty-four participants completed this study (32 males & 32 females). Participant’s gait kinematics and kinetics were collected during normal gait (NG) and an unexpected slip (US). A prediction equation for slip outcome and slip severity were created using a binary logistic regression model. Results: Our findings show an increased time to peak hip extension (OR = 1.006, CI: 1.000-1.011) and ankle dorsiflexion (OR = 1.005, CI: 1.001-1.009) moments increased the odds of falling, while the average ankle moment was negatively associated with falling (OR = 0.001, CI: 0.001-0.005). Conclusions: Rapid lower extremity corrective responses appear critical in arresting the slip and preventing a fall. While there are various strategies for slip recovery, our findings suggest that the primary recovery mechanism at the slipping hip may play a vital role in preventing the fall

Microbiome function predicts amphibian chytridiomycosis disease dynamics

[Background] The fungal pathogenBatrachochytrium dendrobatidis (Bd) threatens amphibian biodiversity and ecosystem stability worldwide. Amphibian skin microbial community structure has been linked to the clinical outcome of Bd infections, yet its overall functional importance is poorly understood. [Methods] Microbiome taxonomic and functional profiles were assessed using high-throughput bacterial 16S rRNA and fungal ITS2 gene sequencing, bacterial shotgun metagenomics and skin mucosal metabolomics. We sampled 56 wild midwife toads (Alytes obstetricans) from montane populations exhibiting Bd epizootic or enzootic disease dynamics. In addition, to assess whether disease-specific microbiome profiles were linked to microbe-mediated protection or Bd-induced perturbation, we performed a laboratory Bd challenge experiment whereby 40 young adult A. obstetricans were exposed to Bd or a control sham infection. We measured temporal changes in the microbiome as well as functional profiles of Bd-exposed and control animals at peak infection. [Results] Microbiome community structure and function differed in wild populations based on infection history and in experimental control versus Bd-exposed animals. Bd exposure in the laboratory resulted in dynamic changes in microbiome community structure and functional differences, with infection clearance in all but one infected animal. Sphingobacterium, Stenotrophomonas and an unclassified Commamonadaceae were associated with wild epizootic dynamics and also had reduced abundance in laboratory Bd-exposed animals that cleared infection, indicating a negative association with Bd resistance. This was further supported by microbe-metabolite integration which identified functionally relevant taxa driving disease outcome, of which Sphingobacterium and Bd were most influential in wild epizootic dynamics. The strong correlation between microbial taxonomic community composition and skin metabolome in the laboratory and field is inconsistent with microbial functional redundancy, indicating that differences in microbial taxonomy drive functional variation. Shotgun metagenomic analyses support these findings, with similar disease-associated patterns in beta diversity. Analysis of differentially abundant bacterial genes and pathways indicated that bacterial environmental sensing and Bd resource competition are likely to be important in driving infection outcomes. [Conclusions] Bd infection drives altered microbiome taxonomic and functional profiles across laboratory and field environments. Our application of multi-omics analyses in experimental and field settings robustly predicts Bd disease dynamics and identifies novel candidate biomarkers of infection. [MediaObject not available: see fulltext.]K.A.B. was funded by a CASE studentship from NERC, NERC Biomolecular Analysis Facility grant (NBAF939) and an E.P. Abraham Junior Research Fellowship from St Hilda’s College, University of Oxford. M.C.F and T.W.J.G. were funded by NERC award NE/E006701/1 and the Biodiversa project RACE: Risk Assessment of Chytridiomycosis to European Amphibian Biodiversity. T.W.J.G was also funded by Research England and NERC NE/S000062/1. D.S.S. and A.L. received funding through the project People, Pollution, and Pathogens financed through the call “Mountains as Sentinels of Change” by the Belmont-Forum (ANR-15-MASC-0001 - P3, DFG-SCHM3059/6-1, NERC-1633948, NSFC-41661144004). D.S.S. holds the AXA Chair for Functional Mountain Ecology funded by the AXA Research Fund through the project GloMEc and M.C.F. is a fellow in the CIFAR ‘Fungal Kingdoms’ Program

Phenyl Saligenin Phosphate Induced Caspase-3 and c-Jun N-Terminal Kinase Activation in Cardiomyocyte-Like Cells

At present, little is known about the effect(s) of organophosphorous compounds (OPs) on cardiomyocytes. In this study we have investigated the effects of phenyl saligenin phosphate (PSP), two organophosphorothioate insecticides (diazinon and chlorpyrifos) and their acutely toxic metabolites (diazoxon and chlorpyrifos oxon) on mitotic and differentiated H9c2 cardiomyoblasts. OP-induced cytotoxicity was assessed by monitoring MTT reduction, LDH release and caspase-3 activity. Cytotoxicity was not observed with diazinon, diazoxon or chlorpyrifos oxon (48 h exposure; 200 μM). Chlorpyrifos-induced cytotoxicity was only evident at concentrations >100 μM. In marked contrast, PSP displayed pronounced cytotoxicity towards mitotic and differentiated H9c2 cells. PSP triggered the activation of JNK1/2, but not ERK1/2, p38 MAPK or PKB, suggesting a role for this pro-apoptotic protein kinase in PSP-induced cell death. The JNK1/2 inhibitor SP 600125 attenuated PSP-induced caspase-3 and JNK1/2 activation, confirming the role of JNK1/2 in PSP-induced cytotoxicity. Fluorescently labelled PSP (dansylated PSP) was used to identify novel PSP binding proteins. Dansylated PSP displayed cytotoxicity towards differentiated H9c2 cells. 2D-gel electrophoresis profiles of cells treated with dansylated PSP (25 μM) were used to identify proteins fluorescently labelled with dansylated PSP. Proteomic analysis identified tropomyosin, heat shock protein β-1 and nucleolar protein 58 as novel protein targets for PSP. In summary, PSP triggers cytotoxicity in differentiated H9c2 cardiomyoblasts via JNK1/2-mediated activation of caspase-3. Further studies are required to investigate whether the identified novel protein targets of PSP play a role in the cytotoxicity of this OP, which is usually associated with the development of OP-induced delayed neuropathy