Do Interprofessional Educational Programmes on Eating Disorders Provide Proximal and Distal Benefits? Findings from a National Cohort Collected from 1998 to 2010

Background: Many programs are launched aiming to raise knowledge and competence in treating eating disorders, yet few of them have been evaluated. Methods and Findings: Using a pre-post and one-year repeated measures design we evaluated a 17-month interprofessional education program (Body and Self-Esteem) comprising a national cohort of participants (n = 845) enrolled from 1998 to 2010. The purpose of the program is to raise health professionals’ 1) knowledge, 2) confidence, 3) clinical competence, and 4) to promote an understanding of how patient care can be organized in an interdisciplinary fashion. The program format consists of five to six one- to three-day seminars with plenary lectures, and four to six closed network groups. The detected changes in all four outcomes were unrelated to program-irrelevant covariates. Program satisfaction was high, and on par with initial expectations. Conclusions: Limited by the fact that a randomized controlled design was impossible to use, a reasonable conclusion is that the program may have provided both immediate and longer-term benefits

How do males recover from eating disorders? An interview study

Objectives - The aim of the current study is to investigate what males experience as helpful in their recovery process from eating disorders (ED). Methods - Qualitative in-depth interviews within a phenomenological approach, and using content analysis to excavate overarching text themes. Setting - Norway and Sweden. Participants - Included were 15 males with an age range from 19 to 52 years. Duration of illness varied between 3 and 25 years of experience with anorexia nervosa (n=10), bulimia nervosa (n=4) or ED not otherwise specified (n=1). Results - The content analysis revealed four main categories, that is, ‘the need for a change’, ‘a commitment to leave the eating disorder behind’, ‘interpersonal changes’ and ‘searching for a life without an eating disorder’. These categories comprise features like motivation to change, gaining structure in eating situations, a re-learning of personal and interpersonal skills as well as accepting losses and starting a reorientation of identity and meaning. We noted a rather goal-oriented approach to help seeking and a variation in how the males engaged their social network in resolving the challenges associated with the recovery process. Still, the overall nature of the recovery process highly accords with what has been reported for women. Discussion - A clinical implication from our findings is that symptom relief is important to facilitate good circles of improvement, but that the nature of the recovery process would require a wider perspective in treatment. Clinicians may also be informed about challenges related to an instrumental approach to help seeking reported in this study

Psychopathy in women: theoretical and clinical perspectives

Prior research on psychopathy has primarily focused on the problem in men. Only a few studies have examined whether psychopathy even exists in women, and if so, how the disorder manifests itself in them. This paper presents a narrative review of the literature on gender and psychopathy. We briefly discuss why this is an important topic for women and we discuss its causes. The concept of psychopathy is defined and related to the diagnostic systems. The discussion includes a presentation of diagnostic tools, including the Hare Psychology Checklist – Revised, which are examined in relationship to the importance of biological gender. While emphasizing the similarities as well as the differences between the sexes, we discuss the matters of prevalence, behavioral expressions, comorbidity, progression, and treatment of the disorder

Effectiveness and acceptability of the physical exercise and dietary therapy in a healthy life center

Objective: The high burden of eating disorders (EDs) and limited availability of treatment speaks of a need to explore new avenues for treatment delivery. To understand if new treatment avenues are helpful and acceptable to patients, we investigated the effectiveness of Physical Exercise and Dietary Therapy (PED-t) in participants with bulimia nervosa or binge-eating disorder, and acceptability when the PED-t was implemented in a Healthy Life Center in a municipal primary healthcare service. Method: Exercise physiologists and one dietitian were trained in ED literacy and to run PED-t, before screening women for eligibility. Effectiveness (n = 16) of PED-t and participants' experiences (n = 8) were evaluated by a mixed methods study design. Results were analyzed by relevant statistics and reflexive thematic analysis. Results: Of 19 eligible participants, 16 completed treatment. At post-treatment, the Eating Disorder Examination Questionnaire global score, binge-eating frequency, and symptoms of depression were lower, and nine (56% of completers) were in remission. Participants' treatment experiences were classified into two overarching themes: “competence” and “emotional support.” Participants reported high acceptance for PED-t, the local venue and group format, and felt that PED-t provided them with coping tools and increased mental strength. However, many also spoke of an unmet need to address emotional eating. Discussion: Findings point to a potential for making an effective ED therapy more accessible, and that participants find the local low-threshold delivery within a groupformat helpful. With small adjustments, the PED-t could emerge as a promising firstline treatment for bulimic EDs. Public Significance Statement: Limited access to treatment for EDs, patients' high barriers to help-seeking, and the high rates of limited efficacy from psychotherapy speak of a need to explore new therapies and avenues for delivery. In this study, we build on findings from a controlled ED treatment trial and replicate the beneficial effects and find a high patient acceptance of “physical exercise and diet therapy” implemented in a real, non-clinical setting.publishedVersio

Sexual Harassment and Abuse among Young Elite Athletes, Recreational Athletes, and Reference Students: A Prospective Study

Purpose: To examine the 12-months prevalence and 12-months prospective change in reported sexual harassment and abuse (SHA)-victimization among young elite athletes, recreational athletes, and reference students in three different social settings and identify the perpetrators. Methods: In total, 919 adolescents responded to an online questionnaire in 12th grade (T1) and 13th grade (T2). The sample consisted of elite athletes (n = 482) and recreational athletes (n = 233) attending Norwegian elite sport high schools (n = 26), and reference students (n = 200) attending ordinary high schools with no sport specialization (n = 6). Data were analyzed using Independent sample t-test, Pearson Chi-Square for independence/Fisher’s Exact test, McNemar test and logistic regression analysis. Results: The total 12-months prevalence of SHA was 38.6% at T1 and 35.1% at T2. Most of the participants (74.6-85.0%) reported no change in SHA from T1 to T2. The prevalence of SHA was higher for girls compared to boys, and elite athletes reported less SHA than recreational athletes and reference students, respectively. SHA occurred most often in a free time setting. Verbal SH, non-verbal SH, and physical SHA were reported by 24.6%, 27.0%, and 14.0%, respectively. Peers were reported as perpetrators by 83.1%, trainer/teacher/health personnel by 20.1%, and “other” perpetrators by 56.4%. Conclusions: As one in three elite athletes and nearly one in two recreational athletes and reference students, respectively, reported SHA-victimization within a 12-months period, well-targeted preventive measures are needed for both young athletes and non-athletes.Sexual Harassment and Abuse among Young Elite Athletes, Recreational Athletes, and Reference Students: A Prospective StudypublishedVersionPaid open acces

Patient and public involvement in health research from researchers' perspective

Background: Patient and public involvement (PPI) is increasingly considered an integral part of health research, and the focus has shifted from why we need PPI to how users can be involved in a meaningful way. The rationale for investigating experiences with PPI from the perspective of occupational therapy (OT)‐trained researchers' originates in the interrelationship between the inclusive approach to knowledge production, and participation and inclusion as core tenets of OT. The aim of this study was to explore PPI in health research from the perspective of OT‐trained researchers. Method: Semi‐structured individual interviews were conducted online with nine Norwegian researchers. The interviews were analysed using reflexive thematic analysis. Results: Professional background and clinical experience from person‐centred OT formed the foundation for how these researchers approached and facilitated PPI in their research. Valuing experiential knowledge and facilitating PPI to be meaningful for public collaborators were highlighted as essential for PPI to have an impact. The need to balance mutual expectations, requirements for research, and what might be possible to achieve within a research study were found to be vital. Conclusion: Collaborative clinical experience constituted a sound foundation for implementing PPI in research. The occupational perspective underlines the importance of acknowledging experiential knowledge as essential to facilitating meaningful PPI. Challenges related to requirements for research and culture for implementing PPI were addressed by clarifying roles and expectations. Patient or Public Contribution: Three public collaborators were involved in developing the aims, the interview guide, and the data analysis. They all had previous experience being involved in research

Analysis and modeling of high temporal resolution spectroscopic observations of flares on AD Leo

We report the results of a high temporal resolution spectroscopic monitoring of the flare star AD Leo. During 4 nights, more than 600 spectra were taken in the optical range using the Isaac Newton Telescope (INT) and the Intermediate Dispersion Spectrograph (IDS). We have observed a large number of short and weak flares occurring very frequently (flare activity > 0.71 hours-1). This is in favour of the very important role that flares can play in stellar coronal heating. The detected flares are non white-light flares and, though most of solar flares belong to this kind, very few such events had been previously observed on stars. The behaviour of different chromospheric lines (Balmer series from H_alpha to H_11, Ca II H & K, Na I D_1 & D_2, He I 4026 AA and He I D_3) has been studied in detail for a total of 14 flares. We have also estimated the physical parameters of the flaring plasma by using a procedure which assumes a simplified slab model of flares. All the obtained physical parameters are consistent with previously derived values for stellar flares, and the areas - less than 2.3% of the stellar surface - are comparable with the size inferred for other solar and stellar flares. Finally, we have studied the relationships between the physical parameters and the area, duration, maximum flux and energy released during the detected flares.Comment: Latex file with 17 pages, 11 figures. Available at http://www.ucm.es/info/Astrof/invest/actividad/actividad_pub.html Accepted for publication in: Astronomy & Astrophysics (A&A

Energy expenditure, dietary intake and energy availability in female professional football players

Objectives: To quantify energy expenditure and intake in professional female footballers playing on a national and/or international level. Second, to determine the prevalence of low energy availability among these players, defined as <30 kcal/kg fat-free mass (FFM)/day. Methods: Fifty-one players completed a 14-day prospective observational study during the 2021/2022 football season. Energy expenditure was determined using the doubly labelled water method. Energy intake was assessed using dietary recalls, while global positioning system determined the external physiological load. Descriptive statistics, stratification and the correlation between explainable variables and outcomes were conducted to quantify the energetic demands. Results: The mean energy expenditure for all players (22±4 years) was 2918±322 kcal. Mean energy intake was 2274±450 kcal, resulting in a discrepancy of ~22%. Carbohydrate intake was below the recommended guidelines on match day at 4.5±1.9 g/kg. The mean energy availability was 36.7±17.7 kcal/kg FFM/day on matchday and 37.9±11.7 kcal/kg FFM/day on training days, resulting in a prevalence of 36% and 23% for low energy availability during the observational period, respectively. Conclusion: These elite female football players displayed moderate energy expenditure levels and failed to meet the recommended levels of carbohydrate intake. In conjunction with inadequate nutritional periodisation, this will likely hamper performance through inadequate muscle glycogen resynthesis. In addition, we found a considerable prevalence of low energy availability on match and training days

Evaluating the suitability of the Low Energy Availability in Females Questionnaire (LEAF-Q) for female footballers

Background - The Low Energy Availability in Females Questionnaire (LEAF-Q) is a screening tool developed to detect endurance athletes and dancers at risk for development of persistent low energy availability (LEA) and the female athlete triad (Triad). This study investigated the applicability of the LEAF-Q in a cohort of sixty professional female football players. Methods - The participants were classified as at risk (≥ 8) or not at risk ( Results - Thirty-two percent of participants were classified as at risk by the LEAF-Q. We found no statistically significant differences between the two groups for any markers associated with persistent LEA. Except for acceptable accuracy in determining menstrual status, all other LEAF-Q components exhibited poor accuracy and predictive values. Youden’s index scores imply that increasing the overall and injury cut-off values to ≥ 10 and ≥ 5 respectively, would yield increased performance. Conclusions - Our findings do not support the use of the LEAF-Q for the purpose of detecting LEA and Triad conditions among female football players