Exploring Therapists Reflective Experiences of Working with British Ethnic Minorities with Eating Disorders

Research highlights that ethnic minority females are less likely to receive a diagnosis or treatment for an eating disorder (ED). The other half of the therapeutic alliance is therapists, and their role and input should not be understated when aiming for positive outcomes for this group. This research explores therapists perspectives in terms of their experiences; what working with this group means to the therapists themselves; and their experience of working with cultural concepts. Semi-structured interviews were conducted with 12 therapists in the UK, London and thematic analysis was used to analyse the data. Shame was often cited as a barrier to accessing help. This had different influences on their therapeutic work, such as not questioning shame or linking this to a negative interpretation of parents. There was also the concept that ethnic minorities were more likely to present with emotional and interpersonal factors fuelling the ED, although this conflicted with the notion of the Western body ideal being an influence. Participants also revealed a feeling of being restricted by service management, having a limited time to reflect on cultural issues, and the worry about being offensive or doing something wrong. Subtle steps can be taken to encourage new and creative ways of addressing the issues highlighted. Services and guidelines should support therapists through regular reflective practice on cultural issues. Hierarchy in teams could be addressed by encouraging diversity in decision making. To break down the perceived barrier of shame, the use of cultural genograms and cultural scripts could be encouraged to understand the ED context. Referral guides could be developed to inform primary care of the warning signs of EDs that may not feature in the diagnostic criteria. Recommendations should aim to balance the nuances of the individual, alongside a systematic rollout to address unmet needs

Motivating People with Chronic Pain to do Physical Activity: Opportunities for Technology Design

Physical activity is important for improving quality of life in people with chronic pain. However, actual or anticipated pain exacerbation, and lack of confidence when doing physical activity, make it difficult to maintain and build towards long-term activity goals. Research guiding the design of interactive technology to motivate and support physical activity in people with chronic pain is lacking. We conducted studies with: (1) people with chronic pain, to understand how they maintained and increased physical activity in daily life and what factors deterred them; and (2) pain-specialist physiotherapists, to understand how they supported people with chronic pain. Building on this understanding, we investigated the use of auditory feedback to address some of the psychological barriers and needs identified and to increase self-efficacy, motivation and confidence in physical activity. We conclude by discussing further design opportunities based on the overall findings

Pre-treatment patient characteristics as predictors of drop-out and treatment outcome in individual and family therapy for adolescents and adults with anorexia nervosa: A systematic review and meta-analysis

Understanding variables predicting drop-out or unfavourable outcome following treatment for anorexia nervosa (AN) may help to improve upon intervention efforts. However, the current literature has demonstrated sparse and inconsistent significant findings. The current systematic review and meta-analysis summarised the evidence base examining baseline predictors of drop-out and outcome in AN treatment. A literature search was conducted to identify research investigating predictors of drop-out and outcome in individuals treated for AN. Four online databases were searched, and predictors were organised by category and dependent variable (outcome versus drop-out). 27 studies were included. Lower motivation, lower BMI, and having the binge-purge subtype of AN predicted drop-out. Greater ED pathology and poorer motivation predicted poorer outcome. Clinical recommendations include taking particular care during assessment stages to identify patients at risk of drop-out and/or poor outcome based on their clinical profile and level of motivation for recovery. At-risk patients should be receiving tailored treatment to enhance engagement and reduce risk of drop-out. In conclusion, there's some evidence that motivation, BMI, subtype, and ED pathology predicts drop-out and/or outcome in individual and family-based therapy for AN amongst adolescents and adults; however, research incorporating carefully designed multi-site studies is required to further examine these findings

Synthesis based on cyclohexadienes: Part 4. Novel synthesis of the 6-aryl-2,4-dimethoxybenzoates. Alternariol and methyl trimethylaltenusin

A novel method for the preparation of 6-aryl-2,4-dimethoxybenzoic acids involving the Alder-Rickert reaction of 1,5-dimethoxycyclohexa-1,4-dienes and arylpropiolic esters is described. This strategy has been extended to the synthesis of the mould metabolite alternariol and methyl trimethylaltenusin

Getting RID of pain-related behaviour to improve social and self perception: A technology-based perspective

People with chronic musculoskeletal pain can experience pain-related fear of physical activity and low confidence in their own motor capabilities. These pain-related emotions and thoughts are often communicated through communicative and protective non-verbal behaviours. Studies in clinical psychology have shown that protective behaviours affect well-being not only physically and psychologically, but also socially. These behaviours appear to be used by others to appraise not just a person's physical state but also to make inferences about their personality traits, with protective pain-related behaviour more negatively evaluated than the communicative behaviour. Unfortunately, people with chronic pain may have difficulty in controlling the triggers of protective behaviour and often are not even aware they exhibit such behaviour. New sensing technology capable of detecting such behaviour or its triggers could be used to support rehabilitation in this regard. In this paper we briefly discuss the above issues and present our approach in developing a rehabilitation system