Eating Disorders, Trauma, PTSD, and Psychosocial Resources

The frequency of traumatic events and comorbid post-traumatic stress disorder (PTSD) in women with eating disorders (EDs) was assessed. Also, patients with anorexia nervosa (AN) and bulimia nervosa (BN) were compared with regard to post-traumatic symptomatology and the role of psychosocial resources was analyzed. 103 ED patients (29.1±10.5 years) were studied through the use of standardized questionnaires. 23.1% of AN and 25.5% of BN patients fulfilled the study definition for a current diagnosis of PTSD. Cumulative traumatization led to more severe symptomatology. Psychosocial resources were found to have strong associations with symptomatology. These findings provide additional support for the association between traumatization and ED. Clinical interventions for traumatized ED patients may benefit from a focus on post-traumatic stress symptomatology and personal resources

Collaborative Care for Depressed Patients With Chronic Medical Conditions: A Randomized Trial in Puerto Rico

This study examined whether a collaborative care model for depression would improve clinical and functional outcomes for depressed patients with chronic general medical conditions in primary care practices in Puerto Rico

A Description of Disordered Eating Behaviors in Latino Males

Objective: To explore disordered eating and eating disorders (EDs) in Latino males. Participants: Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Methods: Participants were selected from a list of sections of required courses for first-year students on each campus. Self-report instruments were used to explore ED symptoms (the Eating Attitudes Test [EAT-26] and the Bulimia Test-Revised [BULIT-26-R] and the Beck Depression Inventory depression (BDI). Results: Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for bulimia nervosa. Depression symptomatology was found in those who scored above the cut-off point on both instruments of EDs. Conclusion: College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Culturally sensitive intervention for Latina women with eating disorders: A case study / Intervención sensible culturalmente para mujeres latinas con trastornos de la conducta alimentaria: Un estudio de caso

Abstract Objective: We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. Method: A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. Results: The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). Conclusions: The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery. Resumen Objetivo: Describimos la terapia cognitiva conductual para la bulimia nerviosa (TCC-BN) con una mujer latina incorporando tópicos que son culturalmente rele- vantes. Método: Un estudio de caso de una mujer latina monolingüe de 31 años con BN en el que se describe la incorporación de una intervención de pareja adjunta al TCC-BN. Resultados: Para la sesión 20, la paciente no reportó atracones ni conductas purgativas y continuó libre de síntomas hasta el final del tratamiento (sesión 26). La mejoría se observó en el Eating Disorders Examination (EDE) al comparar la evaluación de base (EDE=5.74) con la evaluación post tratamiento (EDE=1.25). Conclusión: El caso ilustra como adaptaciones culturales como incluir a un miembro familiar, ser flexible en los tópicos y en la agenda de trabajo, y proveer intervenciones culturalmente relevantes pueden llevar a una exitosa culminación de un proceso terapéutico y facilita las intervenciones que se llevan a cabo para asegurar un continuo proceso de recuperación.

A Description of Disordered Eating Behaviors in Latino Males

OBJECTIVE: To explore disordered eating and eating disorders (ED) in Latino males. PARTICIPANTS: 722 male college students from a larger prevalence study conducted in the University of Puerto Rico (UPR) system. METHOD: Participants were selected from a list of sections of required courses for first-year students on each campus. Self report instruments were used to explore ED symptoms (EAT-26 & BULIT-26) and depression (BDI). RESULTS: Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for BN. Depression symptomatology was found in those who scored above the cut-off point on both instruments of ED. CONCLUSION: College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students

Eating Disorders, Trauma, PTSD, and Psychosocial Resources

The frequency of traumatic events and comorbid post-traumatic stress disorder (PTSD) in women with eating disorders (EDs) was assessed. Also, patients with anorexia nervosa (AN) and bulimia nervosa (BN) were compared with regard to post-traumatic symptomatology and the role of psychosocial resources was analyzed. 103 ED patients (29.1±10.5 years) were studied through the use of standardized questionnaires. 23.1% of AN and 25.5% of BN patients fulfilled the study definition for a current diagnosis of PTSD. Cumulative traumatization led to more severe symptomatology. Psychosocial resources were found to have strong associations with symptomatology. These findings provide additional support for the association between traumatization and ED. Clinical interventions for traumatized ED patients may benefit from a focus on post-traumatic stress symptomatology and personal resources

Depression symptoms and stressful life events among college students in Puerto Rico

BACKGROUND: The transition from adolescence to adulthood is associated with stressful adaptation experiences that may increase symptoms of depression. We explored the prevalence and sex differences of depressive symptoms and suicidal ideation in freshmen Latino college students in Puerto Rico, and identified stressful life events that could contribute to symptoms of depression. METHODS: Two thousand one hundred sixty-three freshmen college students from the University of Puerto Rico (UPR) public education system were assessed for depression symptoms using the Beck Depression Inventory (BDI) and stressful life events using open questions. RESULTS: Nine percent of the sample reported depression symptoms at a moderate or severe level (BDI ≥ 20). Chi square analyses revealed a significantly higher prevalence for three of the stressful life events in females than males: relocation (10.2% females vs. 7.3% males; X(2) (1) = 4.13, p=.042), break-up of a significant relationship (25.3% females vs. 17.8% males; X(2) (1) = 13.76, p<.001), and illness (11.2% females vs. 7.3% males; X(2) (1) = 7.23, p=.007). The model that best explained the variance of BDI scores among females was the presence of suicide risk, relationship break-up, illness, and relocation for college, whereas for males a similar model without the relationship break-up variable resulted in a better fit. CONCLUSIONS: Freshmen college students present a broad range of depression symptoms and certain stressful life events are associated with an increased prevalence of depression symptoms. Early detection of depression and tailored prevention programs should be developed to improve both mental health and academic performance among the college population