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

Integrating psychoeducation in a basic computer skills course for people suffering from social anxiety: participants’ experiences

We describe a psychoeducational program integrated in a basic computer skills course for participants suffering from social anxiety. The two main aims of the course were: that the participants learn basic computer skills, and that the participants learn to cope better with social anxiety. Computer skills were taught by a qualified teacher. Psychoeducation and cognitive therapy skills, including topics such as anxiety coping, self-accept, and self-regulation, were taught by a clinical psychologist. Thirteen of 16 participants completed the course, which lasted 11 weeks. A qualitative analysis was performed, drawing on observations during the course and on interviews with the participants. The participants were positive about the integration of psychoeducation sessions in the computer course, and described positive outcomes for both elements, including improved computer skills, improved self-esteem, and reduced social anxiety. Most participants were motivated to undertake further occupational rehabilitation after the course

Psychological correlates to dysfunctional eating patterns among morbidly obese patients accepted for bariatric surgery

Objective: To examine the relationships between dysfunctional eating patterns, personality, anxiety and depression in morbidly obese patients accepted for bariatric surgery. Design: The study used cross-sectional data collected in running a randomized controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). Subjects: A total of 102 patients (69 women, 33 men) with a mean (SD) age of 42.6 (9.8) years and a mean BMI 43.5 (4.4) kg/m2 participated. Measurements: Measurements included the NEO PI-R (personality: neuroticism, extroversion, openness, conscientiousness and agreeableness), the TFEQ R-21 (dysfunctional eating: emotional eating (EE), uncontrolled eating (UE) and cognitive restraint of eating (CR) and the HADS (anxiety and depression). Results: The personality traits neuroticism and conscientiousness were more strongly correlated with dysfunctional eating compared with anxiety and depression. These differences were most pronounced for emotional and cognitive restraint of eating. Emotional eating occurred more often in female than male patients, a finding that was partially mediated by neuroticism but not by anxiety and depression. Conclusion: Personality traits may be important to address in the clinical management of morbidly obese patients seeking bariatric surgery as neuroticism is particularly salient in female patients displaying an emotional eating behaviour

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

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

Expectations of a new eating disorder treatment and its delivery: Perspectives of patients and new therapists

Background A significant number of people with bulimia nervosa (BN) or binge-eating disorder (BED) do not seek professional help. Important reasons include limited knowledge of eating disorders (EDs), feelings of shame, treatment costs, and restricted access to specialized healthcare. In this study, we explored if a novel therapy delivered in a primary care setting could overcome these barriers. We investigated factors such as motivation and expectations and included the patients' and newly trained therapists' perspectives. Method We interviewed 10 women with BN (n = 2) or BED (n = 8), enrolled in the Physical Exercise and Dietary therapy (PED-t) program, in a Healthy Life Center (HLC) located in a primary healthcare facility. Interview topics discussed were motivations for and expectations of therapy, and the treatment location. In addition, 10 therapists from HLC's were interviewed on their experiences with the PED-t training program and expectations of running PED-t within their service. The semi-structured interviews were analyzed using reflexive thematic analysis. Results Most patients had limited knowledge about EDs and first realized the need for professional help after learning about PED-t. Patients exhibited strong motivations for treatment and a positive perception of both the PED-t, the new treatment setting, and the therapists' competencies. The therapists, following a brief training program, felt confident in their abilities to treat EDs and provide PED-t. With minor operational adjustments, PED-t can seamlessly be integrated into national HLC service locations. Conclusion PED-t is an accessible therapeutic service that can be delivered in a primary care environment in a stepped-care therapy model. Public Significance This study investigates the views and experiences of patients and newly trained therapists of PED-t (Physical Exercise and Dietary therapy), a new program-led primary care therapy for binge-eating spectrum eating disorders. The treatment and the locations for the intervention, that is, local health care centers, were found to be highly acceptable to both patients and therapists, thus PED-t could easily be integrated as a first step into a step-care delivery model.publishedVersio

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

Does Personality Moderate the Effects of Mindfulness Training for Medical and Psychology Students?

The majority of mindfulness research to date has reported only on the group-level effects of interventions. Therefore, there is a need to better understand who is most likely to benefit from mindfulness interventions. This study reports on moderation analyses from a two-centre randomised controlled trial of mindfulness-based stress reduction (MBSR) among 288 medical and psychology students. The study investigated whether baseline personality factors (neuroticism, conscientiousness and extroversion) and baseline mindfulness moderated effects on mental distress, study stress and subjective well-being measured after the intervention. An increased effect of the intervention on mental distress and subjective well-being was found in students with higher scores on neuroticism. Students with higher scores on conscientiousness showed an increased effect of mindfulness training on study stress. The training protected students against an increase in mental distress and study stress and a decrease in subjective well-being that was seen in the control group. Baseline mindfulness and extroversion did not moderate the effects of the intervention on the outcomes. The majority of the 288 medical and psychology students in the study sample were female. Female participants scored significantly higher on neuroticism and conscientiousness, and they may therefore be an important target group for mindfulness interventions among students