Factors Associated With Recovery From Anorexia Nervosa.

Factors associated with recovery from anorexia nervosa.

J Psychiatr Res. 2013 Mar 24;
Zerwas S, Lund BC, Von Holle A, Thornton LM, Berrettini WH, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, La Via M, Mitchell J, Rotondo A, Strober M, Woodside DB, Kaye WH, Bulik CM

Previous studies of prognostic factors of anorexia nervosa (AN) course and recovery have followed clinical populations after treatment discharge. This retrospective study examined the association between prognostic factors-eating disorder features, personality traits, and psychiatric comorbidity-and likelihood of recovery in a large sample of women with AN participating in a multi-site genetic study. The study included 680 women with AN. Recovery was defined as the offset of AN symptoms if the participant experienced at least one year without any eating disorder symptoms of low weight, dieting, binge eating, and inappropriate compensatory behaviors. Participants completed a structured interview about eating disorders features, psychiatric comorbidity, and self-report measures of personality. Survival analysis was applied to model time to recovery from AN. Cox regression models were used to fit associations between predictors and the probability of recovery. In the final model, likelihood of recovery was significantly predicted by the following prognostic factors: vomiting, impulsivity, and trait anxiety. Self-induced vomiting and greater trait anxiety were negative prognostic factors and predicted lower likelihood of recovery. Greater impulsivity was a positive prognostic factor and predicted greater likelihood of recovery. There was a significant interaction between impulsivity and time; the association between impulsivity and likelihood of recovery decreased as duration of AN increased. The anxiolytic function of some AN behaviors may impede recovery for individuals with greater trait anxiety. HubMed – eating


Using Portable Health Information Kiosk to assess chronic disease burden in remote settings.

Rural Remote Health. 2013 Jan-Mar; 13(1): 2279
Joshi A, Puricelli Perin DM, Arora M

INTRODUCTION: Cancer, cardiovascular disease, chronic respiratory disease, and type 2 diabetes, are responsible for over 50% of worldwide mortality. Chronic diseases have broad negative impacts in developing countries. Contributing to the development of chronic diseases are sedentary lifestyles, poor nutrition and eating habits, and air pollution, among other risk factors. These are also greatly increasing, and obesity has become a global phenomenon. Health promotion, and chronic disease prevention and surveillance, can be achieved through information and communication technologies (ICT), which acquire, disseminate and store health-related information electronically. The portable health information kiosk (PHIK) can be a powerful tool for promoting health education in communities in both urban and rural settings. The objective of the study was to utilize a PHIK as a tool to assess the burden of chronic disease and associated risk factors in diverse settings in India. METHODS: A convenience sample was enrolled from three diverse geographical locations including urban, rural and tribal to explore the utilization of a PHIK for chronic disease health risk assessment in a community setting. Cross-sectional data was recorded during the period of March-May 2010 in Rourkela and Bhubaneswar in the state of Orissa, India. Participants were asked to use a touch screen, electronic kiosk that gathered subjective and objective data to understand the burden of chronic diseases and associated risk in the community setting. The subjective data included responses to a series of multiple-choice questions and the objective data was gathered using multiple physiological sensors such as weight, blood sugar and blood pressure. Descriptive analysis was performed using univariate statistics with results for the continuous variables being reported as means and standard deviations while results for the categorical variables were reported as frequency statistics as appropriate. RESULTS: A total of 429 participants aged 18 years and older were enrolled in three different community settings: urban, slum and tribal. Significant differences were seen in the systolic blood pressure of those living in the urban settings as compared with those living in either slum (p=0.04) or tribal settings (p=0.02). Significant differences in the blood sugar levels were seen only among those living in the tribal as compared with the urban settings (p=0.04). Results showed high prevalence of pre-hypertension, stages 1 and 2 hypertension among those living in the slum and tribal settings. CONCLUSIONS: The results show the presence of chronic diseases in tribal and slum communities. The assessment of chronic health conditions in these populations is insufficient. Poor infrastructure and lack of qualified personnel are challenges to providing a meaningful service, as low wages, poor living and working conditions are obstacles that prevent the trained workforce from establishing themselves in these areas of extreme need. Health kiosks can be a multifaceted solution, as they can be used to assess health outcomes in areas that normally are not covered due to lack of infrastructure or health personnel, to establish health education modules and inform the local population about them. They can support evidence-based decisions for national and regional programs and policies. HubMed – eating


Feasibility study of asset mapping with children: identifying how the community environment shapes activity and food choices in Alexander First Nation.

Rural Remote Health. 2013 Jan-Mar; 13(1): 2289
Dyckfehderau D, Holt NL, Ball GD, Alexander First Nation Community A, Willows ND

INTRODUCTION: It is estimated that First Nations children living on reserves are 4.5 times more likely to be obese than Canadian children in general. Many First Nations children living on reserves have limited healthy food and physical activity options. Understanding how community factors contribute to First Nations children’s lifestyle choices is an understudied area of research. Furthermore, rarely has health research elicited First Nations children’s perspectives of their communities. The purpose of this study was to understand the external behavior-shaping factors that influence the lifestyle behaviors of First Nations’ children. Asset mapping with children was used to understand how community resources impacted children’s activity and eating options. METHODS: Alexander First Nation is in central Alberta. Asset mapping was one component of a research project in the community to identify risk factors for children developing diabetes. Participants were a convenience sample of two high school students working at the local health centre and seven grade six children. Maps, photographs, and a tour of the town site enabled participants to identify places and spaces where they were active or could obtain food. For each of these assets, a description of how it was used and how it could be modified for better usage was derived from notes and transcripts using content analysis. Assets were grouped into usage categories, which were then mapped onto a layout of the community and presented at a community meeting to address childhood obesity. RESULTS: Twenty-five places and spaces were identified as being activity or food related. Breakfast and/or lunch, concession foods (snack foods, eg chocolate bars, potato crisps) were obtained at school; meals and snack foods where cultural gatherings occur; and snack foods at the local store. Healthy food choices were limited. Children and youth were active at different locations in town, with only two spaces beyond the town site identified as locations for activity. Youth recommended the construction of a leisure centre, that healthier food be sold at the local convenience store, and the development of a community garden and berry farm. CONCLUSIONS: In the ecological framework, weight status is considered embedded within the larger ecology of individual lives because of interrelationships between an individual’s personal dimensions and other components of an individual’s external environment. Asset mapping with children and youth in Alexander First Nation helped to achieve an understanding of the community factors that shaped their health behaviors. Asset mapping not only produced a list of places and spaces where they played, met, and ate, but also showed where they most preferred to be. Further, the exercise enabled children to express how assets could be improved, and the assets they would like in their community, to promote healthy behaviors. The findings enabled adults to contextualize other community data collected about children (ie obesity prevalence, physical activity levels), to better understand how the presence and the condition of places and spaces in the community shaped the physical activity and eating behaviors of children and youth, and how local resources could be modified to be more health promoting. HubMed – eating