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Carter N, Webb C, Findlay S, Grant C, Blyderveen SV. The integration of a specialized eating disorders nurse on a general inpatient pediatric unit. J Pediatr Nurs 2012; 27:549-56. [PMID: 22920665 DOI: 10.1016/j.pedn.2011.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 06/21/2011] [Accepted: 06/25/2011] [Indexed: 11/25/2022]
Abstract
Eating disorders (EDs) affect approximately 5% of Canadian adolescents. Patients experiencing acute medical complications of their illness are often treated on a general pediatric ward with mixed populations. Twenty-one health care providers shared their experiences caring for youth with EDs and provided feedback regarding the integration of a specialized ED nurse (ED-RN). Findings suggest that an RN and ED-RN model produces consistent care for ED patients and satisfying therapeutic relationships for nurses. ED-RNs caring for youth with EDs need support from their peers, whereas other nurses need training regarding this population. Suggestions for the integration of specialized RN roles are discussed.
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Affiliation(s)
- Nancy Carter
- School of Nursing, McMaster University, Hamilton, ON, Canada.
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153
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María Verínica GP, Carolina LC, Marcela MB. Trastornos de la conducta alimentaria en adolescentes y jóvenes. REVISTA MÉDICA CLÍNICA LAS CONDES 2012. [DOI: 10.1016/s0716-8640(12)70352-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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154
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María Verínica GP, Carolina LC, Marcela MB. Trastornos de la conducta alimentaria en adolescentes y jóvenes. REVISTA MÉDICA CLÍNICA LAS CONDES 2012. [DOI: 10.1016/s0716-8640(12)70351-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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155
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Disturbed Eating Severity Scale (DESS) places disturbed eating risk on a continuum. Appetite 2012; 59:168-76. [DOI: 10.1016/j.appet.2012.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 03/31/2012] [Accepted: 04/03/2012] [Indexed: 11/21/2022]
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156
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Quick VM, McWilliams R, Byrd-Bredbenner C. Case-control study of disturbed eating behaviors and related psychographic characteristics in young adults with and without diet-related chronic health conditions. Eat Behav 2012; 13:207-13. [PMID: 22664398 DOI: 10.1016/j.eatbeh.2012.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 01/30/2012] [Accepted: 02/21/2012] [Indexed: 11/29/2022]
Abstract
Young adults with diet-related chronic health conditions (DRCHCs; i.e., type 1 diabetes, celiac disease, cystic fibrosis, inflammatory bowel diseases, irritable bowel syndrome) face challenges complying with dietary restrictions required to effectively manage their health condition. These restrictions could put them at risk for disturbed eating. The purpose of this study was to determine if young adults with and without DRCHCs differed with regard to disturbed eating behaviors and related psychographics characteristics (i.e., body image attributes, mental disorders, intrapersonal characteristics and sociocultural environment [i.e., media and family]). Each DRCHC participant (cases=166) was matched to 4 healthy participants (controls=664) based on gender and BMI (±0.50 BMI units). Conditional logistic regression analyses indicate cases were twice as likely to have been diagnosed by a healthcare provider with an eating disorder (p=0.08, OR=1.99, CI(90) [1.03-3.83]). Cases were significantly more likely to use Inappropriate Compensatory Behaviors to manage their weight, i.e., excessive exercise (p=0.04, OR=1.41, CI(95) [1.02-1.94]) and misuse medication (p=0.04, OR=1.14, CI(95) [1.00-1.29]) than controls. Depression and anxiety were significantly higher, and health status was significantly poorer in cases compared with controls. DRCHC participants were less likely to report feeling body image pressures from the media, placed a greater value on their health, used social diversion, and recalled a greater emphasis being placed on their mothers' weights and mealtimes being less structured than control participants. Findings indicate that nutrition and other healthcare professionals should incorporate screening DRCHC patients for disturbed eating behaviors and eating disorders in their standards of care.
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Affiliation(s)
- Virginia M Quick
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA.
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157
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Meyer F, Volterman KA, Timmons BW, Wilk B. Fluid Balance and Dehydration in the Young Athlete. Am J Lifestyle Med 2012. [DOI: 10.1177/1559827612444525] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many young athletes train and compete under conditions that put their body fluid balance at risk, and hypohydration is usually the major concern. Another less frequent condition is hyperhydration that—if accompanied by other risk factors—may cause hyponatremia. Water and electrolyte losses during physical activities occur primarily from sweat. Such losses have been identified mostly in active (but nonathletic) young populations under laboratory settings. Studies have been trying to estimate fluid losses in the athletic population under field conditions, taking into account the sport modality and environmental conditions. Besides these external conditions, young athletes adopt different drinking attitudes, which may depend on knowledge, education, and the opportunities to drink during the break periods as well as fluid availability. Focusing on the young athlete, this review will discuss water and sodium losses from sweat, the effects of hypohydration on performance, and fluid intake attitudes within and during practices and competitions. Some considerations related to the methods of identifying hydration status and guidelines are also given, with the understanding that they should be individually adapted for the athlete and activity. The young athlete, parents, coaches, and athletic/health professionals should be aware of such information to prevent fluid imbalances and the consequent hazardous effects on performance and health.
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Affiliation(s)
- Flavia Meyer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
| | - Kimberly A. Volterman
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
| | - Brian W. Timmons
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
| | - Boguslaw Wilk
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
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158
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Weight suppression as a predictor of weight gain and response to intensive behavioral treatment in patients with anorexia nervosa. Behav Res Ther 2012; 50:266-74. [PMID: 22398152 DOI: 10.1016/j.brat.2012.02.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 01/09/2012] [Accepted: 02/13/2012] [Indexed: 11/21/2022]
Abstract
Previous studies have documented that weight suppression (a person's highest adult weight minus current weight) predicts weight gain and disordered eating symptoms during treatment of bulimia spectrum disorders, but no research has examined weight suppression in individuals with anorexia nervosa (AN). Thus, this study sought to characterize weight suppression in a large sample of patients with AN (N = 185), and to evaluate whether weight suppression at admission for intensive behavioral treatment predicts weight gain and clinical outcomes at discharge. Weight suppression varied from 0 kg to 78 kg (M [SD] = 17.1 [10.8] kg) in AN patients. Higher levels of weight suppression predicted greater total weight gain, a faster rate of weight gain, and bulimic symptoms during intensive treatment even after controlling for body mass index on admission, length and type of intensive treatment received, restricting versus binge-eating/purging AN subtype, and other predictors of study outcomes. These findings converge with previous research documenting the clinical significance of weight suppression in the treatment of eating disorders. Future work is needed to replicate the current findings, and examine whether weight suppression predicts the course of AN following discharge from intensive treatment.
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159
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Le Grange D, Doyle PM, Swanson SA, Ludwig K, Glunz C, Kreipe RE. Calculation of expected body weight in adolescents with eating disorders. Pediatrics 2012; 129:e438-46. [PMID: 22218841 PMCID: PMC3269114 DOI: 10.1542/peds.2011-1676] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the agreement between three methods to calculate expected body weight (EBW) for adolescents with eating disorders: (1) BMI percentile, (2) McLaren, and (3) Moore methods. METHODS The authors conducted a cross-sectional analysis of baseline information from adolescents seeking treatment of disordered eating at The University of Chicago. Adolescents (N = 373) aged 12 to 18 years (mean = 15.84, SD = 1.72), with anorexia nervosa (n = 130), bulimia nervosa (n = 59), or eating disorder not otherwise specified (n = 184). Concurrence between the BMI percentile, McLaren, and Moore methods was assessed for agreement above or below arbitrary cut points used in relation to hospitalization (75%), diagnosis (85%), and healthy weight (100%). Patterns of absolute discrepancies were examined by height, age, gender, and menstrual status. Limitations to some of these methods allowed comparison between all 3 methods in only 204 participants. RESULTS Moderate agreement was seen between the 3 methods (κ values, 0.48-0.74), with pairwise total classification accuracy at each cut point ranging from 84% to 98%. The most discrepant calculations were observed among the tallest (>75th percentile) and shortest (<20th percentile) cases and older ages (>16 years). Many of the most discrepant cases fell above and below 85% EBW when comparing the BMI percentile and Moore methods, indicating disagreement on possible diagnosis of anorexia nervosa. CONCLUSIONS These methods largely agree on percent EBW in terms of clinically significant cut points. However, the McLaren and Moore methods present with limitations, and a commonly agreed-upon method for EBW calculation such as the BMI percentile method is recommended for clinical and research purposes.
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Affiliation(s)
- Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL 60637, USA.
| | - Peter M. Doyle
- Department of Psychiatry and Behavioral Neuroscience, and
| | - Sonja A. Swanson
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; and
| | - Kali Ludwig
- Department of Psychiatry and Behavioral Neuroscience, and
| | - Catherine Glunz
- Department of Pediatrics and Internal Medicine, The University of Chicago, Chicago, Illinois
| | - Richard E. Kreipe
- Division of Adolescent Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
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160
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161
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Driven exercise among treatment-seeking youth with eating disorders. Eat Behav 2011; 12:328-31. [PMID: 22051370 PMCID: PMC3208827 DOI: 10.1016/j.eatbeh.2011.09.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 07/19/2011] [Accepted: 09/09/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE This study evaluated the prevalence and clinical significance of driven exercise (DE) in treatment-seeking youth. METHODS Participants were 380 consecutive referrals to a pediatric eating disorder program (90.8% female; M age=14.9±2.2). Spearman's rho correlations examined the relation between DE frequency, and Beck Depression Inventory (BDI) and Eating Disorders Examination (EDE) Global Severity scores. ANOVA compared those reporting only DE, only vomiting, or both DE and vomiting on the aforementioned measures. RESULTS 51.3% of participants (n=193) reported DE in the past 3 months, with an average of 21.8 (SD=32.6) episodes. Frequency of DE was related to EDE global severity score (Spearman's rho=.46; p<.001) and BDI Total Score (Spearman's rho=.33; p<.001). Participants reporting both vomiting and DE had the highest EDE global severity and BDI total scores. CONCLUSIONS DE is associated with greater eating disorder and depressive symptomatology, especially when paired with vomiting. The findings highlight the importance of assessing for DE in youth presenting for eating disorder treatment.
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Abstract
Eating disorders have the highest mortality of all the mental health disorders. A missed diagnosis increases the risk of death significantly. The purpose of this article is to provide the practicing NP with evidence-based strategies to identify, manage, and refer individuals with eating disorders.
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163
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Current world literature. Curr Opin Rheumatol 2011; 23:497-503. [PMID: 21844756 DOI: 10.1097/bor.0b013e32834a96c0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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164
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165
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Position of the American Dietetic Association: Nutrition Intervention in the Treatment of Eating Disorders. ACTA ACUST UNITED AC 2011; 111:1236-41. [DOI: 10.1016/j.jada.2011.06.016] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Indexed: 12/12/2022]
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166
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McBride DL. New screening guidelines for eating disorders. J Pediatr Nurs 2011; 26:377-8. [PMID: 21726789 DOI: 10.1016/j.pedn.2010.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Deborah L McBride
- Kaiser Permanente Oakland Medical Center, 1611 Allston Way, Berkeley, CA 94703, USA.
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167
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Interdisziplinäre Eltern-Kind Behandlung von schweren komplexen Fütterstörungen. Prax Kinderpsychol Kinderpsychiatr 2011; 60:452-65. [DOI: 10.13109/prkk.2011.60.6.452] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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