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Objective: Fear of Aversive Consequences (FOAC), such as choking or vomiting, is an important associated feature of Avoidant/Restrictive Food Intake Disorder (ARFID). However, the manifestation of FOAC in young children is poorly understood. This study aimed to describe the fears of children with ARFID symptoms and examine the concordance between parent and child ratings of fear. Method: Child‐reported FOAC was assessed using an interview designed for children between 6 and 10 years old, the Gustatory Avoidance and Gastrointestinal Stress Symptoms (GAGSS). Parents were administered a semi‐structured diagnostic interview regarding their child's symptoms, the Pica, ARFID, and Rumination Interview. Results: Among 68 children with ARFID diagnoses or symptoms (41.2% female, 85.3% White, mean age = 8.2 years, SD = 1.1 years; range 5.2–9.9 years), 91.2% of children endorsed at least one fear relative to 26.5% of parents. Among parent–child dyads, 36.8% disagreed about the child's fear of stomach pain (κ = 0.12) and 48.5% disagreed about the child's fear of vomiting, (κ = 0.08), both indicating low inter‐rater reliability. On average, children endorsed 4.3 (SD = 2.3) fears out of 9 options. The most frequently endorsed fears were that food will "taste bad," (n = 43, 63.2%), "make you gag" (n = 37, 54.4%), and "look disgusting" (n = 36, 52.9%). Discussion: Findings highlight ways in which fear may manifest in children with ARFID that are not easily discernable by adults. Greater precision in depicting childhood fears may facilitate the earlier detection of problematic eating behaviors. [ABSTRACT FROM AUTHOR]

Background: Parastomal hernias are a common consequence of stoma surgery and can occur in up to 50% of patients. They are mangaged either conservatively, through support hosiery, or surgically. A patient feasibility study called the Hernia Active Living Trial (HALT) was designed to examine if a clinical pilates-based exercise programme offers an alternative approach to managing a parastomal hernia or bulge. Method: Adults with an ileostomy or colostomy who perceived they had a bulge around their stoma were included in the study. The intervention included up to 12 online sessions of an exercise booklet and videos with an exercise specialist. Interviews were conducted to explore participants' experiences of the intervention. The interview data were analysed systematically and thematically. Participants were also asked to complete patient diaries every week. Results: Twelve of the 13 participants who completed the intervention agreed to be interviewed. Following analysis, three main themes emerged including managing a hernia/bulge, benefits and barriers. Participants talked about the benefits of this programme including: reduction of the size of their hernia, increased abdominal control, body confidence and posture, as well as increased physical activity levels. The barriers described were generally overcome allowing participants to engage in what was perceived to be a positive and potentially life-changing experience. Conclusions: A clinical pilates-based exercise programme for people with a parastomal hernia can bring both direct and indirect improvements to a patient's hernia management, sense of wellbeing and day-to-day life. Individuals with a hernia should be informed about the need for, and value of, exercise to strengthen core muscles, as part of their non-surgical options for self-management. [ABSTRACT FROM AUTHOR]

Public health agencies are increasingly concerned with ensuring that they are maximizing limited resources by delivering effective programs to enhance population-level health outcomes. Preventing mis-implementation (ending effective activities prematurely or continuing ineffective ones) is necessary to sustain public health efforts and resources needed to improve health and well-being. The purpose of this paper is to identify the important qualities of leadership in preventing mis-implementation of public health programs. In 2019, 45 state health department chronic disease employees were interviewed via phone and audio-recorded, and the conversations were transcribed verbatim. Thematic analysis focused on items related to mis-implementation and the manners in which leadership were involved in continuing ineffective programs. Final themes were based on a Public Health Leadership Competency Framework. The following themes emerged from their interviews regarding the important leadership competencies to prevent mis-implementation: '(1) leadership and communication; (2) collaborative leadership (3) leadership to adapt programs; (4) leadership and organizational learning and development; and (5) political leadership'. This first of its kind study showed the close interrelationship between mis-implementation and leadership. Increased attention to public health leader competencies might help to reduce mis-implementation in public health practice and lead to more effective and efficient use of limited resources. [ABSTRACT FROM AUTHOR]

Background: Children whose parents have type 2 diabetes (T2D) are at high‐risk for developing T2D. In youth, negative affect has been shown to predict insulin resistance (IR), and disinhibited‐eating behaviors have been linked to IR. It is unknown if youth with a parent with T2D (P‐T2D) report greater psychological and behavioral symptoms than those without a P‐T2D. Objective: To compare youth with and without a P‐T2D on symptoms of negative affect and disinhibited‐eating. Methods: Nine‐hundred thirty‐two youth (13.3 ± 2.6 years; BMIz 1.06 ± 1.06; 67.8% female; 53.6% people of color; 10.7% with a P‐T2D) completed questionnaires of anxiety and depressive symptoms, eating in the absence of hunger, and emotional‐eating. Loss‐of‐control (LOC)‐eating was assessed by interview. In two separate subsamples, energy intake was explored using laboratory test meals simulating eating in the absence of hunger and LOC‐eating, respectively. Analyses were adjusted for age, sex, race/ethnicity. In follow‐up analyses, fat mass (kg) and height, and IR were included as covariates, respectively. Results: Adjusting for all covariates including adiposity and IR, compared to youth without a P‐T2D, youth with a P‐T2D reported more anxiety and depression symptoms, greater eating in the absence of hunger, and emotional‐eating (ps < 0.05). No significant differences were found for LOC‐eating, or in exploratory analyses of energy intake for either test meal (ps > 0.16). Conclusions: Self‐reported negative affect and disinhibited‐eating may be higher among youth with P‐T2D compared to those without P‐T2D. Prospective studies should examine, among those with a P‐T2D, what role such symptoms may play for their subsequent risk for T2D. [ABSTRACT FROM AUTHOR]

There is worldwide recognition of the need to redesign health service delivery with a focus on strengthening primary health care and aligning health and social care through integrated models. A defining feature of integrated models is improved patient and carer experience of care. This study explored the experiences of older people and their carers enrolled in a unique model of integrated care that provides a specialist geriatric intervention in the primary care setting for older adults with complex needs in Far North Queensland. A qualitative exploratory descriptive design using semistructured interviews was used to address the study aims. Seventeen older people and nine carers took part in the study. Data were analysed inductively, guided by the principles of thematic analysis. Three themes emerged: getting by; achieving positive change; and improving and maintaining the OPEN ARCH (Older Persons ENablement And Rehabilitation for Complex Health conditions) approach. The findings indicate that enablement models of integration can be successful in activating positive change towards independence for the older person with complex needs. Understanding patients' and carers' experiences is essential to comprehensive service evaluation. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore consumers' experiences of receiving a home care package (HCP). Methods: Community engagement was used to recruit older people approved for a HCP. Data were collected through face‐to‐face interviews, and data analysis identified themes. Results: Effective consumer‐directed care depends on access to reliable information. Participants who reported satisfactory experiences had: (a) providers that charged reasonable fees; (b) case managers who delivered person‐centred care; (c) support workers who were consistently assigned to them; (d) a family member for support and advocacy; and (5) ongoing community engagement. Conclusion: Consumer experience requires tighter regulation of providers and policy attention to fees and minimal standards of staff training. The policy of full cost recovery restricts consumers' access to local government services. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate two questionnaires, an updated youth version of the questionnaire on eating and weight patterns (Questionnaire on Eating and Weight Patterns‐5 Children/Adolescent [QEWP‐C‐5]) and the Loss‐of‐Control (LOC) Eating Disorder Questionnaire (LOC‐ED‐Q), against the Eating Disorder Examination (EDE) interview to assess the presence of LOC‐eating among youth. Method: Two‐hundred and eighteen youths (12.8 ± 2.7 years) completed the QEWP‐C‐5, LOC‐ED‐Q, and EDE, depressive and anxiety questionnaires, and adiposity assessment. Sensitivity, specificity, positive‐predictive value, negative‐predictive value, and diagnostic accuracy were calculated; Cochran's Q and McNemar's tests were used to compare measures. Receiver operating characteristic area under the curve (AUC) analyses were performed. Mood and adiposity based on LOC‐eating presence and absence based on each measure were examined. Results: The QEWP‐C‐5 and LOC‐ED‐Q demonstrated poor sensitivity (33%; 30%) and high specificity (95%; 96%) compared with the EDE. The AUCs suggested neither the QEWP‐C‐5 (0.64) nor the LOC‐ED‐Q (0.62) demonstrated acceptable diagnostic accuracy. Comparing distributions of LOC‐eating presence between assessments, the QEWP‐C‐5 and EDE did not differ significantly (p =.10), while the LOC‐ED‐Q and EDE had significantly different distributions (p =.03). LOC‐eating presence was associated with higher depressive and anxiety symptoms across all measures (ps <.02). Greater adiposity (ps <.02) was associated with LOC‐eating presence on the EDE and LOC‐ED‐Q, and higher BMI z‐score (p =.02) on the LOC‐ED‐Q. Discussion Neither the QEWP‐C‐5 nor the LOC‐ED‐Q was sensitive for identifying LOC‐eating presence as determined by the EDE, although both were associated with greater mood symptoms. Research is needed to improve self‐report questionnaires to better screen for LOC‐eating presence among pediatric populations. [ABSTRACT FROM AUTHOR]

Objectives. There is a shift toward a “health in all policies” approach in public health; however, most practitioners are not equipped with the necessary knowledge or skills to engage in and practice policy. This study explores how public health professionals can become policy practitioners and better engage in the policy process. This article also provides recommendations for training programs on how to increase students’ policy-related knowledge and skills. Method. We conducted in-depth interviews with 10 public health policy experts in the United States spanning academic, governmental, advocacy, and practice settings. Key informants provided perspectives regarding strengths and skill sets that practitioners need to better position themselves to do policy-relevant work and opportunities for public health programs to improve training. The research team conducted thematic analyses to determine commonality among expert responses. Results. Informants identified a number of strengths and skills that either support or impede practitioners’ ability to conduct policy work and proposed recommendations for public health curricula to integrate policy-related coursework or practical experiences to prepare practitioners for policy careers. Conclusion. Public health professionals need to become more politically astute to practice and advance public health policy. To facilitate the development of such skills, public health training and pedagogy must integrate policy practice into traditional public health coursework, include new policy-focused courses, and provide opportunities for real-world policy experience. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to explore obese pregnant women's experiences to better understand the factors to consider when developing services that meet maternal needs. The researchers detail the study design using thematic analysis of a low-structured depth interviews of pregnant women. The study suggests that using pregnant women's views in the development of obesity maternal services could encourage engagement by focussing on women's priorities and motivations.

More than 60% of Bosnian refugees in the United States may be current smokers. Examining health beliefs can provide insight into smoking behaviors in this community. Four hundred ninety-nine Bosnians were interviewed about health beliefs and personal health risks related to smoking. ANOVA was used to compare current, former, and never smokers. General health beliefs were significantly different by smoking status with medium effect sizes ( P < .001; η = 0.04-0.06); current smokers were less likely to agree that smokers live shorter lives and that smokers are more likely to get heart disease. Significant differences with large effect sizes ( P < .001; η = 0.11-0.29) were found in perception of personal risk of lung cancer and heart disease among current, former, and never smokers. Current smokers perceived their own health risks as less severe than those of other smokers. High smoking rates and smokers' optimism related to health indicate that culturally tailored educational and cessation interventions are needed for Bosnian refugee communities. [ABSTRACT FROM AUTHOR]

The article discusses a study related to concerns regarding ageing on Hammond Island. It mentions an increased risk of dementia in Aboriginal Australians; and higher risks of cognitive impairment for men as compared to women. It also highlights high rates of vascular risk factors that affected individuals with cognitive impairment.