The Experience Sampling Method (ESM) is a promising approach for research on self-disorders, as it may enable studying how momentary changes in anomalous world experiences (AWEs) impact delusion development and maintenance. Using ESM to study AWEs requires clarification on two key issues: 1) discerning to what extent self-reports for AWEs align with clinician-based assessments; and 2) demonstrating the dynamic variability of AWEs in order to justify the use of ESM. This paper reports an exploratory ESM study (n = 7; 286 total ESM observations) on these two issues. False-positive indices and agreement rates between self-reports and clinician-based assessments were calculated, and ESM data was used to observe dynamic variability in AWEs. Exploratory mixed-effects models were conducted, using the AWE Unknown/Unstatable Significance as a predictor, and paranoia as an outcome. Two models were compared on indices of fit: Model 1, using all obtained data for the predictor variable (n = 6), and Model 2 (n = 5), eliminating data suspected of containing false-positives of the predictor. Average ESM completion rate was 68

There have been numerous investigations of aberrant eating and substance abuse among patients who have undergone bariatric surgery, which affects the metabolism and the pharmacokinetics of alcohol. However, there is a dearth of literature considering the complex interplay between changes in post-surgery food and alcohol consumption. Furthermore, despite the increasing recognition of issues surrounding replacing food consumption with alcohol consumption (Food and Alcohol Disturbance [FAD]), most emerging research has focused on young adult populations. This perspective reviews and synthesizes the small but growing body of research on the interplay between food and alcohol consumption, particularly FAD, and considers its application to bariatric surgery in general. There are unique considerations for patients who have undergone bariatric surgery. Patients experience altered gastric anatomy, which affects food and alcohol metabolism, and are advised to abstain from drinking alcohol after surgery. After reviewing the available literature, this perspective highlights future directions for research and practice in bariatric surgery.

The self-disorder model provides a phenomenological framework for understanding how the core symptoms of Schizophrenia Spectrum Disorders (SSDs) are rooted in an instability of minimal selfhood. This instability involves a range of "anomalous experiences": transformations in an individual's perceptual field and sense of being an agent of action. The explanatory value of this theoretical model can be summarized in two claims about the role of anomalous experiences in self-disorders: (1) anomalous experiences express a common trait-like disturbance that is characteristic of SSDs, and (2) anomalous experiences contribute to explanations regarding how self-disorders progress into SSDs. While hypotheses consistent with the first claim have been substantiated in several studies, hypotheses consistent with the second claim remain underexamined. We argue that attending to this gap in the literature requires considering which methodological strategies are best suited for investigating if and how anomalous experiences contribute to the development of self-disorders into SSDs and psychotic states. Network modeling is discussed as one such strategy suitable for examining the role of anomalies of lived-world in the maintenance of paranoid delusions in SSDs.

Background: Universally, nurses’ limited educational opportunities to expand their genomic literacy may have implications on patient care management, research, and training. Purpose: To evaluate the impact of a self-paced online course on genomic knowledge and competency acquisition in a sample of nurses possessing a doctoral degree and doctoral students. Methods: Pre- and postcourse data were collected using the “Genomic Nursing Concept Inventory” (GNCI) (N = 129) and a self-report survey based on the Essential Genetic and Genomic Competencies for Nurses with Graduate Degrees (N = 131). Results: GNCI scores in all 4 topical categories and in 9 of the 16 domains significantly improved. All Genetic Competency scores significantly improved. Significant correlations were observed between Genetic Competency self-ratings and GNCI scores precourse and change of scores. Conclusions: The positive outcomes should encourage the development of more accessible educational opportunities for nurses and other healthcare professionals to improve genomic literacy and competency.

Purpose: To test the feasibility of recruiting dementia family caregivers to participate in the holistic intervention of mindfulness self-compassion (MSC) to decrease perceived distress. There are few studies focused on MSC for dementia caregivers. Design: An interdisciplinary approach (nursing and psychology) and uncontrolled experimental design tested a holistic intervention Mindfulness Self Compassion (MSC) as a coping strategy using the Stress Process framework. Findings: Twenty-four caregivers participated. Dementia caregivers' use of positive reappraisal increased with a mean difference of 2.53 (t = 2.10; SD = 5.23) (p = .049) indicating that family caregivers may have increased their use of positive reappraisal. MSC sessions impacted the caregivers ways of coping with increases in accepting responsibility [model: F(4, 13) 3.18, p-value 0.0499, R-sq = 49.5%, estimate: B = 1.11, t = 2.64, p-value = 0.02)] and impacted caregivers' ways of coping using distancing [model: F(4, 13) 1.47, p-value 0.2682, R-sq = 31.1%, estimate: B = 1.63, t = 2.19, p-value = 0.05)]. Conclusion: Satisfaction with MSC was high among caregivers. At the study's conclusion, caregivers appraised their caregiving non-judgmentally and reduced their negative thoughts of difficult situations. MSC as a holistic practice has the potential to shift caregivers' focus to positive appraisals and promote caregiver wellbeing.

OBJECTIVELoss of control (LOC) eating following bariatric surgery remains insufficiently understood, reflected in a lack of clear conceptualization, valid measurements, and effective treatments. This study explored patients' perspectives on LOC eating post-bariatric surgery, focusing on the relevance of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) indicators of impaired control, and patients' experiences before (precipitating factors), during (eating patterns, perpetuating factors), and after the episodes (strategies used to stop eating).METHODSThis was a qualitative study using descriptive phenomenology. Participants were adults who have undergone gastric bypass or sleeve gastrectomy and self-reported recent LOC eating. Data were collected by semi-structured interviews and analyzed using a combined inductive and deductive approach.RESULTSParticipants were all women (N = 15; age: 34.5 ± 9.2 years). Results suggested that (1) except for feeling disgusted, guilty, or depressed after eating, other DSM-5 indicators did not seem to be highly relevant to this bariatric cohort; (2) LOC eating could occur across contexts, with food access, boredom, and food craving being consistent triggers; (3) the food amount consumed during a LOC episode was not necessarily considered excessive; (4) "mindlessness" and "satisfying hedonic, physiological, and mental needs" were the main perpetuating factors of LOC eating; and (5) self-talk and distracting attention were the most adopted strategies to stop eating.DISCUSSIONStudy findings have implications concerning the conceptualization, measurement, and intervention of LOC eating among bariatric patients. For example, results suggested the need for more data to determine the appropriate indicators of LOC eating and the inclusion of boredom as an intervention target in bariatric patients.PUBLIC SIGNIFICANCELoss of control (LOC) eating is characterized by a sense of being unable to stop while eating. LOC eating is prevalent in patients who have undergone weight loss surgery and is associated with worse surgical outcomes. This qualitative study that explored post-bariatric surgery patients' experiences of LOC eating will inform efforts to better assess and intervene in this disordered eating behavior, thus ultimately optimizing patients' health following weight loss surgery.

Background: This paper explores a possible dialogue between Metacognitive Training (MCT) for psychosis and the tradition of phenomenological psychopathol- ogy. MCT includes modules targeting cognitive and affective biases that 10 are purported to be key mechanisms in the generation and maintenance of delusions in schizophrenia. Work in phenomenological psychopathology has also considered underlying psychological processes associated with delusions, emphasizing how distinct types of anomalous experiences may act as pathways to different types of delusions. Phenomenology's 15 emphasis on the variety of delusional experiences suggests the importance of considering whether particular modules of MCT might be especially suited to the treatment of specific delusion types. Methods: A scoping review was used to determine whether module-specific effects on specific types of delusions occurring in Schizophrenia-Spectrum Disorders (SSD) have 20 been examined in research on MCT. Results: Results suggest that although some module-specific research exists, the heterogeneity of delusions has not been fully considered in MCT research. Conclusions: We offer examples of possible ways in which particular MCT modules may be differentially effective, and we advocate placing greater focus on the phenomenology and measure- 25 ment of different types of delusions in future research.

Despite the increasing demand for nurses to understand and apply genetics in their research, clinical practice, and teaching, most nursing doctoral programs (PhD, DNP) do not offer education or training in the fundamentals of genome science, clinical genomics, or their social and ethical implications.1 The National Human Genome Research Institute (NHGRI) seeks to foster a qualified and diverse biomedical workforce in order to advance science and improve human health. In this article, we describe an NHGRI-funded, self-paced, free online course designed to improve nurses' literacy in genetics and genomics. We also describe our efforts to support inclusivity in the course, which is open to all doctoral-level nurses, faculty, and students. Need for Genomic Education for Doctoral-Level Nurses A limited number of nursing doctoral programs include content on genomics, which may be due to crowded curricula, a lack of faculty expertise, or other factors. Once doctoral students graduate, it can be challenging for them to learn or keep current with the rapidly evolving field of genomics. An integrative review found that nurses believe genetics to be relevant, yet they possess little genomic knowledge or core genomic competencies, with minimal evidence of progress over a 5-year period.2 It is encouraging that nurses indicated that they were willing to pursue additional educational opportunities on their own time or at conferences. Indeed, by maximizing the genomic education of doctoral-level nurses today, the knowledge will transmit to future generations of nurse scientists. Recognizing this area of need, we reviewed current educational offerings for health care providers. Online courses have the flexibility to allow doctoral-level nurses, faculty, and students to learn on their own time and at their own pace, and increase accessibility for individuals who live in remote areas. However, most courses involve a cost to the participant and have a specific content focus (eg, pharmacogenomics). In addition, most offer broad information to a wide audience, or a specialized information to a nonnursing audience (eg, genetic counselors). Therefore, to address these gaps we designed a no cost, self-paced online course tailored to a diverse audience of doctoral-level nurses. A Novel Approach to Genomic Education for Doctoral-Level Nurses Our approach to maximizing research education in genomics is based on the premise that increasing opportunities for all doctoral-level nurses, faculty, and students, with a special focus on diversity and inclusion, will carry widespread benefits for both the nursing workforce and the patients they serve. To promote inclusive recruitment, various nursing organizations offered support and expressed interest in participating with this course: Chi Eta Phi Sorority, Inc; International Society of Nurses in Genetics (ISONG); National Association of Hispanic Nurses; National Organization of Nurses with Disabilities; Philippine Nurses Association of America, Inc; and Transcultural Nursing Society. Overview of the Online Course The online course, Genomic Competencies for Nurses from Theory to Application, has the following aims: (1) increase literacy in genomics among doctoral-level nurses and faculty to improve the delivery of health care in the era of genomic medicine; (2) provide a foundational introduction to the genetic basis of disease, health risk assessment, epigenetics, and personalized health care with an emphasis on the associated ethical implications of genetic and genomic advancements; (3) identify opportunities for doctoral-level nurses and nursing faculty to apply genomic medicine into research, teaching, and clinical practice; and (4) prepare doctoral-level nurses and faculty to assimilate state-of-the-science genetics and related ethical issues into their research, teaching, and clinical practice with a focus on patients from underrepresented groups. The online course, delivered asynchronously and with enrollment twice per year, encourages participants to complete the course within 6 to 12 weeks at a pace of 3 hours per week. The pedagogical program design leverages scaffolding of content, supports meaningful engagement, and maximizes the desired learning outcomes most effectively. We are also providing nursing contact hours, thus helping satisfy continuing education professional requirements. The self-paced online course begins with a primer module on the basics of genetics and genomics. This module is optional but helps tailor learning for those participants who may not have a recent background in the basics of genetics. Six subsequent and required modules are based on the Essential Genetic and Genomic Competencies for Nurses With Graduate Degrees.3 These competencies were developed and validated using a consensus model that involved 31 nursing leaders and genetic experts who represented professional nursing organizations, academic institutions, regulatory bodies, and government agencies. These competencies create the foundation for course-learning objectives and outcomes. The course modules are listed in the Table. Table. - Course Modules Module 0: Genetic primer (optional) Module 1: Risk assessment and interpretation Module 2: Genetic education, counseling, testing and results interpretation Module 3: Clinical management Module 4: Ethical, legal, and social implications Module 5: Research—translation to practice Module 6: Professional role and leadership The modules consist of a variety of evidence-based online learning modalities that include prerecorded lectures, cases studies, and video recordings, along with various interactive learning and formative assessment activities. Each module has 3 components: gaining, applying, and checking knowledge. Videotapes of local and national experts, presenting on contemporary topics, are uploaded to the online learning platform thus giving real-life application. Content focuses on genetic, genomic, and epigenetic variables affecting population health outcomes as well as translation of research to be population inclusive. Each module concludes with an assessment of student knowledge, development of a personal action plan, and a continuing education unit certificate. Pre- and postcourse, participants complete the Genomic Nursing Concept Inventory4 to measure the acquisition of foundational genomic concepts and complete a self-assessment to ascertain short-term acquisition of genetic and genomic competencies. The number of course referrals, research projects, and presentations stimulated by the course—plus monitoring collaborative efforts among alumni—will provide metrics of long-term successes. In the first cohort, 83 participants enrolled with 31% diverse representation. In addition, 51 (61%) participants completed the entire course with 98% reporting good, very good, or excellent satisfaction with content, their knowledge enhancement, and committed to change practice. Summary and Future Directions Nurses are a vital part of the biomedical workforce and need training about genomics as applied to research, clinical practice, and teaching. In this article, we presented an overview of our NIH/NHGRI-funded online long course, a novel approach to genomics education for diverse, doctoral-level nurses. Hopefully, course participants will further their education and be part of the group of nurses who go on to work in this component of biomedical research with an appreciation of why we must conduct such research with all populations. Participants who do not pursue genomics education beyond this course will have more knowledge about this topic as applied to their clinical practice and teaching, including recognition of the issues related to groups underrepresented in biomedical research. As we continue to offer the course over a 5-year period, we will adopt a continuous quality improvement approach to keeping content relevant to a complex and changing health care environment. Alumni of our course will become an integral part of a pool of mentors and will connect to current students based on common interests, needs, and career trajectory, thus building a network of collegial scholars, clinicians, and educators.

Most American girls are not meeting physical activity guidelines, placing them at risk for adverse health consequences. In response, our team developed Frolic, an evidence-based mobile application to address this problem through play. Frolic uses a socio-ecological framework and behavioral design principles to address barriers and social norms that are specific to girls. Parents are leveraged as important sources of support and motivation, with key design elements to help girls initiate play, adapt to the space, and play independently. The current paper contributes design principles for creating socio-ecological activity games for girls. In addition, we contribute the design of Frolic itself, a game constructed according to these guidelines, and outline future intervention studies with the app itself. Finally, we provide the perspectives of professional game designers and health experts on our work and interpretative insights for game designers and researchers who hope to work in this space.

Background: Loss-of-control (LOC) eating is associated with poor weight-loss outcomes following bariatric surgery. It is not clear whether eating patterns (e.g., total number of daily meals/snacks, eating after suppertime, eating when not hungry) and unhealthy weight control behaviors (e.g., smoking, using laxatives) are associated with or predictive of LOC eating. Objectives: To examine whether eating patterns and unhealthy weight-control behaviors are associated with LOC eating and, if so, whether they predict LOC eating in bariatric patients. Setting: Multicenter study, United States. Methods: This is a secondary analysis of the Longitudinal Assessment of Bariatric Surgery-2 study. Assessments were conducted before surgery and at 12, 24, 36, 48, 60, and 84 months after surgery. Logistic mixed models were used to examine the longitudinal associations between eating patterns, unhealthy weight-control behaviors, and LOC eating. Time-lag techniques were applied to examine whether the associated patterns and behaviors predict LOC eating. Results: The participants (n = 1477) were mostly women (80%), white (86.9%), and married (62.5%). At the time of surgery, the mean age was 45.4 +/- 11.0 years and the mean body mass index was 47.8 +/- 7.5 kg/m(2). The total number of daily meals/snacks, food intake after suppertime, eating when not hungry, eating when feeling full, and use of any unhealthy weight-control behaviors were positively associated with LOC eating (P < .05). Food intake after suppertime, eating when not hungry, and eating when feeling full predicted LOC eating (P < .05). Conclusion: Meal patterns and unhealthy weight control behaviors may be important intervention targets for addressing LOC eating after bariatric surgery. (C) 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Eating disorders are associated with significant medical morbidity and mortality and serious psychological impairment. Individuals seeking bariatric surgery represent a high-risk group for evidencing disordered eating and eating disorders, with some patients experiencing the persistence or onset of disordered eating postsurgery. This review synthesizes the available literature on problematic or disordered eating in the bariatric field, followed by a review of measurement and conceptual considerations related to the use of eating disorder assessment tools within the bariatric population.

BACKGROUND People of all weights need to prevent changes that could lead to obesity, a leading public health issue. OBJECTIVE To assess the feasibility of Healthy Measures, a moderate carbohydrate (160-300 g/d) nutrition education and behavioral intervention. DESIGN An uncontrolled intervention feasibility study including in-person group meetings every 2 weeks for 3 months. SAMPLE Fifteen participants of normal and overweight BMI. MEASUREMENTS We assessed feasibility of recruitment, attendance, retention and satisfaction as well as anthropometric measures and social cognitive variables with Healthy Measures, a nutrition-focused intervention with moderate carbohydrate portions that also emphasizes self-monitoring of anthropometric measurements. An intent-to-treat analysis was used. RESULTS Healthy Measures was feasible, with 13 participants (86.7%) completing pre- and post-intervention assessments. Eight participants lost or maintained weight (53.3%); four gained weight. Healthy eating self-efficacy increased overall (t = -2.54, p = .024). Increased protein and fat intake was associated with weight loss, while reduced protein, carbohydrate, and fat intake resulted in weight gain. CONCLUSIONS Healthy Measures shows promise for prevention of weight gain, with evidence of feasibility and positive outcomes. Further research is needed to establish efficacy relative to alternative approaches.

The symptom-related neurobiology characteristic of schizophrenia in the brain from a network perspective is still poorly understood, leading to a lack of potential biologically-based markers and difficulty identifying therapeutic targets. We aim to test the dysregulated cross-network interactions among the Salience Network (SN), Central Executive Network (CEN) and Default Mode Network (DMN) and how they contributed to different symptoms in schizophrenia patients.We examined network interactions among the SN, CEN and DMN in 76 patients with schizophrenia vs. 80 well-matched controls using dynamic causal modeling (DCM). We further analyzed the relation between network dynamics and Positive and Negative Syndrome Scale (PANSS).We observed that the DMN, CEN and SN across healthy controls and schizophrenia patients showed several similarities within or between-network pattern in the resting state. Comparing schizophrenia to controls, SN-centered cross-network interactions were most significantly reduced. Crucially, the strength of connections from CEN subnetwork 1 to DMN subnetwork 1 was positively correlated with the Positive Score of PANSS. The connection from the DMN subnetwork 2 to CEN subnetwork 2 was negatively correlated with the Negative Score of PANSS.Our study provides strong evidence for the dysregulation among SN, CEN and DMN in a triple-network perspective in schizophrenia. The connection between DMN and CEN could be clinically-relevant neurobiological signature of schizophrenia symptoms. Our study indicated that the description of brain triple network hypothesis could be a novel and possible bio-marker for schizophrenia.

AbstractObjectivesGreater dietary self‐monitoring adherence is associated with weight loss, however, the dietary self‐monitoring adherence criteria that predict weight loss are unknown. The criteria used to define adherence to dietary self‐monitoring in obesity treatment tend to vary, particularly in studies that include dietary self‐monitoring via mobile applications (apps). The objectives of this study were to (a) determine weight change outcomes related to app‐based dietary self‐monitoring and (b) determine the associations between the frequency, consistency, and completeness of dietary self‐monitoring and weight change.MethodsIn this single‐arm uncontrolled prospective study, employees at a large, urban health system who had overweight or obesity self‐monitored dietary intake for 8 weeks using the Calorie Counter by FatSecret app. A paired sample t‐test examined the association of app‐based dietary self‐monitoring and weight change; linear regression examined the associations of frequent, consistent, and complete dietary self‐monitoring and weight change.ResultsA significant mean difference [t (89) = 6.59, p < 0.001] was found between baseline and 8‐week weight (M = −1.5 ± 2.1 kg) in the sample (N = 90). Linear regression revealed a significant association [F (1, 88) = 7.18, p = 0.009] between total weeks of consistent dietary self‐monitoring (M = 4.4 ± 2.8) and percent weight loss (M = −1.54% ± 2.26%), and a significant association [F (1, 88) = 6.42, p = 0.013] between dietary self‐monitoring frequency (M = 50.1% ± 33.3%) and percent weight loss. The total weeks of complete dietary self‐monitoring (M = 3.42 ± 2.87) was not associated [F (1, 88) = 3.57, p = 0.062] with percent weight loss.ConclusionsConsistent and frequent app‐based dietary self‐monitoring were associated with short‐term weight loss. Emphasizing these aspects of self‐monitoring may be an avenue for decreasing the burden of self‐monitoring.

Introduction: Potential risk factors of infant overweight/obesity in Salvadoran mother-infant dyads (N = 88) at routine 9- to 12-month wellbaby visits were examined in a correlational study at two pediatric offices on Long Island, New York. Method: Maternal factors and infant feeding practices in the first 5 months were self-reported; infant birth weight, current weight/recumbent length were obtained. Bivariate logistic regression measured the relationship of the variables with infant weight status >85th percentile weight-for-length (WFL) for sex. Results: The majority of mothers were born in El Salvador, with a mean age of 28.5 years (SD = 5.9); 43% of infants had WFL >85th percentile. Infant birth weight was significantly associated with WFL >85th percentile, p = .0007. After controlling for maternal age, insurance type, education, and marital status, no significant associations with infant WFL >85th percentile were found. Feeding practices during infants' first 5 months, mothers' pre-pregnancy weight, pregnancy weight gain, and history of gestational diabetes mellitus, were not associated with infant weight status. Conclusion: This was the first study to examine infant weight status in Salvadorans. Future studies should objectively measure infant feeding practices and other potential factors among Salvadoran mother infant dyads, since nearly half of the infants had WFL >85th percentile.

BACKGROUND:People who experience childhood sexual abuse (CSA) have a higher rate of adolescent pregnancy than people who do not experience CSA. The purpose of this integrative review was to identify risk or protective factors that are associated with this group to help understand the high rate of adolescent pregnancy in people with CSA histories.METHODS:This review was conducted using strategies described by Whittemore and Knafl (2005). Five research articles met the following criteria: written in English, published in peer-reviewed journals in the past 10 years, and included the examination of predictors of adolescent pregnancy in any domain of the social ecological model of individual, relationship, community, or societal factors present among girls with CSA histories.RESULTS:Studies suggest that people who are abused in childhood through adolescence and are not believed when they report abuse may be at greater risk for pregnancy in adolescence. CSA was associated with a range of sexual risk taking behavior (e.g., ineffectual contraception use, drug and alcohol use prior to sex, multiple partners) which could lead to adolescent pregnancy. Individual-level behaviors where predominantly studied. There were no reports at the community or societal level of the model.CONCLUSIONS:Identifying additional risk or protective factors at the relationship, community, and societal level may prove helpful in developing strategies tailored to this population. The unique characteristics that lead to higher rates of sexual risk-taking behavior that can lead to adolescent pregnancy have not been well documented and deserve further study to guide design and prevention/intervention modalities.