Syfte och frågeställningar Studien undersöker hur lärare i idrott och hälsa och lärare i andra ämnen i Stockholms län arbetar kring ätstörningar i skolan. Syftet med detta är att ge en bild av vilka faktorer som sätter ramar för arbetet med ätstörningar. Studiens frågeställningar är: 1. Hur påverkar lärarens ålder och kön hens arbete kring ätstörningar i skolan inom Stockholms län? 2. Hur påverkar lärarens undervisningsämne hur hen arbetar kring ätstörningar i skolan inom Stockholms län? 3. Hur påverkar antalet år i yrket hur lärare arbetar kring ätstörningar i skolan inom Stockholms län? Metod För att besvara studiens syfte och frågeställningar används en kvantitativ metodteori, med en deskriptiv ansats. Studien utfördes genom enkäter digitalt. Urvalet bestod av 137 lärare som undervisar i grund- eller gymnasieskolan i Stockholms Län. En pilotstudie utfördes på fyra nyutexaminerade lärare i idrott och hälsa. Studiens teoretiska ramverk är det salutogena perspektivet, för att kunna förstå studien utifrån ett hälsoperspektiv. Datan analyserades i Google Spreadsheet och presenteras i stapeldiagram. Resultat Lärarens ålder och yrkesverksamma år har ett samband med hur högt man skattar sin kunskap om ätstörningar, hur bekväm man är att bemöta elever som visar varningssignaler samt veta hur man ska gå tillväga. Kvinnor skattar sin kunskap om ätstörningar och tillvägagångssätt högre än män, dock anser män att de är mer bekväma i mötet med elever med ätstörningar. Lärare i idrott och hälsa skattade sina kunskaper, bemötande och tillvägagångssätt lägre än lärare i andra undervisningsämnen. Det framkommer en kunskapslucka gällande ätstörningar hos lärare som arbetar i Stockholms Län.  Slutsats De slutsatser man kan dra är att studiens olika faktorer påverkade hur högt eller lågt lärare skattade sig själva i de olika värderingsfrågorna. Lärarnas tillvägagångssätt tyder på ett patogent synsätt, men hur de ser på människans hälsa är mer utifrån ett salutogent perspektiv. Ett samband kunde ses mellan ålder och yrkesverksamma år. / Aim The study examines how physical education teachers and teachers in other subjects in Stockholm County work with preventing eating disorders in school. The purpose of this is to give a better picture of which factors that set the framework for the work around eating disorders. The questions we’re studying is: 1. How does the teacher's age and gender affect hers/his work around eating disorders in schools within Stockholm County? 2. How does the teacher’s subject affect hers/his work around eating disorders in schools within Stockholm County? 3. How does the number of years in the profession affect how teachers work around eating disorders in schools within Stockholm County? Method To answer the study's purpose and questions, a quantitative method theory was used, which had a descriptive approach. The study was conducted through digital surveys. The sample consisted of 137 teachers who teach in primary or secondary school in Stockholm County. A pilot study was conducted on four newly graduated physical education teachers. The theoretical framework of the study is the salutogenic perspective, in order to be able to understand the study from a health perspective. The data was analyzed in Google Spreadsheet and presented in bar graphs. Results Age and professional years are related to how well you consider your knowledge to be of eating disorders, how comfortable you are to respond to students with warning signals and the knowledge of how to act. Women considered their knowledge of approaches to be higher than men, however, men considered themselves to be more comfortable in meeting students with eating disorders. Teachers in physical education rated themselves lower than teachers of other subjects. There was a knowledge gap about eating disorders. Conclusions The conclusion of the result is that the different factors of the study had an influence on how high or low one teacher valued one self. A correlation could be seen between age and working years. Teachers' approach indicates that they see human health from a pathogenic point of view, but at the same time, how they are really seeing human health is more from a salutogenic perspective. There is a knowledge gap that needs to be filled.

Purpose of review – This systematic review sought to compare available evidence-based clinical treatment guidelines for all specific eating disorders. Recent findings – Nine evidence-based clinical treatment guidelines were located through a systematic search. The international comparison demonstrated notable commonalities and differences among current evidence-based clinical guidelines for eating disorders. Consistency across guidelines was greatest for treatments with a larger evidence base, while those with a lower evidence base had recommendations that varied considerably. Summary – Evidence-based clinical guidelines represent an important step toward the dissemination and implementation of evidence-based treatments into clinical practice. Despite advances in clinical research on eating disorders, a growing body of literature demonstrates that individuals with eating disorders often do not receive an evidence-based treatment for their disorder. Regarding the dissemination and implementation of evidence-based treatments, current guidelines do endorse the main empirically validated treatment approaches with considerable agreement, but additional recommendations are largely inconsistent. An increased evidence base is critical in offering clinically reliable and consistent guidance for the treatment of eating disorders. Because developing and updating clinical guidelines is time-consuming and complex, an international coordination of guideline development, for example, across the European Union, would be desirable.

In this paper I investigate the emotional benefits of textile crafts in general and embroidery in particular. How can embroidery be used to express love and care for others? Can embroidery be used as a therapeutic tool? Using my own embroidery project Flower heart as a starting point, my research goes into craft as a manifestation of love, from handmade gifts in the 18th century to contemporary art, and crafting as a therapeutic medium, from rehabilitation of soldiers after WW1, to a recent study on 92 Finnish craft makers. My material is based on research on (textile) craft, research on occupational therapy, interviews with contemporary embroidery artists Michelle Kingdom, Alexandra Drenth and Willemien de Villiers, as well as my own experiences with the project Flower heart. My conclusions are that there are many emotional benefits to textile crafts. Our crafts can comfort us from sorrow, help us deal with pain, both physical and mental, make us connect to one another, provide meaning to our lives, anchor us in the present and live on long after we are gone as a manifestation of our lives and our love.

Orientador: Carmen Maria Bueno Neme / Resumo: Os transtornos alimentares em adolescentes constituem parcela significativa da demanda clínica da atualidade. Tratam-se de modalidades de sofrimento e de adoecimento humano que se constituem com base em um modelo etiológico multifatorial composto pela inter-relação de fatores familiares, individuais, sociais e biológicos, cuja complexidade se configura como problema de saúde pública e, ainda, um desafio para a compreensão teórica e o manejo clínico psicológico. A questão central deste estudo é a associação entre as relações de cuidados parentais e a manifestação dos transtornos alimentares em adolescentes. Pressupõe-se que as relações de cuidado entre os pais e o filho(a) perpassam, inevitavelmente, as relações alimentares e contribuem para a constituição da saúde mental ou, ainda, para distorções e fraturas no processo de desenvolvimento emocional que podem predispor o indivíduo à vulnerabilidade psicopatológica própria dos transtornos alimentares. Deste modo, este estudo buscou compreender os significados e as experiências afetivo-emocionais associados às relações de cuidado na perspectiva de uma adolescente acometida por bulimia nervosa e seus pais. Trata-se de um estudo de caso descritivo com enfoque qualitativo, orientado pelo método psicanalítico. Os instrumentos utilizados para a coleta de dados foram a entrevista clínica semiestruturada aplicada individualmente a cada membro da tríade e o Procedimento de Desenhos-Estórias com Tema, usado como recurso mediador dialógic... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Eating disorders in adolescents constitute a significant portion of the current clinical demand. These are modalities of suffering and human illness that are based on a multifactorial etiological model composed by the interrelation of family, individual, social and biological factors, which complexity is configured as a public health problem and still a challenge for theoretical understanding and clinical psychological management. The central issue of this study is the association between parental care relationships and the manifestation of eating disorders in adolescents. It is assumed that the care relationships between the parents and the child inevitably permeate dietary relationships and contribute to the constitution of mental health or, still, to distortions and fractures in the emotional development process that may predispose the individual to the psychopathological vulnerability inherent in eating disorders. Thus, this study aimed to understand the meanings and affective-emotional experiences associated with care relationships from the perspective of a teenager with bulimia nervosa and her parents. This is a descriptive case study with a qualitative approach, guided by the psychoanalytic method. The instruments used for data collection were the semi-structured clinical interview applied individually to each member of the triad and the Procedure of Drawings-Stories with Theme, used as a dialogical mediating resource, focusing on the depth of the experiences associate... (Complete abstract click electronic access below) / Doutor

INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a reproductive and endocrine disorder common among women of reproductive age. It is characterized by elevated androgen levels, menstrual irregularities, and several cysts ranging from 2 to 9 mm on one or both ovaries. PCOS is prevalent in approximately 10% of women typically between the ages of 18-44. It is significantly underdiagnosed due to variation in disease manifestation. Treatment for PCOS includes oral contraceptives, Metformin, and Spironolactone. However, supplements such as zinc and magnesium are increasingly promising additions to PCOS treatment regimens to manage symptoms and co-morbid chronic diseases. The objective of this thesis is to determine the prevalence of supplement use as a treatment for PCOS in the Ovulation and Menstruation Health Pilot Study (OM). The OM Pilot study is an epidemiological, online survey that aims to study the characteristics and determinants of female reproductive diseases in a diverse population. This thesis also explores the overall role of nutrition in PCOS management. METHODS: The goal of the OM Pilot Study is to determine women’s gynecological health outcomes in a multi-ethnic cohort and to characterize the lifestyle, health, and menstrual risks of reproductive diseases such as polycystic ovary syndrome, endometriosis, and uterine fibroids. The eligibility criteria included: being of reproductive age, having the ability to menstruate, being able to read in English, and having a working email address to receive the link to the survey. The survey and questions were designed by a board-certified reproductive endocrinology and infertility specialist at Boston Medical Center and was administered through REDCap, a cloud-based clinical software application for building and managing online surveys and databases. The questionnaire was comprised of each of the following sections: Demographics, Baseline Questionnaire, Anthropometrics, Menstrual Cycle, Contraceptive History, Health and Body, Polycystic Ovary Syndrome, Reproductive Health Questions, General Health Questions, Diet and Lifestyle, and Pregnancy and Birth History. Participants were recruited from multiple cities across the United States using in-person recruiting methods, online recruitment through a link, flyers, posters, word-of-mouth, and advertisements on Facebook and other social media websites such as Twitter and LinkedIn. Consenting participants were entered into a raffle to win a $200 gift card. Data analysis was conducted on SAS 9.4 and manually as needed. RESULTS: In terms of prevalence of PCOS: Of the 249 women who completed the survey, 60 women self-reported to having polycystic ovary syndrome (37 were diagnosed by a physician and 23 diagnosed by self). And of those 60 women who reported having PCOS, 24 reported taking medication for PCOS and out of these women, 10 women reported taking one, two, or three of the supplementary treatment options. Of the 60 women with PCOS, 4 women currently take a multivitamin for PCOS, 2 women currently take a dietary supplement, 2 women currently take herbal remedies, and 4 women reported drinking spearmint tea to help with PCOS management. Additionally, out of the 60 women who reported yes to having PCOS whether they were diagnosed by a physician and self-diagnosed, 11 women also reported yes to having an eating disorder. Of those 11 women, 7 women have anorexia, 7 women have bulimia, and 4 women have binge eating disorder. CONCLUSION: In this thesis, the prevalence rates of PCOS diagnoses, supplement use among PCOS patients, and eating disorders among PCOS patients were determined. Based on current literature on the effectiveness of supplements on PCOS symptoms, it seems advisable to study the effects of supplements further to incorporate them into treatment. With additional research, medical personnel such as physicians and registered dietitians should consider adding supplements to treatment regimen for PCOS. A personalized diet and exercise plan along with a plan to treat mental health to curb the prevalence of eating disorders may be beneficial to add to the treatment regimen for PCOS.

Mandometermetoden hjälper personer med ätstörningar genom att med träning lära dem ätapå ”rätt” sätt med en produkt som kallas Mandometer®. Detta sker genom att användarna viadisplayen på Mandometers® handdator får återkoppling på om de äter för fort eller förlångsamt under måltiden. Mando Group AB, företaget som utvecklat Mandometermetoden,har även tagit fram ett datorprogram som fungerar som en simulering av en måltid medMandometer®. Syftet med det här arbetet var att undersöka om träning med denna simuleringskulle kunna ge samma effekt som träning med Mandometer®. Genom att låta en gruppfriska testpersoner träna med simuleringen under tre veckor erhölls ett resultat som tydligtvisade att testpersonerna ändrat sitt ätbeteende i önskad riktning. Resultatet visar att det finnsen möjlighet att i framtiden lägga till träning med simuleringen som en del avMandometermetoden förutsatt att utökade tester samt utveckling av programmet förstgenomförs.För att förbättra Mandometer® ytterligare har dessutom en ny version tagits fram därhanddatorn ersatts med en mobil och dess funktioner med en applikation. Applikationensfunktionalitet och användarvänlighet testades bland annat med metoden cognitivewalkthrough vilken visade att applikationen generellt höll en hög standard. Med någrajusteringar på sidorna där användarvänligheten var låg bör applikationen kunna ersättaden nuvarande versionen av Mandometer® i framtiden. / The Mandometer® Method helps people with eating disorders by teaching them how to eat ina ”correct” way by training with a product called Mandometer®. The users learn the correcteating behavior by receiving feedback from the display on the Mandometer® handheldcomputer on whether they eat too fast or too slow during the meal. Mando Group AB, thecompany which has developed the Mandometer® Method, has also created a computerprogram that works as a simulation of a meal with the Mandometer®. The purpose of thisstudy was to examine if training with the simulation could give the same effect as trainingwith Mandometer®. By letting a group of healthy testpersons practice with the simulationduring three weeks a result was given which clearly showed that the eating behavior of thetest persons had changed in the desired direction. The result indicates that there is a possibilityto add the simulation to the Mandometer® Method in the future. However, more testing anddeveloping of the program is first required.To improve Mandometer® further, a new version of the product has been developed wherethe handheld computer has been replaced by a cellphone and its functions by anapplication. The functionality and usability of the application was tested with the methodcognitive walkthrough, which showed that most of the pages of the application maintaineda high standard. With some adjustment of the pages where the usability was low, theapplication should be able to replace the old version of Mandometer® in the future.

Distorted thinking about food is common in both clinical and nonclinical populations from dieters to diabetics and eating disorder patients. This type of thinking is triggered by exposure to dieting culture (including related social media), familial dieting, and internalization of the thin ideal, among other factors. The consequences of distorted thinking about food include disordered eating, weight management problems, body dissatisfaction and many others. Despite these findings, distorted thinking about food in nonclinical samples remains poorly understood. Thus, the current research sought to investigate distorted thinking about food within a broad theoretical model that includes societal antecedents important to understanding the nature of this construct in the general population. This model, which is based on Cognitive Behaviour Therapy (CBT) and the Theory of Planned Behaviour (TPB; Ajzen, 1991), was investigated in two studies. The first study is a psychometric validation study of a tool designed to measure distorted thinking about food, the Calorie Catastrophizing Scale (CCS; Monaghan & Santor, 2017) as well as the tool designed to measure dietary misinformation, the Dietary Misinformation Questionnaire (DMQ; Monaghan & Santor, 2017). Results lend support for defining and measuring distorted thinking about food as a distinct construct in nonclinical individuals and suggest that dietary misinformation is an important antecedent to this type of thinking and unhealthy eating behaviours. The second study is a randomized controlled trial of a CBT- and TPB-based workshop intervention aimed at reducing these antecedents. Results show that this intervention led to a significant reduction in distorted thinking about food, dietary misinformation, and other important clinical variables such as symptoms of eating pathology. These findings have a number of important implications for how subclinical eating problems are conceptualized, measured, and prevented.

The thesis focuses on female university students and their body image in relation with their parents' body image. The satisfaction of the students with their own bodies depends on many elements such as the influence of the media and the judgements of their peers, family and authorities. A substantial part of our thesis is an unprecedented analysis of the possibility of a trans-generation transfer of the extent of satisfaction with one's own body from parents to their daughters. We have used the quantitative research strategy to assess the results gathered from questionnaires focusing on the students' as well as the parents of both male and female children's perception of their own bodily features. Physical parameters such as height and weight were also checked. The study also focused on whether the trans- generation transfer is affected by the way the parents treat their children during childhood and adolescence. Our results have shown that there is a positive relation between the student's and the mother's body image. This positive relation can be perceived as a consequence of the trans-generation transfer which is probably a mechanism of observational learning. The results further show that the student's body image and their mothers' loving care during childhood and adolescence are also in a...

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Background: Eating disorders (EDs) are often stereotyped as a “women’s health issue,” due in part to the striking gendered inequities in risk. However, this stereotype has contributed to the prioritization of gender as the dominant analytic category through which to study the epidemiology of EDs, as well as research practices that erroneously treat the observed inequities as universal, fixed, or even self-evident. There are thus important knowledge gaps regarding the social patterning and structural drivers of EDs that may be undermining equitable resource allocation and intervention. Drawing on intersectionality and other critical feminist theories, this dissertation sought to address these gaps in three specific aims: (1) to examine how gender identity intersects with gender expression, sexual orientation, and weight status to shape the social patterning of EDs; (2) to evaluate the extent to which structural sexism (i.e., systematic gender inequality in power and resources) contributes to gendered inequities in EDs; and (3) to assess whether the relationship between structural sexism and EDs differs within gender identity groups by gender expression, sexual orientation, and/or weight status. Methods: Participants came from the Growing Up Today Study (GUTS), a U.S. national cohort of ~27,000 young people that began in 1996 and is ongoing. For Aim 1, a novel multilevel modeling method for quantitative intersectionality research was used to estimate the prevalence of ED diagnoses and associated symptomology (i.e., binge-purge behaviors) for 32 intersectional strata, or subgroups defined by all possible combinations of two gender identity categories, two gender expression categories, four sexual orientation categories, and two weight status categories. For Aims 2 and 3, a composite index of U.S. state-level structural sexism was linked to the geocoded GUTS data and sequential conditional mean models were used to evaluate the overall, gender identity-specific, and intersectional stratum-specific relationships between time spent living in a structurally sexist state and subsequent risk of ED symptomology. Results: Aim 1 revealed a complex social patterning of ED prevalence characterized by meaningful levels of heterogeneity both between and within gender identity categories. Importantly, intersectional strata including multiply marginalized girls and women (i.e., those who were gender nonconforming, sexual minority, and/or living in a larger body) reported the highest prevalence of both ED diagnoses and associated symptomology. In Aim 2, it was found that each additional year of living in a state characterized by a high degree of structural sexism (e.g., large wage gaps, few legal protections) increased ED symptomology risk by up to 9%; further, girls and women who had lived in a structurally sexist state for four or more years evidenced excess risk relative to boys and men, partially explaining the observed inequities. Aim 3 integrated findings from Aims 1 and 2 by demonstrating how long-term exposure to state-level structural sexism was particularly deleterious for multiply marginalized girls and women. Conclusions: Findings from this dissertation challenge prevailing stereotypes about EDs by demonstrating their inherently intersectional and contextual nature. This work also contributes theoretical and methodological advancements for social epidemiologic research on gender and EDs, and intersectional health inequities more broadly.