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Background: Severe and enduring anorexia nervosa (SE-AN), is a serious and persistent illness, despite 'state of the art' treatment. Criteria have been theoretically proposed, but not tested, and may not adequately capture illness complexity, which potentially inhibits treatment refinements. The clinical reality of death as an outcome for some people who experience SE-AN (1 in 20) and broadening access to voluntary assisted dying, further complicates the field, which is undeveloped regarding more fundamental concepts such as nosology, treatment, recovery definitions and alternative conceptualisations of SE-AN. The present paper is in response to this and aims to build upon qualitative literature to enhance phenomenological understandings of fatal SE-AN. Method: A published book, being the legacy of a 32-year-old professional artist offers a rich account of a life lived with AN, for 18 years with continuous treatment. A polysemous narrative via the interrelationship between the languages of the artist's words and visual art is translated via interpretative phenomenological analysis (IPA), offering rich insight into the SE-AN experience. Findings: The process of analysis induced three superordinate themes (1) Disappearing Self (2) Dialectical Dilemma (3) Death and Dying: Finding Meaning. Two cross cutting themes traversed these themes: (a) Colour and (b) Shifting Hope, where the former produced a visual representation via the 'SE-AN Kaleidoscope'. Collectively the themes produce a concept of SE-AN, grounded in the data and depicted visually through the artist's paintings. Conclusions: The picture of SE-AN revealed in the analysis extends upon conceptualisations of SE-AN, highlighting key processes which are thus far under explored. These factors are implicated in illness persistence eliciting opportunities for further research testing including diagnostic considerations and treatment directions. In SE-AN, distorted body image extends to a global distortion in the perception of self. Additional criteria for the severe and enduring stages of illness related to (1) self and identity processes (2) measures of 'global impoverishment' across life domains are proposed for consideration in the future testing of putative defining features of SE-AN. Plain English summary: Anorexia Nervosa (AN) is a serious and life-threatening illness. There is a need to understand more about why AN persists in becoming severe and enduring (SE-AN) for some people. One such way to build understanding of a condition is via the stories of those who experience it. This study utilizes a person's unique artistic language to do so. This has the potential to generate new ideas about a condition, especially those that may be beyond words for some people and therefore progress classifications for SE-AN for research and treatment purposes. The artist in this study contributes a unique perspective offering new areas for potential research such as understudied complex psychological processes for example shame, dissociation, 'self', emotional literacy, and anorexia as an identity. Additionally, other factors to be considered in the assessment and classifications of long-term cases of AN as well as an alternative understanding of AN persistence is proposed, beyond the concept of 'body image disturbance'. Alternative treatment approaches such as art therapy are indicated. Note: Contents of this paper may be distressing to people who have lost a loved one to an eating disorder and the following website may provide access to support if any of the content of his paper causes the reader distress: USA - NEDA https://www.nationaleatingdisorders.org/ UK BEAT https://www.beateatingdisorders.org.uk/ Australia Butterfly https://butterfly.org.au/ or Lifeline - which is an international organisation with local websites. [ABSTRACT FROM AUTHOR]

Emerging evidence points to unique conceptualisations of positive body image in autistic individuals. However, there are no existing measures of positive body image that have been developed or validated for use with autistic adults. To rectify this, we developed a revised version of the BAS-2 - the BAS-2A - and examined its factorial validity and psychometric properties in a sample of autistic adults from the United Kingdom. Based on the results of exploratory factor analysis and scale purification, we extracted a 12-item, unidimensional model of BAS-2A scores in a first split-subsample (n = 273). Confirmatory factor analysis supported the unidimensional model of BAS-2A scores in a second split-subsample (n = 277). BAS-2A scores presented adequate composite reliability, measurement invariance across gender identity, and patterns of construct validity. For both women and men, BAS-2A scores correlated positively with self-esteem, well-being, quality of life, and adaptive coping, and inversely with dietary restraint, weight/shape overvaluation, body dissatisfaction, and depression. Finally, BAS-2A scores demonstrated incremental validity, predicting self-esteem over-and-above body dissatisfaction. However, temporal stability of the BAS-2A over three weeks was not supported. These results support the BAS-2A as a psychometrically robust measure of body appreciation for use in autistic adults from the United Kingdom., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work presented in this paper., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Previous work has supported direct, positive associations between body appreciation and positive mental health, but has largely neglected to examine possible indirect mechanistic pathways. Here, we propose one relevant mediational pathway, wherein body appreciation is associated with positive mental health via positive self-beliefs (i.e., cognitions that lead individuals to view themselves, their lives, and/or their futures under a positive outlook). To test this hypothesis, we asked an online sample of 496 adults (249 women, 247 men) from the United Kingdom to complete measures of body appreciation, positive self-beliefs, and positive mental health. Participants also completed measures of self-efficacy and resilience, and provided their demographic information. Correlational analysis revealed significant, positive, and strong associations between body appreciation and facets of positive self-beliefs and positive mental health, respectively. Structural equation modelling showed that positive self-beliefs mediated the association between body appreciation and positive mental health after controlling for self-efficacy and resilience. This model was robust across women and men separately, and the mediational effects remained intact in sensitivity and robustness analyses. We discuss ways in which greater body appreciation may help individuals develop and maintain positive self-beliefs, which in turn shape mental health outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

British South Asian women may experience unique appearance pressures associated with their intersecting (racialised and gendered) identities; yet qualitative investigations of intersectional understandings of their body image are scarce. The aim of this study was to explore sociocultural factors influencing British South Asian women's body image using an intersectional framework. Seven focus groups were conducted with 22 women of South Asian heritage living in the UK between the age of 18 and 48 years old who were comfortable speaking in English. Data were analysed using reflexive thematic analysis. We generated four themes (1) navigating (often marriage-related) appearance pressures from South Asian elders and aunties (2) negotiating cultural and societal standards across different aspects of one's identity (3) representation of South Asian women in the wider context and (4) forms of healing from the pressures imposed on South Asian women. The findings have important implications for the body image experiences of South Asian women by acknowledging the need for tailored and nuanced responses to their complex needs in the sociocultural, political and relational context such as family, peers, education, health, media and the wider consumer landscape., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This paper reflects on some of the ethical dilemmas that social workers face when assessing risk in relation to those using substances. It explores how legislation and societal factors can impact not just on people's choices and decisions but also on their 'vulnerability' and access to services. Vulnerability, a contested term, is linked, in this paper, to assessment of risk. There are ethical issues that arise when assessing risk with people who use Anabolic Androgenic Steroids (AAS) from both service user and professional perspectives. These ethical issues concern a person's right to choose and make potentially harmful decisions. The paper argues that using substances such as AAS in and of itself does not suffice to make a person vulnerable but this does not mean that people using AAS are not in need of support. It suggests that there may be some groups of people who are more at risk to starting AAS use and that social workers should be aware of these. It also recommends the need for further qualitative research to understand the reasons for starting use and support to help people stop using AAS. [ABSTRACT FROM AUTHOR]

This paper is a reflection on an experiment undertaken during a Medical Ethics lecture delivered to a group of medical students in the UK as part of a project for a programme in Higher Education Practice. The aim of the project, following Paulo Freire's idea of 'liberating education,' was to identify students' ethical assumptions and biases in relation to a problem of resource allocation in healthcare, and their role in decision-making. The experiment showed the importance placed by medical students on disputed values such as free will, desert, social worth and body image, and highlighted the difficulty and importance of bringing students' process of moral decision-making to awareness in ethics teaching, in order to a) decrease the role of implicit bias in students' decision making and b) allow students to decide whether they in fact agree with assumed values and ethical frameworks that influence their thinking. [ABSTRACT FROM AUTHOR]

Since the 1980s, the primary public health response to injecting drug use in the UK has been one of harm reduction. That is, reducing the harms associated with drug use without necessarily reducing consumption itself. Rooted in a post-Enlightenment idea of rationalism, interventions are premised on the rational individual who, given the right means, will choose to avoid harm. This lies in stark contrast to dominant addiction models that pervade popular images of the ‘out of control’ drug user, or worse, ‘junkie’. Whilst harm reduction has undoubtedly had vast successes, including challenging the otherwise pathologising and often stigmatising model of addiction, I argue that it has not gone far enough in addressing aspects of drug use that go beyond ‘rational’ and ‘human’ control. Drawing on my doctoral research with people who inject drugs, conducted in London, UK, this paper highlights the role of the injecting ‘event’, which far from being directed or controlled by a pre-defined individual or ‘body’ was composed by a fragile assemblage of bodies, human and nonhuman. Furthermore, in line with the ‘event’s’ heterogeneous and precarious make-up, multiple ways of ‘becoming’ through these events were possible. I look here at these ‘becomings’ as both stabilising and destabilising ways of being in the world, and argue that we need to pay closer attention to these events and what people are actually in the process of becoming in order to enact more accountable and ‘response-able’ harm reduction. [ABSTRACT FROM PUBLISHER]

Based upon the findings of a qualitative in-depth interview study with 23 women aged 23-72 years recruited from members of the general public and a psychosexual clinic, this paper explores participants understandings of the term 'sexuality'. The findings are set within the context of historical, prevailing and often contradictory perceptions of the term. Data were analysed thematically using the conventions of template analysis within a material discursive framework. This paper questions the assumption that sexuality is an altogether powerful and naturally occurring phenomenon. The ability to isolate and give credence to a definitive meaning of the term is, both for participants and academics alike, an arduous undertaking. Rather than focusing primarily on the material body, the extent to which ideology, culture and power intersect with the former indicate its multidimensional, constructed nature. Given the whole host of meanings evoked by the term, the paper asserts that it is more fitting to talk of multiple understandings of sexuality rather than a singular authoritative one whilst also contingent on social and historical practices. The findings have implications that should be considered when evaluating previous sexological research and conducting future research where this term is used throughout as a focus of academic enquiry. [ABSTRACT FROM AUTHOR]

The anatomical body figures as a privileged site in the signification of sexual difference. This paper argues that the historical discourses and practices of surgery are implicated in this figuration of the body as composed of sexually differentiated anatomical parts. Through historical analysis of the institutional and discursive developments of British surgery in the late eighteenth and early nineteenth centuries, the paper demonstrates how surgeons promoted an anatomical view of the body as representative of scientific, empirical knowledge. During this period, surgeons were deemed of lower medical and social status than physicians because, unlike physicians, surgeons physically touched the patient's body and were not university trained. In order to gain medical authority, surgeons thus had to resignify their practices (which included dissection) and approach to the body as illustrative of scientific knowledge, worthy of gentlemen. In contrast to the medical orthodoxy of physicians who diagnosed disease through external symptoms, surgeons attributed disease to the internal, material structures of the body and advocated surgical intervention as a means of medical management. In doing so, the human body was reconceived as an anatomical form, comprised of different parts to which surgeons have privileged access and knowledge. As this view gained legitimacy over the course of the nineteenth century, understandings about sexual difference became anatomically, and hence surgically, legitimised. This paper thus argues that the practices and discourses of surgery, and the surgeons implicated in its development, are instrumental in the historical production and ongoing reproduction of anatomy as a site of sexual significance. [ABSTRACT FROM AUTHOR]

Body image issues associated with eating disorders involve attitudinal and perceptual components: individuals' dissatisfaction with body shape or weight, and inability to assess body size correctly. While prior research has mainly explored social pressures produced by the media, fashion, and advertising industries, this paper focuses on the effects of personal networks on body image, particularly in the context of internet communities. We use data collected on a sample of participants to websites on eating disorders, and map their personal networks. We specify and estimate a model for the joint distribution of attitudinal and perceptual components of body image as a function of network-related characteristics and attributional factors. Supported by information gathered through in-depth interviews, the empirical estimates provide evidence that personal networks can be conducive to positive body image development, and that the influence of personal networks varies significantly by body size. We situate our discussion in current debates about the effects of computer-mediated and face-to-face communication networks on eating disorders and related behaviors.

Purpose – Current western society promotes a strong desirability to be thin. The majority of young females are unhappy with their body shape and wish to be thinner. This can lead to many health problems such as addictive exercising, depression and disordered eating. It is also established that certain groups tend to be more prone to body image dissatisfaction (BID) than others. The purpose of this paper is to determine if there was a high prevalence of BID and/or disordered eating among students studying a food-related degree course. Design/methodology/approach – Students were recruited via e-mail. Subjects were weighed, measured and BMI calculated. A software package Anamorphic Micro was used to measure BID and a validated questionnaire "BITE" assessed for disordered eating. Findings – Nutrition students had a low mean BMI of 21.8 kg/m2. Despite this, the majority (90 per cent) were dissatisfied with their body; with 83 per cent wishing to be thinner and 60 per cent overestimating their body size. The BITE questionnaire revealed that 30 per cent scored for disordered eating and 10 per cent scored for Bulimia Nervosa. Originality/value – This paper confirms that students studying food-related degree courses are at greater risk of developing eating disorders. [ABSTRACT FROM AUTHOR]

This paper reviews four major topics related to the long-term psychosocial rehabilitation for burn survivors; (1) Body image adjustment process; (2) Social functioning challenges; (3) Interventions designed to address psychosocial rehabilitation challenges; and (4) Current policy developments in the USA and the UK that focus on raising the rehabilitation standards for psychosocial care for burn survivors. While acknowledging the close relationship between body image distress and social functioning, these two areas are reviewed separately with the goal of addressing two specific questions. First, what does current empirical research and clinical experience teach us about each of these areas, and second, what are the most important gaps in current knowledge about body image and social functioning, respectively? The final section of the paper specifically addresses the question of what can be done, from a practical and a health policy perspective, to ensure that existing body image and social difficulties are appropriately addressed. [ABSTRACT FROM AUTHOR]

Eve Sedgwick suggests that it is possible to “speak” your fatness, to “come out” as fat and renegotiate the “representational contract between one's body and one's world.”(1994: 230). Sedgwick's words have resonated particularly loudly with the Fat Acceptance movement, which has been embraced with feverish glee by fat women in the United States and the United Kingdom. I was immediately attracted to the politics of this new fat pride movement, who seemed to take up this idea of intervening in the ‘contract’ one's fatness had with the world, insisting on being seen in new ways. So, I go out into the world armed with the Fat Manifesto (Waun: 1998), wearing a sleeveless top, my dimpled arms on display. I feel strong, powerful, swollen with my fat identity, snarling at others who cast withering glances at my bulky frame. And then, I pass a shop window. I shudder as I catch a reflection of myself, my body appearing to me as grotesque and foreign, a bulging, jiggling vehicle of disgust and shame I want nothing to do with. I experience myself/my body in ways that shift and vary and contradict each other. NIkki Sullivan points out the problems with the act of ‘coming out’ as part of a project to overturn public ‘knowingness’ about homosexuality.“The call to come out presupposes that such an action is in itself transformative and that the identity that one publicly declares is unambiguous.” (Sulilvan: 31) In this paper, I take up Sullivan's point about the problematic act of ‘coming out’ as a fat woman. I critique the problematic model of subjectivity the Fat Acceptance Movement is founded on, given the ways in which I live my fat body are always multiple, contradictory and eminently ambiguous. This paper looks at the rise of the Fat Pride movement in the United States, and the model of subjectivity it proposes as a means of overcoming oppression of the fat woman. I critique the humanist principles on which this model of subjectivity is founded, and, moreover, the difficulties with liberationist politics. [ABSTRACT FROM AUTHOR]

Background: Patients opting for haemodialysis as a form of renal replacement therapy require prompt and reliable vascular access. The gold standard for delivering high-quality and safe haemodialysis is through the creation of an arteriovenous fistula (AVF), typically formed at the wrist or elbow. This intervention promotes increased blood flow through superficial veins, fortifying them for repeated needle insertion during haemodialysis treatment. The emergence of percutaneous endovascular arteriovenous fistula (pAVF) introduces a non-surgical alternative for AVF creation. This method eliminates the need for incisions, reducing the likelihood of surgical scarring and changes in vein appearance. Advantages of pAVF encompass the potential for accelerated convalescence, enhanced comfort for the patient, and a diminished adverse effect on body image perception. These non-surgical options may motivate patients to undergo the procedure promptly, enhancing the timeliness of vascular access for haemodialysis and positively impacting overall health outcomes. These relatively new interventions are evolving, enabling the refinement of more efficient and safer techniques. Dialysis nurses play a crucial role in overall success, necessitating further training and development of their skills and knowledge for needling these new fistulas. With an increasing number of successful cases and more readily available information, these non-surgical techniques are gaining popularity among patients, particularly those conscious about their body image. Aim: The goal is to outline an early experience with a comprehensive approach to planning a percutaneous endovascular arteriovenous fistula service at King's College Hospital. Method: This article describes the referral process, screening, clinical assessments, procedural elements and cannulation. Insights are drawn from a single-centre experience in the UK with the WavelinQ System (BD). Emphasis will be placed on key staffing needs, particularly related to patient selection and dialysis nurse training. Conclusion: By addressing these essential considerations, a pAVF service can be successfully implemented. [ABSTRACT FROM AUTHOR]

Twenty academic psychologists and neuroscientists, with an interest in autism and based within the United Kingdom, were interviewed between 2012 and 2013 on a variety of topics related to the condition. Within these qualitative interviews researchers often argued that there had been a ‘turn to infancy’ since the beginning of the 21st century with focus moving away from the high functioning adolescent and towards the pre-diagnostic infant deemed to be ‘at risk’ of autism. The archetypal research of this type is the ‘infant sibs’ study whereby infants with an elder sibling already diagnosed with autism are subjected to a range of tests, the results of which are examined only once it becomes apparent whether that infant has autism. It is claimed in this paper that the turn to infancy has been facilitated by two phenomena; the autism epidemic of the 1990s and the emergence of various methodological techniques, largely although not exclusively based within neuroscience, which seek to examine social disorder in the absence of comprehension or engagement on the part of the participant: these are experiments done to participants rather than with them. Interviewees claimed that these novel methods allowed researchers to see a ‘real’ autism that lay ‘behind’ methodology. That claim is disputed here and instead it is argued that these emerging methodologies other various phenomena, reorienting the social abnormality believed typical of autism away from language and meaning and towards the body. The paper concludes by suggesting that an attempt to draw comparisons between the symptoms of autism in infant populations and adults with the condition inevitably leads to a somaticisation of autism. [ABSTRACT FROM AUTHOR]

Aim To understand the experiences of young women with a disorder of sex development when sharing information about their body with healthcare professionals, friends and intimate partners. Background Disorders of sex development are lifelong conditions that create bodily difference such as absence of reproductive organs which can impact on young women's fertility and sexual experiences. Design Interpretive phenomenological analysis with thirteen young women (14-19 years old) with a disorder of sex development. Methods The young women chose to participate in either a face-to-face semi-structured interview or to complete a paper diary between 2011-2012. Results A superordinate theme focusing on the meaning bodily differences held for these young women is presented through three themes: self-awareness and communicating this to others; actualizing intimacy; and expressing meaning of altered fertility to self or professionals or partners. During early adolescence, the young women were guarded and reticent about sharing personal information about their disorder of sex development but as they moved towards adulthood, some of the young women learnt to engage in conversations with more confidence. Frustrations about their bodily differences and the limitations of their bodies were talked about as factors which limited physical spontaneity, impacted on their perceived sexual fulfilment and challenged the development or sustainability of close friendships or intimate partnerships. The young women wanted empathic, sensitive support from knowledgeable health professionals to help them understand their bodies. Conclusion Attachment and a 'sense of being' were the concepts that were closely linked to the young women's development of a secure identity. [ABSTRACT FROM AUTHOR]

This article draws on three mutually independent ethnographic studies to explore the private sector market for image and performance enhancing drug (IPED) harm reduction in the UK, specifically examining (1) steroid accessory supplements; (2) blood testing services; and (3) bloodletting services. After contextualising the work with a discussion of IPED use and harm reduction and the substantial growth of the global health and fitness industry, each private sector provision is critically interrogated with the following questions in mind: what is the role and utility of these services compared to public sector provision? Why has the private sector begun to deliver IPED harm reduction products and services in the UK? And how does this provision relate to the health and fitness industry more broadly? The paper concludes with some reflections about the future direction of IPED harm reduction, the importance of community-led services, and the need to think innovatively if we are to best protect users' health and wellbeing. [ABSTRACT FROM AUTHOR]

• Body was perceived as a multimodal term rather than a viscosity characteristic. • Consumers indicated flavour as the major contributor to wine and beer body. • Conceptually texture contributed more substantially to body perception in wine than beer. • Ethanol had a stronger relationship with body for wine than beer, according to the consumers. • Aroma and appearance influenced consumer expectations rather than body perception. Body is a key sensory characteristic for beverage acceptability, drinkability and an important consideration when making a purchase decision. Evidence suggests that consumers perceive low-alcohol beverages as lacking body. Despite the significance of body, little is known about consumer's understanding of the term. This paper employed a qualitative approach to gain insights into regular beer and wine consumers' understanding of beer and wine body in the UK. Focus group (FG) and the Free Choice Description (FCD) techniques helped explore the term with frequent beer and wine consumers (n = 90). In contrast with most research within alcoholic beverages which has focused on body perception as a one-dimensional viscosity component, this paper identified other sensory characteristics and compositional factors for both beer and wine that were perceived to contribute to body perception from a consumer perspective. It was evident from the present exploratory study that body constituted several modalities, including flavour, mouthfeel and aroma. Other essential factors for beer and wine body perception included appearance and overall beverage quality. It was also demonstrated that specific flavours, including dark fruit (blackberry, cherry, plum), citrus and tropical fruit flavours, Maillard reaction and cereal, as well as the barrel-age flavours (chocolate, coffee, caramel, smoke, grain, oak, roasted malt) were important for body perception. Mouthfeel attributes, such as velvety, smooth, and creamy, were also perceived to be responsible for body perception in beer and wine. Overall, findings from this study are compared across beverage types to provide direction to researchers and new-product developers on the key factors contributing to body perception from the consumer perspective. [ABSTRACT FROM AUTHOR]

This study explores the religious and spiritual aspects of eating disorder recovery and the role of social media in the context of a third sector community-based recovery group in the UK. Four online focus groups explored participant perspectives (17 participants in total) using thematic analysis. The qualitative findings highlight that relational support from God is important in eating disorder recovery and coping, although this can be challenged by spiritual struggles and tensions. Relational support from people is also relevant where it offers a place to share different experiences together giving a sense of community belonging. Social media was also found to be important in relation to eating disorders, either providing a community of support or exacerbating existing issues. This study suggests that the role of religion and social media should be acknowledged where it is important for that individual in relation to eating disorder recovery. [ABSTRACT FROM AUTHOR]

The ageing process has both psychological and physiological effects on women, and tactical choices are often made regarding beauty interventions to mask the outward signs of increasing age. The bra is believed to counteract the negative effects of ageing on the breast and alter the perceptions of one's body. Due to the profound anatomical changes to the breast with increasing age, this paper aimed to examine the influence of ageing on women's perceptions of their breasts and their bra preferences. 208 women aged 45-65 years were surveyed about their breasts, their bras and how they felt ageing may have influenced these. The findings showed 80 % of women surveyed had noticed a significant change in their breasts with ageing, just 7 % of the women surveyed were still proud of their breasts and 84 % of women dressed to look younger. Further, over 50 % of respondents would now not wear the bra they had worn in their twenties, indicating a change in bra preferences with age. The bra variables of primary importance to participants were: comfort, the bra's ability to stay in place, optimal fit, appearance under clothing, support, discreetness, shoulder strap design, silhouette, breast shape, fabric and breast lift. These variables are perceived as being influential in the appropriateness of the bra and its social role for mature women; therefore, it is these bra variables that should be the focus of subsequent research regarding the optimisation of bras for women aged 45-65 years. [ABSTRACT FROM AUTHOR]

This paper presents the results of the qualitative phase of Healthy Foundations, a study that groups people according to their motivations to live healthily or otherwise, their lifestyles, and the circumstances that affect this. These segments are ‘Health Conscious Realists’, ‘Balanced Compensators’, ‘Live for Todays’, ‘Unconfident Fatalists’ and ‘Hedonistic Immortals’. The aim was to explore people’s attitudes and motivations to live healthily or otherwise and the targeted healthcare interventions appropriate for each segment. The qualitative phase involved two strands: (i) focus groups and immersion in-depth interviews and (ii) video ethnographic ‘pen portraits’. It provides robust insight into the five segments’ motivations and behaviour and how these are constructed within and influenced by the wider environment. It also enabled the segments to give their views of and design appropriate interventions aligned to their individual requirements, lifestyles and structural environments. It demonstrates the usefulness of the qualitative approach to health segmentations and enhances the case for methodological pluralism, and a critical perspective, to enable development of health-related behaviour change interventions and policy more widely. [ABSTRACT FROM PUBLISHER]

ABSTRACT Penile cancer is an uncommon, gender-specific, malignancy that has the potential to profoundly affect physical, social, sexual and psychological functions. For most patients the method of treatment is surgery. The degree of surgical intervention is dependent on the stage of the disease at presentation. To date, relatively little is known about the impact of penile cancer surgery on psychological function and overall quality of life in men. Understanding the outcomes of treatment will influence the development of optimal methods of rehabilitation. This paper provides an outline of the context of two reviews of the existing literature: (i) a systematic review of the quantitative literature and (ii) a meta-synthesis of the qualitative literature. The implications for clinical practice, and an outline of forthcoming research are also presented. [ABSTRACT FROM AUTHOR]

This paper outlines the findings of a qualitative study involving interviews with eight transsexual individuals who had volunteered to take part in a television (TV) documentary about transsexuality. The participants were interviewed before taking part in the documentary and after its screening on national TV. The author proposes that for either biological and/or psychological reasons, some transsexual individuals experience early on a profound and disturbing incongruence at the level of the bodily self. In turn, this experience of incongruity is not contingently mirrored by primary attachment figures and remains unmentalized, thus disrupting self-coherence. In an attempt to restore self-coherence, the individual searches for the 'right' body that is anticipated to relieve the felt incongruity. The way this modified body relieves the incongruity is through the certainty it imparts that the image in the 'mirror' will match the subjective experience of the body. In this study, the experience of being mirrored through the group process during filming and the audience's response to the TV series, which was very positive, appeared to be associated with an attenuation in the urgency with which planned body modifications were being discussed post-TV screenings. [ABSTRACT FROM AUTHOR]

This paper aims to provide developmental data on two connected naïve inheritance concepts and to explore the coherence of children's naïve biology knowledge. Two tasks examined children and adolescents' (4, 7, 10, and 14 years) conceptions of phenotypic resemblance across kin (in physical characteristics, disabilities, and personality traits). The first task required participants to predict and explain feature outcomes in both an offspring and a sibling, in a modified version of the phenotypic similarity task. In the second task, participants offered explanations for instances of parent-offspring dissimilarity and grandparent-offspring resemblance (phenotypic difference task). The inclusion of two tasks and a broad age range revealed significant age trends between 4 and 10 years in naïve inheritance concepts. However, there was little consistency in children's inheritance explanations within or across tasks. The findings are discussed with reference to debates concerning the development and structure of naïve biology concepts. [ABSTRACT FROM AUTHOR]

kennedy f., harcourt d. & rumsey n. (2011) The shifting nature of women's experiences and perceptions of ductal carcinoma in situ. Journal of Advanced Nursing 68(4), 856-867. Abstract Aim. This paper is a report of a descriptive qualitative study of the evolution of women's perceptions and experiences of ductal carcinoma in situ from the period near to diagnosis to 1 year later. Background. Ductal carcinoma in situ is a non-invasive breast condition where cancer cells are detected but confined to the ducts of the breast. With treatment, the condition has a positive prognosis but ironically patients undergo treatment similar to that for invasive breast cancer. There is a lack of longitudinal qualitative research studying women's experiences of ductal carcinoma in situ, especially among newly diagnosed patients, and how experiences change over time. Methods. Forty-five women took part in an initial interview following a diagnosis of ductal carcinoma in situ and 27 took part in a follow-up interview 9-13 months later. Data were collected between January 2007 and October 2008. Transcripts were analysed using a hybrid approach to thematic analysis. Findings. Women's early perceptions of ductal carcinoma in situ merged and sometimes conflicted with their lay beliefs of breast cancer. Perceptions and experiences of the condition shifted over time. These overriding aspects were evident in four themes identified across the interviews: (i) perceptions of ductal carcinoma in situ vs. breast cancer, (ii) from paradox to acceptance, (iii) personal impact, and (iv) support and interactions with others. Conclusion. This study represents one of the few longitudinal qualitative studies with newly diagnosed patients, capturing women's initial and shifting experiences and perceptions of the condition. The issues identified need to be recognized in clinical practice and supported appropriately. [ABSTRACT FROM AUTHOR]

This paper reports young adolescent female norms for the Eating Disorder Examination Questionnaire (EDE-Q). The standardization sample was comprised of 808 girls aged between 12 and 14 years from three single-sex schools (one private and two state schools). Means, standard deviations and percentile ranks for raw EDE-Q subscale scores are presented. Prevalence figures for key eating disorder behaviors over the previous two weeks were as follows: 4% self-induced vomiting; 1% laxative misuse; 0.4% diuretic misuse; and 8% regular binge eating.

This paper reports on work with groups in secondary schools in the UK using dance movement psychotherapy techniques. This is an innovative way of working in the educational setting, targeting students who find it hard to verbalise thoughts and feelings and who are unable to access help for themselves. These students often have emotional difficulties which manifest themselves in withdrawn, depressed, or unduly passive behaviour. Such young people, in avoiding attention, can sometimes be more at risk of low self esteem, social isolation, and poor body image, and their difficulties may lead to academic underachievement. The objective of this group project was that, using movement within a safe group environment, we might provide an early intervention through which the withdrawn young person could engage creatively in a process of development and growth. Such a category of students might be less likely than others to self refer for counselling. However because schools provide a ready-made universal constituency for preventative mental health work, there is the opportunity to proactively engage these young people in valuable therapeutic work. The project was planned for secondary school children in the UK National Curriculum Keystage 3 (11-13 years old) a vital age (and window of opportunity) for early intervention. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between Western medicine, female body image and gender inequalities. It evaluates the extent to which the medicalisation of appearance through cosmetic surgery may serve to reinforce limited and restrictive models of femininity. Collusion with these processes, it is suggested, may be rational for some women at the individual level as they seek to increase their social power in a society where women are judged by their appearance more than men. At the social level, however, such action can be seen to go against women's collective interests and perpetuate wider social inequalities.

The main drivers of COVID-19 disease severity and the impact of COVID-19 on long-term health after recovery are yet to be fully understood. Medical imaging studies investigating COVID-19 to date have mostly been limited to small datasets and post-hoc analyses of severe cases. The UK Biobank recruited recovered SARS-CoV-2 positive individuals (n = 967) and matched controls (n = 913) who were extensively imaged prior to the pandemic and underwent follow-up scanning. In this study, we investigated longitudinal changes in body composition, as well as the associations of pre-pandemic image-derived phenotypes with COVID-19 severity. Our longitudinal analysis, in a population of mostly mild cases, associated a decrease in lung volume with SARS-CoV-2 positivity. We also observed that increased visceral adipose tissue and liver fat, and reduced muscle volume, prior to COVID-19, were associated with COVID-19 disease severity. Finally, we trained a machine classifier with demographic, anthropometric and imaging traits, and showed that visceral fat, liver fat and muscle volume have prognostic value for COVID-19 disease severity beyond the standard demographic and anthropometric measurements. This combination of image-derived phenotypes from abdominal MRI scans and ensemble learning to predict risk may have future clinical utility in identifying populations at-risk for a severe COVID-19 outcome. [ABSTRACT FROM AUTHOR]

Objectives: Within current research, little is known about the long-term outcomes of craniosynostosis. A priority-setting exercise by UK charity Headlines Craniofacial Support identified 2 key questions in this area: (1) What are the long-term physical and psychological effects for individuals with syndromic and non-syndromic craniosynostosis? and (2) Are individuals with craniosynostosis likely to suffer from mental health difficulties, or are they more resilient? The aim of the current study was to conduct an initial investigation of these priority questions. Methods: A comprehensive UK-wide survey consisting of 9 standardized psychological outcome measures and open-ended questions was distributed online. Thirty-six eligible adults (69.4% female) with a mean age of 30.8 years responded to the survey. Participants reported having single suture craniosynostosis (27.8%) or syndromic craniosynostosis (52.8%), with 19.4% being unsure of their diagnosis. Sample means were compared to published norms using independent samples t tests. Qualitative responses were analysed using inductive content analysis. Results: Compared to the general population, participants reported significantly less favorable scores related to appearance concerns, attachment in adult relationships, anxiety, optimism, and resilience. Self-worth, depression, and social anxiety scores were similar to norms. Qualitative responses provided additional insight into participants' satisfaction with appearance, physical health, medical treatment, employment, relationships, and recurrence risks. Few participants had accessed psychological support. Discussion: This preliminary study illustrates the potential long-term implications for individuals with craniosynostosis. Improved treatment protocols are needed to address physical health concerns in adulthood, while dedicated psychological resources are necessary to promote emotional well-being, social confidence, and resilience. [ABSTRACT FROM AUTHOR]

Background: The symptoms of obsessive−compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. Methods: A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive−Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). Results: Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. Conclusions: Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD. [ABSTRACT FROM AUTHOR]

The psychological and social impact of hair loss and its ongoing treatment can be considerable. Medical treatments are not always successful, and alternative treatments, such as medical tattooing, are growing in popularity. The aims of this study were to explore adults' motivations, experiences, and self-perceived outcomes in relation to medical tattooing. Individual telephone interviews were conducted with 22 women from the United Kingdom aged 26–67 years who had undergone medical tattooing in the past 5 years related to hair loss. Interviews were transcribed and inductive thematic analysis was performed. Appearance concerns, loss of self-confidence/identity, and the practicalities of daily upkeep were cited as reasons for seeking a semi-permanent solution. Trust in the practitioner and the ongoing costs of tattoo maintenance were important considerations in participants' decision-making process and their overall satisfaction with treatment outcomes. Participants felt the emotional impact of hair loss and the subsequent need for appearance-restoring treatment remains unrecognised. This study provides insight into participants' perceptions of an under-researched and unregulated but widely accessible treatment. Implications for the decision-making process are discussed, and suggestions for health professionals are offered. [ABSTRACT FROM AUTHOR]

Background: Retinoblastoma is a rare form of pediatric eye cancer for which enucleation is a common treatment modality. There is an increasing focus upon the impact of enucleation on children and families. This study aimed to explore the experiences of children and their families following enucleation to consider the barriers that may be encountered when adjusting to living with an artificial eye and identifying the support services and strategies used to address these barriers. Methods: Using a descriptive qualitative approach, interviews were conducted with 12 parents and seven children and thematic analysis was used to identify four themes representing the perspective of parents and children. Results: Parent themes identified were (a) entry into the world of retinoblastoma; (b) the importance of specialist support; (c) a family learning to cope; and (d) navigating school. The perspectives of children were (a) the importance of preparation and play; (b) positive reinforcement and hospital support; (c) support and openness at home; and (d) the importance of good school planning. Two overarching themes related to parent and child adaptation were also identified. Discussion: The study findings reveal that the process of adapting to living with an artificial eye extended to influencing decisions around parenting, learning to advocate for their child, and supporting children through school and peer relationships. For children, the importance of ongoing support and information was vital to enhance understanding, adaptation, and development of independence. Overall, the study suggests that children and families undergoing enucleation need continuing, individualized, and specialist support. [ABSTRACT FROM AUTHOR]

Self-compassion has been identified as a protective factor against body image concerns, but the relationship has not been explored in women in the menopausal transition, when body image perceptions may be particularly vulnerable. Women in the UK (N = 248) self-reported on levels of body appreciation, body preoccupation, self-compassion and mental distress. Correlation and mediation analyses were used. Results indicated that self-compassion was positively associated with body appreciation and negatively associated with body preoccupation. Mental distress mediated the relationships between self-compassion and body appreciation, and self-compassion and body preoccupation. Findings suggest that self-compassion is important to body image in women in the menopausal transition, and having good mental health can enhance these pathways. [ABSTRACT FROM AUTHOR]

Objective: To compete in lightweight rowing, strict limits are placed on the maximum body weight of each individual. As a result, lightweight rowers commonly restrict calorie intake despite high energy expenditure. This can result in Relative Energy Deficiency in Sport (RED-S). The aim of this study is to investigate the physical and psychosocial impact of RED-S, from the perspective of lightweight rowers. Design: Semi-structured individual qualitative interviews. Participants: Adults living in the United Kingdom who are current or former lightweight rowing participants and experienced ≥1 symptom of RED-S. Method: Audio-recorded semi-structured individual telephone interviews were performed. Data was analysed using an inductive thematic approach, coding was iterative and data-driven, facilitated by NVivo software. Results: Twelve current or former lightweight rowers (intermediate to international standard, 67% female, aged 19–32 years) participated. Participants restricted calories and increased energy expenditure to elicit weight-loss in order to meet weight requirements. This resulted in psychosocial implications (reduced social interaction, difficulty maintaining relationships, poor emotional regulation, low mood, poor concentration, disordered eating, guilt and anxiety around food, and a negative body image). Some psychosocial implications persisted after retirement from lightweight rowing. Participants described a range of physical implications, including disrupted sleep, decreased performance and recovery, bowel disruption, menstrual dysfunction, fatigue, musculoskeletal pain, injury and weakened immune systems. Conclusions: This study describes short and long-term physical and psychosocial impacts of RED-S from the perspective of lightweight rowers. Findings highlight the importance of effective RED-S prevention and management strategies for lightweight rowers. These findings may be used to educate health-care professionals, coaches and athletes on the personal impacts and serious health consequences of RED-S. [ABSTRACT FROM AUTHOR]

The research presented here evaluates the delivery of Happy Being Me (HBM; Dunstan, Paxton & McLean, 2017) with boys and girls in their first year of secondary school in the UK (Year 7 and after comparisons aged 11–12). HBM is a manualised universal prevention programme which aims to improve body dissatisfaction and associated risk factors. Risk factors studied here were internalization of the thin ideal, physical appearance comparisons, appearance conversations. Secondary outcomes measured were self-esteem and eating disorder symptoms Study 1 tested the effectiveness of HBM (n = 172) compared to a control group (n = 197) who received curriculum as usual. HBM resulted in significantly improved body satisfaction post-intervention which was maintained at follow up. There were no significant changes in risk factors. Study 2 compared clinician (n = 172) and teacher (n = 174) delivery. Students who received clinician-led, but not teacher-led, HBM had improved body satisfaction and this was maintained at follow up. Internalization of the thin ideal and self-esteem, improved in both clinician and teacher-led groups with small to medium sized effects. HBM can be delivered by clinicians independent of programme developers in a heterogeneous sample with positive effects on body satisfaction. Issues arising for wider delivery are discussed [ABSTRACT FROM AUTHOR]

Key Content: Despite attention on obesity in pregnancy, within the UK and globally, many women enter pregnancy underweight. There remains a paucity of evidence‐based guidance on the optimal care of these women.Maternal underweight is associated with low birthweight and preterm birth, both spontaneous and iatrogenic, but appropriate gestational weight gain may mitigate low body mass index (BMI).Although being underweight may be protective against several antenatal and intrapartum complications, low BMI can be related to underlying organic disease and/or eating disorders, or there may be modifiable lifestyle factors that should be addressed in pregnancy.BMI at booking should assist as a screening tool. Body image, genetic, socioeconomic and cultural factors may affect BMI, making underweight women a heterogeneous group requiring individualised assessment. Learning Objectives: To understand the associations of low BMI in pregnancy and its impact on maternal and fetal outcomes.To understand the antenatal care of underweight women, including nutritional advice and when additional fetal surveillance is required.To understand the heterogeneity of underlying causes of low BMI in pregnancy and the importance of gestational weight gain. Ethical Issues: Beware making assumptions about different ethnicities that will interfere with offering the most appropriate care.Low BMI that is not managed as a risk issue during pregnancy is an avoidable cause of low birthweight and preterm birth.Women presenting with low BMI may have features in their history, such as certain mental health disorders, that mean they should be referred for safeguarding as a vulnerable adult. The unborn child and other children may also need assessment. [ABSTRACT FROM AUTHOR]

Background: Body mass index (BMI), waist and hip circumference are strongly correlated and do not reflect body composition. A Body Shape Index (ABSI) and Hip Index (HI) define waist and hip size among individuals with the same weight and height and would thus reflect body density. We examined differences in body composition between body-shape phenotypes defined with ABSI and HI and used this information to propose explanations for associations between body-shape phenotypes and colon cancer risk.Methods: We used data from the UK Biobank Resource for 15,520 men, 16,548 women with dual-emission X-ray absorptiometry (DXA) measurements; 3997 men, 4402 women with magnetic resonance imaging (MRI) measurements; 200,289 men, 230,326 women followed-up for colon cancer. We defined body-shape phenotypes as: large-ABSI-small-HI ("apple"), small-ABSI-large-HI ("pear"), small-ABSI-small-HI ("slim"), large-ABSI-large-HI ("wide"). We evaluated differences in body composition in linear models and associations with colon cancer risk in Cox proportional hazards models adjusted for confounders and explored heterogeneity by BMI.Results: Among individuals with the same height and weight, visceral adipose tissue (VAT) was lowest for "pear" and highest for "apple", while abdominal subcutaneous adipose tissue (ASAT) was lowest for "slim" and highest for "wide" phenotype. In the gynoid region, differences between "apple" and "pear" phenotypes were accounted for mainly by fat mass in women but by lean mass in men. In men, lean mass was inversely associated with waist size, while the pattern of gynoid fat resembled ASAT in women. Lean and fat mass were higher for higher BMI, but not hand grip strength. Compared to normal weight "pear", the risk of colon cancer in men (1029 cases) was higher for "apple" phenotype for normal weight (hazard ratio HR = 1.77; 95% confidence interval: 1.16-2.69) and comparably for overweight and obese, higher for "wide" phenotype for overweight (HR = 1.60; 1.14-2.24) and comparably for obese, but higher for "slim" phenotype only for obese (HR = 1.98; 1.35-2.88). Associations with colon cancer risk in women (889 cases) were weaker.Conclusions: ABSI-by-HI body-shape phenotypes provide information for body composition. Colon cancer risk in men appears related to ASAT quantity for "slim" and "wide" but to factors determining VAT accumulation for "apple" phenotype. [ABSTRACT FROM AUTHOR]

We describe the implementation of psychotherapeutic weight loss groups involving an intuitive eating approach, carried out within a deprived area with a highly diverse population. Challenges to implementation were identified through thematic analysis of data from the group facilitators' reflexive practice meetings. These challenges included: attending to power processes related to culture and gender, respecting cultural norms around familial eating and ideal weight, acknowledging group participants' stress, and accommodating group participants' employment and caring responsibilities. We offer some practice recommendations, highlighting facilitators' adoption of the non-expert stance, and explicit acknowledgement of differences as well as commonalities. We argue for the need for sensitively tailored psychotherapeutic interventions for weight loss when working with differences among diverse populations in deprived areas. [ABSTRACT FROM AUTHOR]

Objective: Adolescents and young adults with cancer face unique psychosocial and practical issues. However, patients across this group encounter different life experiences, cancer diagnoses and treatment settings given the tailored services for patients ages 15 to 24. Here, we qualitatively explore the psychosocial experiences and practical challenges of young adults (YAs) with cancer diagnosed between ages 25 and 39 in the United Kingdom. Methods: We invited YAs diagnosed with cancer in the 5 years prior to enrolment at participating sites to take part in semi‐structured interviews or focus groups. Transcripts were analysed using inductive thematic analysis. Two YA patients reviewed the results to ensure robustness. Results: Sixty‐five YAs with varied diagnoses participated. Participants struggled to balance work, childcare and financial solvency with treatment. The halt in family and work life as well as changes in image and ability threatened participants' identity and perceived 'normality' as a YA, however, these also stimulated positive changes. YAs experienced social isolation from friends and family, including children. Many struggled to cope with uncertainty around treatment outcomes and disease recurrence. Conclusion: The disruption of family and work life can lead to age‐specific issues in YAs diagnosed with cancer. Age‐tailored psychological and practical services must be considered. [ABSTRACT FROM AUTHOR]

Management of pituitary conditions can be problematic with many patients experiencing long-term psychological and social difficulties that impact on their quality of life. This study aimed to identify psychosocial symptoms associated with pituitary conditions that lead to poor quality of life and identify differences in symptomatology between patient groups. A survey using measures of psychological and social symptoms was sent to 2000 members of the Pituitary Foundation in January 2016. The survey was completed by 1062 patients (683 female), aged under 18 to over 65 years, using categorical age ranges. Physical and psychosocial symptoms including appearance issues, fatigue, anxiety and depression were reported. Using correlational and regression analyses, significant variation in symptoms were identified across gender, age range and condition type that were impairing patients' long-term functioning and impacting quality of life. There is a need for greater patient information and advice surrounding psychosocial symptoms of pituitary conditions. [ABSTRACT FROM AUTHOR]

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem's concepts of "the normal and the pathological" as a theoretical frame, we examine the gendered assumptions that shape medical understandings of "healthy" and "dysfunctional" exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them. [ABSTRACT FROM AUTHOR]

Background: The motherhood myth has been associated with perceptions of idealised motherhood which makes it difficult for women to express related struggles or distress. This is a second follow-up study focusing on the experiences of mothers from the United Kingdom (UK) and Israel. Methods: Forty-one women were interviewed about their experience of motherhood, body-image, feeding and well-being. Interviews were analysed thematically. Data were driven by the following questions: 1. how do Israeli and UK women experience motherhood 6–12 months postpartum? 2. Are these experiences associated with body satisfaction and well-being? 3. Whether perceptions of motherhood remained stable or changed from early (<6 months) to 12 months postpartum. Results: Three meta-themes were derived from the data relating to motherhood as ideal, good enough or burdened. Such experiences were associated with body acceptance and well-being. The ideal mother was associated with lack of preoccupation with body image whereas the good enough mother aspired to reclaim her mind and her old body. Our findings suggested that the burdened mothers' struggles in relating to motherhood often correlated to a negative body image. Israeli women perceived motherhood as ideal in the early and later postpartum whereas UK mothers continued to relate to their motherhood as ideal 6–12 months postpartum. Conclusions: Perceptions of motherhood varied between Israeli and UK mothers suggesting a diversity positively associated with culture and country. Encouraging mothers to openly share their perceptions of motherhood could lead to improvements in maternal well-being and more positive interactions with the newborn. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation (FGM) is a deeply-rooted cultural practice mainly undertaken in Africa, the Middle East and Asian countries. Evidence to date suggests that although first-generation migrants to the West are abandoning FGM, the custom continues in some places, albeit in small numbers. This study examined how young people living in FGM affected communities in the United Kingdom (UK), interpreted and explained FGM.Methods: A community-based participatory research (CBPR) approach was used to recruit and train nine young people aged 15-18 as co-researchers. These comprised eight females and one male from second-generation FGM affected communities, living in Bristol. The co-researchers then undertook focus groups and semi-structured interviews with twenty participants aged 13-15 living in Bristol, Cardiff and Milton Keynes. The qualitative data from the training workshops, interviews and focus groups were collected and analysed using thematic analysis.Results: There were conflicting views among participants. Some perceived FGM as a historical tradition that was of very little, if any, relevance to them. In contrast, others perceived that the more archaic, cultural interpretation of FGM, more commonly shared by older generations, had been supplanted by a new form of FGM, which they believed to be a safe procedure, made so by the availability of highly-trained, qualified doctors and better equipment in the UK. Participants spoke of challenges encountered when attempting to raise the issue of FGM with parents. Nevertheless, they acknowledged that- being born and raised in the UK - enabled them to talk openly and to challenge others.Conclusion: Future strategies to address and prevent FGM in the UK will require a public health approach that is holistic, intersectional and empowering. Such measures should be relevant to young people born and raised in the UK who interpret FGM differently to previous first-generation migrant relatives and communities. Tackling FGM requires a shift away from a principal preoccupation with harm reduction and criminalisation towards collaboration and active dialogue with communities, in positive and productive ways that acknowledge and engage issues of identity, race, gender, and generation, enabling people affected by FGM to take control of their health and well-being. [ABSTRACT FROM AUTHOR]

Objectives: Previous research with adults born with cleft lip and/or palate (CL/P) has identified a range of concerns regarding mental health and quality of life, concluding that overall emotional functioning is poorer compared to the general population. The aim of the current study was to build on this previous work by investigating the self-reported emotional well-being of adults born with CL/P in the United Kingdom. Design: An online, mixed methods survey was designed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research at the University of the West of England. A total of 207 eligible responses were received between July and October 2018. Qualitative data were analyzed using inductive content analysis, while quantitative data were analyzed using descriptive statistics and independent t tests. Results: Almost half of the sample reported a diagnosis of a mental health condition. Scores on standardized measures indicated significantly lower global self-worth, higher levels of fear of negative appearance evaluation, and lower self-perceived job competence compared to normative data. Scores of overall body esteem were in line with the general population. Most participants had not received psychological support from their regional CL/P team and 41% were unaware of their entitlement to treatment from the National Health Service. Conclusions: Individuals with CL/P may be at risk of emotional distress persisting into adulthood. The integration of routine psychological support from an early age is highly recommended, as is information for young adults about to complete routine treatment. Comprehensive psychological screening for adults returning to the service later in life is also strongly advised. [ABSTRACT FROM AUTHOR]

Advanced (early) biological maturation may be a risk factor for inactivity among adolescent girls. To test the mediational effects of body attractiveness and physical self-worth on the relationship between biological maturity and accelerometer assessed moderate-to-vigorous physical activity (MVPA) in a large multi-ethnic sample of girls from the Midlands area in the UK (11–14 years). Biological maturity (predicting age at peak height velocity (APHV)); self-perceptions of body attractiveness, physical self-worth, and minutes spent in MVPA were assessed in 1062 females aged 11–14 years. Structural equation modelling using maximum likelihood estimation and boot- strapping procedures supported the hypothesised model. Later maturation predicted higher perceptions of body attractiveness (β = 0.25, p <.001) which, in turn, predicted higher perceptions of physical self-worth (β = 0.91, p <.001) and, significantly higher MVPA (β = 0.22, p <.001). Examination of the bootstrap-generated bias-corrected confidence intervals suggested that perceptions of body attractiveness and physical self-worth partially mediated a positive association between predicted APHV and MVPA (β = 0.05, p <.001). Greater biological maturity (i.e. early maturity) in adolescent girls is associated with less involvement in MVPA and appears to be partly explained by lower perceptions of body attractiveness and physical self-worth. Physical activity interventions should consider girls' perceptions of their pubertal related physiological changes during adolescence, particularly among early maturing girls. [ABSTRACT FROM AUTHOR]

Background: Prenatal infections have been proposed as a putative risk factor for a number of psychiatric outcomes across a continuum of severity. Evidence on eating disorders is scarce. We investigated whether exposure to prenatal maternal infections is associated with an increased risk of disordered eating and weight and shape concerns in adolescence in a large UK birth cohort. Methods: We used data from the Avon Longitudinal Study of Parents and Children. The primary exposure was maternal experience of infections at any time in pregnancy. Study outcomes were presence of any, monthly or weekly disordered eating at 14 and 16 years of age, and weight and shape concerns at 14 years. We defined the causal effect of the exposure on these outcomes using a counterfactual framework adjusting our analyses for a number of hypothesised confounders, and imputing missing confounder data using multiple imputation. Results: In total, 4884 children had complete exposure and outcome data at age 14 years, and 4124 at 16 years. Exposed children had a greater risk of reporting weekly disordered eating at both age 14 [risk difference (RD) 0.9%, 95% confidence interval (CI) −0.01 to 1.9, p = 0.08] and 16 (RD 2.3%, 95% CI 0.6–3.9, p < 0.01), though evidence of an association was weak at age 14 years. Exposed children also had greater weight and shape concerns at age 14 years (mean difference 0.15, 95% CI 0.05–0.26, p < 0.01). Conclusions: Exposure to prenatal maternal infection is associated with greater risk of disordered eating in adolescence. This association could be explained by in utero processes leading to impaired neurodevelopment or altered immunological profiles. Residual confounding cannot be excluded. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the feasibility of the Male Genital Self‐Image Scale (MGSIS‐5) and Groin and Lower Limb Lymphedema questionnaire (G3L‐20) in a community sample of cisgender men aged 40 years and older. Psychometric measures can aid urologic practice by prompting patients to talk about aspects of their body that are either too sensitive or a natural part of aging. Importantly, reliable and valid measures can also contribute to an evidenced‐based‐practice‐based‐evidence cycle where they can establish the impact of changes recommended by research while using the results in turn to inform research. In this study, we examine two psychometric measures on the opposite ends of a psychological‐physical continuum; the MGSIS‐5 and the G3L‐20. A non‐experimental psychometric design was employed, administering the questionnaires online to a community sample of cisgender men aged 40 years old and above. Validity and reliability analyses were conducted. Thirty men completed the study; 14 aged 40 to 49, 14 aged 50 to 59 and 2 aged 60 to 69. The MGSIS‐5 and G3L‐20 show acceptable reliability and validity with one‐ and three‐component structures, respectively. The MGSIS‐5 and G3L‐20 show sufficient feasibility to justify the resources for studies with larger community samples and for pilot studies with clinical populations. [ABSTRACT FROM AUTHOR]