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This article presents an analysis of the mobile telecommunication industry in western Balkan countries. More than 130 million residents, with different languages and religious beliefs, populate the, South Eastern European (SEE) region, which is situated at the crossroads of three continents and is the home of numerous cultures and traditions. Since all countries of the region have declared on a political level their aspiration to become members of the European Union and therefore a willingness to adopt the relevant acquis communautaire in the telecom sector, appropriate categorization would be based to their status in the European Union. The constant growth of the mobile market in SEE countries has drawn the interest of foreign telecommunications companies, which have launched significant investment plans.

Background and Objective: Weight stigma has negative consequences for both physiological and psychological health. Studies on weight stigma in adolescence, particularly from general populations, are scarce in the Mediterranean area. The main aim of this study is to describe the prevalence of experienced and internalized weight stigma among a representative sample of adolescents from the Spanish city of Terrassa, and to determine its association with sociodemographic variables and weight status., Methods: Drawing on data from the initial assessment of a longitudinally funded project on weight stigma in adolescents, a cross-sectional survey-based study was conducted using random multistage cluster sampling. Weight stigma experiences, their frequency and sources, and weight bias internalization with the Modified Weight Bias Internalization Scale (WBISM) were assessed in a sample of 1016 adolescents. Adjusted odds ratios (AOR) between sociodemographic variables, weight status and having experienced weight stigma, and having reported high scores of WBISM (WBISM ≥ 4) were estimated by multiple logistic regression models., Results: The prevalence of weight-related stigma experiences was 43.2% in the sample (81.8 in adolescents with obesity) and the prevalence of high levels of weight bias internalization was 19.4% (50.7 in adolescents with obesity). Other kids and school were the most prevalent sources of weight stigma, with society and family being other significant sources of stigma reported by girls. A significantly higher risk of having experienced weight stigma was observed in girls (AOR = 2.6) and in older adolescents (AOR = 1.9). Compared to normal weight adolescents, all weight statuses showed higher risk, being 3.4 times higher in adolescents with underweight and reaching 11.4 times higher risk in those with obesity. Regarding high levels of weight bias internalization, girls had a risk 6.6 times higher than boys. Once again, a "J-shaped" pattern was observed, with a higher risk at the lowest and highest weight statuses. The risk was 6.3 times higher in adolescents with underweight, and 13.1 times higher in adolescents with obesity compared to those with normal weight., Conclusions: Considering the high prevalence of experienced and internalized weight stigma among adolescents in Spain, especially in adolescents with obesity and girls, it seems important to implement preventive strategies in different settings and address all sources of stigma., (© 2024. The Author(s).)

Breast cancer is associated with adverse physical and psychological consequences. Although research has identified the various benefits linked to psychosocial interventions, mixed results have been found in relation to peer support. The aim of the present systematic review and meta-ethnography is to explore the qualitative evidence on the experience of breast cancer survivors in peer support. A systematic search of the literature was conducted until June 2023, and a meta-ethnographic approach was used to synthesize the included papers. Eleven articles were included, collecting the experience of 345 participants. The following four core areas involved in peer support implementation were identified from the synthesis: Peer support can create understanding and a mutual therapeutic and emotional connection; peer support can facilitate an educational and supportive patient-centered journey; peer support should monitor group members for unpleasant emotional experiences; peer support should have professional supervision of recruitment and training to prioritize quality. These results can be used as patient-centered insights by healthcare professionals to provide evidence-informed peer support programs and address current limitations in the field., (© 2023 The Authors. Applied Psychology: Health and Well‐Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.)

Background: Virtual reality (VR) interventions, based on cognitive behavioral therapy principles, have been proven effective as complementary tools in managing obesity and have been associated with promoting healthy behaviors and addressing body image concerns. However, they have not fully addressed certain underlying causes of obesity, such as a lack of motivation to change, low self-efficacy, and the impact of weight stigma interiorization, which often impede treatment adherence and long-term lifestyle habit changes. To tackle these concerns, this study introduces the VR self-counseling paradigm, which incorporates embodiment and body-swapping techniques, along with motivational strategies, to help people living with obesity effectively address some of the root causes of their condition., Objective: This study aims to assess the clinical efficacy of ConVRself (Virtual Reality self-talk), a VR platform that allows participants to engage in motivational self-conversations., Methods: A randomized controlled trial was conducted with 68 participants from the bariatric surgery waiting list from the obesity unit of the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were assigned to 1 of 3 groups: a control group (CG), which only received treatment as usual from the obesity unit; experimental group 1 (EG1), which, after intensive motivational interviewing training, engaged in 4 sessions of VR-based self-conversations with ConVRself, and underwent embodiment and body-swapping techniques; and experimental group 2 (EG2), which engaged in 4 VR-based sessions led by a virtual counselor with a prerecorded discourse, and only underwent the embodiment technique. In the case of both EG1 and EG2, the VR interventions were assisted by a clinical researcher. Readiness to change habits, eating habits, and psychological variables, as well as adherence and satisfaction with ConVRself were measured at baseline, after the intervention, 1 week after the intervention, and 4 weeks after the intervention., Results: Regarding the primary outcomes, EG1 (24/68, 35%) and EG2 (22/68, 32%) showed significant improvements in confidence to lose weight compared to the CG (22/68, 32%) at all assessment points (β=-.16; P=.02). Similarly, EG1 demonstrated a significant increase after the intervention in readiness to exercise more compared to the CG (β=-.17; P=.03). Regarding the secondary outcomes, EG1 participants showed a significant reduction in uncontrolled eating (β=.71; P=.01) and emotional eating (β=.29; P=.03) compared to the CG participants, as well as in their anxiety levels compared to EG2 and CG participants (β=.65; P=.01). In addition, participants from the experimental groups reported high adherence and satisfaction with the VR platform (EG1: mean 59.82, SD 4.00; EG2: mean 58.43, SD 5.22; d=0.30, 95% CI -0.30 to 0.89)., Conclusions: This study revealed that using VR self-conversations, based on motivational interviewing principles, may have benefits in helping people with obesity to enhance their readiness to change habits and self-efficacy, as well as reduce dysfunctional eating behaviors and anxiety., Trial Registration: ClinicalTrials.gov NCT05094557; https://www.clinicaltrials.gov/study/NCT05094557., (©Dimitra Anastasiadou, Pol Herrero, Paula Garcia-Royo, Julia Vázquez-De Sebastián, Mel Slater, Bernhard Spanlang, Elena Álvarez de la Campa, Andreea Ciudin, Marta Comas, Josep Antoni Ramos-Quiroga, Pilar Lusilla-Palacios. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 05.04.2024.)

A variety of methods are employed to synthesize amorphous silica-alumina (ASA) to resolve the role of Al speciation and surface area in the catalytic performance in the Diels-Alder cycloaddition reaction of 2,5-dimethylfuran and ethylene to p -xylene. ASA was prepared by homogeneous deposition-precipitation (HDP) of Al 3+ on ordered mesoporous silica, i.e. , SBA-15 and OMS prepared under hydrothermal synthesis conditions using an imidazole-based template, and one-step flame spray pyrolysis (FSP). IR spectroscopy and 27 Al MAS NMR showed that the resulting ASA represented a set of materials with distinct textural and acidic properties. ASA prepared by grafting Al to ordered mesoporous silica led to a much higher concentration of Brønsted acid sites (BAS). These samples performed much better in the DAC reaction, with p -xylene yields higher than those obtained with a HBeta zeolite benchmark. Materials with Al partially in the bulk of silica (OMS, FSP) and containing significant alumina domains are less acidic and exhibit much lower p -xylene yields. These findings point to the importance of Brønsted acidity for p -xylene formation. This study shows that careful design of the Al speciation can lead to amorphous silica-alumina with similar DAC performance to microporous zeolites., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Urea is a commonly used nitrogen fertiliser synthesised from ammonia and carbon dioxide using thermal catalysis. This process results in high carbon dioxide emissions associated with the required amounts of ammonia. Electrocatalysis provides an alternative method to urea production with reduced carbon emissions while utilising waste products like nitrate. This manuscript reports on urea synthesis from the electroreduction of nitrate and carbon dioxide using CuO x ZnO y electrodes under mild conditions. Catalysts with different ratios of CuO and ZnO, synthesised via flame spray pyrolysis, were explored for the reaction. The results revealed that all the CuO x ZnO y electrocatalyst compositions produce urea, but the efficiency strongly depends on the metal ratio composition of the catalysts. The CuO 50 ZnO 50 composition had the best performance in terms of selectivity (41% at -0.8 V vs RHE) and activity (0.27 mA/cm 2 at -0.8 V vs RHE) towards urea production. Thus, this material is one of the most efficient electrocatalysts for urea production reported so far. This study systematically evaluates bimetallic catalysts with varying compositions for urea synthesis from carbon dioxide and nitrate., (© 2023. Springer Nature Limited.)

Introduction: We aim to examine the usability of a Virtual Reality (VR) platform, called ConVRSelf , which has been designed to address the needs of People Living With Obesity (PLWO)., Methods: Fourteen participants with a desire to eat healthier and exercise more (6 normal weight and 8 PLWO; Mean age = 41.86, SD  = 13.89) were assigned to the experimental group (EG) or the control group (CG). EG participants, after being trained on motivational interviewing skills, engaged in a virtual self-conversation using embodiment and body swapping techniques, which aimed to normalize and resolve their ambivalence to change lifestyle habits. CG participants, embodied in their virtual bodies, participated in a pre-established discourse with a virtual counselor giving them psychoeducational advice about how to change lifestyle habits. A mixed-methods design was used, involving a semi-structured interview and self-report questionnaires, including readiness to change habits (Readiness Rulers), body ownership (Body Ownership Questionnaire, BOQ), and system usability (System Evaluation Questionnaire, SEQ). Thematic content analysis was carried out for qualitative data while statistical data analysis was carried out using SPSS 20.0., Results: Participants from both groups showed high readiness to change lifestyle (Readiness Rulers) before engaging with the virtual experiences, which was maintained at the same level after the interventions and their scores on the SEQ and BOQ were satisfactory. Regarding qualitative information obtained from the interviews, almost all participants found the VR experience to be novel, interesting, and enjoyable. A higher acceptability was observed among PLWO from the EG than normal weight participants from the same group, a promising finding for the ConVRSelf platform, which had been specifically designed to address the needs of PLWO., Conclusion: The ConVRSelf system is well-accepted by participants and is ready to be tested with PLWO in a clinical setting., Competing Interests: MS and BS are Founders of the University spin-off company Virtual Bodyworks. EÁ was employed by Virtual Bodyworks S.L. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Anastasiadou, Herrero, Vázquez-De Sebastián, Garcia-Royo, Spanlang, Álvarez de la Campa, Slater, Ciudin, Comas, Ramos-Quiroga and Lusilla-Palacios.)

It remains a real challenge to control the selectivity of the electrocatalytic CO 2 reduction (eCO 2 R) reaction to valuable chemicals and fuels. Most of the electrocatalysts are made of non-renewable metal resources, which hampers their large-scale implementation. Here, we report the preparation of bimetallic copper-lead (CuPb) electrocatalysts from industrial metallurgical waste. The metal ions were extracted from the metallurgical waste through simple chemical treatment with ammonium chloride, and Cu x Pb y electrocatalysts with tunable compositions were fabricated through electrodeposition at varying cathodic potentials. X-ray spectroscopy techniques showed that the pristine electrocatalysts consist of Cu 0 , Cu 1+ and Pb 2+ domains, and no evidence for alloy formation was found. We found a volcano-shape relationship between eCO 2 R selectivity toward two electron products, such as CO, and the elemental ratio of Cu and Pb. A maximum Faradaic efficiency towards CO was found for Cu 9.00 Pb 1.00 , which was four times higher than that of pure Cu, under the same electrocatalytic conditions. In situ Raman spectroscopy revealed that the optimal amount of Pb effectively improved the reducibility of the pristine Cu 1+ and Pb 2+ domains to metallic Cu and Pb, which boosted the selectivity towards CO by synergistic effects. This work provides a framework of thinking to design and tune the selectivity of bimetallic electrocatalysts for CO 2 reduction through valorization of metallurgical waste., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors. ChemCatChem published by Wiley-VCH GmbH.)

Introduction: Previous research has shown that it is feasible to integrate motivational interviewing techniques with behavioural and psychological interventions for the treatment of obesity. Moreover, these combined interventions have the potential to improve health-related outcomes of people living with obesity (PLWO) and to afford maintenance of behavioural changes over time. In addition, the use of virtual reality (VR) embodiment techniques in the treatment of eating disorders and obesity has promising preliminary effectiveness. The objective of this study is to assess the clinical efficacy of a VR intervention that uses embodiment and body-swapping techniques and has been specifically developed to cover the needs of PLWO., Methods and Analysis: A randomised control trial will be carried out with an estimated sample of 96 participants with body mass index (BMI)>30. The whole duration of the trial will be 12 months. Participants will be recruited from the external consultations of the Vall d'Hebron University Hospital and be randomly assigned to three groups. The experimental group 1 will engage in a virtual self-conversation using the ConVRself platform, the experimental group 2 will participate in a 'pre-established discourse' provided by the virtual counsellor, who will give psychoeducation advice, and the control group will continue with treatment as usual. Readiness to change, BMI, eating habits and physical activity, psychological well-being, body image satisfaction, quality of life in relation to body image, and weight bias internalisation will be assessed at baseline, post intervention, 1-week and 4-week follow-up. Finally, variables related to adherence and satisfaction with the VR tool will be evaluated for the experimental groups., Ethics and Dissemination: This study was approved by the Research Projects Committee of the Vall d'Hebron University Hospital. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences and other events for the scientific and clinical community, and the general public., Trial Registration Number: NCT05094557., Competing Interests: Competing interests: MS and BS are the founders of the university spin-off company Virtual Bodyworks., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Eating disorders (ED) are considered as heterogeneous disorders with a complex multifactor etiology that involves biological and environmental interaction. Objective: The aim was to identify specific ED bio-psychological-familial correlates at illness onset. Methods: A case-control (1:1) design was applied, which studied 50 adolescents diagnosed with ED at onset (12-17 years old) and their families, paired by age and parents' socio-educational level with three control samples (40 with an affective disorder, 40 with asthma, and 50 with no pathology) and their respective families. Biological, psychological, and familial correlates were assessed using interviews, standardized questionnaires, and a blood test. Results: After performing conditional logistic regression models for each type of variable, those correlates that showed to be specific for ED were included in a global exploratory model ( R 2 = 0.44). The specific correlates identified associated to the onset of an ED were triiodothyronine (T3) as the main specific biological correlate; patients' drive for thinness, perfectionism and anxiety as the main psychological correlates; and fathers' emotional over-involvement and depression, and mothers' anxiety as the main familial correlates. Conclusion: To our knowledge, this is the first study to use three specific control groups assessed through standardized interviews, and to collect a wide variety of data at the illness onset. This study design has allowed to explore which correlates, among those measured, were specific to EDs; finding that perfectionism and family emotional over-involvement, as well as the T3 hormone were relevant to discern ED cases at the illness onset from other adolescents with or without a concurrent pathology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Sepúlveda, Moreno-Encinas, Martínez-Huertas, Anastasiadou, Nova, Marcos, Gómez-Martínez, Villa-Asensi, Mollejo and Graell.)

Introduction: Psychosocial interventions for patients with breast cancer (BC) have demonstrated their effectiveness at reducing emotional distress and improving quality of life. The current digitisation of screening, monitoring and psychosocial treatment presents the opportunity for a revolution that could improve the quality of care and reduce its economic burden. The objectives of this study are, first, to assess the effectiveness of an e-health platform with integrated and stepped psychosocial services compared with usual psychosocial care, and second, to examine its cost-utility., Methods and Analysis: This study is a multicentre randomised controlled trial with two parallel groups: E-health intervention with integrated and stepped psychosocial services vs usual psychosocial care. An estimated sample of 338 patients with BC in the acute survival phase will be recruited from three university hospitals in Catalonia (Spain) and will be randomly assigned to one of two groups. All participants will be evaluated at the beginning of the study (T1: recruitment), 3 months from T1 (T2), 6 months from T1 (T3) and 12 months from T1 (T4). Primary outcome measures will include number of clinical cases detected, waiting time from detection to psychosocial intervention and proportion of cases successfully treated in the different steps of the intervention, as well as outcomes related to emotional distress, quality of life, post-traumatic stress and growth, treatment adherence and therapeutic alliance. Secondary outcomes will include the acceptability of the platform, patients' satisfaction and usability. For the cost-utility analysis, we will assess quality-adjusted life years and costs related to healthcare utilisation, medication use and adherence, work absenteeism and infrastructure-related and transport-related costs., Ethics and Dissemination: This study was approved by the Ethics committee of the Institut Català d'Oncologia network in Hospitalet, Spain. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences among the scientific community, workshops with patients and media press releases., Trial Registration Number: Online Psychosocial Cancer Screening, Monitoring and Stepped Treatment in Cancer Survivors (ICOnnectat-B),NCT04372459., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Organic carbonates are considered environmentally benign alternatives for various fossil-derived compounds used in the chemical industry. Replacing current costly and toxic production methods by greener alternatives offers opportunities to cover the increasing demand for these intermediates in a more sustainable manner. In this feature article, the prospect of electrochemical synthesis of organic carbonates is presented as an approach to use carbon dioxide and green electricity to arrive at such compounds. We explore the strengths and limitations of the different methods by looking into the electrode and electrolyte composition effects and operating conditions with a focus on the synthesis of dimethylcarbonate from methanol and either carbon monoxide or carbon dioxide. The proposed mechanisms are discussed in an effort to understand the underlying steps and their challenges. This review concludes with a perspective on the broader developments needed to turn the basic chemistry into a practical application.

Herein we report on the synthesis and molecular structures of six silver(I) mixed-ligand complexes containing a heterocyclic thioamide [4-phenyl-imidazole-2-thione (phimtH) or 2,2,5,5-tetramethyl-imidazolidine-4-thione (tmimdtH)] and a tertiary arylphosphane [triphenylphosphine (PPh 3 ), tri-o-tolylphosphane (totp)] or diphosphane [(1,2-bis(diphenylphosphano)ethane (dppe), bis(2-diphenylphosphano-phenyl)ether (DPEphos) or 4,5-bis(diphenylphosphano)-9,9-dimethylxanthene) (xantphos)]. The interaction of the compounds with calf-thymus DNA (CT DNA), as monitored directly via UV-vis spectroscopy and DNA-viscosity measurements and indirectly via its competition with ethidium bromide for DNA-intercalation sites, is suggested to take place via an intercalative mode. The new complexes show selective significant in vitro antibacterial activity against four bacterial strains. The antiproliferative effects and cytostatic efficacies of the complexes against four human cancer cell lines were evaluated. The best cytostatic and cytotoxic activity was appeared for the complexes bearing the phimtH moiety. In order to explain the described in vitro activity of the complexes, and to approach a possible mechanism of action, molecular docking studies were adopted on the crystal structure of CT DNA, DNA-gyrase, human estrogen receptor alpha and a cell-cycle specific target protein, human cyclin-dependent kinase 6., 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 © 2020 Elsevier Inc. All rights reserved.)

Objective: The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT)., Method: A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment., Results: Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group., Discussion: The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals., (© 2020 Wiley Periodicals, Inc.)

Herein we report on the synthesis, molecular structures, DNA-binding properties and antibacterial activity of four new copper(I) mixed-ligand complexes obtained by reacting copper(I) halides or [Cu(CH 3 CN) 4 ](BF 4 ) with 1,2-bis(diphenylphosphano)ethane (dppe) and 2,2,5,5-tetramethylimidazolidine-4-thione (tmimdtH). Depending on the nature of the halide, the resulting compounds adopt two different structural motifs. Thus, using CuCl or CuBr, doubly dppe-bridged symmetrical dimmers of type [(κ-S-tmimdtH)XCu(μ-dppe) 2 CuX(κ-S-tmimdtH)] are formed, while in the case of CuI, a rare example of a trinuclear complex was isolated, in which the Cu atom of a CuI(tmimdtH) moiety is linked by two bridging dppe units with the two Cu atoms of a cluster-type Cu 2 I 2 (dppe) core. On the other hand, [Cu(CH 3 CN) 4 ](BF 4 ) reacts with the anion of tmimdtH in the presence of dppe to form a binuclear complex consisting of two (dppe)Cu(tmimdt) units linked together by the P atoms of a dppe bridging ligand. The complexes show significant in vitro antibacterial activity against certain bacterial strains. An intercalative mode is suggested as the most probable interaction fashion of the compounds with calf-thymus (CT) DNA, monitored directly via UV-vis spectroscopy, DNA-viscosity measurements and indirectly via their competition with ethidium bromide for DNA as studied by fluorescence emission spectroscopy. The binding of the complexes to human (HSA) and bovine serum albumin (BSA) is tight. In order to explain the described in vitro activity of the compounds, we adopted molecular docking studies on the crystal structure of HSA, BSA, CT DNA and DNA-gyrase., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The aim of this study was to test the hypothesis that a negative reaction to the illness would be reduced through the "Collaborative Care Skills Workshops" programme among Spanish caregivers of relatives with an eating disorder. Caregivers were randomly allocated to either the skill-based workshops (n = 32) or psycho-educational workshops (n = 31), and assessments were carried out over time (T 0 vs. T 1 vs. T 2 ). There were no significant differences between interventions on primary or secondary caregiver outcomes or among the patients themselves. However, caregivers in both interventions showed greater improvement at T 2 on accommodating and enabling behaviours and an improvement at T 1 in terms of psychological distress and appraisals towards the caregiving experience. Eating pathology, psychological distress, and some indices of psychosocial adjustment were significantly lower among the patients following both interventions (T 1 ). Overall, both interventions may be able to help caregivers and patients to decrease their psychological distress. HIGHLIGHTS: Involvement of family members in the treatment could be the best resource for aiding in their relative's recovery. This is the first controlled study to test the effectiveness of the Collaborative Care Skills Workshops in Spanish caregivers. Both interventions could be implemented as both help Spanish caregivers and patients., (© 2018 John Wiley & Sons, Ltd and Eating Disorders Association.)

Cathodic corrosion is an electrochemical etching process that alters metallic surfaces by creating nanoparticles and a variety of etching features. Because these features typically have a preferential orientation, cathodic corrosion can be applied to modify and nanostructure electrode surfaces. However, this application of cathodic corrosion is currently limited by an insufficient chemical understanding of its underlying mechanism. This includes the role of alkali metal cations, which are thought to be crucial in both enabling cathodic corrosion and controlling its final facet preference. This work addresses this knowledge gap by exploring the cathodic corrosion of Pt, Rh, and Au in LiOH, NaOH, and KOH through both experimental and theoretical methods. These methods demonstrate that cations are adsorbed during cathodic corrosion and play a major role in controlling the onset potential and final surface morphology in cathodic corrosion. Interestingly, an equally significant role appears to be played by adsorbed hydrogen, based on calculations using literature density functional theory data. Considering the significance of both hydrogen and electrolyte cations, it is hypothesized that cathodic corrosion might proceed via an intermediate ternary metal hydride. This fundamental insight leads to both metal-specific recommendations and more general guidelines for applying cathodic corrosion to structure metallic surfaces.

Objective: To systematically review the existing evidence of mobile health (mHealth) tools for the treatment of eating disorders (ED)., Method: Electronic databases (Pubmed, PsycInfo, and SCOPUS) were searched, and PRISMA guidelines were followed. Selected studies were divided into three categories according to the intended purpose of the mHealth tools used: (a) sole means of support, (b) complementary to standard face-to-face treatment, and (c) for relapse prevention. Additionally, studies were assessed on efficacy, qualitative information, and methodological quality., Results: Fifteen studies were identified. Most studies using mHealth as a sole means of intervention or adjunct to traditional therapy showed no effects, although an improvement at postassessment was present in vodcast, smartphone application, and text-messaging interventions. Between group effects were only found for a text-messaging intervention for relapse prevention. Qualitative analyses showed that most mHealth interventions were considered as acceptable, supporting, and motivating by patients and therapists, although different important problems were observed in individual studies., Conclusions: Limited effects were found for mHealth interventions to reduce ED-related symptoms. A common evaluation framework for ED mHealth interventions should be proposed to assess the validity of interventions before implementing them on a larger scale in clinical practice., (© 2018 John Wiley & Sons, Ltd and Eating Disorders Association.)

Background: Multimorbidity is becoming increasingly common and is a leading challenge currently faced by societies with aging populations. The presence of multimorbidity requires patients to coordinate, understand, and use the information obtained from different health care professionals, while simultaneously striving to distinguish the symptoms of different diseases and self-manage their sometimes conflicting health problems. Electronic health (eHealth) tools provide a means to disseminate health information and education for both patients and health professionals and hold promise for more efficient and cost-effective care processes., Objective: The aim of this study was to analyze the use of eHealth tools, taking into account the citizens' sociodemographic and clinical characteristics, and above all, the presence of multimorbidity., Methods: Cross-sectional and exploratory research was conducted using online survey data from July 2011 to August 2011. Participants included a total of 14,000 citizens from 14 European countries aged 16 to 74 years, who had used an eHealth tool in the past 3 months. The variables studied were sociodemographic variables of the participants, the questionnaire items assessing the frequency of using eHealth tools, the degree of morbidity, and the eHealth adoption gradient. Chi-square tests were conducted to examine the relationship between the sociodemographic and clinical variables of participants and the group the participants were assigned to according to their frequency of eHealth use (eHealth user group). A one-way analysis of variance (ANOVA) allowed for assessing the differences in the eHealth adoption gradient average between different groups of individuals according to their morbidity level. A two-way between-groups ANOVA was performed to explore the effects of multimorbidity and age group on the eHealth adoption gradient., Results: According to the eHealth adoption gradient, most participants (68.15%, 9541/14,000) were labeled as rare users, with the majority of them (55.1%, 508/921) being in the age range of 25 to 54 years, with upper secondary education (50.3%, 464/921), currently employed (49.3%, 454/921), and living in medium-sized cities (40.7%, 375/921). Results of the one-way ANOVA showed that the number of health problems significantly affected the use of eHealth tools (F 2,13996 =11.584; P<.001). The two-way ANOVA demonstrated that there was a statistically significant interaction between the effects of age and number of health problems on the eHealth adoption gradient (F 4,11991 =7.936; P<.001)., Conclusions: The eHealth adoption gradient has proven to be a reliable way to measure different aspects of eHealth use. Multimorbidity is associated with a more intense use of eHealth, with younger Internet users using new technologies for health purposes more frequently than older groups with the same level of morbidity. These findings suggest the need to consider different strategies aimed at making eHealth tools more sensitive to the characteristics of older populations to reduce digital disadvantages., (©Francisco Lupiáñez-Villanueva, Dimitra Anastasiadou, Cristiano Codagnone, Roberto Nuño-Solinís, Maria Begona Garcia-Zapirain Soto. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 03.05.2018.)

Caring for a relative with an eating disorder (ED) is associated with heightened psychological distress, which, according to a stress-coping model, may be influenced by coping and appraisal. However, limited quantitative studies have assessed coping in ED caregivers. This cross-sectional study aims to assess 1) the differences in coping between caregivers of three groups: patients with an ED, patients with a substance use disorder, and healthy teens, and 2) the patient and caregiver variables associated with coping and appraisal of the caregiving experience. A one-way MANOVA was significant for caregiver group for mothers, but not fathers. Mothers of both patient groups used more self-sufficient problem focused coping than mothers of healthy teens. Patient caregivers did not significantly differ from caregivers of healthy teens in their use of avoidance. Mothers used social support strategies more than fathers. A positive experience of caregiving was significantly associated with the use of approach-oriented coping in ED caregivers and a negative experience of caregiving was significantly associated with avoidance in ED mothers. Older ED caregivers were less likely to use avoidance. Future interventions could help ED caregivers to recognize their coping preferences and how to appropriately use these strategies when faced with illness-related stressors., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversing cognitive impairment among elderly, although findings are inconclusive. Therefore, a systematic update of the existing evidence of cognitive therapy for people suffering from dementia is needed., Aim: To review existing scientific evidence regarding the efficacy of cognitive therapies for elderly suffering from dementia., Methods: Studies were retrieved from several bibliographic databases (January 2009 to December 2017) with prespecified selection criteria, data extraction, and methodological quality assessment., Results: In total, 10 reality orientation, 25 skills training, and 12 mixed trials were identified as meeting the inclusion criteria and were systematically reviewed. Results from reality orientation trials showed minor effects for cognitive assessments, while skills training trials and mixed trials showed contradicting effects on cognition. Effects on other outcomes (e.g., daily functioning, depression, language) were limited or not found., Conclusions: Skills training trials and mixed trials seem to affect cognitive impairment in a positive way, although the results are inconclusive. Comparison between studies was difficult due to differences in form of intervention. Because findings are inconclusive, more structuralized and comparable randomized controlled trials are needed., (© 2018 S. Karger AG, Basel.)

High rates of comorbidity are found among eating disorder (ED) patients, which may negatively affect treatment outcome and prognosis. However, there is a shortage of studies in Spain using clinician administered interviews to assess rates of comorbidity among these patients, particularly in adolescents. This study aimed to evaluate Axis I psychiatric diagnoses in adolescent patients with an ED and to compare them with patients with a distinct disorder with adolescent onset, substance use disorder (SUD) patients. Considering that maternal psychological distress is another factor involved in ED prognosis, a secondary aim was to examine the relationship between patient's psychological variables and maternal distress (depression and anxiety). The cross-sectional study included 50 ED patients, 48 SUD patients, and their mothers. More than half of the patients received a diagnosis for a comorbid disorder. Internalizing problems were more common among EDs and externalizing disorders were the most common comorbidities among SUDs, similar to findings from other countries. Maternal distress was associated with higher levels of depression and symptom severity in patients. No differences in distress were found between mothers of patients with a comorbid diagnosis and those without. Elevated anxiety or depression in mothers did not increase the likelihood of patients having a particular primary diagnosis. In short, while both ED and SUD patients presented high rates of comorbidity, the types of comorbid diagnoses were specific to each group. Assessing for the presence of comorbid disorders and targeting maternal psychological distress may guide treatment interventions and improve patient prognosis., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The objective of the authors in this study was to identify factors related to dysfunctional family functioning that may be associated with the severity of symptoms among adolescent patients with an eating disorder (ED) at first-contact care. A total of forty-eight mothers and forty-five fathers of fifty patients with EDs were recruited from an ED unit in Madrid, Spain, between October 2011 and July 2012. Parents completed self-report assessments related to family functioning and psychological wellbeing. Patients went through clinical interviews and completed a self-report questionnaire assessing symptom severity. Compared to fathers, mothers showed higher levels of anxiety and emotional over-involvement and perceived to a greater degree the positive and negative aspects of their experience as caregivers. Regarding the relationship between family functioning and symptom severity, mothers' perceptions of their family relationships as enmeshed and less adaptive, along with anxiety, accounted for 39% of variance in the severity of ED symptoms. Anxiety and symptom accommodation by the fathers accounted for 27% of variance in the symptom severity. Interventions that help parents to cope with their caregiving role should target behavioral, cognitive, and emotional aspects of their functioning and be gender-specific, to improve the outcome of ED in patients.

The aim of this study was to compare the family functioning of Spanish parents of patients with an eating disorder (ED) with that of carers of patients with substance-related disorders (SRDs) and families of healthy controls (HC). This cross-sectional study included 48 mothers and 45 fathers of 48 adolescent patients with an ED, 47 mothers and 37 fathers of 47 patients with an SRD and 66 mothers and 50 fathers of 68 HCs. Families of ED patients reported lower levels of criticism, symptom accommodation and negative caregiving experience than families of SRD patients. However, relatives of both ED and SRD patients reported similar levels of quality of life related to their mental health. Furthermore, families of HCs generally exhibited better scores on all scales assessing their caregiving experiences. Regarding gender differences, there was a tendency in mothers, primarily those from the ED group, to report more adverse experiences as caregivers compared with fathers. Symptoms characteristic to each disorder may be associated with differential patterns of family functioning and may require specifically tailored family interventions. Early family intervention in adolescence is crucial, as relatives' quality of life does not seem to have been badly affected at this point in the course of the illness. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association., (Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.)

Drive for Muscularity (DM) has been shown to be a relevant construct for measuring and understanding male body image. For this reason, it is important to have reliable and valid instruments with which to measure DM, and to date no such instruments exist in Spain. This study analyzes the psychometric and structural properties of the Drive for Muscularity Scale (DMS) in a sample of Spanish adolescent males (N=212), with the aim of studying the structural validity of the scale by using a confirmatory factor analysis (CFA), as well as analyzing the internal consistency and construct (convergent and discriminant) and concurrent validity of the instrument. After testing three models, results indicated that the best structure was a two-dimensional model, with the factors of muscularity-oriented body image (MBI) and muscularity behavior (MB). The scale showed good internal consistency (α=.90) and adequate construct validity. Furthermore, significant associations were found between DM and increased difficulties in emotional regulation (rho=.37) and low self-esteem (rho=-.19). Findings suggest that the two-factor structure may be used when assessing drive for muscularity among adolescent males in Spain., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The objective of the study was to review systematically the available new evidence on family caregiving in eating disorders (ED), updating the study of Zabala, Macdonald, and Treasure (2009). Electronic databases were searched from October 2008 until May 2013. Selected studies included carers of people with ED and employed one or more measures of caregiving experience, accommodation and enabling behaviours, expressed emotion, and/or psychological distress. Twenty-nine studies were identified. Most of the studies examined these features in mothers of patients with anorexia. Only a few studies included a control group. The majority of studies found high levels of negative aspects of caregiving, accommodation and enabling behaviours, expressed emotion and psychological distress in carers of people with ED, although positive aspects and emotions were also reported. These features varied depending on some sociodemographic and clinical characteristics of carers and patients; moreover, interesting preliminary cultural and gender differences emerged. Progress has been made in research on family caregiving in ED and there is evidence that these factors can be associated with the outcome of ED. Theoretical, research and clinical implications of the findings are discussed., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Purpose: Differences in mental health among primary caregivers of eating disorder patients with purging and non-purging behaviors were explored and predictors of psychopathological distress among caregivers were also determined., Methods: 177 caregivers, ranging from 29 to 75 years of age, of adults and adolescents with an ED participated in the study. The caregivers completed self-report assessments related to psychopathological distress (GSI), specific experience of caregiving and expressed emotion. Results A statistically significant difference in psychopathological distress was presented by caregivers of patients with purging behaviors (38.9%) compared with non-purging ones (25%), using a GSI cut-off point. In patients who purged, caregiver’s intrusiveness and difficulties related to eating behavior accounted for 25% of the variance and in those who did not purge, difficulties related to eating behavior, guilt, social isolation, hostility and negative attitude toward illness accounted for 44% of variance., Conclusions: The differences observed indicate the importance of identifying purging as a significant clinical marker of increased risk of psychopathological distress in caregivers.

Background: The objective of this study is to evaluate the psychometric properties of the Spanish version of the Family Questionnaire (FQ) and to further examine the differences between mothers' and fathers' emotional response to an eating disorder (ED)., Method: A total of 382 carers of patients with an ED participated in the study, with ages ranging from forty to fifty-three years old., Results: The use of confirmatory factor analysis according to gender supported both factor models of the FQ, with only minor differences in comparison to the original study performed in 2002 by Wiedemann and collegues. The internal consistency of the Spanish version of the FQ was good. Mothers displayed significantly higher levels of emotional over-involvement than fathers, while gender differences in critical comments were nonsignificant. The correlation of the two subscales of the FQ with a conceptually related measure (Expressed Emotion) and two unrelated ones (negative caregiving experience, distress) supports the convergent and concurrent validity of the instrument in both samples., Conclusions: The FQ has adequate psychometric properties and may be of value in assessing the impact of ED symptoms on the family environment. Finally, interventions that aim to reduce Expressed Emotion in carers may consider a gender-specific approach.

Expressed emotion (EE) is considered a general predictor of poor outcome across a range of conditions, including eating disorders, and is valuable in measuring the effect of family interventions. There are no self-report questionnaires validated in Spanish to measure EE among relatives of patients with a psychiatric condition. The aim of this study was to examine the psychometric properties of the Spanish version of the Level of Expressed Emotion scale (LEE) among relatives of eating disorder patients. A cross-sectional study of 270 relatives of patients with an eating disorder was conducted to examine the factor structure, reliability and validity of the LEE scale. Results indicated that the LEE-S (Spanish version) did not correspond to the a priori subscales described in the original version. The refined 45-item LEE-S scale consisted of four factors which explained 25.5% of variance in EE for relatives. Reliability was acceptable (alpha ranged from .73 to .86). The discriminant validity of the subscales was moderately supported by correlations with psychological distress (GHQ-12; rho = .34) and specific caregiving experience (EDSIS; rho = .39). The LEE-S instrument has adequate psychometric properties and may be of value to assess families at risk of a negative emotional climate at home.

The aim of this study was to examine and identify the psychological, clinical and sociodemographic factors associated with emotional well-being by type of caregiver. A cross-sectional study was conducted among 185 primary caregivers and 92 secondary caregivers of patients with an eating disorder using the Hospital Anxiety and Depression Scale, the Experience of Caregiving Inventory and the Eating Disorders Symptom Impact Scale. According to a multiple regression analysis, a total of four models were obtained accounting for 42%-47% of the variance in emotional well-being. The variable that accounted for most of the variance of emotional well-being in three of the models was the impact of nutrition. Improving aspects of the relationships with the patients reduced anxiety and depression levels in primary caregivers. Similarly, a positive personal experience reduced depression in secondary caregivers. A higher education level was associated with decreased anxiety levels in both types of caregivers. Specific family interventions including both types of caregivers may be useful for providing emotional and adaptive personal coping skills., (Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.)