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Solution-processable 2D materials are promising candidates for a range of printed electronics applications. Yet maximizing their potential requires solution-phase processing of nanosheets into high-quality networks with carrier mobility (μ Net ) as close as possible to that of individual nanosheets (μ NS ). In practice, the presence of internanosheet junctions generally limits electronic conduction, such that the ratio of junction resistance ( R J ) to nanosheet resistance ( R NS ), determines the network mobility via μ NS /μ Net ≈ R J / R NS + 1. Hence, achieving R J / R NS < 1 is a crucial step for implementation of 2D materials in printed electronics applications. In this work, we utilize an advanced liquid-interface deposition process to maximize nanosheet alignment and network uniformity, thus reducing R J . We demonstrate the approach using graphene and MoS 2 as model materials, achieving low R J / R NS values of 0.5 and 0.2, respectively. The resultant graphene networks show a high conductivity of σ Net = 5 × 10 4 S/m while our semiconducting MoS 2 networks demonstrate record mobility of μ Net = 30 cm 2 /(V s), both at extremely low network thickness ( t Net < 10 nm). Finally, we show that the deposition process is compatible with nonlayered quasi-2D materials such as silver nanosheets (AgNS), achieving network conductivity close to bulk silver for networks <100 nm-thick.

Background: Weight stigma is a fundamental cause of health inequality. Body positivity may be a counterbalance to weight stigma. Social media is replete with weight-stigmatizing content and is a driver of poor mental health outcomes; however, there remains a gap in understanding its potential to mitigate the prevalence and impact of harmful messaging and to promote positive effects on a large scale., Objective: We selected musical artist Lizzo, whose brand emphasizes body positivity and empowerment, for an instrumental case study on the discourse on social media and specifically Instagram. We focused on 3 domains, including body positivity, physical health, and emotional well-being. These domains challenge social norms around weight and body size and have the potential to positively affect the physical and psychological health of people with diverse body sizes., Methods: We evaluated posts by Lizzo, comments from Instagram users, and replies to comments over a 2-month period (October 11 to December 12, 2019). Two coders rated Lizzo's posts and Instagram users' comments for their sentiments on the 3 domains. Replies to Instagram users' comments were assessed for their reactions to comments (ie, did they oppose or argue against the comment or did they support or bolster the comment). Engagement metrics, including the number of "likes," were also collected., Results: The final sample included 50 original posts by Lizzo, 250 comments from Instagram users, and 1099 replies to comments. A proportion of Lizzo's content included body positive sentiments (34%) and emotional well-being (18%); no posts dealt explicitly with physical health. A substantial amount Instagram users' comments and replies contained stigmatizing content including the use of nauseated and vomiting emojis, implications that Lizzo's body was shameful and should be hidden away, accusations that she was promoting obesity, and impeachments of Lizzo's health. In spite of the stigmatizing content, we also discovered content highlighting the beneficial nature of having positive representation of a Black woman living in a larger body who is thriving. Moreover, analysis of the discourse between users illustrated that stigmatizing expressions are being combated online, at least to some degree., Conclusions: This study demonstrates that Lizzo has exposed millions of social media users to messages about body positivity and provided more visibility for conversations about weight and shape. Future research should examine the extent to which body positive messages can lead to greater acceptance of individuals living in larger bodies. Instagram and other social media platforms should consider ways to reduce body-shaming content while finding ways to promote content that features diverse bodies. Shifting the landscape of social media could decrease stereotypes about weight and shape while increasing dialog about the need for greater acceptance and inclusion of people with diverse bodies., (©Stephanie L Albert, Rachel E Massar, Omni Cassidy, Kayla Fennelly, Melanie Jay, Philip M Massey, Marie A Bragg. Originally published in JMIR Formative Research (https://formative.jmir.org), 04.11.2024.)

Graphite is one of only a few layered materials that can be exfoliated into nanosheets with semimetallic properties, which limits the applications of nanosheet-based electrodes to material combinations compatible with the work function of graphene. It is therefore important to identify additional metallic or semimetallic two-dimensional (2D) nanomaterials that can be processed in solution for scalable fabrication of printed electronic devices. Metal diborides represent a family of layered non-van der Waals crystals with semimetallic properties for all nanosheet thicknesses. While previous reports show that the exfoliated nanomaterial is prone to oxidation, we demonstrate a readily accessible inert exfoliation process to produce quasi-2D nanoplatelets with intrinsic material properties. For this purpose, we demonstrate the exfoliation of three representative metal diborides (MgB 2 , CrB 2 , and ZrB 2 ) under inert conditions. Nanomaterial is characterized using a combination of transmission electron microscopy, scanning electron microscopy, atomic force microscopy, IR, and UV-vis measurements, with only minimal oxidation indicated postprocessing. By depositing the pristine metal diboride nanoplatelets as thin films using a Langmuir-type deposition technique, the ohmic behavior of the networks is validated. Furthermore, the material decomposition is studied by using a combination of electrical and optical measurements after controlled exposure to ambient conditions. Finally, we report an efficient, low-cost approach for sample encapsulation to protect the nanomaterials from oxidation. This is used to demonstrate low-gauge factor strain sensors, confirming metal diboride nanosheets as a suitable alternative to graphene for electrode materials in printed electronics.

Unlabelled: Exposure to unhealthy food and beverage marketing is a major contributor to excessive weight gain among young people and it may disproportionately affect Black and Latinx communities. Appropriate and comprehensive regulations on food and beverage companies are essential, particularly as companies expand their reach and leverage the latest technologies to create marketing experiences using immersive virtual reality (VR). Although immersive VR technology is in its infancy, the potential effects of immersive VR food and beverage marketing on consumption, coupled with the history of racially targeted marketing by food and beverage corporations toward Black and Latinx communities, and the heightened burden of diet-related illnesses in Black and Latinx communities underscore a critical need to investigate immersive VR marketing targeting young people of color. This viewpoint will provide a brief description of VR food and beverage marketing as the newest food and beverage marketing frontier, highlight key concerns and knowledge gaps, and underscore future directions in research., (© Omni Cassidy, Marie Bragg, Brian Elbel. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org).)

Background: Depression and anxiety are common in adolescents and have increased over the last decade. During that period, smartphone usage has become ubiquitous., Objectives: The study aim was to assess the association between problematic smartphone usage (PSU) and anxiety., Methods: Using a prospective mixed methods cohort study design, students aged 13-16 year old from two schools were enrolled regarding their smartphone use, mood and sleep via a semistructured questionnaire at baseline and week 4. The primary outcome was symptoms of anxiety (Generalised Anxiety Disorder Questionnaire, GAD-7) and exposure was PSU (Smartphone Addiction Scale Short Version). A linear regression was fitted to assess the change in anxiety. Thematic analysis of free-text responses was conducted., Findings: The sample included 69 participants that were enrolled and followed up between 28 March and 3 June 2022. Of those with PSU, 44.4% exhibited symptoms of moderate to severe anxiety compared with 26.4% of those without PSU. There was a linear association between change in symptoms of anxiety and PSU β=0.18 (95% CI 0.04 to 0.32, p=0.013). Several themes were found: both positive and negative effects of smartphones on relationships; negative effects on school performance and productivity; mixed effects on mood; a desire to reduce the amount of time spent on smartphones., Conclusions: Increased anxiety, depression and inability to sleep were seen in participants as their PSU score increased over time. Participants reported both positive and negative effects of smartphones and almost all used strategies to reduce use., Clinical Implications: Interventions need to be developed and evaluated for those seeking support., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. Published by BMJ.)

Objectives: We present an empirical comparison of relative-efficacy estimate(s) from matching-adjusted indirect comparisons (MAICs) with estimates from corresponding standard anchored indirect treatment comparisons., Methods: A total of 80 comparisons were identified from 17 publications through a systematic rapid review. A standardized metric that used reported relative treatment efficacy estimates and their associated uncertainty was used to compare the methods across different treatment indications and outcome measures., Results: On aggregate, MAICs presented for connected networks tended to report a more favorable relative-efficacy estimate for the treatment for which individual-level patient data were available relative to the reported indirect treatment comparison estimate., Conclusions: Although we recognize the importance of MAIC and other population adjustment methods in certain situations, we recommend that results from these analyses are interpreted with caution. Researchers and analysts should carefully consider if MAICs are appropriate where presented and whether MAICs would have added value where omitted., (Copyright © 2023. Published by Elsevier Inc.)

The investigation of high-mobility two-dimensional (2D) flakes beyond molybdenum disulfide (MoS 2 ) will be necessary to create a library of high-mobility solution-processed networks that conform to substrates and remain functional over thousands of bending cycles. Here we report electrochemical exfoliation of large-aspect-ratio (>100) semiconducting flakes of tungsten diselenide (WSe 2 ) and tungsten disulfide (WS 2 ) as well as MoS 2 as a comparison. We use Langmuir-Schaefer coating to achieve highly aligned and conformal flake networks, with minimal mesoporosity (∼2-5%), at low processing temperatures (120 °C) and without acid treatments. This allows us to fabricate electrochemical transistors in ambient air, achieving average mobilities of μ MoS 2 ≈ 11 cm 2 V -1 s -1 , μ WS 2 ≈ 9 cm 2 V -1 s -1 , and μ WSe 2 ≈ 2 cm 2 V -1 s -1 with a current on/off ratios of I on / I off ≈ 2.6 × 10 3 , 3.4 × 10 3 , and 4.2 × 10 4 for MoS 2 , WS 2 , and WSe 2 , respectively. Moreover, our transistors display threshold voltages near ∼0.4 V with subthreshold slopes as low as 182 mV/dec, which are essential factors in maintaining power efficiency and represent a 1 order of magnitude improvement in the state of the art. Furthermore, the performance of our WSe 2 transistors is maintained on polyethylene terephthalate (PET) even after 1000 bending cycles at 1% strain.

Unhealthy food advertisements ("advertisements" hereafter referred to as "ads") are linked to poor diet and obesity, and food companies disproportionally target Black youth. Little is known about the mechanisms whereby food ads influence diet. One possibility may be racially-targeted ads that appeal to Black youth. Those with food-related attentional biases may be especially vulnerable. The objective of this project was to assess the feasibility and initial effects of a pilot study testing the influence of racially-targeted food ads and food-related attentional biases on eating behaviors among a sample of Black adolescent females. Feasibility of recruitment, retention, and procedures were examined. Participants (N = 41, 12-17y) were randomized to view a television episode clip of the Big Bang Theory embedded with either four 30-second racially-targeted food ads or neutral ads. A computer dot probe task assessed food-related attentional biases. The primary outcome was caloric consumption from a laboratory test meal. Interactions based on weight and ethnic identity were also examined. Analyses of variance and regressions were used to assess main and interaction effects. Exposure to racially-targeted food ads (versus neutral ads) did not affect energy consumption (p > .99). Although not statistically significant, adolescents with obesity consumed nearly 240 kcal more than non-overweight adolescents (p = 0.10). There were no significant preliminary effects related to food-related attentional biases or ethnic identity (ps = 0.22-0.79). Despite a non-significant interaction, these data provide preliminary support that adolescents with obesity may be particularly vulnerable to racially-targeted food ads. An adequately powered trial is necessary to further elucidate the associations among racially-targeted food ads among Black adolescent girls with obesity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: Food advertisement exposure is associated with children's increased caloric intake, but little is known about food/beverage placements in child-oriented educational YouTube videos. We aimed to quantify the prevalence of food/beverages in these videos and assess their nutritional quality. Methods: Researchers identified child-oriented educational YouTube videos from 2020, using keyword searches. We coded the names of featured food/beverages, coded how the food/beverages were interacted with, quantified the number of minutes the food/beverages appeared, and assessed the nutritional quality of the food/beverages. Results: A sample of 400 videos with the highest number of views was identified, 165 of which featured food/beverages. These 165 videos were collectively viewed over 1.1 billion times. Among these videos, 108 (67.4%) featured unhealthy foods and 86 (52.1%) featured branded products. Most food/beverages were used in experiment/tutorials ( n  = 143, 86.7%). Of the 165 videos featuring food/beverages, 91 (55.2%) did not depict food/beverages in their video thumbnail. Conclusions: While unhealthy food/beverages appear frequently in child-oriented educational YouTube videos, parents and teachers may not be aware of the presence of branded food/beverage products in these videos that could influence their children's food and brand preferences. The Federal Trade Commission should collect data on food and beverage company sponsorship of educational videos aimed at children and adolescents.

Background: Food companies have increased digital and social media ad expenditures during the COVID-19 pandemic, capitalizing on the coinciding increase in social media use during the pandemic. The extent of pandemic-related social media advertising and marketing tactics have been previously reported. No studies, however, have evaluated how food and beverage companies used COVID-washing on social media posts in the United States or analyzed the nutritional content of advertised food and beverage products. This study was designed to address these gaps by evaluating how food and beverage companies capitalize on the COVID-19 pandemic to promote unhealthy foods and sugary beverages., Objective: We aimed to document the types and frequencies of COVID-19-related themes in US food and beverage companies' Twitter posts during the first wave of the pandemic in the United States, and assess the nutritional quality of food and beverage products featured in these tweets., Methods: Research assistants visited the Twitter accounts of the most-marketed food and beverage brands, and screen-captured all tweets posted between March 1 and May 31, 2020. Researchers documented the date of the tweet; the number of likes, views, comments, and "retweets"; and the type of food and beverage products. We coded tweets for the following 10 COVID-19 themes: (1) social distancing, staying home, or working remotely; (2) contactless delivery or pick-up; (3) handwashing or sanitizing; (4) masks; (5) safety or protection; (6) staying connected with others; (7) staying active; (8) frontline or essential workers; (9) monetary relief, donations, or unemployment; and (10) pandemic, unprecedented, or difficult times. Researchers calculated the nutrient profile index scores for featured foods and sorted beverages into categories based on sugar content., Results: Our final sample included 874 COVID-19-themed tweets from 52 food and beverage brands. Social distancing themes appeared most frequently (n=367, 42%), followed by pandemic, unprecedented, or difficult times (n=246, 28.2%), and contactless delivery (n=237, 27.1%). The majority of tweets (n=682, 78%) promoted foods and beverages. Among those tweets featuring foods and beverages, 89.6% (n=611) promoted unhealthy products, whereas 17.2% (n=117) promoted healthy products., Conclusions: Our findings point to a concerning marketing tactic in which major food and beverage companies promote unhealthy foods and sugary beverages during the COVID-19 pandemic. Given that nutrition-related diseases such as obesity and diabetes are risk factors for COVID-19 morbidity and mortality, food and beverage companies should reduce the promotion of unhealthy products to help decrease the prevalence of health conditions that place people at higher risk for severe illness and death due to COVID-19., (©Krystle A Tsai, Omni Cassidy, Josh Arshonsky, Sara Bond, Inés M Del Giudice, Marie A Bragg. Originally published in JMIR Formative Research (https://formative.jmir.org), 14.10.2022.)

Background: Social media advertising by fast food companies continues to increase globally, and exposure to food advertising contributes to poor diet and negative health outcomes (eg, cardiovascular disease). McDonald's-the largest fast food company in the world-operates in 101 countries, but little is known about their marketing techniques in various regions. The objective of this study was to compare the social media advertising practices of McDonald's-the largest fast food company in the world-in 15 high-income, upper-middle-income and lower-middle-income countries., Methods: We randomly selected official McDonald's Instagram accounts for 15 high-income, upper-middle-income and lower-middle-income countries. We captured all the screenshots that McDonald's posted on those Instagram accounts from September to December 2019. We quantified the number of followers, 'likes', 'comments' and video views associated with each account in April 2020. We used content analysis to examine differences in the marketing techniques., Results: The 15 accounts collectively maintained 10 million followers and generated 3.9 million 'likes', 164 816 comments and 38.2 million video views. We identified 849 posts. The three lower-middle-income countries had more posts (n=324; M, SD=108.0, 38.2 posts) than the five upper-middle-income countries (n=227; M, SD=45.4, 37.5 posts) and seven high-income countries (n=298; M, SD=42.6, 28.2 posts). Approximately 12% of the posts in high-income countries included child-targeted themes compared with 22% in lower-middle-income countries. Fourteen per cent of the posts in high-income countries included price promotions and free giveaways compared with 40% in lower-middle-income countries., Conclusions: Social media advertising has enabled McDonald's to reach millions of consumers in lower-middle-income and upper-middle-income countries with disproportionately greater child-targeted ads and price promotions in lower-middle-income countries. Such reach is concerning because of the increased risk of diet-related illnesses, including cardiovascular disease, in these regions., 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.)

Food and beverage marketing is a major driver of childhood obesity, and companies target their least nutritious products to Black youth. However, little is known about adolescents' perceptions of and responses to racially targeted food marketing. In this qualitative study, we investigated how Black and White adolescents perceived and responded to racially targeted television commercials for food and beverages. We recruited 39 adolescents aged 12-17 years in New York City to watch a series of commercials and then participate in an in-depth interview using a semi-structured interview guide. The research team recorded, transcribed, and analyzed interviews using ATLAS.ti. Overall, participants responded positively to commercials that featured celebrities. They were also able to recognize the commercials and reported they had been exposed to marketing from these companies on social media and in subways/buses. Many participants considered the advertised brands as healthy or able to enhance athletic performance because of their endorsement by or association with athletes. Participants also understood that marketers were using racial targeting in their ads but that targeting did not translate into improved perceptions or responses towards advertised products. These findings suggest the need to empirically evaluate and further explore Black and White adolescents' responses to racially targeted food marketing.

Aim: To investigate the impact of tinnitus on professional musicians in the UK., Background: Tinnitus is the experience of sound when an external source is absent, primarily associated with the ageing process, hearing loss, and noise exposure. Amongst populations exposed to industrial noise, noise exposure and noise-induced hearing loss (NIHL) have been found to be the factors most associated with tinnitus. The risk of NIHL amongst professional musicians is greater than that amongst the general population, meaning they may be at increased risk of tinnitus., Methods: Seventy-four professional musicians completed an online survey involving closed and open-ended questions, and completed the Tinnitus fuctional Index (TFI) questionnaire. Descriptive statistics and thematic analysis of open-ended qualitative responses were used to analyse the data., Results: Three themes were generated from the analysis of the responses to the open-ended questions. These themes were: (1) the impact of tinnitus on the lives of professional musicians, (2) professional musician experience of tinnitus services, support, and hearing health and safety, and (3) the support professional musicians want. The mean global TFI score for professional musicians was 39.05, interpreted as tinnitus being a moderate problem. Comparisons with general population data revealed lower TFI scores for the TFI subscales of 'sense of control' and 'intrusiveness' for professional musicians and higher for auditory difficulties associated with tinnitus amongst professional musicians., Conclusion: Tinnitus can negatively impact on professional musicians' lives. There is a need for bespoke self-help groups, awareness raising, and education to prevent tinnitus and promote hearing health among musicians.

Objectives: We aimed to determine the frequency with which kid influencers promote branded and unbranded food and drinks during their YouTube videos and assess the nutritional quality of food and drinks shown., Methods: Researchers used Socialbakers data to identify the 5 most-watched kid influencers (ages 3 to 14 years) on YouTube in 2019. We searched for 50 of their most-watched videos and 50 of their videos that featured food and/or drinks on the thumbnail image of the video. We coded whether kid influencers consumed or played with food or toys, quantified the number of minutes food and/or drinks appeared, and recorded names of branded food and/or drinks. We assessed the nutritional quality of foods using the Nutrient Profile Model and identified the number of drinks with added sugar., Results: A sample of 418 YouTube videos met the search criteria, and 179 of those videos featured food and/or drinks. Food and/or drinks were featured in those videos 291 times. Kid influencers' YouTube videos were collectively viewed >48 billion times, and videos featuring food and/or drinks were viewed 1 billion times. Most food and/or drinks were unhealthy branded items ( n = 263; 90.34%; eg, McDonald's), followed by unhealthy unbranded items ( n = 12; 4.1%; eg, hot dogs), healthy unbranded items ( n = 9; 3.1%; eg, fruit), and healthy branded items ( n = 7; 2.4%; eg, Yoplait yogurt)., Conclusions: Kid influencers generate millions of impressions for unhealthy food and drink brands through product placement. The Federal Trade Commission should strengthen regulations regarding product placement on YouTube videos featuring young children., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

: Background: To determine how many adolescents follow food/beverage brands on Instagram and Twitter, and examine associations between brands' youth-targeted marketing practices and percentages of adolescent followers., Methods: We purchased data from Demographics Pro to characterize the demographics of Twitter and Instagram users who followed 27 of the most highly advertised fast food, snack, and drink brands in 2019. We used one-sample t -tests to compare percentages of adolescent followers of the selected brands' accounts versus all social media accounts, independent samples t -tests to compare followers of sugary versus low-calorie drink brands, and linear regression to examine associations between youth-targeted marketing practices and the percentages of adolescent followers., Results: An estimated 6.2 million adolescents followed the selected brands. A higher percentage of adolescents followed the selected brands' accounts (9.2%) compared to any account on Twitter (1.2%) ( p < 0.001), but not Instagram. A higher percentage of adolescents followed sugary (7.9%) versus low-calorie drink brands (4.3%) on Instagram ( p = 0.02), but we observed the opposite pattern for adults on Twitter and Instagram. Television advertising expenditures were positively associated with percentages of adolescent followers of the selected brands on Twitter ( p = 0.03), but not Instagram., Conclusions: Food and sugary drink brands maintain millions of adolescent followers on social media., Competing Interests: The authors declare no conflict of interest.

Poor physical fitness contributes to the early progression of cardiometabolic disease, yet the physiological and psychological factors underpinning poor fitness in at-risk adolescents are not well understood. In this study, we sought to determine the relationship of physical fitness with two developmental phenomena of adolescence, insulin resistance and depression/anxiety symptoms among at-risk youth. We conducted secondary data analyses of 241 overweight or obese adolescents (12-17 years), drawn from two study cohorts. Insulin sensitivity index was derived from oral glucose tolerance tests. Adolescents self-reported depressive symptoms and anxiety symptoms on validated surveys. A walk/run test was administered to determine perceived exertion and physical fitness (distance traveled). Insulin sensitivity was positively associated with walk/run distance ( b =0.16, P< 0.01), even after accounting for all covariates. Anxiety symptoms were inversely related to perceived exertion ( b =-0.11, P< 0.05), adjusting for covariates. These findings suggest that insulin resistance and anxiety symptoms are associated with different dimensions of physical fitness in overweight or obese adolescents and could both potentially contribute to declining fitness and worsening metabolic outcomes in at-risk youth.

Objective: Pediatric loss-of-control (LOC) eating is associated with, and predictive of, gains in adiposity and adverse metabolic outcomes. In addition, some preliminary data suggest that anxiety may exacerbate the relationship of LOC eating with weight and metabolic syndrome (MetS)-related measures. We therefore examined whether anxiety moderated the relationship between LOC eating and body mass index z (BMIz), adiposity, and MetS-related measures in youth., Methods: A convenience sample of non-treatment-seeking boys and girls of varying weight strata were interviewed to determine the presence of LOC eating and completed a questionnaire assessing trait anxiety. BMIz and MetS-related measures (blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, and insulin) were measured after an overnight fast. Adiposity was assessed by air displacement plethysmography or dual-energy x-ray absorptiometry. Analyses adjusted for age, sex, race, height, fat mass, and depressive symptoms, as appropriate., Results: In all, 379 youths (13.0 ± 2.8 years; 53% female; BMIz = 0.8 ± 1.1; 22% with LOC eating) were studied. Anxiety was not significantly related to BMIz, adiposity, or MetS-related measures. However, anxiety and LOC eating interacted such that only among youth with LOC eating, anxiety was positively associated with fasting insulin (p = .02) and insulin resistance (p = .01). The interaction of anxiety and LOC eating was not significantly related to BMIz, adiposity, or any other MetS-related measure (ps = ns)., Conclusions: Only among non-treatment-seeking youth with LOC eating, anxiety may be associated with increased insulin secretion and insulin resistance. Longitudinal studies are required to confirm these findings and explore mechanisms for these relationships.

Objective: Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children's psychosocial functioning, LOC-eating, and body mass., Method: A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC-eating. Youth-parent dyads were randomized to 12-week FB-IPT (n = 15) or FB-HE (n = 14) and evaluated at post-treatment, six-months, and one-year. Changes in child psychosocial functioning, LOC-eating, BMI, and adiposity by dual-energy-X-ray-absorptiometry were assessed. Missing follow-up data were multiply imputed., Results: FB-IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow-up assessments were completed by 73% FB-IPT and 86% FB-HE at post-treatment, 60% and 64% at six-months, and 47% and 57% at one-year. At post-treatment, children in FB-IPT reported greater decreases in depression (95% CI -7.23, -2.01, Cohen's d = 1.23) and anxiety (95% CI -6.08, -0.70, Cohen's d = .79) and less odds of LOC-eating (95% CI -3.93, -0.03, Cohen's d = .38) than FB-HE. At six-months, children in FB-IPT had greater reductions in disordered-eating attitudes (95% CI -0.72, -0.05, Cohen's d = .66) and at one-year, tended to have greater decreases in depressive symptoms (95% CI -8.82, 0.44, Cohen's d = .69) than FB-HE. There was no difference in BMI gain between the groups., Discussion: Family-based approaches that address interpersonal and emotional underpinnings of LOC-eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered-eating or excess weight gain requires further study., (© 2017 Wiley Periodicals, Inc.)

Objective: The Eating Disorder Examination (EDE) was originally developed and validated in primarily white female samples. Since data indicate that eating pathology impacts black youth, elucidating the psychometric appropriateness of the EDE for black youth is crucial., Methods: A convenience sample was assembled from seven pediatric obesity studies. The EDE was administered to all youth. Confirmatory factor analyses (CFA) were conducted to examine the original four-factor model fit and two alternative factor structures for black and white youth. With acceptable fit, multiple-group CFAs were conducted. For measurement invariant structures, the interactive effects of race with sex, BMIz, adiposity, and age were explored (all significance levels p < .05)., Results: For both black and white youth (N = 820; 41% black; 37% male; 6-18 years; BMIz -3.11 to 3.40), the original four-factor EDE structure and alternative eight-item one-factor structure had mixed fit via CFA. However, a seven-item, three-factor structure reflecting Dietary Restraint, Shape/Weight Overvaluation, and Body Dissatisfaction had good fit and held at the level of strict invariance. Girls reported higher factor scores than boys. BMIz and adiposity were positively associated with each subscale. Age was associated with Dietary Restraint and Body Dissatisfaction. The interactional effects between sex, BMIz, and age with race were not significant; however, the interaction between adiposity and race was significant. At higher adiposity, white youth reported greater pathology than black youth., Conclusion: An abbreviated seven-item, three-factor version of the EDE captures eating pathology equivalently across black and white youth. Full psychometric testing of the modified EDE factor structure in black youth is warranted., (2017 Wiley Periodicals, Inc.)

Objective: Interpersonal psychotherapy (IPT) is aimed at improving negative affect that is purported to contribute to the development and maintenance of loss-of-control (LOC) eating. Although youth who report LOC over eating tend to consume more snack-foods than those without LOC, it is unknown if IPT impacts objective energy intake., Methods: To test if IPT improves mood and eating in the laboratory, we examined a sample of 88 girls with LOC eating who were randomized to either IPT (n = 46) or a standard-of-care health education (HE) group program. At baseline, and 6-month (follow-up 1) and 1-year (follow-up 2) following the initiation of the groups, girls consumed lunch from a multi-item meal with an instruction designed to model a LOC episode. Girls also reported mood state immediately before each meal., Results: Girls in IPT experienced no significant changes in pre-meal state depressive affect, while girls in HE experienced a non-significant improvement by follow-up 1 and then returned to baseline by follow-up 2 (p < .04). We found no significant group difference for changes in total intake relative to girls' daily energy needs (p's ≥ .25). However, IPT reduced, while HE increased, the percentage of daily energy needs consumed from snack-foods by follow-up 2 (p = .04). Within-groups, HE increased their snack food intake from follow-up 1 to follow-up 2 (p = .01)., Conclusions: In adolescent girls with LOC, IPT did not change total intake at the test meal and was associated with reduced snack-food intake. Data are required to determine if IPT effectively prevents excess weight gain in the longer-term. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:490-498)., (© 2015 Wiley Periodicals, Inc.)

Obesity is widespread, associated with several physical and psychosocial comorbidities, and is difficult to treat. Prevention of obesity across the lifespan is critical to improving the health of individuals and society. Screening and prevention efforts in primary care are an important step in addressing the obesity epidemic. Each period of human development is associated with unique risks, challenges, and opportunities for prevention and intervention. Screening tools for overweight/obesity, although imperfect, are quick and easy to administer. Screening should be conducted at every primary care visit and tracked longitudinally. Screening tools and cutoffs for overweight and obesity vary by age group., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: Extant research indicates that some of the comorbidities associated with adult obesity may be adversely affected by the stress resulting from negative body image and weight-related stigma. This study examined the association between weight-related pressure and insulin sensitivity in adolescents, who are vulnerable to both weight-based teasing and the onset of metabolic dysregulation., Methods: Participants were 215 adolescent healthy volunteers (55% female; 59% white; 35% overweight/obese; mean ± standard deviation age = 15.4 ± 1.4 year), who completed a self-report measure of pressure to be thin from parents, friends, and romantic partners. Fasting blood samples were obtained to assess serum insulin and glucose, which were used to calculate insulin sensitivity; fat mass (kg) and fat-free mass (%) were measured with air-displacement plethysmography. Pubertal stage was determined by physical examination., Results: Pressure to be thin was positively associated with fasting insulin (p = .01) and negatively associated with insulin sensitivity (p = .02), after controlling for pubertal stage, sex, race, height, fat-free mass, and adiposity. Pressure to be thin was associated with a greater odds of having hyperinsulinemia (fasting insulin ≥ 15 μIU/mL; odds ratio (95% confidence interval): 1.65 [1.08-2.50], p = .02), adjusting for the same covariates., Conclusions: Results indicate that adolescents perceiving more pressure to be thin have greater elevations of fasting insulin and poorer insulin sensitivity above and beyond the effect of fat mass. Future research is warranted to elucidate the mechanisms responsible for this relationship., (Published by Elsevier Inc.)

Objective: The purpose of this investigation was to examine the relationship of dispositional mindfulness to binge eating and associated eating attitudes and behaviors among adolescent girls at risk for type 2 diabetes (T2D)., Methods: Participants were 114 overweight or obese adolescents enrolled in a study of girls with a family history of T2D and mild depressive symptoms. Adolescent self-reports of mindfulness, eating in the absence of hunger, and depressive symptoms were collected. An interview was administered to determine presence of binge eating episodes and a behavioral task was used to assess the reinforcing value of food relative to other nonsnack food rewards. Body composition was assessed using dual-energy X-ray absorptiometry., Results: In analyses accounting for race, percent body fat, lean mass, height, age, and depressive symptoms, dispositional mindfulness was associated with a lower odds of binge eating (p = .002). Controlling for the same potential confounds, mindfulness was also inversely associated with eating concern, eating in the absence of hunger in response to fatigue/boredom, and higher food reinforcement relative to physical activity (all p < .05)., Discussion: In girls with a family history of T2D, independent of body composition and depressive symptoms, intraindividual differences in mindfulness are related to binge eating and associated attitudes and behaviors that may confer risk for obesity and metabolic problems. Further research is needed to determine the extent to which mindfulness plays a role in the etiology and/or maintenance of disinhibited eating in adolescents at risk for T2D., (© 2015 Wiley Periodicals, Inc.)

Emerging data indicate that adults with binge eating may exhibit an attentional bias toward highly palatable foods, which may promote obesogenic eating patterns and excess weight gain. However, it is unknown to what extent youth with loss of control (LOC) eating display a similar bias. We therefore studied 76 youth (14.5 ± 2.3 years; 86.8% female; BMI-z 1.7 ± .73) with (n = 47) and without (n = 29) reported LOC eating. Following a breakfast to reduce hunger, youth participated in a computerized visual probe task of sustained attention that assessed reaction time to pairs of pictures consisting of high palatable foods, low palatable foods, and neutral household objects. Although sustained attentional bias did not differ by LOC eating presence and was unrelated to body weight, a two-way interaction between BMI-z and LOC eating was observed (p = .01), such that only among youth with LOC eating, attentional bias toward high palatable foods versus neutral objects was positively associated with BMI-z. These findings suggest that LOC eating and body weight interact in their association with attentional bias to highly palatable foods cues, and may partially explain the mixed literature linking attentional bias to food cues with excess body weight., (Published by Elsevier Ltd.)

Over the past three decades, there has been an increase in the number of empirical investigations of the phenomenology of eating disorders among African American adolescents. Despite efforts to understand racial/ethnic differences, relatively few eating disorder models address the important sociocultural factors that exert powerful influences on beliefs and behaviors related to weight status and eating patterns in this population. Nevertheless, researchers must be culturally competent in order to develop appropriate models. Therefore, we propose an approach to developing researcher cultural competence by addressing potential barriers that may hinder efforts to explore relevant, culturally appropriate factors that contribute to eating disturbance in African American girls. In this regard, we highlight the importance of integrative collaboration that can assist in identification and exploration of potential risk factors that may lead to model generation. We believe such information will lead to the development of culturally appropriate assessments, models, and, ultimately, interventions.

Objective: Pediatric loss of control (LOC) eating is predictive of partial- and full-syndrome binge eating disorder. The interpersonal model proposes that LOC eating is used to cope with negative mood states resulting from interpersonal distress, possibly on a momentary level. We therefore examined temporal associations between interpersonal problems, negative affect, and LOC eating among overweight adolescent girls using ecological momentary assessment (EMA)., Method: Thirty overweight and obese (≥85th body mass index (BMI) percentile; BMI: M = 36.13, SD = 7.49 kg/m(2)) adolescent females (Age: M = 14.92, SD = 1.54 y; 60.0% African American) who reported at least two LOC episodes in the past month completed self-report momentary ratings of interpersonal problems, state affect, and LOC eating for 2 weeks. A series of 2-level multilevel models with centering within subjects was conducted., Results: Between- and within-subjects interpersonal problems (p's < .05), but not between- (p = .12) or within- (p = .32) subjects negative affect predicted momentary LOC eating. At the between-subjects level, interpersonal problems significantly predicted increases in negative affect (p < 001)., Discussion: Naturalistic data lend support to the predictive value of interpersonal problems for LOC eating among adolescents. Interventions targeting interpersonal factors on a momentary basis may be useful during this developmental stage., (© 2014 Wiley Periodicals, Inc.)

Objective: To obtain focus group data regarding the perspectives of rural African American (AA) girls, parents/guardians, and community leaders on obesity, loss of control (LOC) eating, relationships, and interpersonal psychotherapy for the prevention of excessive weight gain (IPT-WG)., Methods: 7 focus groups (N = 50 participants) were moderated and the transcripts analyzed by Westat researchers using widely accepted methods of qualitative and thematic analysis. A session was held with experts in health disparities to elucidate themes., Results: Participants understood LOC eating; however, they had culturally specific perceptions including usage of alternative terms. Relationships were highly valued, specifically those between mothers and daughters. IPT-WG program components generally resonated with participants, although modifications were recommended to respect parental roles. Experts interpreted focus group themes and discussed potential barriers and solutions to recruitment and participation., Conclusion: Findings suggest that adapting IPT-WG may be acceptable to rural AA families. This research is the first step in developing a sustainable excessive weight gain and binge eating disorder prevention program for rural AA adolescents.

Limited data exist regarding the association between binge eating and quality of life (QOL) in obese adolescent girls and boys. We, therefore, studied binge eating and QOL in 158 obese (BMI ≥ 95th percentile) adolescents (14.5 ± 1.4 years, 68.0% female, 59% African-American) prior to weight-loss treatment. Youth completed an interview to assess binge eating and a questionnaire measure of QOL. Controlling for body composition, binge eating youth (n = 35), overall, reported poorer QOL in domains of health, mobility, and self-esteem compared to those without binge eating (ps < 0.05). Also, girls, overall, reported poorer QOL than boys in activities of daily-living, mobility, self-esteem, and social/interpersonal functioning (ps < 0.05). Girls with binge eating reported the greatest impairments in activities of daily living, mobility, self-esteem, social/interpersonal functioning, and work/school QOL (ps < 0.05). Among treatment-seeking obese adolescents, binge eating appears to be a marker of QOL impairment, especially among girls. Prospective and treatment designs are needed to explore the directional relationship between binge eating and QOL and their impact on weight outcomes.