Medicine and Health Sciences Commons^™

Abuse Of Benzodiazepines Among The Elderly Population, Sofia A. Padilla

College of Pharmacy Student Research

Throughout the years, benzodiazepines are safe drugs to treat several conditions among the elderly population, including anxiety, mixed anxiety-depression, and insomnia. However, inappropriate use of this drug, together with known risks such as cognitive impairment, delirium, and falls, is on the rise in these recent years, making the elderly population more inclined to suffer adverse effects when using them. The literature review paper will examine the use of benzodiazepines among the elderly population and their abuse through various published articles that addressed these concerns. The paper will also examine some potential solutions that will reduce the inappropriate use of benzodiazepine …

Implications Of Covid-19 Mitigation Policies On Recreational Trail Users: Exploring Antecedents To Physical Distancing On Trails Across The Rural-Urban Continuum, Christopher J. Wynveen, Ingrid Schneider, Deonne Vanderwoude, Taylor Stein, Heather Gibson, Kim Shinew, William Hendricks, Megha Budruk

Journal of Rural Social Sciences

The COVID-19 pandemic and subsequent travel restrictions led to a worldwide increase in greenspace use. The U.S. Centers for Disease Control and Prevention encouraged policies including physical distancing and COVID-related signage. However, the extent to which these policies influenced behavior is unknown. To fill this gap, we report on a 2020 observational study at 14 trails across six U.S. states framed within a social-ecological model. Behavioral observations of 8,093 groups assessed compliance rates with infection-mitigation behaviors. Additionally, we noted the presence of COVID-related signs, the days between the observation and stay-at-home order start date, the setting (i.e., urban, suburban, and …

How Different Pre-Existing Mental Disorders And Their Co-Occurrence Affects Covid-19 Clinical Outcomes? A Real-World Data Study In The Southern United States, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Shujie Chen, Bankole Olatosi Ph.D., Suzanne Hardeman, Meera Narasimhan, Larisa Bruner, Abdoulaye Diedhiou, Cheryl Scott, Ali Mansaray, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Background: Although a psychiatric history might be an independent risk factor for COVID-19 infection and mortality, no studies have systematically investigated how different clusters of pre-existing mental disorders may affect COVID-19 clinical outcomes or showed how the coexistence of mental disorder clusters is related to COVID-19 clinical outcomes.

Methods: Using a retrospective cohort study design, a total of 476,775 adult patients with lab-confirmed and probable COVID-19 between March 06, 2020 and April 14, 2021 in South Carolina, United States were included in the current study. The electronic health record data of COVID-19 patients were linked to all payer-based claims data …

Lessons Learned Recruiting Comparison Elementary Schools For Impact Evaluation Of Snap-Ed Interventions, Amanda Linares, Phoebe Harpainter, Kaela Plank, Gail Woodward-Lopez

Journal of Extension

To determine the effectiveness of Supplemental Nutrition Assistance Program- Education (SNAP-Ed) nutrition and physical activity programming in elementary schools, it is necessary to recruit socioeconomically similar comparison schools not receiving SNAP-Ed programming. We developed a flexible recruitment strategy to tailor our approach to each individual school district and site. Here we discuss the lessons learned during the 10-month recruitment period, including early outreach, emphasizing participation benefits, leveraging and building relationships, and visiting sites.

Is Body Composition Or Body Mass Index Associated With The Step Count Accuracy Of A Wearable Technology Device?, Jeffrey Montes, Richard D. Tandy, John C. Young, Szu-Ping Lee, James W. Navalta

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 3: Issue 1, Article 5, 2022. A simple way to gauge daily physical activity levels is to use a wearable technology device to count the number of steps taken during the day. However, it is unknown whether these devices return accurate step counts for persons with different body fat percentages or body mass index scores. The purpose was to determine if there is a correlation between either body fat percentages and/or body mass index values and the percent error calculated between a manual step count and values recorded by a wearable technology device. …

An Evidence--Based Intervention: Use Of Visual Aids For Patient Education During Bedside Team Rounding, Kristin Clifford, Shay Gruber

Nursing DNP Projects

Abstract Purpose: To increase patient health literacy and satisfaction in hospitalized adult medical-surgical patients through an evidence-based provider intervention (advanced practice providers, APPs, or physicians, MDs) adding visual aids to current verbal patient education methods during daily bedside team rounding (BTR).

Strength of Evidence: A literature review resulted in 15 studies meeting inclusion criteria including two meta-analyses, three randomized control trials, two quasi-experimental studies, five systematic reviews, two descriptive studies, and one clinical practice guideline. Evidence revealed the addition of visual information to verbal and written education methods significantly improves patient knowledge, understanding, and recall of health information and increases …

Does Income Class Affect Life Satisfaction? New Evidence From Cross-Country Microdata, Joanne Haddad, Jad Chaaban, Ali Chalak, Hala Ghattas Ph.D.

Faculty Publications

This paper analyzes the impact of income class on subjective wellbeing. Using rich data from the Gallup World Poll, we investigate whether belonging to locally (both country-and time-specific) defined income classes influences individuals’ life satisfaction. We rely on a latent class analysis estimation method, using individual income proxied by household income divided by household size, as an observable characteristic to hypothesize the income classes. We fit a model with one categorical latent variable with three unobserved groupings, here: income classes, which we interpret as lower, middle and upper classes. Our estimates suggest that individuals in the low and middle income …

Preliminary (Year 1) Report To Oha On Pediatric Sogi: Executive Summary. Report To The Oregon Health Authority, Office Of Equity And Inclusion, Martin Arrigotti, Kieran Chase, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Overview: The enclosed report is the result of collaboration between the authors and the Oregon Health Authority. The report synthesizes the thinking and recommendations of the authors about routine data collection of SOGI data in minors for clinical and demographic purposes. Primary motivations to routinely collect SOGI data include: (1) inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations, (2) to promote health equity between minority and majority SOGI identities, and (3) to direct group-specific services towards those who need them.

Investigation and Findings: These recommendations are informed …

How Different Pre-Existing Mental Disorders And Their Co-Occurrence Affects Covid-19 Clinical Outcomes? A Real-World Data Study In The Southern United States, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Shujie Chen, Bankole Olatosi Ph.D., Suzanne Hardeman, Meera Narasimhan, Larisa Bruner, Abdoulaye Diedhiuo, Cheryl Scott, Ali Mansaray, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Background: Although a psychiatric history might be an independent risk factor for COVID-19 infection and mortality, no studies have systematically investigated how different clusters of pre-existing mental disorders may affect COVID-19 clinical outcomes or showed how the coexistence of mental disorder clusters is related to COVID-19 clinical outcomes. Methods: Using a retrospective cohort study design, a total of 476,775 adult patients with lab-confirmed and probable COVID-19 between March 06, 2020 and April 14, 2021 in South Carolina, United States were included in the current study. The electronic health record data of COVID-19 patients were linked to all payer-based claims data …

Public Libraries As Community Health Partners, Melinda Hodges

Certified Public Manager® Applied Research

Public libraries are a combination meeting space, educational resource, information repository, and community building organization. As such, they are already positioned to act as a valuable partner in the public health arena. This article researches the basic tenets of public health and identifies areas that public libraries could participate in productively. This article also reviews literature about the potential of public libraries as health partners, as well as what is already being accomplished from the perspective of both library/information sciences and public health studies. This will include the benefits that libraries can bring to public health work and the barriers …

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean …

Multilevel Determinants Of Racial/Ethnic Disparities In Severe Maternal Morbidity And Mortality In The Context Of The Covid-19 Pandemic In The Usa: Protocol For A Concurrent Triangulation, Mixed-Methods Study, Jihong Liu, Peiyin Hung Ph.D, Chen Liang Ph.D., Jiajia Zhang Ph.D., Shan Qiao Ph.D., Berry A. Campbell, Bankole Olatosi Ph.D., Myriam E. Torres Ph. D., Neset Hikmet, Xiaoming Li Ph.D.

Faculty Publications

Introduction The COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic black and Hispanic pregnant women appear to have disproportionate SARS-CoV-2 infection and death rates.

Methods and analysis We will use the socioecological framework and employ a concurrent triangulation, mixed-methods study design to achieve three specific aims: (1) examine the impacts of the COVID-19 pandemic on racial/ethnic disparities in severe maternal morbidity and mortality (SMMM); (2) explore how social contexts (eg, racial/ethnic residential segregation) have contributed to the widening of racial/ethnic disparities in SMMM during the pandemic and identify distinct mediating pathways through maternity care and mental health; and …

Investigating The Covid-19 Pandemic In Your Community, Tanzina Ahmed

Open Educational Resources

In this writing assignment, students will conduct research on statistics about COVID-19 in New York City and their embedded communities using free online databases from the New York City Department of Health (NYC DOH). For questions 1, 2, 3, and 4, students will conduct research on COVID-19 statistics within NYC and their specific neighborhood/community in New York City. In questions 5 and 6, students will analyze the data you have gathered while using your own knowledge of your community. A full set of instructions for accessing NYC DOH databases and a complete rubric for grading the assignment is included.

Patient Portal Use And Patient Education Materials Access Among Mississippi Adult Residents, Anna K. Swann

Dissertations

Patient education plays a vital role in improving the health outcomes of patients with chronic diseases and helps prevent illness in otherwise healthy individuals. Patient portals allow patients to access their EHRs, communicate with their healthcare providers, and access patient education materials. Despite the potential for patient portals and education materials to improve health outcomes, many barriers prevent patients from utilizing them. Uneducated patients are more likely to participate in risky health behaviors, which leads to poor health outcomes. Poor health outcomes lead to higher medical costs. Mississippi has a high rate of chronic diseases. Suppose the barriers to patient …

Development, Validity, And Cross-Context Equivalence Of The Child Food Insecurity Experiences Scale For Assessing Food Insecurity Of School-Age Children And Adolescents, Edward A. Frongillo Jr., Maryah S. Fram, Hala Ghattas Ph.D., Jennifer Bernal, Zeina Jamaluddine, Sharon I. Kirkpatrick, David Hammond, Elisabetta Aurino, Sharon Wolf, Sophie M. Goudet, Mara Nyawo, Chika Hayashi

Faculty Publications

Background: Children ages 6 to 17 years can accurately assess their own food insecurity, whereas parents are inaccurate reporters of their children's experiences of food insecurity. No globally applicable scale to assess the food insecurity of children has been developed and validated.

Objectives: We aimed to develop a globally applicable, experience-based measure of child and adolescent food insecurity and establish the validity and cross-contextual equivalence of the measure.

Methods: The 10-item Child Food Insecurity Experiences Scale (CFIES) was based on items previously validated from questionnaires from the United States, Venezuela, and Lebanon. Cognitive interviews were conducted to check understanding of …

Bringing People Back Into Public Health Data: Community Feedback On A Set Of Visualization Tools - Summary Report, Alejandro Cerón, Mia Glover, Quisi Rodriguez-Oregel, Dani Thompson, Tom Adams, Naomi Asakura, Kaela Belknap, Anna Block, Nicole Boehler, Hannah Boeve, Sarah Bomers, Sasha Borovok, Grace Bryan, Kate Buffington, Majesty Cain, Beth Carideo, Haley Chesno, Grace Connell, Jake Corbett, Camille Cruz, Chloe Dawkins, Anna Denniston, Lydia Dickens, Sophie Duplock, Samuel Dwinell, Avery Ess, Sam Ferman, Ellis Geis, Ethan Graupmann, Xander Hedrick, Angel Hernandez-Miramontes, Grant Huyghe, Sara Ibrahiem, Anna Jamieson, Ian Kang, Allie Kris, Erin Lawrence, Maddie Leake, Ryan Leary, Taylor Loh, Charlotte Monroe, Alexander Nguyen-Lopez, Henry O’Daffer, Cat Parish, Jaylee Recountre, Grace Rizzo, Noah Roseth, Grace Rothstein, Katie Sage, Marie Saltzmann, Stephen Shlain, Riley Shores, Mackenna Simson, Mark Teneza, Jack Weinmeister, Justin Weinzweig, Alison Wenman, Patch Whelan, Lea Zimmerman

Anthropology: Undergraduate Student Scholarship

This course-based study is a product of the University of Denver’s Spring 2022 The Social Determination of Health (ANTH 2424) class. The study aimed to understand how well a set of public health visualization tools tells the data stories about people in Colorado, and about important public health problems. For this, a team of almost sixty undergraduate students taking the class, coordinated by three graduate teaching assistants, and directed by the course instructor interviewed a total of fifty-six people from Colorado, qualitatively analyzed those interviews, and wrote reports that draw conclusions and recommendations.

Non-Metropolitan And Metropolitan Trends In Mental Health Treatment Availability In Community Health And Community Mental Health Centers, Tyrone F. Borders, Timothy Williams, Katherine Youngen, Julia Cecil

Rural & Underserved Health Research Center Publications

Key Findings

The supply of community mental health centers (CMHCs) decreased substantially from 2000 to 2019 and became nearly non-existent in non-metropolitan counties.

• The number of CMHCs in non-metropolitan counties declined from 182 to 15.
• The number of CMHCs in metropolitan counties declined from 582 to 104.

The supply of community health centers (CHCs) offering mental health services increased substantially over the same time period, or from 2000 to 2019.

• The number of CHCs in non-metropolitan counties increased from 184 to 573.
• The number of CHCs in metropolitan counties increased from 126 to 797.

Tobacco 21 Laws May Reduce Smoking And Tobacco-Related Health Disparities Among Youth In The U.S., David C. Colston, Yanmel Xie, Megan E. Patrick, Jim F. Thrasher Ph.D., Ma, Ms, Andrea R. Titus, Michael R. Elliot, David T. Levy, Nancy L. Fleischer

Faculty Publications

The goal of our study is to understand the impact of Tobacco 21 (T21) laws on youth smoking and health equity. We conducted modified Poisson regression models using 2014–2019 Monitoring the Future data to measure the impact of attending school in a county 100% covered by a T21 law versus counties with <100% T21 coverage on past 30-day smoking participation (n = 262,632), first cigarette smoking initiation (n = 189,698), and daily smoking initiation among 8th, 10th, and 12th graders (n = 214,496), separately. Additive interactions were tested between T21 coverage and sex, race/ethnicity, parental education, and college plans. T21 coverage was associated with a lower likelihood of smoking participation among 12th graders. T21 coverage was most strongly associated with a lower likelihood of smoking participation among: Hispanic and NH (Non-Hispanic) Other/Multiracial individuals; respondents with parents who had less than a college education; and respondents who were not definitely planning on attending college. T21 laws were associated with a lower likelihood of smoking participation among 12th graders. T21 policies were most impactful for individuals disproportionately impacted by tobacco, indicating T21 laws might help reduce tobacco-related health disparities.

J Mich Dent Assoc June 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this June 2022 issue, the reader will find the following original content:

• A cover feature on the MDA Public Education Campaign
• A 10-Minute EBD, "Are Neoplasms a Risk for Peri-Implantitis?"
• A feature on "The President’s Address to the House of Delegates"
• News you need: an Editorial, a Headquarters Report, Facts about MDA Peer Review, and regular department articles, Dentistry and the Law, Staff Matters, Advocacy, and component news …

The Teacher, Yoga, And The Third Eye, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

This editorial discusses a dental assistant's concern about a teacher promoting unfounded claims about fluoride and the "third eye" concept, impacting students' choices. The author explores the dubious origins of the third eye idea, referencing a yoga article, and emphasizes the importance of evidence-based approaches in dental care. Drawing from historical examples and challenges in patient beliefs, the editorial stresses the need for clinicians to blend scientific evidence, expertise, and patient preferences in a patient-centered approach. The author advocates presenting valid, reliable information in plain language to empower patients in making informed decisions and highlights the obligation to provide care …

The Racial And Ethnic Diversity Of The Family Physician Workforce In Non-Metropolitan And Metropolitan Counties, Lars E. Peterson, Zachary J. Morgan

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• The family physician workforce is becoming more racially diverse; however, non-metropolitan family physicians are not.
• Using data from over 24,000 family physicians who either registered to continue their American Board of Family Medicine (ABFM) certification or completed the graduate survey from 2017 to 2019, we found that early career family physicians are more diverse than later career physicians (66.9% vs. 72.8% White; 58.3% vs. 44.0% female) but, in both groups, the percentage of White non-metropolitan family physicians was even higher (82.7% to 90.5%).
• Minority non-metropolitan family physicians, particularly Black and Native American/Alaska Native physicians, are more …

Find Your Flow: A Menstrual Health Social Media Campaign, Sarah Hamp-Adams

Kinesiology and Public Health

In many cultures, menstruation is surrounded by silence and shame instead of being celebrated as a sign of health and vitality. Globally, challenges, including stigma surrounding menstruation, create barriers for menstruators (White, 2013; Crawford, 2014; Garg, 2015). It proves to be difficult for young menstruators to navigate menarche due to the taboos and socio-cultural restrictions surrounding menstruation (Sharma,2015). Encouraging women to have open conversations about their periods is necessary to combat these challenges.

To understand how to address the stigmas around menstruation, the researchers first conducted a literature review, revealing that education messages via the Internet, posters, storytelling, and peer …

The Relationship Between Voting Restrictions And Covid-19 Case And Mortality Rates Between Us Counties, Roman Pabayo, Erin Grinshteyn, Brian Steele, Peter Muennig, Sze Yan Liu

Department of Public Health Scholarship and Creative Works

Background

Since the 2010 election, the number of laws in the U.S. that create barriers to voting has increased dramatically. These laws may have spillover effects on population health by creating a disconnect between voter preferences and political representation, thereby limiting protective public health policies and funding. We examine whether voting restrictions are associated with county-level COVID-19 case and mortality rates.

Methods

To obtain information on restricted access to voting, we used the Cost of Voting Index (COVI), a state-level measure of barriers to voting during a U.S. election from 1996 to 2016. COVID-19 case and mortality rates were obtained …

Investigating The Efficacy & Implications Of Abstinence-Based Drug Education, Sophia Hanken

University Honors Theses

The United States has a long and complex history surrounding substance use. Drug education programs have become widely implemented in American schools and the media. Policy, rhetoric, and ideology have directly affected the curriculum of drug education programs. Drug education in the United States centers around substance abstinence. While well-intended, abstinence-based drug education is not a pragmatic solution for reducing substance-related harm or promoting health. The purpose of this thesis is to critique two of the most widely used abstinence-based drug education programs; Drug Abuse Resistance Education (D.A.R.E) and Project ALERT. These programs often emphasize the dangers of substance use …

Shared Language Builds A Foundation For Health Equity, Deborah Stamps, Ebony Caldwell, Ajda Ince

Advances in Clinical Medical Research and Healthcare Delivery

Achieving Health Equity requires developing a shared language that allows people to understand diversity in various contexts. For instance, shared language allows us to discuss diversity issues concerning gender identity, just as much as it allows us to discuss diversity issues concerning citizenship, race, or sexual attraction. This article sets out five key terms that form the foundation of a shared language: Diversity, Equity, Inclusion, Cultural Humility, and Cultural Responsiveness. The five key terms provide a solid foundation for efforts to further expand our shared language around diversity, such as a glossary defining terms like gender identity, race.

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Benign Prostatic Hyperplasia (Bph): A Comprehensive Analysis Of The Malaise And Summarizing Possible Management Options Through Phytotherapeutic Agents, Shan Sasidharan, Kumarapillai Parameswaran Srinivasakumar, Sandeep Poddar, Amiya Bhaumik, Sreemoy Kanti Das, Hareendran Nair J

Kesmas

Benign prostatic hyperplasia (BPH) is a severe illness affecting middle-aged and geriatric male patients. This disease normally occurs at the age of 40 or above and is also associated with sexual dysfunction. Alpha-blockers and 5α-reductase inhibitors are the preferred drugs practiced to treat BPH. However, invasive surgical therapy remains the gold standard for managing the condition in the case of refractory and intricate BPH conditions. Due to the fear of sexual dysfunction and the detrimental influence on their quality of life, most patients seek to avoid synthetic drugs and surgery. For this reason, several patients turn to phytotherapy and other …

Treatment Adherence And Incidence Of Coronary Heart Disease In Type 2 Diabetes Mellitus Patients, Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Kesmas

Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed …

Local Wisdom Enriching Complementary Feeding Practices During Disaster Situations In Indonesia, Astuti Astuti, Happy Hayati, Fajar Tri Waluyanti, Dessie Wanda

Kesmas

This study aimed to analyze complementary food fulfillment during disaster situations in Indonesia since it frequently experiences natural disasters and young children face unique challenges related to their feeding needs in disaster situations. This qualitative case study based on the Mount Merapi eruption and Sumedang landslide in 2021 collected data using observations, forum group discussions, and in-depth interviews; then, a thematic analysis was conducted. This study involved 17 participants, including Non-governmental Organizations (NGO) activists, health workers, residents involved in making complementary foods, and primary caregivers of children aged 6–24 months. This study found that there were five themes generated from …

Muscle Dysmorphia In Fitness Center Members: Its Affecting Factors And Impacts, Deny Yudi Fitranti, Nurmasari Widyastuti, Etika Ratna Noer, Ayu Rahadiyanti, Fillah Fithra Dieny, Rachma Purwanti, Dewi Kurnia Sandi, Widya Destikasari

Kesmas

Muscle dysmorphia (MD) has several impacts on the decline in social and health functions. This study aimed to determine the correlation between MD with eating behaviors and exercise loading among fitness center members and analyze the factors affecting it. This study used a cross-sectional design with 100 subjects chosen by a consecutive sampling method at three fitness centers in Semarang City. The subjects were all male members of an active fitness center between 17 and 45 years. The data of MD were obtained using the Drive Muscular Scale (DMS), while eating behavior data were obtained using the Eating Attitude Test-40 …