"Hair is your crown and glory" - Black women's experiences of living with alopecia and the role of social support.

BACKGROUND: Alopecia is an autoimmune condition that results in hair loss, mainly from the scalp. There are three specific types of autoimmune alopecia: alopecia areata (AA; small patches of hair loss), alopecia totalis (AT; total hair loss from the scalp) and alopecia universalis (AU; total hair loss from the scalp and body). Whilst research has explored the experiences of White women living with alopecia, there is a lack of research exploring the impact of alopecia on women in the Black community. The current study aimed to explore Black women's experience of living with autoimmune types of alopecia with a focus on the cultural importance of hair within the Black community and the impact of social support. PARTICIPANTS AND PROCEDURE: Seven Black women (age range: 37-68 years; mean age: 51 years) were recruited purposively through alopecia support group organisations and social media to participate in a semi-structured interview; four participants were diagnosed with AA, two participants were diagnosed with AU, and one participant was diagnosed with AT. One-to-one interviews were conducted online, and interpretative phenomenological analysis was used to guide data collection and analysis. RESULTS: Participants discussed the significance of hair specifically within the Black community and the complex relationship between psychological wellbeing, coping and seeking support. CONCLUSIONS: This novel area, specific to Black women's psychological experience of alopecia, acknowledges the influence of cultural and ethnic differences. The findings suggest that proactive awareness from health professionals and social support groups are needed due to the nuances of Black women's alopecia experience to provide better support and to enhance the quality of life for Black women to manage their alopecia.

'Surgery is my only hope': A qualitative study exploring perceptions of living with obesity and the prospect of having bariatric surgery.

The health benefits of bariatric surgery are well documented; however, the occurrence of weight-regain after surgery, along with the development of mental health difficulties poses a question of how contemporary psychology could assist to prepare people living with obesity prior to undergoing bariatric surgery. This research explored individuals' (in the immediate pre-operative and post-operative population) attitudes, beliefs and experiences towards obesity and their journey to bariatric surgery. Seventeen adult participants (males n = 4; age range: 26-64 years) were recruited and participated in a semi-structured interview. Twelve individuals participated prior to undergoing bariatric surgery. Five individuals participated in the early post-operative period (<3 months post-surgery). People living with obesity displayed high optimism for positive outcomes, with participants hoping that bariatric surgery would be different to previous attempts at weight regulation, with there being a clear shift in the locus of control for weight management from self to healthcare professionals. Whilst this is adaptive, there was the presence of seemingly unrealistic optimism, with many pre-surgery participants not relaying the realistic possibility of post-surgery weight-regain. Despite the optimism individuals feel about bariatric surgery, participants felt that the psychological factors influencing eating behaviours are not being addressed by healthcare. These findings suggest that mindfulness, mindful eating, and self-compassion approaches should be incorporated into clinical practice to support weight regulation and adaption to physiological changes after bariatric surgery.

Does controlling for epicurean eating or the tendency to supersize food portions change the relationship between mindful eating and grazing?

The study examines the potential for Epicurean eating to offer fresh perspectives on the predictive value of mindful eating. This research seeks to ascertain whether accounting for Epicurean eating (or its antithesis, supersizing), could influence the previously identified negative relationship between mindful eating and grazing habits. In a cross-sectional study, 419 participants completed questionnaires on epicurean eating, grazing, and mindful eating. The findings suggested mindful eating and epicurean eating were significantly associated with grazing, with both variables accounting for a significant amount of variance in grazing. Further analysis of the mindful eating subscales showed that eating without distraction, eating with awareness, and hunger and satiety cues accounted for this association with grazing when epicurean eating was included. Finally, whilst eating without distraction, eating with awareness, and hunger and satiety cues were associated with grazing, preference for supersizing did not account for a significant amount of variance in the relationship with grazing. The complex interplay between grazing and mindful eating becomes more apparent when considering the influence of epicurean eating. Exploring cross-cultural factors through additional research could provide valuable insights into the dynamics of epicurean eating and grazing. Simultaneously, incorporating alternative mindful eating scales may yield a more nuanced interpretation of mindful eating. Collectively, these avenues of inquiry warrant further investigation. Limitations and future directions are discussed.

The Mediating Role of Body Acceptance in Explaining the Relation of Mindfulness, Self-Compassion and Mindful Eating to Body Image in Gay Men and Bisexual Men.

Objectives: Mindfulness and mindfulness-based constructs, such as self-compassion and mindful eating, have been positively associated with healthier eating and body related perceptions. Exploration of mindfulness and related concepts have not been investigated extensively in gay and bisexual men, a population where eating and body related concerns have been found to be widespread. Method: Participants completed an online questionnaire, assessing mindfulness, self-compassion, mindful eating, body image and body acceptance. Correlation analysis and further mediation analysis was conducted to explore the relations between these constructs within the present sample (n = 163). Results: A community sample showed a positive association of body image to mindfulness-based concepts, and negative to body non-acceptance, within the target population. Mediation analysis showed the role of body acceptance in explaining the relation between mindfulness, self-compassion and mindful eating to body image. Conclusions: Findings highlight the importance of body acceptance when considering the development of a mindfulness or compassion-based intervention to attenuate body related issues among gay and bisexual men. Preregistration: This manuscript has not been preregistered.

'I didn't feel like I was a doctor': a qualitative interview study exploring the experiences and representations of healthcare professionals' capacity to deliver compassionate care and to practice self-care during the Covid-19 pandemic.

OBJECTIVE: The increased demand on healthcare professionals (HCPs) during the Coronavirus Disease (Covid-19) pandemic reduces opportunities for HCPs to deliver compassionate care to patients and to maintain self-care. This study explored how HCPs understand and experience compassionate working practices during the Covid-19 pandemic to better support HCPs' wellbeing and to sustain quality of care. DESIGN: All nineteen participants worked as an HCP during the Covid-19 pandemic, resided in the United Kingdom (UK) and took part in individual semi-structured interviews. MAIN OUTCOME MEASURES: Using a thematic analysis approach, we developed three themes: (a) The art of compassionate care: Feeling and action, (b) The impact of Covid-19 on compassionate care and (c) Suffering during Covid-19: The importance of self-compassion and self-care. RESULTS: Overall, the analysis illustrated the strong and negative impact that Covid-19 had on the ability to deliver compassionate care, resulting in moral injury and psychological and behavioural difficulties for HCPs, particularly in terms of self-care. CONCLUSIONS: This research demonstrates an imperative need for organisations to better support HCPs' health and wellbeing, through a self-care system that promotes self-compassionate and self-care practices.

The psychological implications and health risks of cystic fibrosis pre- and post- CFTR modulator therapy.

OBJECTIVES: Cystic Fibrosis (CF) care is entering a period of personalised medicine with the emergence of CF transmembrane conductance regulator (CFTR) modulator therapies. Anecdotally individuals are reporting life-changing effects of modulator therapies, proposing an important area of study. METHODS: Twenty adult participants (males: 8, age range: 22-51 years, average FEV1: 53.45%) were recruited via social media to participate in a semi-structured interview; 17 participants were currently taking Elexacaftor/Tezacaftor/Ivacaftor (Kaftrio). RESULTS: An appreciation of a "normal life" post-modulator therapy is paramount, with improvements in symptoms and quality-of-life bringing a more urgent imperative for the provision of effective support to encourage positive health and lifestyle choices. DISCUSSION: In this new era of CF care, there remains many challenges present for the CF community, with participants suggesting that proactive psychological support is required along with proactive awareness regarding health risk behaviours for the current and future CF generations.

Exploring the association between self-compassion, mindfulness and mindful eating with eating behaviours amongst patients with obesity.

Background: People who have obesity often experience problematic eating behaviours, contributing towards their excessive weight gain. Aims: Understanding problematic eating behaviours and their association to self-compassion, mindfulness and mindful eating is important for the development of future interventions that improve weight-loss and weight-regulation. Methods: One hundred and one participants attending their first session of a 6-session dietetic programme within a Tier 3 medical weight management service in the West Midlands, UK were recruited to complete questionnaires on self-compassion, mindfulness, mindful eating and eating behaviours, such as, emotional, restrained, external, fat and sugar consumption and grazing. Results: The findings suggested all three constructs, self-compassion, mindfulness and mindful eating were significantly and negatively associated with grazing and emotional eating, but mindful eating was the only construct that also displayed a significant and negative association with other eating behaviours that are often barriers to successful weight regulation, such as external eating and fat consumption. Further investigation suggested mindful eating had an indirect effect on fat consumption and grazing via external eating. Conclusion: Whilst, self-compassion, mindfulness and mindful eating displayed a negative relationship with grazing and emotional eating, mindful eating also displayed a negative relationship with fat consumption and external eating. Possible explanations and directions for future work are discussed with an emphasis on the need for more empirical work.

The Challenges of Eating Well for People Living with Cystic Fibrosis: an Interview Study Exploring the Use of Mindful Eating Approaches and Behaviours to Support Optimal Nutritional Status.

BACKGROUND: Nutritional status and weight are closely linked to lung function and health status in cystic fibrosis (CF). The investigation of eating behaviours has shown mindfulness practices to be useful in modifying eating behaviours, particularly with obesity; to date, no research specifically explores how these concepts may be utilised within a CF population who face specific challenges in eating behaviours. METHOD: Adult patients (n = 20, M = 8, age range 21-62 years) were recruited from a UK CF regional centre to take part in qualitative semi-structured interviews. Experiences of eating behaviours focusing on the use of mindful (or mindless) eating as barriers and enablers to achieving and maintaining optimal nutritional status were explored. Data were analysed using thematic analysis with a contextualist approach to understand how participants experienced eating behaviours within the context of health and weight status. RESULTS: Participants engaged readily in discussions of eating behaviour describing active self-regulation of food eaten and calorie intake. Participants who struggled to maintain weight employed strategies to increase calorie intake such as distraction and multitasking while eating. Most participants reported no pleasure in food, describing eating as another treatment to endure. Confusion existed around how to eat healthily for CF alongside co-morbid health conditions including diabetes, cholesterol and heart disease. CONCLUSION: Participants were highly aware of their eating behaviours, engaging in intentional and deliberate preparations, which could be described as mindful, for making eating a more automatic or mindless activity. Modifications to usual mindful eating interventions are needed to support people with CF.

Exploring the Experiences of Gay Men with Regards to Eating, Exercise, and Mindfulness-Based Concepts.

Existing research investigating gay men's eating behavior has focused on stereotypes and body image, rather than to understand why disordered eating is prevalent in gay men. The current study adopted a qualitative approach and employed interview methodology to explore gay men's attitudes, feelings and experiences of their eating behavior, and the potential link to mindfulness and self-compassion. Twenty gay men aged from 21 to 51 years were interviewed using an interview schedule with open-ended questions. Three main themes emerged from the transcript data sets: "Lean to be Seen," "Sod it 'I'll Have a Pizza," and "You Can't Sit with Us." The first theme was developed following responses that participant's eating behavior and exercise engagement were influenced by their perceived attractiveness by the gay community. All participants spoke of achieving or maintaining a slim or muscular body type and adopted their eating behavior or exercise regime to reach corresponding goals. The second theme relates to the lack of acceptance felt from the gay community upon not conforming to the bodily expectations set out by the community. The third theme relates to the conflicts in participants' attitudes around how exercising and eating healthily would improve their mental well-being; but that they also would give preference to calorie dense foods to reduce stress. These reflections are observed through a context of self-kindness and self-compassion and are seen to be related to increased feelings of self-criticism and body dissatisfaction. The limitations and implication for this research and suggestions for future research are discussed.

Healthcare professionals' perceptions of risky health behaviours: A qualitative evaluation of preventative measures for populations with cystic fibrosis.

OBJECTIVES: Previous qualitative data highlight why individuals with Cystic Fibrosis may be motivated to initiate in risky behaviours (smoking, excessive alcohol consumption and illicit drug use). To inform interventions aimed to reduce the occurrence of risky behaviours, we investigated how Cystic Fibrosis health care professionals perceive the issue of risky behaviours, providing insight into what interventions could work in practice. METHODS: This research had two phases of data collection. In phase one, nine Cystic Fibrosis Specialist Nurses participated in a semi-structured interview via telephone. In phase two, health care professionals, who work within a Cystic Fibrosis multi-disciplinary team, participated in a dissemination meeting. RESULTS: Cystic Fibrosis health care professionals identified that although risky behaviours were a major concern within the Cystic Fibrosis population, education regarding the adverse health effects of such behaviours is not embedded within practice, with the issue of risky behaviours being addressed on an individualised basis. Health care professionals suggested that they would welcome interventions, and that such interventions first need to raise health care professionals awareness and knowledge regarding risky behaviours before focusing upon patients. DISCUSSION: Within this research, health care professionals provided practical insight into the need for policy change for the prevention and reduction of risky behaviours by informing current advice and practice.

Exploring the Environmental Manifestation of Types of Music on Reinforcing Mindfulness and Concurrent Calorie Intake.

BACKGROUND: The role of music on energy intake is conflicting, and recent research has suggested a positive association between classical music listening and mindfulness. OBJECTIVE: The purpose of the present study was to investigate the effect of music, specifically classical music on state mindfulness and calorie intake of energy-dense foods. METHOD: One hundred participants were randomly assigned to either a classical, popular or no music condition, and were served a variety of sweet (i.e., chocolate and cookies) and savoury (i.e., crisps) energy-dense foods. Results: The results found no significant differences in state mindfulness, overall calorie intake, or intake of sweet foods across the three conditions. However, participants in the classical music condition did consume significantly less savoury food than those in the no music condition. CONCLUSION: Playing classical music may be beneficial in reducing intake of savoury foods, but not through the association to changes in state mindfulness. Future research should explore extended sessions of music listening on state mindfulness and other experiential evaluations of mindfulness to conclude on the direct and indirect effects of music on sweet and savoury foods.

Exploring the Role of Self-Kindness in Making Healthier Eating Choices: A Preliminary Study.

BACKGROUND: Food selection is an important factor in the prevalence of obesity, and regularly choosing nutrient-poor high-energy foods can have negative health consequences. The present study tested whether the use of mindful construal diaries (MCD) combined with self-kindness could promote healthier eating choices. METHOD: Ninety participants were randomly assigned to either a self-kindness to the mind condition or self-kindness to the mind and body condition, and were served M&Ms and grapes as an unhealthy and healthy option, respectively. RESULTS: The results suggested that a difference in consumption was found between the two conditions, with participants in the self-kindness to the mind condition consuming significantly more grapes than those in the self-kindness to the mind and body condition. However, this difference was restricted to those who are usually low consumers of fruit and vegetable. CONCLUSION: The effect of self-kindness towards promoting heathier eating whilst considering the body thus appears to require further investigation. Limitations and recommendations for future research are discussed.

How does mindful eating without non-judgement, mindfulness and self-compassion relate to motivations to eat palatable foods in a student population?

BACKGROUND: Previous research acknowledges the impact mindfulness, mindful eating and self-compassion has upon weight regulation and motives to eat palatable foods, with mindful eating showing an increased impact of eating behaviours. Some research has identified that present moment awareness should be the primary focus of mindful eating. AIM: This research aimed to explore the relationship between mindfulness, self-compassion and mindful eating with motivations to eat palatable food. METHODS: A cross-sectional study was conducted to investigate this relationship among university students (n = 211), utilizing a newly developed mindful eating scale primarily focusing on present moment awareness. RESULTS: Results indicated significant negative correlations between both self-compassion and mindful eating and motives to eat palatable foods. Mindful eating positively correlated with self-compassion and other mindfulness elements that are suggesting indirect acceptance measurements of the mindful eating scale. CONCLUSION: Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work. In addition, suggestions are provided regarding the reinterpretation of elements that are investigated and explored in eating literature.

An exploration into experiences and attitudes regarding risky health behaviours in an adult cystic fibrosis population.

Health risk behaviours (HRBs) are prevalent within the cystic fibrosis (CF) population, and there is a lack of research around what influences their engagement. This research explored beliefs associated with HRBs within an adult CF population using qualitative semi-structured interviews. Participants' beliefs towards their CF and its life impact were investigated to explore reasons for engaging in HRB. A desire for normalcy was evident, often accompanied by engagement in everyday HRB as a method of minimising the illness identity. Evidence of a life-orientated illness perspective was also prevalent, with participants engaging in some risky behaviours for fun. Overall, there was a lack of knowledge on the consequences of HRB, with many participants reporting not being informed of these by clinicians. This research highlights a dilemma between clinical recommendations and personal life strategies undertaken by individuals with CF to support their identity.

An Exploration Into Knowledge, Attitudes, and Beliefs Towards Risky Health Behaviours in a Paediatric Cystic Fibrosis Population.

Risky behaviours are prevalent within the cystic fibrosis (CF) population; however, there is a lack of research which has investigated risky behaviour engagement among adolescents with CF, with reasons for initiation currently being unknown, as no qualitative studies have been conducted. This research therefore examines knowledge, attitudes, and beliefs towards risky behaviours at an age commonly associated with initiation. Ten paediatric participants were recruited. Thematic analysis illustrated several psychological factors associated with risky behaviours. A desire for normalcy was evident, with this been associated with a desire to engage in normalised risky behaviours. Evidence of a life-orientated illness perspective was also prevalent, with participants believing that many individuals engage in risky behaviours for fun. Overall, there was a reported lack of knowledge on consequences of risky behaviours, with many participants not being informed of these by health care professionals (HCPs). This research provides insight into an area of CF paediatric care which could be improved on, with the provision of awareness regarding risky behaviours not being embedded within paediatric CF care. Consequently, this research demonstrates the need for interventions to be integrated into paediatric CF care for the prevention and reduction of risky behaviours.

Mindfulness, self-compassion, and mindful eating in relation to fat and sugar consumption: an exploratory investigation.

While much research has focused on overeating when exploring constructs of mindfulness, mindful eating, and self-compassion, there is limited research on the specific relationship of these constructs with consumption of energy-dense foods that have a large impact on weight regulation. In a cross-sectional study, university students (n = 546) were recruited to explore the relationship between mindfulness, mindful eating, self-compassion, and fat and/or sugar consumption. Results indicated that all constructs were negatively related to fat and sugar consumption, but self-compassion did not do so in a univariate fashion. When investigating subscales, negative aspects such as isolation and over-identification show a significant positive relationship to fat and sugar consumption. Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work. Level of Evidence: Level V, cross-sectional descriptive study.

How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population?

Contemporary research investigating obesity has focused on grazing (i.e. an uncontrolled and repetitive consumption of small amounts of food). Meanwhile, constructs such as mindfulness, mindful eating and self-compassion have received much attention in assisting individuals with eating behaviours and weight regulation. The association between those constructs and grazing, however, has not been explored. In a cross-sectional study, university students (n = 261) were recruited to explore the relationship of mindfulness, mindful eating and self-compassion with current weight and grazing. Results indicated that all constructs were negatively related to grazing, but only mindful eating related negatively to current weight. In addition, mindful eating mediated the relationship between grazing and current weight. Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work.