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This study investigated fatigue, sleep quality, mental health and physical activity in paramedic shiftworkers. Although limited, previous studies have established high fatigue levels and poor health in this sector from shiftwork rostering and occupational demands. A modified version of the Standard Shiftwork Index was completed by 342 paramedics (243 male and 98 females). Single sample t tests found significantly higher levels of fatigue, depression, anxiety, and stress, and significantly poorer sleep quality than reference samples. Paramedics also reported less physical activity than community samples. Depression and sleep quality explained the greatest amount of variance in fatigue scores, followed by level of exercise. No differences were detected in levels of depression or fatigue on the basis of gender. The findings suggest that ambulance paramedic shiftworkers are at particular risk for increased levels of fatigue and depression (regardless of age or gender) and poor quality sleep. Organisational intervention was suggested.

Positive body image plays a vital role in fostering healthy psychological and physical development in girls. Conversely, poor body image has a wide range of negative consequences. In this chapter we provide a general back ground about the nature of body image in girls and the consequences of poor body image. We describe epidemiological research and risk factors related to body image and body disturbance in girls. Models for the development of body image disturbance are also described. Finally, prospective research examining the negative consequences of body dissatisfaction and appearance concerns, particularly related to dieting, disordered eating, depression, and self-esteem, are reviewed. OVERVIEW OF BODY IMAGE DISTURBANCE Range of Body Image DisturbanceBody image is generally considered a multidimensional construct, cov ering cognitive, affective, and behavioral dimensions (Thompson, Heinberg, 47

Objective: Residential centres for the treatment of eating disorders are becoming increasingly common, yet data following residential care are scarce. We reviewed outcomes of residential treatment for eating disorders across all diagnoses, age groups and genders. A secondary goal was to identify treatment elements and patient characteristics that predicted a greater response to treatment.Method: Peer-reviewed studies published in the last 20 years were identified through a systematic search of the electronic databases PubMed and Cochrane Library.Results: Nineteen open-label studies reporting changes between admission and discharge were included in this review. Most took an eclectic approach to treatment, integrating elements from several different techniques without a unifying theoretical framework. All studies reported improvements in most outcomes at discharge, including changes in eating disorders psychopathology, weight, depression, anxiety and quality of life. Eight studies reported outcomes at some interval after discharge, with largely positive outcomes. Conclusions: While residential care was associated with consistently positive outcomes, the variability in program characteristics and poor quality of research designs prevent firm conclusions from being drawn about their efficacy. Future research should include controlled studies that evaluate specific theoretical approaches and program elements, include long-term follow-up, and compare residential care to other treatment settings. K E Y W O R D Seating disorder, outcome, residential, treatment

Background Eating disorders (EDs) are potentially severe, complex, and life-threatening illnesses. The mortality rate of EDs is significantly elevated compared to other psychiatric conditions, primarily due to medical complications and suicide. The current rapid review aimed to summarise the literature and identify gaps in knowledge relating to any psychiatric and medical comorbidities of eating disorders. Methods This paper forms part of a rapid review) series scoping the evidence base for the field of EDs, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021–2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for English-language studies focused on the psychiatric and medical comorbidities of EDs, published between 2009 and 2021. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised. Results A total of 202 studies were included in this review, with 58% pertaining to psychiatric comorbidities and 42% to medical comorbidities. For EDs in general, the most prevalent psychiatric comorbidities were anxiety (up to 62%), mood (up to 54%) and substance use and post-traumatic stress disorders (similar comorbidity rates up to 27%). The review also noted associations between specific EDs and non-suicidal self-injury, personality disorders, and neurodevelopmental disorders. EDs were complicated by medical comorbidities across the neuroendocrine, skeletal, nutritional, gastrointestinal, dental, and reproductive systems. Medical comorbidities can precede, occur alongside or emerge as a complication of the ED. Conclusions This review provides a thorough overview of the comorbid psychiatric and medical conditions co-occurring with EDs. High psychiatric and medical comorbidity rates were observed in people with EDs, with comorbidities contributing to increased ED symptom severity, maintenance of some ED behaviours, and poorer functioning as well as treatment outcomes. Early identification and management of psychiatric and medical comorbidities in people with an ED may improve response to treatment and overall outcomes.