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Item A Systematic Review and Qualitative Analysis of Existing Dietary Mobile Applications for People With Chronic Kidney Disease(Elsevier, 2022) Russell, Carl R., III; Zigan, Clarisse; Wozniak, Kirsten; Soni, Kshaunish; Hill Gallant, Kathleen M.; Friedman, Allon N.; Medicine, School of MedicineObjective: The goal of this study was to systematically evaluate the quality of electronic applications (apps) available for chronic kidney disease (CKD) dietary management. Methods: The review consisted of (1) a systematic search for all mobile CKD diet apps available on the App Store and Google Play Store, (2) an evaluation to determine how well existing apps met criteria for an ideal app, and (3) a systematic literature review of publications found through Google Scholar, Mendeley, and PubMed that reviewed specific CKD diet apps and the broader field. Results: After applying systematic search criteria, 10 unique apps were identified. Ten of 14 criteria considered necessary in an ideal CKD diet app were applied to the 13 apps. Important criteria such as tailoring recommendations to CKD stage or individual dietary needs, tracking nutrient intake, allowing data to be accessible to clinicians, availability on different app platforms, and including CKD-friendly recipes were not consistently available in the apps. None of the apps used the most contemporary nutrition guidelines on which to base their recommendations. While the literature suggests there is demand for CKD diet apps, common shortcomings of available apps including barriers to usability, inclusion of erroneous information, the requirement of a high e-literacy level, user costs, lack of privacy, security, and interactive features, and the inability of caregivers or family members to use apps to assist in patient care. Conclusions: The few CKD dietary apps currently on the market for people with CKD have notable limitations in terms of content and software design. Opportunities therefore exist for improving on available CKD diet apps and thereby fulfilling an important unmet need for patients with CKD.Item Food attentional biases and adiposity: are energy intake and external eating mediators of this relationship?(2015-08) Vrany, Elizabeth; Stewart, Jesse C.; Cyders, Melissa Anne; Mosher, Catherine EstherObesity is a substantial threat to the health of over a third of adults in the United States. Some evidence suggests that food attentional bias, or the tendency to automatically direct attention toward food-related stimuli in the environment, may contribute to the development of obesity in susceptible individuals. This study hypothesized that (1) food attentional bias would be positively associated with adiposity, (2) food attentional bias would be positively associated with energy intake and external eating, and (3) energy intake and external eating would partially mediate the association between food attentional bias and adiposity. Data were collected from a sample of 120 undergraduate students. Three measures of food attentional bias were obtained: reaction time bias obtained from a visual dot-probe task and direction bias and duration bias obtained from eye tracking. Adiposity indices of body mass index (kg/m2) and body fat percent were measured using standard medical devices. Data were obtained for two mediators: 1) energy intake was assessed by web-based automated 24-hour dietary recall and 2) external eating was assessed using the External Eating Subscale of the Dutch Eating Behavior Questionnaire. Separate linear regression models examining the association between each measure of food attentional bias with each measure of adiposity (adjusted for age, sex, race/ethnicity, and subjective hunger) indicated no associations. Similarly, linear regression analyses revealed no associations between measures of food attentional bias and energy intake or external eating. Models testing for statistical mediation demonstrated that energy intake and external eating were not significant mediators. However, mediation analyses demonstrated a significant overall effect and direct effect between direction bias and BMI in a reduced sample used to test for energy intake as a mediator, suggesting the presence of an association which may not have been detected in the larger sample due to methodological issues, measurement error, or type I error. Despite the overall null results, these findings, in conjunction with previous studies on food attentional biases and adiposity, highlight the need for future investigations examining prospective associations between food attentional bias and adiposity.