Impact of Classical Risk Factors on Subclinical Carotid Atherosclerosis Progression: Insights from a Non-Diabetic Cohort.

Background: Several markers have been proposed for the detection and progression of subclinical atherosclerosis. We aimed to analyse the impact of classical risk factors on the presence and short-term progression of subclinical carotid atherosclerosis in a non-diabetic, primary prevention cohort. Methods: This analysis included participants with completed visits at baseline and at 5-year follow-up (N = 141; 56.7% females, 43.3% males; aged 49.6 ± 4.7 years). Clinical and laboratory parameters, risk profiles, carotid artery intima-media thickness (CIMT) and plaque presence were analysed. Results: There was a significant progression in mean CIMT (0.54 ± 0.09 mm-0.62 ± 0.10 mm; p < 0.001), prevalence of carotid plaque (4.8%-17.9%; p < 0.001) and age- and sex-adjusted abnormal CIMT (52.9%-78.8%; p < 0.001) at the end of follow-up, compared to baseline. In multivariate regression analysis, among the classical risk factors, their number, metabolic syndrome and SCORE (Systematic Coronary Risk Estimation) risk only the number of risk factors showed an independent and significant impact on the occurrence of a carotid plaque (Exp(B) = 1.71; p = 0.017) and 5-year CIMT progression. Conclusions: During a short follow-up, the significant progression of subclinical atherosclerosis was confirmed. The number of risk factors predicted the occurrence of carotid plaques and CIMT progression. The high prevalence and short-term progression of subclinical carotid atherosclerosis underly the rationale for its screening in personalized cardiovascular risk stratification in asymptomatic middle-aged subjects over 50 years old, at low-to moderate cardiovascular risk, particularly with several risk factors.

Sleep characteristics and adolescent physical activity-related injuries in sports clubs, leisure time and schools.

OBJECTIVE: Sleep has been identified as an important factor in relation to physical activity-related injury (PARI) in adolescents. The study aimed to explore associations between sleep duration, sleep problems and PARI among Slovak adolescents in three different settings: sports clubs, leisure time and schools. METHODS: We analysed data from the cross-sectional Health Behaviour in School-aged Children study conducted in 2022 on a representative sample of 10 163 Slovak adolescents aged from 10.5 to 18.3 (mean age 13.4 (SD=1.5); 50.9% boys). Data were collected through self-administered online questionnaires completed by respondents in schools during the classes. Multiple logistic regression models were used to assess associations between sleep duration during schooldays and weekends, sleep problems and PARI in sports clubs, leisure time and schools. RESULTS: Adolescents with normal sleep duration during schooldays and those who reported no problems with falling asleep, waking up at night and day sleepiness had a higher chance of not being injured during PA in sports clubs, leisure time and schools compared with adolescents with short sleep duration and sleep problems. Sufficient sleep duration during the weekend increased the probability of not having PARI in leisure time and schools, with the strongest association between long sleep duration and PARI in leisure time. CONCLUSION: Good sleep quality and sufficient sleep duration were found to play a protective role in relation to PARI in adolescents. The findings suggest implementing sleep interventions in PARI prevention programmes, which must be considered a key component of adolescent PA promotion.

Adolescents' health literacy is directly associated with their physical activity but indirectly with their body composition and cardiorespiratory fitness: mediation analysis of the Slovak HBSC study data.

BACKGROUND: Health literacy is a core public health issue in relation to children and adolescents associated with multiple health behaviours and health outcomes. The aim of the study is to test the direct associations between health literacy, physical activity behaviour, health outcomes of body composition and cardiorespiratory fitness among Slovak adolescents and possible indirect effect of health literacy on health outcomes of body composition and cardiorespiratory fitness mediated by adolescents' physical activity behaviour. METHODS: Data from the Slovak Health Behaviour in School-aged Children (HBSC) study conducted in 2022 were used. For the purposes of this study, a subsample of the adolescents (n = 508; mean age = 14.50; SD = 0.82; 54.3% boys) which provided HBSC questionnaire data on health literacy, moderate-to-vigorous physical activity and vigorous physical activity and participated in body composition (InBody 230) and cardiorespiratory fitness (20-m shuttle run test) measurements. Data were analysed using linear regression analysis. RESULTS: The findings showed that higher health literacy of the adolescents was directly associated with higher frequency of physical activity represented by moderate-to-vigorous physical activity and vigorous physical activity and only with the visceral fat area in the crude model. Furthermore, there was an indirect effect of health literacy on cardiorespiratory fitness and most of the body composition variables (except the Body Mass Index) which was mediated by physical activity of the respondents. CONCLUSIONS: Health literacy is indirectly associated to body composition and cardiorespiratory fitness through higher frequency of physical activity. It seems that health literacy as cognitive and social competencies need behavioural components to be involved in the proposed causal pathway between health literacy and health outcomes. Our findings may contribute to the process of creating a framework for future health literacy interventions in adolescents.

How can an immunologist influence the occurrence of secondary infections in breast cancer? Real­life study.

BACKGROUND: Clinical manifestation of secondary immunodeficiency is responsible for the decrease in lfe quality in cancer­treated patients, which may result in administration delays, dose reductions, even in discontinuation of treatment. The main aim of presented study was to stress the possibility of influencing secondary infections with adjunctive immuno-regulatory medicament (AIRT). METHODS: The presented real-life retrospective study involved a cohort of 94 adult female patients aged from 30 to 87 years with mean age of 58.4 (SD = 11.37). The cohort was divided into two groups. One group (54 patients; 57.45 %) was treated by using the adjunctive immuno-regulatory medicaments and the other, control group (40 patients; 42.55 %), was without any immunological interventions in relation to secondary immunodeficiency. Patients in both groups were treated by standard oncotherapy. RESULTS: The results show that in patients who were sent for immunological consultation, double-digit values of mild secondary infection frequencies were revealed. When immunologists decided to add adjunctive immunomodulatory medicament, the occurrence of infection and consumption of antibiotics decreased. The decrease was significant in the second evaluated interval (6th - 12th month). CONCLUSIONS: Our results strongly advise regular or even preventive examination of cancer patients by immunologic specialist for the purpose of attenuating some negative consequences of applied anti-tumor therapy (Tab. 1, Fig. 4, Ref. 14). Text in PDF www.elis.sk Keywords: secondary infection, breast cancer, real­life study, clinical immunology, treatment.

Homocysteine Is a Marker of Increased Cardio-Cerebrovascular Disease Risk in Psoriatic Patients, but It Does Not Reflect the Effect of Biological Therapy in the Longitudinal Observation.

Background: Psoriasis is linked to atherosclerosis. Homocysteine (HCYS) has been identified as a marker of increased risk of cardio-cerebrovascular diseases (CCVD) in population. Objective: The aim of the study was to determine whether elevated HCYS serves as a marker of increased CCVD in psoriasis and whether biological therapy for long-term monitoring influences HCYS levels. Methods: Clinical data, laboratory tests, and comorbid diagnoses were summarized for the two groups of patients based on entrance HCYS levels. Patients (n = 76) were included in the follow-up gradually over a period of 5 years. Results: The psoriatic patients with normal (54%) and elevated (46%) HCYS before biological treatment did not vary in clinical data, laboratory tests, treatment, and comorbid diagnoses apart from CCVD. Elevated HCYS group showed a four-fold excess of CCVD (OR 4.2, 95%CI 1.21-4.86, p=0.024). HCYS levels in the longitudinal observation did not vary. Conclusion: An increased CCVD risk, independent of other risk factors, is present in psoriatic patients with elevated HCYS. The HCYS level was not influenced by biological therapy in longitudinal observation. Further studies are needed to explore if elevated HCYS could serve as a marker of increased CCVD in any stage of psoriasis and if it should be included in classical screening strategies.

Does G2677T Polymorphism of the MDR1 Gene Make a Difference in the Therapeutic Response to Paroxetine in Depressed Patients in a Slovakian Population?

BACKGROUND The role of multidrug resistance 1 gene (MDR1 or ABCB1) polymorphism G2677T was studied in relation to paroxetine therapeutic efficacy and its side effects, as well as its association with selected demographic and clinical characteristics of patients with depressive disorder. MATERIAL AND METHODS To evaluate therapeutic efficacy, all patients (n=61) were rated at week 0, 2, 4, and 6 using the Hamilton Rating Scale for Depression (HAMD-21). They were labelled as "responders" (a decrease in HAMD ≥50%) and "nonresponders". The frequency of the side effects of nausea and sexual dysfunction were assessed using the Utvalg for Kliniske Undersogelser rating scale. The PCR-restriction fragment length polymorphism method was used for genotyping. RESULTS A significantly enhanced therapeutic efficacy of paroxetine was observed in patients carrying at least one T allele at week 4 (GG versus GT: 0.049; GG versus GT+TT: 0.035) and week 6 (GG versus TT: 0.001; GG versus GT+TT: 0.016; GG+GT versus TT: 0.003; G versus T: 0.001). On the other hand, carriers of the T allele showed only a nonsignificant increase in HAMD-21 score reduction. In the present study, no significant association between G2677T polymorphism and side effects was detected. However, we found a marginally significant difference between GG and GT genotypes regarding family history of depressive disorder (p=0.049). CONCLUSIONS Our study provided evidence for the potential effect of MDR1 G2677T polymorphism on paroxetine therapeutic efficacy, and eventually on depressive disorder family history. Larger multicenter studies and studies across other ethnic groups are needed to elucidate the contradictory implications of G2677T polymorphism with depressive disorder and its treatment.

A randomized controlled trial to evaluate utilization of physical activity recommendations among patients of cardiovascular healthcare centres in Eastern Slovakia: study design and rationale of the AWATAR study.

BACKGROUND: Guidelines on modifiable risk factors regarding cardiological patients are poorly implemented in clinical practice perhaps due to low health literacy. Several digital tools for improving lifestyle and behavioural intervention were developed. Our primary aim is to evaluate the effectiveness of a digital exercise prescription tool on the adherence to physical activity recommendations among patients with cardiovascular diseases. METHODS: A randomized controlled trial will be realized in cooperation with Cardiovascular Health Centres in Eastern Slovakia. Patients recruited through their cardiologists, will be randomised at 1:1 ratio to the three-months' experimental condition or control condition. The experimental group will receive standard lifestyle consultation leading to individually optimized prescription of physical activity. The control group will receive standard, usual-cardio-care lifestyle counselling, also in the domain of physical activity. The digital system will be used for optimized exercise prescription. The primary outcome is a change in the patient's adherence to exercise recommendations. Data will be collected in both groups prior to consultation and after 3 months. DISCUSSION: This study protocol presents background and design of a randomized control trial to investigate the effectiveness of a digital system-provide exercise prescription tool on the adherence to physical activity recommendations. An optimized exercise prescription that better reflects patient's diagnosis, comorbidities and medication can have a significant impact on secondary prevention of cardiovascular disease. This trial can provide important evidence about the effectiveness of digital exercise guidance in everyday practice of cardiovascular healthcare. TRIAL REGISTRATION: The study was registered on 1st November, 2017 and is available online at ClinicalTrials.gov (ID: NCT03329053 ).

Associations of multidimensional health literacy with reported oral health promoting behaviour among Slovak adults: a cross-sectional study.

BACKGROUND: Modification of health literacy (HL) is an important factor for improving and maintaining oral health. The aim of the study is to examine the association of HL with oral health-promoting behaviour (OHPB) and assess possible mediating effects of HL on the impact of socioeconomic status on OHPB. METHODS: A cross-sectional questionnaire survey on the Slovak general adult population (N = 360, mean age 39) was conducted in 2014 and 2015. The association of HL (9 domains of the Health Literacy Questionnaire) and OHPB was analysed using logistic regression models adjusted for gender, age and educational level. Testing the mediating effect of HL domains between education attainment and OHPB was performed using the Sobel test. RESULTS: Women and respondents with higher education reported better OHPB. Regular tooth-brushing is associated with better HL in five domains: Feeling understood and supported by healthcare provider, Having sufficient information to manage my health, Activelymanaging my health, Social support for health, Appraisal of health information (Odds ratios (ORs) from 1.64 to 2.33, p < 0.05). Using interdental tools is in association with better HL in two domains: Feeling understood and supported by a healthcare provider and Having sufficient information to manage my health (ORs 1.71 to 1.80, p < 0.05). Respondents who visited a dentist for prevention score higher in Social support for health (OR 1.79, p < 0.05). Using a tongue scraper and single brush and reporting gums bleeding is notstatistically significantly associated with HL. Mediation was confirmed between the effect of respondents' education on using fluoride toothpaste - mediated respondent's ability to find good health information. Frequency of tooth-brushing and using interdental hygiene aids were both mediated by patient's sufficient information to manage health. CONCLUSIONS: Our results indicate HL to be an important factor related to good oral health, and HL should be considered when planning oral health interventions.

Regular energy drink consumption is associated with the risk of health and behavioural problems in adolescents.

Consumption of energy drinks has become popular and frequent among adolescents across Europe. Previous research showed that regular consumption of these drinks was associated with several health and behavioural problems. The aim of the present study was to determine the socio-demographic groups at risk for regular energy drink consumption and to explore the association of regular energy drinks consumption with health and behavioural problems and negative school experiences in adolescents. Data from the Health Behaviour in School-aged Children Study conducted in 2014 in Slovakia were analysed. We assessed socio-demographic characteristics, energy drink consumption, health and behavioural problems and negative school experiences based on self-reports from 8977 adolescents aged 11-15 years (mean age/standard deviation 13/1.33; 50.0% boys). The prevalence of regular energy drink consumption in the present sample was 20.6% (95%CI: 20%-21%). Regular energy drink consumption was more frequent among boys and older adolescents. Adolescents with a medium-level family affluence were less likely to drink energy drinks regularly. Adolescents who consumed energy drinks regularly had more health and behavioural problems and negative school experiences. CONCLUSION: Adolescents drinking energy drinks are at risk of a wide range of negative outcomes and should be specifically addressed by preventive interventions. What is Known • Energy drink consumption has become popular and frequent among adolescents across Europe. • There is growing evidence that energy drink consumption is related to negative social, emotional and health outcomes, but only a few studies have explored this relationship in adolescents. What is New • Regular energy drink consumption was more frequent among boys and adolescents reporting low family affluence and increased with age. • Adolescents reporting regular energy drink consumption were in higher risk to suffer from health and behavioural problems and negative school experiences.

The Spiritual Well-Being Scale: Psychometric Evaluation of the Shortened Version in Czech Adolescents.

The aim of this study was to psychometrically evaluate the shortened version of the Spiritual Well-Being Scale (SWBS) in Czech adolescents. A nationally representative sample of 4217 adolescents participated in the 2014 Health Behaviour in School-aged Children survey. The internal consistency of the SWBS was assessed using Cronbach's alpha (α) and Mean Inter-Item Correlation (MIIC) values. The factor structure was evaluated using principal component analyses. After adjustment, our new seven-item version of the scale supports a two-factorial model of the SWBS with satisfactory internal consistency (α = 0.814, MIIC = 0.379). This version of the SWBS is suitable for measuring spiritual well-being in a secularising environment.

Lack of parental rule-setting on eating is associated with a wide range of adolescent unhealthy eating behaviour both for boys and girls.

BACKGROUND: Unhealthy eating habits in adolescence lead to a wide variety of health problems and disorders. The aim of this study was to assess the prevalence of absence of parental rules on eating and unhealthy eating behaviour and to explore the relationships between parental rules on eating and a wide range of unhealthy eating habits of boys and girls. We also explored the association of sociodemographic characteristics such as gender, family affluence or parental education with eating related parental rules and eating habits of adolescents. METHODS: The data on 2765 adolescents aged 13-15 years (mean age: 14.4; 50.7 % boys) from the Slovak part of the Health Behaviour in School-Aged Children (HBSC) study 2014 were assessed. The associations between eating-related parental rules and unhealthy eating patterns using logistic regression were assessed using logistic regression. RESULTS: Unhealthy eating habits occurred frequently among adolescents (range: 18.0 % reported skipping breakfast during weekends vs. 75.8 % for low vegetables intake). Of all adolescents, 20.5 % reported a lack of any parental rules on eating (breakfast not mandatory, meal in front of TV allowed, no rules about sweets and soft drinks). These adolescents were more likely to eat unhealthily, i.e. to skip breakfast on weekdays (odds ratio/95 % confidence interval: 5.33/4.15-6.84) and on weekends (2.66/2.12-3.34), to report low consumption of fruits (1.63/1.30-2.04) and vegetables (1.32/1.04-1.68), and the frequent consumption of sweets (1.59/1.30-1.94), soft drinks (1.93/1.56-2.38) and energy drinks (2.15/1.72-2.70). CONCLUSIONS: Parental rule-setting on eating is associated with eating behaviours of adolescents. Further research is needed to disentangle causality in this relationship. If causal, parents may be targeted to modify the eating habits of adolescents.

The mediating effect of discrimination, social support and hopelessness on self-rated health of Roma adolescents in Slovakia.

BACKGROUND: According to the EU-MIDIS report on discrimination, Roma are the most discriminated against group in Europe. Research suggests that experiencing discrimination may itself be detrimental to health. The aim of this paper is to investigate whether discrimination, hopelessness and social support mediate differences in self-rated health (SRH) between Roma and non-Roma adolescents. METHODS: We conducted a cross-sectional study among Roma from separated and segregated settlements in the eastern part of Slovakia (N = 330; mean age = 14.50; interview) and non-Roma adolescents (N = 722; mean age = 14.86; questionnaire); only non-missing data were used for analyses (n = 759). The effect of perceived discrimination, mother and father social support, and hopelessness on SRH was analysed as crude and adjusted for ethnicity, age, gender, parental education and social desirability. Mediating effects were separately assessed using the Sobel test and structural equation modelling. RESULTS: Roma adolescents reported poorer SRH and more discrimination, mother and father social support, hopelessness and social desirability. Roma ethnicity (Odds ratio/95 %-Confidence interval 3.27/2.40-4.47), discrimination (2.66/1.82-3.88), hopelessness (1.35/1.20-1.51) and mother (0.92/0.88-0.97) and father social support (0.96/0.93 - 0.997) were statistically significant predictors of poor SRH. Perceived discrimination, social support and hopelessness mediated the ethnicity-health association, with adjustment for social support increasing its strength and the other two variables decreasing it. CONCLUSIONS: Perceived discrimination, social support and hopelessness mediate a part of the association between Roma ethnicity and poor SRH, with discrimination and hopelessness being risk factors and social support a protective factor.

Is subjective perception of negative body image among adolescents associated with bullying?

UNLABELLED: Adolescents' body image dissatisfaction has an adverse effect on peer relationships. It may lead to changes in behaviour (aggressive or passive) and consequently to bullying behaviour. Our aim was to assess the association between body image dissatisfaction and involvement in bullying and whether this differs by gender. We used data from the Slovak part of the 2010 Health Behaviour in School-aged Children study. The final sample comprised 8050 adolescents aged 11 to 15 years old (mean age 13.57), less than half of whom were boys. The association between self-reported body image and involvement in bullying was determined using multinomial logistic regression. We found a significant association between body dissatisfaction and involvement in bullying. Adolescents dissatisfied with their bodies because due to feeling overweight were more likely to become passive or reactive victims. Self-reported thinness was found to be significantly associated with bully-victims only in boys. CONCLUSION: Adolescent body dissatisfaction is strongly associated with bullying behaviour. Our findings point out the importance of incorporating at schools different types of intervention programmes supporting positive self-perceptions of adolescents and reducing bullying behaviour.

Socioeconomic characteristics of the population living in Roma settlements and their association with health and health-related behaviour.

BACKGROUND: The aim of this study was to compare socioeconomic characteristics of the Roma population living in Roma settlements with the majority population. Moreover, it was aimed to assess socioeconomic differences in health and health-related behaviour within the population living in Roma settlements. METHODS: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Roma in selected settlements were recruited by local Roma community workers. Respondents from the major population were randomly selected from a list of patients from general practitioners. Data were collected via questionnaire, anthropometric measures and analysed blood samples. Differences in socioeconomic characteristics between the population living in Roma settlements and the majority population were tested using the chi-square test. The contribution of selected socioeconomic characteristics on health and health-related behaviour of the population living in Roma settlements was assessed by logistic regression models adjusted for age and gender. RESULTS: The population living in Roma settlements is characterised by significantly lower socioeconomic standards, and the living conditions are significantly worse compared with the majority. With few exceptions, the study did not confirm any significant association between socioeconomic indicators and health and health-related behaviour within the population living in Roma settlements. CONCLUSIONS: The deteriorating effect of living in Roma settlement on health and health-related behaviour seems to be immense regardless differences in socioeconomic characteristics or living condition within the settlement population.

SCORE2 Screening Tool for Cardiovascular Risk Assessment in Psoriasis-A Case-Control Study.

Background: Psoriasis is a common, T-cell-mediated inflammatory and immune-mediated skin disease. Numerous studies confirmed that patients with psoriasis have a significant frequency of cardiovascular (CV) risk factors and CV diseases (CVDs). Risk stratification is helpful in light of the elevated risk of CVD in psoriasis patients. SCORE2 and SCORE2-OP, a new algorithm derived, calibrated and validated to predict the 10-year risk of first-onset CVD in European populations, enhances the identification of individuals at higher risk of developing CVD across Europe. Objective: Using the SCORE2 and SCORE2-OP scoring systems, the current study objective was to evaluate CV risk in Slovak psoriasis patients and the relationship between CV risk and psoriasis features in a real-world setting. Results: A case-control study was conducted involving 115 outpatients with plaque psoriasis and 66 age- and gender-matched controls with skin conditions other than psoriasis. Patients with psoriasis had significantly higher mean SCORE2 values. In the age group up to 50 years, more psoriasis patients were classified as moderate risk than controls (33.8% vs. 13.6%, p = 0.010); the high-risk category was dominated by psoriasis patients. Analysing the relationship between CV risk and selected variables, we determined, using linear regression, the dependence of the SCORE2 risk score on gender in the age group up to 50 years, on age in both age groups, on waist circumference (WC) in the category up to 50 years and on the duration and severity of psoriasis in both age groups using linear regression. For individuals older than 70, we estimated the SCORE2-OP risk score, with the average risk score being 19.5 ± 4.95. We did not observe controls with a high risk score. Psoriasis patients were more likely to be smokers and had significantly higher mean values for body mass index (BMI), WC, total cholesterol (TC), low-density lipoprotein (LDL) and systolic blood pressure (BP). Conclusions: Because CV risk factors and psoriasis are strongly related, the importance of CV risk stratification is growing, and initiating preventive lifestyle changes or therapeutic interventions in patients with psoriasis is warranted.

Subclinical Atherosclerosis Progression in Low-Risk, Middle-Aged Adults: Carotid Leads Femoral in IMT Increase but Not in Plaque Formation.

This study investigated subclinical atherosclerosis progression in low-risk, middle-aged adults (N = 141; a mean age of 49.6 ± 4.7 years) using a 5-year ultrasound follow-up. We compared the involvement of the carotid and femoral arteries. METHODS: Clinical data, risk factors, carotid/femoral intima-media thickness (IMT), and plaque presence were analyzed. RESULTS: Cardiovascular risk factors and scores increased significantly at follow-up. Both carotid and femoral mean IMT increased (p < 0.001). While plaque prevalence rose and was similar in both arteries (carotid: 4.8% to 17.9%, femoral: 3.6% to 17.7%, p < 0.001 for both), the progression of plaque burden was greater in femorals. Notably, the carotid mean IMT demonstrated a faster yearly progression rate compared to the mean femoral IMT. The prevalence of pathological nomogram-based mean IMT right or left was higher in the carotids (52.9% to 78.8%, p < 0.001) compared to femorals (23.2% to 44.7%, p < 0.001), with a significant increase at the end of follow-up in both territories. CONCLUSIONS: This study demonstrates significant subclinical atherosclerosis progression in low-risk, middle-aged adults over 5 years. Carotid arteries showed a faster progression rate of mean IMT and a higher prevalence of pathological nomogram-based mean IMT compared to the femoral arteries. However, plaque burden was similar in both territories, with greater progression in femorals. Identifying carotid and femoral atherosclerosis burden may be a valuable tool for risk stratification in this population.

Parenting by mothers from marginalized communities and the role of socioeconomic disadvantage: insights from marginalized Roma communities in Slovakia.

Background: Roma living in marginalized communities often face poor living conditions and material deprivation, which may negatively impact parenting. Our aim is to compare the parenting behavior (support, harsh discipline, and stimulation) of mothers from marginalized Roma communities and the majority population in Slovakia. We also examine the role of socioeconomic disadvantage and related worries in the differences in parenting behavior between these groups. Methods: We obtained cross-sectional data from mothers of children aged 14-18 months using the first wave of the longitudinal RomaREACH study dataset. Two groups were included in the sample: 93 mothers from MRCs and 102 mothers from the majority. We performed multiple regression and mediation analyses to assess whether the educational level of mothers, the degree of poverty, and poverty-related feelings of stress and worries explain parenting behavior differences between the groups of mothers. Results: We found significant differences in parenting, especially in harsh disciplining and stimulation. These two domains were significantly associated with maternal education, degree of poverty, and poverty-related stress and worries. The degree of poverty partially mediated stimulation differences between the two groups of mothers. Conclusion: Parenting in MRCs seems harsher and less stimulative than parenting in the Slovak majority. These differences are associated with the socioeconomic disadvantage of mothers. The degree of poverty partially explains why parenting in MRCs is less stimulative. These results may inform intervention efforts aimed at disadvantaged families.

Age and sex differences in the effectiveness of intradialytic resistance training on muscle function.

Previous research shows the beneficial effects of an intradialytic resistance training (IRT) on muscle function in haemodialysis patients. However, patients vary highly in their functional responses to IRT, may be due to effects of age and sex heterogeneities in adaptation. Therefore, the aim of this study was to investigate the degree to which the effects of IRT on the muscle function of haemodialysis patients vary by age and sex. We included 57 patients who completed a 12-week IRT (EXG) and 33 patients who received no IRT (CNG) during haemodialysis. Muscle function (MF) was assessed using dynamometry before and after a 12-week intervention and after a 12-week follow-up. After the 12-week intervention, we found a moderation effect of age in the relative (%) change (p = 0.011) and absolute (Δ) change (p = 0.027) of MF, and a moderation effect of sex in %MF (p = 0.001), but not in ΔMF (p = 0.069). Regarding patients' age, the change of MF was only significantly different between EXG and CNG patients aged 60-70 years (%MF, EXG: + 34.6%, CNG: - 20.1%, p < 0.001; ΔMF, EXG: + 44.4 N, CNG: - 22.1 N, p < 0.001). Regarding patients' sex, the change of MF was only significantly different between EXG and CNG female patients (%MF, EXG: + 23.9%, CNG: - 23.6%, p < 0.001). Age and sex did not significantly moderate changes in MF measures after 12 weeks of follow-up. We conclude that both age and sex of haemodialysis patients affect their functional response to IRT in the short term.Trial Registration: Intradialytic Resistance Training in Haemodialysis Patients (IRTHEP)-#NCT03511924, 30/04/2018, https://clinicaltrials.gov/ct2/show/NCT03511924 .

Does the influence of peers and parents on adolescents' drunkenness differ between Roma and non-Roma adolescents in Slovakia?

BACKGROUND: Roma adolescents have been shown to use less alcohol than non-Roma adolescents. This could be due to the protective influences of peers and parents. OBJECTIVE: The purpose of this study was to explore differences in the levels of peer and parental influence and their effects on drunkenness between Roma and non-Roma adolescents. DESIGN: Data were obtained in Eastern Slovakia from 330 Roma (mean age=14.50; 48.5% boys) and 722 non-Roma (mean age=14.86; 53.2% boys) primary school pupils. We analysed data on adolescent drunkenness (being drunk at least once in the past four weeks), parental monitoring (parents knowing with whom their children are when they go out) and peer influence (best friend drinking alcohol at least once a week) using logistic regression. RESULTS: Roma adolescents self-reported more parental monitoring and less peer influence when compared with their non-Roma counterparts (p<0.001). Less parental monitoring contributed to the probability of drunkenness only among girls (OR/CI: 4.17/2.00-8.69). This effect of parental monitoring was not modified by ethnicity. Peer influence affected drunkenness in both boys (OR/CI: 3.34/1.91-5.85) and girls (4.84/2.55-9.19), but there was no significant interaction of ethnicity with peer influence. CONCLUSION: While both boys and girls seem to be sensitive to peer influence, only girls appear to be sensitive to parental monitoring in regard to drunkenness. Stronger parental monitoring and weaker peer influence partially explain the lower prevalence of drunkenness among Roma adolescents, whereas the effects of these factors per level do not vary between Roma and non-Roma adolescents.