Influenza vaccine uptake in juvenile idiopathic arthritis: a multi-centre cross-sectional study.

While most countries provide safe and effective influenza vaccines for at-risk groups, influenza vaccine coverage among children with rheumatic diseases remains uncertain. This study investigated influenza vaccination rates in children with juvenile idiopathic arthritis (JIA) during the 2019-2020 season and assessed the knowledge and attitudes of caregivers of children with JIA regarding influenza vaccination. The secondary aims were to identify barriers to vaccination and explore strategies to improve vaccination rates. A multi-centre, cross-sectional anonymous survey was conducted in 7 countries during the 2019-2020 influenza season to assess the uptake history of influenza vaccination. Among 287 participants, only 87 (30%) children with JIA received the influenza vaccine during the 2019-2020 season. Children who were more likely to be vaccinated were those with systemic juvenile idiopathic arthritis (sJIA), a history of previous vaccination and those aware of the vaccination recommendations. Conversely, children who previously experienced adverse vaccine-related events reported the lowest uptake. The primary reason for non-vaccination was lack of awareness about the necessity of influenza vaccination.  Conclusion: Despite variations among countries, the uptake of influenza vaccines remains low in children with JIA. Improving awareness among families about the importance of influenza vaccination may increase vaccination rates in children with rheumatic diseases. What is Known: • Rheumatic children are at increased risk for influenza infection due to immunosuppressive therapy and immune dysregulation. • Influenza vaccine is formally recommended to children with rheumatic diseases. What is New: • This multicentre study showed that influenza vaccine uptake rates remain suboptimal among children with Juvenile Idiopathic Arthritis despite formal recommendations. • Factors like previous experience with vaccination and information provided by medical professionals via different ways play essential roles in increasing vaccination rates and can contribute to improved health outcomes for these vulnerable children.

Alterations in immunophenotype and metabolic profile of mononuclear cells during follow up in children with multisystem inflammatory syndrome (MIS-C).

Introduction: Although children seem to be less susceptible to COVID-19, some of them develop a rare but serious hyperinflammatory condition called multisystem inflammatory syndrome in children (MIS-C). While several studies describe the clinical conditions of acute MIS-C, the status of convalescent patients in the months after acute MIS-C is still unclear, especially the question of persistence of changes in the specific subpopulations of immune cells in the convalescent phase of the disease. Methods: We therefore analyzed peripheral blood of 14 children with MIS-C at the onset of the disease (acute phase) and 2 to 6 months after disease onset (post-acute convalescent phase) for lymphocyte subsets and antigen-presenting cell (APC) phenotype. The results were compared with six healthy age-matched controls. Results: All major lymphocyte populations (B cells, CD4 + and CD8+ T cells, and NK cells) were decreased in the acute phase and normalized in the convalescent phase. T cell activation was increased in the acute phase, followed by an increased proportion of γ/δ-double-negative T cells (γ/δ DN Ts) in the convalescent phase. B cell differentiation was impaired in the acute phase with a decreased proportion of CD21 expressing, activated/memory, and class-switched memory B cells, which normalized in the convalescent phase. The proportion of plasmacytoid dendritic cells, conventional type 2 dendritic cells, and classical monocytes were decreased, while the proportion of conventional type 1 dendritic cells was increased in the acute phase. Importantly the population of plasmacytoid dendritic cells remained decreased in the convalescent phase, while other APC populations normalized. Immunometabolic analysis of peripheral blood mononuclear cells (PBMCs) in the convalescent MIS-C showed comparable mitochondrial respiration and glycolysis rates to healthy controls. Conclusions: While both immunophenotyping and immunometabolic analyzes showed that immune cells in the convalescent MIS-C phase normalized in many parameters, we found lower percentage of plasmablasts, lower expression of T cell co-receptors (CD3, CD4, and CD8), an increased percentage of γ/δ DN Ts and increased metabolic activity of CD3/CD28-stimulated T cells. Overall, the results suggest that inflammation persists for months after the onset of MIS-C, with significant alterations in some immune system parameters, which may also impair immune defense against viral infections.

Emotions and Food Consumption: Emotional Eating Behavior in a European Population.

Emotion can reflect in the perception of food consumption. An increase in food intake during emotional and psychological conditions may have a negative impact on human health. The aim of this cross-sectional study was to determine the associations between food consumption, emotional eating behavior, and emotional conditions such as stress, depression, loneliness, boredom eating, maintaining vigilance and alertness, and emotional food consolation. We used a Motivations for Food Choices Questionnaire (Eating Motivations, EATMOT) to determine the emotional aspects of food consumption in 9052 respondents living in 12 European countries between October 2017 and March 2018. Ordinal linear regression was used to identify the associations between the emotional eating behavior and emotional conditions such as stress, depression, loneliness, emotional consolation, and reasons to improve physical and psychological conditions. The regression models confirmed the associations between food consumption, emotional conditions, and emotional eating behavior. Associations were found between the emotional eating behavior and stress (odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.07-1.60, p = 0.010), depressive mood (OR = 1.41, 95% CI = 1.40-1.43, p < 0.001), loneliness (OR = 1.60, 95% CI = 1.58-1.62, p < 0.001), boredom (OR = 1.37, 95% CI = 1.36-1.39, p < 0.001), and emotional consolation (OR = 1.55, 95% CI = 1.54-1.57, p < 0.001). Emotional eating was associated with an effort to improve physical and psychological conditions, such as controlling body weight (OR = 1.11, 95% CI = 1.10-1.12, p < 0.001), keeping awake and alert (OR = 1.19, 95% CI = 1.19-1.20, p < 0.001) and consumption to feel good (OR = 1.22, 95% CI = 1.21-1.22, p < 0.001). In conclusion, emotions might provoke emotional eating behavior. The appropriate way to handle stress, depression, or other emotional states is important in conditions of being emotionally overwhelmed. The public should be educated on how to handle different emotional states. The focus should be moved somehow from emotional eating and the consumption of unhealthy food to healthy lifestyle practices, including regular exercise and healthy eating habits. Thus, it is necessary to halt these negative health effects on human health through public health programs.

Link between emotional and external eating behaviors, peripheral neuropeptide Y, and ß-hydroxybutyrate in participants with obesity on 12-week ketogenic diet.

Objective: Understanding the impact of stress on emotional and external eating behaviors and the psychological and the associated metabolic factors can help in designing subsequent interventions to protect health. In particular, psychological trait-like construct related to eating has been shown to be an important target for intervention. Methods and measures: This study aimed to investigate the biochemical variables associated with a decrease in emotional and external eating behaviors due to 12-week ketogenic diet (12KD) in 35 adult participants (12 males) with obesity. Results: Absolute changes in emotional and external eating were independent of changes in body mass, nutritional intake, and Δ cortisol, but were predicted with increases in serum ß-hydroxybutyrate (BHB) and decreases in serum peripheral neuropeptide Y (pNPY) (all p's < 0.050). Decrease in pNPY was also associated with an increase in BHB but was independent of anthropometrical changes, Δ fasting glucose, and Δ insulin. Conclusion: The reductions in emotional and external eating behaviors in participants with obesity were uniquely predicted by an increase in BHB and a decrease in pNPY after 12KD. In ketosis, emotional and external eating dropped independently of body mass change. Change in pNPY predicted changes in emotional and external eating. The role of BHB in modulating eating behavior should be further explored.

Binge Eating in a Slovenian Population-based Sample of Adults.

Introduction: Binge eating is the most common form of disordered eating associated with obesity, reduced quality of life, and medical and psychological comorbidities. It therefore affects the well-being of individuals. This underscores the fact that it is a serious public health problem. The study aimed to investigate binge eating and anxiety across gender, age and body mass index in a large population sample of adults in Slovenia. Methods: A total of 3,310 adult volunteers participated in this cross-sectional study. Questionnaires, including a binge eating and anxiety scale and an eating behaviour questionnaire, were completed by 1,487 subjects (90.9% female, ages 18 to 69). Results: The frequency of reported binge eating was 29.9%, with 9.8% of participants reporting severe binge eating, and the presence of overweight and obesity was high (41.8%). BMI was associated with this problematic eating, and explained 5.4% of the variation in binge eating. Importantly, anxiety was the most important factor related to binge eating, with younger participants and women reporting significantly more anxiety. Conclusion: The high presence of binge eating, obesity and anxiety in the Slovenian population-based sample is worrying. Anxiety is clearly an important factor in understanding the relationship between negative affect and binge eating, as it accounts for a greater proportion of the variance in binge eating symptoms than BMI. Particularly concerning was the fact that the youngest participants showed the greatest anxiety. Targeting anxious adolescents and females is important from a health perspective because it can impact the physical and mental health of the population in the long term.

High incidence of multisystem inflammatory syndrome and other autoimmune diseases after SARS-CoV-2 infection compared to COVID-19 vaccination in children and adolescents in south central Europe.

OBJECTIVES: To estimate the incidence and describe the spectrum of inflammatory and autoimmune diseases linked to SARS-CoV-2 infection and COVID-19 vaccination in children from two neighbouring south central European countries. METHODS: We performed a multi-centre prospective cohort study of children under 18 years diagnosed with inflammatory/autoimmune diseases linked to SARS-CoV-2 infection or COVID-19 vaccination, who were admitted to the paediatric tertiary care hospitals in Slovenia and Friuli Venezia Giulia, Italy, from January 1, 2020, to December 31, 2021. Disease incidence was calculated based on laboratory-confirmed cases only. RESULTS: Inflammatory and autoimmune diseases linked to SARS-CoV-2 were diagnosed in 192 children (127 laboratory-confirmed), of whom 112 had multisystem inflammatory syndrome (MIS-C), followed by vasculitis, neurological and cardiac diseases. Calculated risk of MIS-C was 1 in 860 children after SARS-CoV-2 infection and cumulative incidence of MIS-C was 18.3/100,000 of all children. Fifteen children had severe COVID-19. Two patients with MIS-C and a patient with myositis presented after COVID-19 vaccination. All 3 had at presentation also a serologically proven recent SARS-CoV-2 infection. After MIS-C, nine patients were vaccinated against COVID-19 and 25 patients had a SARS-CoV-2 reinfection, without recurrence of MIS-C. CONCLUSIONS: Autoimmune diseases following SARS-CoV-2 infection in children were 8.5 times as common as severe COVID-19. MIS-C was the most common manifestation and its incidence in this predominantly white population was higher than previously reported. MIS-C does not seem to recur after SARS-CoV-2 reinfection or COVID-19 vaccination. Autoimmune diseases were much more common after SARS-CoV-2 infection than after COVID-19 vaccination.

Edible Insects: Perceptions of Marketing, Economic, and Social Aspects among Citizens of Different Countries.

Because edible insects (EI) have been, in recent years, recommended as a nutritious animal protein food with enormous environmental advantages over other sources of animal protein for human consumption, studies aimed at investigating the consumer perspective have become more prominent. Hence, this study intended to examine the perceptions of participants from different countries about the commercialization and economic and social impacts of edible insects. The study was made using a questionnaire survey, and data were collected in Brazil, Croatia, Greece, Latvia, Lebanon, Lithuania, Mexico, Poland, Portugal, Romania, Serbia, Slovenia, Spain, and Turkey. The final number of received answers was 7222 participants. For the treatment of the results, different statistical techniques were used: factor analysis, internal reliability by Cronbach's alpha, cluster analysis, ANOVA to test differences between groups, and Chi-square tests. The results obtained confirmed the validity of the scale, constituted by 12 out of the 14 items initially considered, distributed by 4 factors: the first related to the economic impact of EIs, the second related to the motivation for consumption of EIs, the third related to the places of purchase of EIs, and the fourth corresponding to a question presented to the participants as a false statement. A cluster analysis allowed identifying three clusters, with significant differences between them according to all the sociodemographic variables tested. Also, it was found that the participants expressed an exceptionally high level of agreement with aspects such as the difficulty in finding EIs on sale, knowledge acting as a strong motivator for EI consumption, and the role of personalities and influencers in increasing the will to consume EIs. Finally, practically all sociodemographic variables were found to be significantly associated with perceptions (country, sex, education, living environment, and income), but not age. In conclusion, the perceptions about EI commercialization were investigated and revealed differences among samples originating from different countries. Moreover, the sociodemographic characteristics of the participants were found to be strongly associated with their perceptions.

Relationship between nursing students' attitudes toward nursing profession and online learning satisfaction during COVID-19 lockdown.

Formal education is crucial for the development of nurses' professional identity and can play a decisive role in attracting students to the nursing profession. This is even more important during a public health emergency such as the COVID-19 pandemic. This study aimed to investigate nursing students' attitudes and feelings toward their future profession and academic studies during the first COVID-19 lockdown. A cross-sectional, descriptive study was conducted on 361 nursing students. The data were collected through the Students' attitudes toward the nursing profession during the COVID-19 outbreak scale, and the Satisfaction with online learning scale. Nursing students expressed higher levels of commitment and dedication to their profession compared to perceived job security. They were generally satisfied with their distance learning experience in terms of accessibility of study materials, adaptation of lectures and quality of communication with academic staff. However, students perceived the ICT-supported distance learning as moderately effective. Students' satisfaction with online learning was positively related to their perceived professional commitment. In times of health crisis, faculties should consider students' perceived quality of nursing education and attitudes toward future profession to promote appropriate professional identity.

The effect of COVID-19 lockdown on mental health, gut microbiota composition and serum cortisol levels.

The aim of this study was to assess changes in mental health, gut microbiota composition, and stress marker serum cortisol due to COVID-19 lockdown in asymptomatic individuals. Healthy adults participated in anthropometric measurements, blood and stool sample collection pre-lockdown and post-lockdown (n = 38, 63.2% females), lifestyle and psychological questionnaires were included in pre-lockdown measurement and lockdown survey (n = 46, 67.4% females). Subjects reported significantly higher body dissatisfaction (p = 0.007) and anxiety (p = 0.002), and significantly lower positive affect (p = 0.001) during lockdown compared with pre-lockdown. According to perceived stress, 51.6% of females and 20% of males experienced moderate to high stress. This was reflected in serum cortisol levels that significantly increased only in females (p = 0.006) post-lockdown and correlated with perceived stress (p = 0.037) and anxiety (p = 0.031). In addition to psychological measures, changes in gut microbiota composition were observed. Gut microbial alpha diversity significantly decreased (p = 0.033), whereas relative abundance of Proteobacteria significantly increased (p = 0.043) post-lockdown. Depression during lockdown was moderately positively correlated with changes in Bacteroidetes abundance (p = 0.015) and negatively with changes in Firmicutes abundance (p = 0.008). Alistipes abundance post-lockdown was moderately positively correlated with anxiety (p = 0.004) and negative affect (p = 0.005) during lockdown. Despite a small sample size and not being able to perform objective measurements during lockdown, the results confirm the effect of lockdown on mental health and gut microbiota composition that could have a great impact on our health (ClinicalTrials identifier: NCT04347213).

Determinants of economic motivations for food choice: insights for the understanding of consumer behaviour.

Food consumption involves several dimensions, being some of them directly associated with the consumers' characteristics. The interrelationships between these domains impact consumer behaviour for food choice and the consequent decisions for food consumption. In these frameworks, economic motivations are determinant. On the other hand, the scientific literature highlights that the economic-based stimuli to choose food is still underexplored. In this perspective, the objective of this study was to assess the main sociodemographic and anthropometric determinants of the economic motivations for food choice. For that, a questionnaire survey was carried out involving 11,919 respondents from 16 countries. A validated questionnaire was used, translated into the native languages in all participating countries, using a back-translation process. First, the information obtained was assessed through factor analysis to reduce the number of variables associated with the economic motivations and to identify indexes. After, and considering the indexes obtained as dependent variables, a classification and regression tree analysis was performed. As main insights, it is highlighted that the main determinants of the economic motivations are country of residence, age, gender, civil state, professional activity, educational level, living environment, responsibility for buying food, weight, height, body mass index, healthy diets and physical exercise practices. Additionally, the results also reveal that economic motivations may be associated with two indexes, one related to convenience attitudes and the other to quality concerns. Finally, the younger persons and the women are the social groups more concerned with healthy diets and food quality. In conclusion, this work confirmed that food choice is to a high extent influenced by several sociodemographic and behavioural factors.

Vaccinology in pediatric rheumatology: Past, present and future.

With the introduction of biological disease-modifying antirheumatic drugs (bDMARDs), the treatment of pediatric patients with autoimmune/inflammatory rheumatic diseases (pedAIIRD) has advanced from the "Stone Age" to modern times, resulting in much better clinical outcomes. However, everything comes with a price, and use of new bDMARDs has resulted in an increased risk of infections. Therefore, preventing infections in pedAIIRD patients is one of the top priorities. The most effective preventive measure against infection is vaccination. The first study on humoral immunity after vaccination in pediatric rheumatology was published in 1974 and on safety in 1993. For many years, data about safety and immunogenicity in pedAIIRD patients were available only for non-live vaccines and the first studies on live-attenuated vaccines in pedAIIRD patients treated with immunosuppressive therapy were available only after 2007. Even today the data are limited, especially for children treated with bDMARDs. Vaccinations with non-live vaccines are nowadays recommended, although their long-term immunogenicity and efficacy in pedAIIRD patients are still under investigation. Vaccinations with live-attenuated vaccines are not universally recommended in immunosuppressed patients. However, measles-mumps-rubella booster and varicella zoster virus vaccination can be considered under specific conditions. Additional research is needed to provide more evidence on safety and immunogenicity, especially regarding live-attenuated vaccines in immunosuppressed patients with pedAIIRD. Due to the limited number of these patients, well-designed, prospective, international studies are needed. Further challenges were presented by the COVID-19 pandemic. This mini review article reviews past and present data and discusses the future of vaccinology in pediatric rheumatology.

Childhood-onset of primary Sjögren's syndrome: phenotypic characterization at diagnosis of 158 children.

OBJECTIVES: To characterize the phenotypic presentation at diagnosis of childhood-onset primary SS. METHODS: The Big Data Sjögren Project Consortium is an international, multicentre registry using worldwide data-sharing cooperative merging of pre-existing clinical SS databases from the five continents. For this study, we selected those patients in whom the disease was diagnosed below the age of 19 years according to the fulfilment of the 2002/2016 classification criteria. RESULTS: Among the 12 083 patients included in the Sjögren Big Data Registry, 158 (1.3%) patients had a childhood-onset diagnosis (136 girls, mean age of 14.2 years): 126 (80%) reported dry mouth, 111 (70%) dry eyes, 52 (33%) parotid enlargement, 118/122 (97%) positive minor salivary gland biopsy and 60/64 (94%) abnormal salivary US study, 140/155 (90%) positive ANA, 138/156 (89%) anti-Ro/La antibodies and 86/142 (68%) positive RF. The systemic EULAR Sjögren's syndrome disease activity index (ESSDAI) domains containing the highest frequencies of active patients included the glandular (47%), articular (26%) and lymphadenopathy (25%) domains. Patients with childhood-onset primary SS showed the highest mean ESSDAI score and the highest frequencies of systemic disease in 5 (constitutional, lymphadenopathy, glandular, cutaneous and haematological) of the 12 ESSDAI domains, and the lowest frequencies in 4 (articular, pulmonary, peripheral nerve and CNS) in comparison with patients with adult-onset disease. CONCLUSIONS: Childhood-onset primary SS involves around 1% of patients with primary SS, with a clinical phenotype dominated by sicca features, parotid enlargement and systemic disease. Age at diagnosis plays a key role in modulating the phenotypic expression of the disease.

Mental health and drug use severity: the role of substance P, neuropeptide Y, self-reported childhood history of trauma, parental bonding and current resiliency.

BACKGROUND: Many risk factors lead to opioid use and drug-related problems. One of the challenges to understand behavioural factors, drug problems and psychopathology is to identify biological markers that are suitable for research on broad substance abuse and dependence involving human participants. AIMS: The study has examined the relationships between the self-reported childhood history of trauma, parental bonding, psychopathology, impulsivity, current resiliency, two neuropeptides, possible markers of behaviour and emotion regulation, and severity of drug-related problems. METHODS: One hundred and sixty-seven individuals with a history of opioid use completed questionnaires. Serum neuropeptide Y (NPY) and substance P (SP) levels were analysed. Moderating and mediating relationships between variables were examined using structural equation modelling (SEM). RESULTS: Antisocial features, depression, impulsivity, SP, NPY, emotional neglect and resilience are associated with severity of drug-related problems. SP is associated with antisocial personality traits. CONCLUSIONS: The novelty of this study is the proposed possible link between biochemical markers, antisocial features and behavioural and emotional regulation. Serum NPY and SP levels have a potential to be used as a biomarker in opioid users before and in the treatment process to account for interactions between biological vulnerabilities and childhood risk factors in predicting behavioural adjustment and more severe drug-related problems.

Study about Food Choice Determinants According to Six Types of Conditioning Motivations in a Sample of 11,960 Participants.

Many aspects linked to personal characteristics, society and culture constitute some of the motivators that drive food choice. The aim of this work was to determine in what extent the eating behaviors of individuals are shaped by six different types of determinants, namely: health, emotions, price and availability, society and culture, environment and politics, and marketing and commercials. This is a descriptive cross-sectional study, involving a non-probabilistic sample of 11,960 participants from 16 countries. The objective of this work was to validate the questionnaire, so as to make it suitable for application in different contexts and different countries. For that, six scales were considered for validation by confirmatory factor analysis with structural equation modelling. The obtained results showed that the six individual scales evaluated presented good or very good fitting indices, with saturation in goodness-of-fit index in all cases. The values of chi-square ratio were 6.921 (for health), 0.987 (environment), 0.610 (emotions) and 0.000 in the remaining cases (convenience, society, marketing). Furthermore, the fit was perfect, with saturation for all indices, in three of the six models (convenience, society and marketing). The results of this wok allowed the validation of the six scales, and the assessing of different types of factors that can influence food choices and eating behaviors, namely in the categories: health, emotions, price and availability, society and culture, environment and politics, and marketing and commercials.

The Eating Motivations Scale (EATMOT): Development and Validation by Means of Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM).

INTRODUCTION: The objective was to develop and validate an instrument that measures different determinants of people's food choices and simultaneously accounts for a variety of factors: health, emotions, price and availability, society and culture, environment and politics, and marketing and advertising. METHODS: This is a cross-sectional study focusing on food choice determinants. It was carried out in 16 countries in 2017 and 2018. This study included 11,960 volunteer adult participants from different countries. The data was validated using Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM). RESULTS: Validation using CFA with SEM revealed that multi-factor modelling produced first- and second-order models that could be used to define the EATMOT scale, the first presenting better fitting indices, with the goodness-of-fit and comparative-fit indices very close to 1, as well as root-mean-square-error-of-approximation, root-mean-square-residual and standardised-root-mean-square-residual at practically zero. CONCLUSION: The validated EATMOT scale guarantees confidence in the information obtained through this instrument, and can be used in future studies to better understand food choice determinants in different geographical areas and help plan strategies to improve healthy eating patterns and diminish the burden of non-communicable diseases.

Vaccination coverage in children with rheumatic diseases.

OBJECTIVES: To assess vaccination status in a cohort of children with rheumatic diseases followed at the University Children's Hospital Ljubljana and to evaluate the most common reasons for vaccination dropout. METHODS: Patients with rheumatic diseases who were evaluated at the rheumatology outpatient clinic between January 2015 and January 2017 received a questionnaire about their vaccination status and reasons for potential vaccination dropout. Vaccination coverage for individual vaccines was determined at 5, 10, 18 years and at the time of their last clinic visit. RESULTS: Data were received from 187 out of 424 enrolled patients (44.1%). Majority of included patients had juvenile idiopathic arthritis (n=165), followed by childhood-onset systemic lupus erythematosus (n=6), juvenile dermatomyositis (n=5), mixed connective tissue disease (n=3), chronic recurrent multifocal osteomyelitis, juvenile systemic sclerosis, Takayasu's arteritis (n=2 each), granulomatous polyangiitis and fibromyalgia (n=1 each). Vaccination coverage was complete in 91.9%, 70.3%, 66.7% and 64.7% of patients at 5, 10, 18 years and at their last clinic visit, respectively. Most commonly omitted vaccines were hepatitis B and second dose of measles, mumps and rubella vaccine. Most common additional vaccine was against rotavirus. Most common reason for vaccination dropout was suggestion of the treating rheumatologist. CONCLUSIONS: Thirty-five percent of our patients remain incompletely vaccinated and thus susceptible to vaccine-preventable diseases. Physicians play a crucial role in the decision to vaccinate.

Influence of sociodemographic factors on eating motivations - modelling through artificial neural networks (ANN).

This study aimed at investigating the influence of some sociodemographic factors on the eating motivations. A longitudinal study was carried conducted with 11960 participants from 16 countries. Data analysis included t-test for independent samples or ANOVA, and neural network models were also created, to relate the input and output variables. Results showed that factors like age, marital status, country, living environment, level of education or professional area significantly influenced all of the studied types of eating motivations. Neural networks modelling indicated variability in the food choices, but identifying some trends, for example the strongest positive factor determining health motivations was age, while for emotional motivations was living environment, and for economic and availability motivations was gender. On the other hand, country revealed a high positive influence for the social and cultural as well as for environmental and political and also for marketing and commercial motivations.

Changes in body image during a 6-month lifestyle behaviour intervention in a sample of overweight and obese individuals.

BACKGROUND: Individuals with long-term chronic body image dissatisfaction may experience excessive stress and negative cognitions and feelings. Changes in negative cognition about body image are often reported as outcomes of obesity treatment. In turn, body image dissatisfaction also influences behavioural adherence and success in weight loss. OBJECTIVES: The purpose of the present study was to elucidate psychological changes during 6 months of lifestyle behaviour intervention and the association of these changes with actual weight loss. METHODS: The study examined associations between body image dissatisfaction and obesity treatment-related variables among 33 overweight and obese adults (age = 38.9 ±â€¯6.5 years) participating in a 6-month diet and exercise weight loss intervention. Measurements of body image dissatisfaction and anthropometric variables were taken at baseline and after 6-months. DISCUSSION: Significant improvements were observed in all physical variables (e.g. weight, percentage of body fat mass, waist and hip circumference) after intervention. Body image dissatisfaction improved significantly over the treatment, and these changes were associated with changes in obesity indicators. CONCLUSIONS: Changes in weight and body image probably influence each other dynamically. Results from this study support the inclusion of cognitive intervention aimed at improving body image in weight management programs.

Impact of attention deficit hyperactivity disorder on metabolic control in adolescents with type1 diabetes.

OBJECTIVE: Diabetes mellitus type 1 (T1D) incidence is increasing in pediatric population. Good metabolic control, measured by glycated hemoglobin (HbA1c), significantly reduces the risk for chronic complications. Comorbid disorders, including attention-deficit hyperactivity disorder (ADHD), may influence glycemic control. To date little is known about the prevalence of ADHD among adolescents with T1D and its influence on diabetes self-management. Therefore, we aimed to identify adolescents with T1D and ADHD and assess the effect of ADHD on metabolic control. METHOD: This cross-sectional case-control study included 101 patients (11-17 years old) with T1D. Development and Well-Being Assessment (DAWBA) questionnaire and subsequent psychiatric clinical examination were used to identify ADHD in a group with T1D. Indicators of metabolic control were collected from available medical documentation for preceding 12 months and compared between the group of patients with T1D and ADHD and the group of T1D patients without ADHD. RESULTS: ADHD was diagnosed in 11.9% adolescents with T1D (12 of 101). We found a statistically significant difference (p = .022) in HbA1c between the two groups - higher in the group with T1D and ADHD (8.4% or 68.3 mmol/mol) than in the group with T1D without ADHD (7.8% or 61.7 mmol/mol). CONCLUSIONS: Almost 12% of adolescents with type 1 diabetes were diagnosed with ADHD and they had poorer glycemic control. Adolescents with T1D and ADHD must be diagnosed early and offered appropriate treatment focused on preventing negative ADHD impact on metabolic control.

Effects of Royal Jelly Administration on Lipid Profile, Satiety, Inflammation, and Antioxidant Capacity in Asymptomatic Overweight Adults.

OBJECTIVES: Obesity and overweight are chronic disorders of multifactorial origin that are characterized by high oxidative status and by chronic activation of macrophages in peripheral tissues. Effective therapeutic approaches to lower inflammation and oxidative stress are currently of general interest. Royal jelly (RJ) is a functional food with a broad range of pharmacological activities, mainly used by healthy individuals or borderline patients to protect themselves against disease onset. The objective of this randomized, double-blind, placebo-controlled trial was to investigate the effects of RJ supplementation on metabolic profile and oxidative and inflammatory parameters in asymptomatic overweight adults, considered at an early stage of developing metabolic syndrome. MATERIAL AND METHODS: The experimental group (n=30) was given RJ and the control group (n=30) was provided with a placebo for eight weeks. Anthropometric, biochemical parameters, biomarkers of oxidative stress, and inflammation were assessed at baseline, after 4 and 8 weeks of the intervention, and after additional 2 weeks of follow up. RESULTS AND CONCLUSION: Compared with the placebo, RJ supplementation demonstrated a statistically significant decrease in total cholesterol (6.7%; p=0.041) and inflammatory marker C-reactive protein (19%; p=0.027), whereas significant increases were observed in anti-inflammatory marker adiponectin (34%; p=0.011), endogenous antioxidants bilirubin (35%; p=0.002) and uric acid (5%; p=0.018), total antioxidant capacity in serum (54%; p=0.005), and leptin (17%; p=0.025). The present study demonstrated positive effects of RJ administration on lipid profile, satiety, inflammation, and antioxidant capacity in overweight adults. Therefore, our study supports the benefits of RJ supplementation for the improvement of human health.