Volume 60 (2021): Issue 1 (March 2021)

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.

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).

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.

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.

National and international research results have highlighted the fact that workplace stress causes mental and somatic problems. The aim of the present paper is to define exposure to workplace-related risk factors, with special focus on psychosocial risk factors, and the way they interconnect with workplace conditions, relationships with superiors and colleagues, and moral, professional and financial appreciation.

Cross-sectional research with the help of an anonymous online self-administered questionnaire was carried out among 261 higher education employees (67% women, 33% men, mean age 43.4 years) from 12 faculties of the University of Szeged, Hungary. Statistical analysis was performed using IBM SPSS 22.0.

The primary workplace stress factors for university employees were strict deadlines (80.4%), frequent overwork (64.2%) and difficulty in meeting requirements (56.7%). Communication problems with colleagues and superiors were also highlighted (47.5%). Job strain was higher for women than for men. With regard to low financial, professional, and moral appreciation, employees were characterised by the existence of work requirements impossible to meet, as well as by low autonomy. Experience of anxiety and aggression came along with low financial and moral appreciation (p<0.001).

Our data suggests that employees at the university were subject to several psychosocial risk factors, and worked under considerable mental stress, leading to a higher prevalence of mental health problems. The results highlight the need for a health-focused policy-making in higher education to reduce health expenditure and increase efficiency at work.

The first large outbreak of SARS-CoV-2 in Europe occurred in Northern Italy in February 2020. The relatively fast spread of the infection to Slovenia was expected, and preventive measures for its suppression were widely discussed.

An online questionnaire was designed to evaluate adherence to preventive measures and the extent to which the taking of preventive measures was associated with people’s anxiety level, psychological burden, their perceived vulnerability to disease, germ aversion and a number of demographic characteristics in the early stage of Covid-19 spread. The survey was active for 24 hours (13–14 March 2020). There were 12,307 responses and 7,764 questionnaires were completed in full.

Higher preventive behaviour was found in individuals who experienced greater psychological distress, were more anxious, and expressed greater perceived infectability and germ aversion. Greater compliance with preventive behaviour was found among women, those sharing a household with people aged over 65, the elderly and those who knew somebody who had been infected. These groups also showed higher anxiety levels, which appeared to be significantly increased in general as a result of the specific situation. Quarantine was evaluated as the most efficient preventive measure, and was respected relatively strictly even before it became an officially announced protective measure.

This research reveals a strong association between preventive behaviour and anxiety. Anxiety, together with social distancing, may affect physical and psychological health in the population in the long term. Other aspects of public health might therefore be influenced by the measures currently being enforced to prevent the spread of SARS-CoV-2.

Introduction: To estimate the procedure-related risks of pregnancy loss following chorionic villus sampling (CVS) and amniocentesis (AC) compared to pregnancies without procedure.

This cohort study enrolled all women who underwent CVS or AC at the Department of Perinatology, University Medical Centre, Ljubljana, Slovenia (from January 2013 to June 2015). For each group we obtained a maternal age and gestational age (11–14 weeks for CVS and >15 weeks for AC) for a matched control group without invasive procedures from the national database. The data was obtained from hospital records and telephone surveys concerning pregnancy outcomes. Pregnancy loss rates in intervention vs. control groups were compared by generating relative risk (RR) with a 95% confidence interval.

During the study period, 828 women underwent CVS and 2,164 women underwent AC. Complete outcome data was available in 2,798 cases (93.5%, 770 CVS, 2,028 AC). Pregnancy loss occurred in 8/770 (1.04%, 95% CI 0.4–2.0%) after CVS vs. 15/1130 (1.33%, 95% CI 0.8–2.2%) in matched control (RR 0.8, 95% CI 0.33–1.8, p=0.6). It occurred in 16/2028 (0.79%, 95% CI 0.5–1.3%) after AC vs. 14/395 (3.29%, 95% CI 2.1–5.8%) in matched control (RR 0.2, 95% CI 0.11–0.45, p<0.0001).

The pregnancy loss rates after CVS and AC were comparable to losses in pregnancies without these procedures. With the increasing use of non-invasive prenatal testing, information that the invasive procedures are safe when indicated is essential.

The aim of the study was to determine the ability of ferritin, haemoglobin, albumin and total cholesterol to identify nutritional risk and malnutrition among elderly primary care patients.

The cross-sectional study included 446 elderly adults over 65 years of age from four areas of Bosnia and Herzegovina. In addition to anthropometric, functional, cognitive and biochemical indicators, nutritional status was evaluated using 24-hour recall of meals, the Mini Nutritional Assessment (MNA), and Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II (SCREEN II).

Malnourished/at-risk study respondents had lower mean levels of haemoglobin (P=0.001) and total cholesterol (P<0.001), compared to those with normal nutritional status. Albumin levels significantly differed regarding nutritional status (P=0.004), but not nutritional risk level (P=0.521). Significant differences in serum ferritin levels were not found between malnourished and normally nourished study respondents (P=0.779) Determinants of albumin level were eating more than three meals a day (P<0.001), fewer than two portions of fruit and vegetables a day (P=0.024), drinking one glass of wine (P<0.001) and reporting functional independence (P=0.011). The AUC curves for serum ferritin, albumin and total cholesterol levels in men and women, as well as for haemoglobin levels in women, were poor to fair (AUC<0.800).

Although ferritin, haemoglobin, albumin and total cholesterol may be useful biomarkers of nutritional status, their accuracy in diagnosing malnutrition and nutritional risk among elderly primary health care patients is limited.

With the aim of providing a foundation for evidence-based public health actions, as well as the more individualised clinical treatment of migraine in Slovenia, the objective of our study was to assess the association between poor self-rated health (PSRH) and migraine, adjusted for selected comorbidity and socioeconomic factors.

The survey, conducted between August and December 2014, involved included 6,262 adults aged 15 years and over. Binary logistic regression was used in univariate as well as multivariate analysis. Three multivariate models were defined: MODEL 1 (migraine and comorbidities related to the physical dimension of health); MODEL 2 (comorbidities related to the mental dimension of health); MODEL 3 (demographic and socioeconomic factors).

In univariate as well as all three multivariate models, the odds of PSRH were statistically significantly higher in migraine sufferers in comparison to non-sufferers (univariate model: ORmigraine=yes vs. migraine=no=2.22 (p<0.001); MODEL 1: ORmigraine=yes vs. migraine=no=2.27 (p<0.001); MODEL 2: ORmigraine=yes vs. migraine=no=1.51 (p=0.002); MODEL 3: ORmigraine=yes vs. migraine=no=1.56 (p=0.001)).

Migraine is an important PSRH-related factor. Comorbidities related to the physical dimension of health do not reduce the power of association between migraine and PRSH, while comorbidities related to the mental dimension reduce the power of association of migraine and other health conditions. The power of the association between migraine and PRSH is also independent of demographic/socioeconomic factors. We can also conclude that migraine seems to be a phenomenon that is in a bi-directional relationship with mental states (thus having an impact on PSRH) and is itself a stressor.

Although nurses in intensive care units (ICUs) are exposed to prolonged stress, no burnout prevention policy has yet been established. This study aims to determine the attitudes and “sense” of knowledge of burnout in nurses with burnout.

The study, which has a qualitative exploratory phenomenological design, was carried out in several Croatian ICUs in 2017. ICU nurses suffering from burnout according to their score on the Maslach Burnout Inventory were chosen randomly from five hospitals. Their participation was voluntary. Of the 28 participants, 86% were women (n=24) and 14% men (n=4). They were aged mainly between 36 and 45 (n=11 (40%)) and between 26 and 35 (n=10 (36%)). Semi-structured interviews were conducted up to the saturation point. The conversations were audio-recorded and transcribed verbatim. The text was analysed using inductive thematic analysis, with codes derived and grouped into clusters by similarities in meaning, and interpretation as the final stage.

Emergent themes, compromised private life, stressful work demands, stress reduction options, protective workplace measures and sense of knowledge reflected a variety of experiences, attitudes and knowledge of burnout.

Nurses with burnout provided an insight into their experience and attitudes, and the problems created by burnout. Given the poor sense of knowledge about this syndrome, there is a need to implement education on burnout in nursing school curricula, and clear strategies in the ICU environment, i.e. information, awareness-raising, and specific guidelines on coping, burnout detection and prevention. Approaching burnout prevention through attitudes/social learning may be a novel and feasible model of addressing this issue.

The aim was to adapt the Croatian and the Serbian versions of the Oral Health Impact Profile for the edentulous population (OHIP-EDENT-CRO and OHIP-EDENT-SRB).

The translation and cross-cultural adaptation were carried out in accordance with accepted international standards. A total of 95 and 177 removable denture wearers were recruited in Croatia and Serbia respectively. The reliability was evaluated by calculating Cronbach’s alpha coefficient and by test-retest (30 participants in each country). The concurrent validity was determined by calculating the Spearman’s rank coefficient between the OHIP-EDENT summary scores and one question related to removable denture satisfaction. Construct validity was determined by exploratory factor analysis (EFA). Responsiveness was determined by comparison of the OHIP-EDENT summary scores before and after dental implant placement to support mandibular overdentures (23 patients in Croatia, 21 in Serbia).

Cronbach’s alpha coefficient was 0.92 in Croatia and 0.87 in Serbia. The intraclass correlation coefficient was 0.98 in Croatia and 0.94 in Serbia. In Croatia the Spearman’s correlation coefficient was -0.71 (p<0.001) and in Serbia -0.74 (p<0.001). Both confirmed concurrent validity. Construct validity was tested by EFA, which extracted four factors in each country, accounting for 66.59% of the variance in Croatia and 59.33% in Serbia. Responsiveness was confirmed in both countries by a significant OHIP-EDENT summary score reduction and a high standardised effect size (3.9 in Croatia, 1.53 in Serbia).

The results prove that both instruments, the OHIP-EDENT-CRO and the OHIP-EDENT-SRB, have very good psychometric properties for assessing OHRQoL in the edentulous population.

Receiving a cancer diagnosis is an important moment in anyone’s life. Consequently, many patients are prepared to change their everyday habits and begin to look for advice from a wide range of sources. Women with breast cancer are particularly motivated and committed to making changes to their lifestyle and diet. The purpose of this study was to elucidate the changes in nutritional and other lifestyle habits following breast cancer diagnosis in Slovenia. A further goal was to estimate the proportion of breast cancer patients using dietary supplements and alternative diets or ascertain their desire to attend a consultation with a dietician.

A link to an online questionnaire was sent to the email addresses of members of Europa Donna and posted on their website (www.europadonna-zdruzenje.si) and Facebook page.

A total of 102 patients were included in the study. We found that a majority of breast cancer patients changed their eating habits (68.6%) and/or physical activity level (53.9%) following diagnosis. On average, they increased their fruit and vegetable intake and reduced their intake of sugar, red meat and fat. Alternative diets were used by 29.4% of patients, with a high proportion of patients (75.5%) consuming dietary supplements. More than a half of the patients (69.6%) expressed a desire for a consultation with a dietician.

Nutritional support during cancer treatment is part of medical treatment and has an important role to play in secondary and tertiary cancer prevention activities. More dieticians should therefore be incorporated into the health system.

Reducing the salt, sugar and fat content of food is recognised worldwide as one of the strategies available for reducing the incidence of obesity and non-communicable diseases. The food industry has a major influence on achieving these goals by preserving intrinsic (chemical and sensory properties) and modifying extrinsic (food packaging and other external information) food attributes that can influence purchasing decisions. This article is a literature review of studies that analyse the influence of intrinsic and/or extrinsic attributes on consumer product preference and purchasing decisions.

A keyword search for relevant studies was conducted using Web of Science, an interdisciplinary electronic resource. Articles from other sources were also included and systematically reviewed.

The search string identified 266 results. Thirty-eight articles were included in the final analysis and coded according to intrinsic and extrinsic food attributes, reformulated nutrient, food category, condition, research methods, consumer response, study location and sample size. There are several authors investigating the effect of intrinsic rather than extrinsic product attributes. Most research deals with processed foods in the category of milk and dairy products, followed by sweetened fruit juices, meat products, sweets and bread. Salt content is the attribute most often reduced, followed by sugar and fat.

Consumers find it hard to swap potential health benefits for hedonic attributes. When evaluating products in expected conditions, they usually rate the reformulated product more highly than the conventional one, while in informed conditions they usually choose the regular product. When products are labelled with a traffic light or nutritional warnings, consumers opt for a reformulated product, even in informed conditions. This review highlights the heterogeneity between food groups, and the fact that many factors influence consumers’ product preferences and purchasing decisions. The product should be analysed as a whole and tested in blind, expected and informed conditions, as each individual factor represents a phase of the consumer purchasing decision. The extent of nutrient reduction should be determined by calculating the difference threshold, and the industry should reformulate products gradually based on how consumers detect the reduction.