Metaphoric perceptions of individuals with diabetes in Turkey: A content analysis.

Background: The diagnosis of diabetes mellitus adversely impacts the quality of life due to treatment, changes in daily life, functional disability, and emerging complications. Using metaphors to convey perceptions of diseases and life experiences is crucial for understanding healthcare behaviors. Objective: This study aimed to explore the metaphorical perceptions of "diabetes" and "being a person with diabetes" within a sample group of individuals with diabetes in Turkey. Methods: A qualitative design was employed to investigate the metaphoric perceptions of 72 people with diabetes. Data were collected face-to-face between 15 May and June 2023 using a semi-structured questionnaire. Data were analyzed using content analysis. Results: From the statements of the individuals with diabetes in the sample, seven metaphoric themes related to diabetes - "pain and distress, helplessness and hopelessness, instability, attention and sensitivity, captivity, positive outlook and acceptance, deprivation" - and six metaphoric themes concerning being a person with diabetes - "suffocation and distress, helplessness, powerlessness and disappointment, captivity, attention and sensitivity, guilt, and being worn out" - were identified. Commonly recurring sub-themes with negative connotations included "darkness, well, convict, prison, captivity, microbe, infectious disease, a hot flush, guilt, clouding life, and being ruined." Some positively framed statements included "friend, traffic sign, and driving a car." Conclusion: The majority of patients in the study used negative metaphors, with fewer expressing positive sentiments regarding the necessity of accepting and paying attention to the disease. Defining individuals' metaphorical perceptions of their disease may enable the provision of better quality and holistic care. Nurses, in particular, play a crucial role in facilitating behavioral changes for patients with diabetes to achieve self-management.

Positive effects of COVID-19 on food preparation and expenditure habits: a comparative study across three countries.

OBJECTIVE: This study seeks to empirically investigate how the changing eating habits affect health habits within three countries with entirely different cultures and diets to understand to what extent the pandemic may be responsible for these changes. DESIGN: Specifically, a questionnaire was conducted in China, Portugal and Turkey in early 2021. A series of statistical analyses were performed to identify how changes in individuals' eating habits have influenced their diets, considering the pandemic context and the varying cultural contexts where this research was performed. SETTING: A structured questionnaire form was developed and uploaded to an online platform with unique links for automatic distribution to respondents in each country. Data for the main survey were gathered between 3 January and 1 February 2021. PARTICIPANTS: Using snowball sampling, the authors leveraged their social networks by asking friends and colleagues to distribute the survey to potentially interested individuals. This distribution was stratified accordingly to the distribution of the population. The authors ultimately collected 319 useable surveys from China, 351 from Portugal and 449 from Turkey. RESULTS: The pandemic inspired healthier food habits, mostly because people have additional time to cook, shop differently for food and spend more money on groceries. CONCLUSIONS: The study suggests that aside from cultural values and dietary habits, the available time and the fear of the pandemic most explained the new eating habits. Several implications are provided for researchers and overall society in these three countries.

Impacts of COVID-19 on changing patterns of household food consumption: An intercultural study of three countries.

In light of COVID-19's effects on individuals' social, economic, political, and psychological values, this paper aims to investigate the pandemic's role in possible changes to people's food consumption and meal habits in three countries, namely China, Portugal, and Turkey. The sample includes individuals from the three countries, exploratory factor analysis and non-parametric tests were used to test the differences. Results suggest that coronavirus has played a strong part in altering households' food consumption and meal habits within these countries. The pandemic has particularly led to greater consumption of fresh fruits and vegetables and spending more time eating meals at home. Portugal appears to be consuming more seafood, bread, and butter whereas China features higher consumption of rice and meat products; Turkey is consuming more meat and eggs. The study closes with a set of recommendations for the society and future research.

Beverage Consumption among Adults in the Balearic Islands: Association with Total Water and Energy Intake.

The paper seeks to describe beverage consumption and examine the association between beverage consumption and total water intake and total energy intake of the adult population in the Balearic Islands. Beverage consumption, total water intake, and total energy intake were obtained by using two 24-h diet recalls from a cross-sectional nutritional survey carried out in the Balearic Islands (n = 1386). The contribution of beverages to total water intake and total energy intake were also assessed. Beverages accounted for 65⁻71% of total water intake and 29⁻35% of it provided by drinking water. Food moisture contributed 31⁻37% of total water intake. The mean daily total water intake from all sources was around 2.2 L for men and 1.9 L for women and slightly lower than the proposed adequate intake (AI) recommendations of the European Food Safety Authority (EFSA). The mean total energy intake was 2222 kcal/day and beverages contributed 10.3% of total energy intake for men and 9.5% for women. Energy intake from beverages varied with age. In both sexes, milk was the main beverage contributed to total energy intake. The energy contribution of caloric soft drinks was 1.8% for men and 1.2% for women and energy intake from these beverages was significantly higher among younger adults. Water was the main beverage in the diet, followed by milk and hot beverages. Beverages were mainly consumed in the main meal times (breakfast, lunch, and dinner) in both sexes. The main findings of this study indicate that consumption of sugar-sweetened beverages (caloric soft drinks and commercial fruit juice) is higher among young adults, consumption of alcoholic beverages is higher among males aged 26 and older, and TWI (total water intake) is lower than the EFSA recommendations. These findings may be used to develop effective, healthy eating and drinking policies and campaigns.

Physical Activity and Beverage Consumption among Adolescents.

This study assessed the relationship between physical activity and beverage consumption among adolescents with a population based cross-sectional survey was carried out in the Balearic Islands, Spain (n = 1988; 12-17 years old). Body composition, educational and income level, physical activity (PA), and beverage consumption and energy intake were assessed. Sixty-two percent of adolescents engaged in >300 min/week of PA. Boys were more active than girls, younger adolescents were more active than older counterparts, low parental income was associated with physical inactivity, and time spent watching TV (including, TV, Internet or handheld cellular devices) was inversely associated with PA practice. The average beverage intake of the studied adolescents was 0.9 L/day, higher in boys than in girls. Beverage intake was positively associated with PA practice, and the highest amount of energy intake from beverages was observed in active boys and girls. Most of the studied adolescent population met the PA recommendations. Gender, age, parental income, and time spent watching TV were significant determinants of PA. Type and amount of beverages drunk varied according to gender and PA, and general daily total beverage intake was lower than recommended adequate fluid intake. PA behavior should be considered when analyzing beverage consumption in adolescents.

Systematic Review of Model-Based Economic Evaluations of Treatments for Alzheimer's Disease.

BACKGROUND: Numerous economic evaluations using decision-analytic models have assessed the cost effectiveness of treatments for Alzheimer's disease (AD) in the last two decades. It is important to understand the methods used in the existing models of AD and how they could impact results, as they could inform new model-based economic evaluations of treatments for AD. OBJECTIVE: The aim of this systematic review was to provide a detailed description on the relevant aspects and components of existing decision-analytic models of AD, identifying areas for improvement and future development, and to conduct a quality assessment of the included studies. METHODS: We performed a systematic and comprehensive review of cost-effectiveness studies of pharmacological treatments for AD published in the last decade (January 2005 to February 2015) that used decision-analytic models, also including studies considering patients with mild cognitive impairment (MCI). The background information of the included studies and specific information on the decision-analytic models, including their approach and components, assumptions, data sources, analyses, and results, were obtained from each study. A description of how the modeling approaches and assumptions differ across studies, identifying areas for improvement and future development, is provided. At the end, we present our own view of the potential future directions of decision-analytic models of AD and the challenges they might face. RESULTS: The included studies present a variety of different approaches, assumptions, and scope of decision-analytic models used in the economic evaluation of pharmacological treatments of AD. The major areas for improvement in future models of AD are to include domains of cognition, function, and behavior, rather than cognition alone; include a detailed description of how data used to model the natural course of disease progression were derived; state and justify the economic model selected and structural assumptions and limitations; provide a detailed (rather than high-level) description of the cost components included in the model; and report on the face-, internal-, and cross-validity of the model to strengthen the credibility and confidence in model results. The quality scores of most studies were rated as fair to good (average 87.5, range 69.5-100, in a scale of 0-100). CONCLUSION: Despite the advancements in decision-analytic models of AD, there remain several areas of improvement that are necessary to more appropriately and realistically capture the broad nature of AD and the potential benefits of treatments in future models of AD.

Adherence to the Mediterranean diet and consumption of functional foods among the Balearic Islands' adolescent population.

OBJECTIVE: To assess differences in adherence to the Mediterranean diet (MD) between consumers and non-consumers of functional foods among the Balearic Islands' adolescent population. DESIGN: Cross-sectional nutritional survey carried out (2007-2008) in the Balearic Islands, a Mediterranean region. Dietary assessment was based on a semi-quantitative FFQ and two non-consecutive 24 h recalls. Anthropometric measurements and questions related to socio-economic status, physical activity and adherence to the MD were assessed. SETTING: Data obtained from a representative sample of all inhabitants living in the Balearic Islands aged 12-17 years. SUBJECTS: A random sample (n 1961) of the adolescent population was interviewed. RESULTS: The mean adherence to the MD among consumers of functional foods was 56.42 (sd 6.05) % and 55.76 (sd 5.41) % among non-consumers. Consumption of fruit juice, fibre-rich bread/cookies, cereal bars, fish and soya milk was higher among adolescents with high MD adherence, and consumption of modified milk, probiotics, breakfast cereals and infusions was higher among adolescents with low MD adherence. Daily intakes of functional dietary components from plant foods (dietary fibre, vitamins C and E, carotene, folic acid) were higher among adolescents with high MD adherence. CONCLUSIONS: The Balearic Islands' adolescent population had moderate adherence to the MD; higher adherence was observed among consumers of functional foods. Average daily intakes of functional foods and functional dietary components were higher among adolescents with high adherence to the MD. Gender, age and low parental education were risk factors for low adherence to the MD, mainly among non-consumers of functional foods.

Consumption of functional foods in Europe; a systematic review.

OBJECTIVE: To assess differences in functional foods consumption between European countries. DESIGN: Systematic review. The literature search was conducted in Medlars Online International Literature (MEDLINE), via PubMed© and Scopus. Twenty two studies were identified to examine the differences in functional food consumption between European countries. RESULTS: Figures on consumers of functional foods reveal differences across European countries. Functional foods are popular in most of European countries like Finland, Sweden, the Netherlands, Poland, Spain and Cyprus, but not so in other countries like Denmark, Italy and Belgium. A high percentage of adolescents in the European Mediterranean countries (Spain and Cyprus, but not Italy) consume functional foods. Evaluation of functional foods consumption according to gender is difficult, because results differ from one study to another. CONCLUSIONS: Functional foods have become very popular in Europe in recent years, but still huge differences exist between Europeans on consumption of functional foods. Further research is needed to find out the reasons behind these differences and to understand consumers' needs for functional foods.

Objetivo: Evaluar las diferencias en el consumo de alimentos funcionales entre los países europeos. Diseño: Revisión sistemática. La búsqueda bibliográfica se realizó en Medlars Online International Literature (MEDLINE), vía PubMed©, y Scopus. Se identificaron veintidós estudios que examinaron las diferencias en el consumo de alimentos funcionales entre los europeos. Resultados: Existen diferencias en la proporción de consumidores de alimentos funcionales entre los países europeos. Así, mientras los alimentos funcionales son muy populares en la mayoría de los países europeos como Finlandia, Suecia, Países Bajos, Polonia, España y Chipre, en algunos países como Dinamarca, Italia y Bélgica no lo son tanto. Un elevado porcentaje de adolescentes europeos mediterráneos (España y Chipre, pero no Italia) consume alimentos funcionales. La evaluación del consumo de alimentos funcionales en función del género es difícil, pues los resultados varían de estudio a estudio. Conclusiones: En los últimos años se ha extendido el consumo de alimentos funcionales en Europa, pero dicho consumo muestra grandes diferencias entre los europeos. Más investigaciones serán necesarias para averiguar las razones subyacentes tras estas diferencias y entender las necesidades de los consumidores de alimentos funcionales.

Consumption of functional foods in Europe; a systematic review / Consumo de alimentos funcionales en Europa; una revisión sistemática

Objective: To assess differences in functional foods consumption between European countries. Design: Systematic review. The literature search was conducted in Medlars Online International Literature(MEDLINE), via PubMed© and Scopus. Twenty two studies were identified to examine the differences in functional food consumption between European countries. Results: Figures on consumers of functional foods reveal differences across European countries. Functional foods are popular in most of European countries like Finland, Sweden, the Netherlands, Poland, Spain and Cyprus, but not so in other countries like Denmark, Italy and Belgium. A high percentage of adolescents in the European Mediterranean countries (Spain and Cyprus, but not Italy) consume functional foods. Evaluation of functional foods consumption according to gender is difficult, because results differ from one study to another. Conclusions: Functional foods have become very popular in Europe in recent years, but still huge differences exist between Europeans on consumption of functional foods. Further research is needed to find out the reasons behind these differences and to understand consumers’ needs for functional foods (AU)

Objetivo: Evaluar las diferencias en el consumo de alimentos funcionales entre los países europeos. Diseño: Revisión sistemática. La búsqueda bibliográfica se realizó en Medlars Online International Literature (MEDLINE), vía PubMed©, y Scopus. Se identificaron veintidós estudios que examinaron las diferencias en el consumo de alimentos funcionales entre los europeos. Resultados: Existen diferencias en la proporción de consumidores de alimentos funcionales entre los países europeos. Así, mientras los alimentos funcionales son muy populares en la mayoría de los países europeos como Finlandia, Suecia, Países Bajos, Polonia, España y Chipre, en algunos países como Dinamarca, Italia y Bélgicano lo son tanto. Un elevado porcentaje de adolescentes europeos mediterráneos (España y Chipre, pero no Italia)consume alimentos funcionales. La evaluación del consumo de alimentos funcionales en función del género es difícil, pues los resultados varían de estudio a estudio. Conclusiones: En los últimos años se ha extendido el consumo de alimentos funcionales en Europa, pero dicho consumo muestra grandes diferencias entre los europeos. Más investigaciones serán necesarias para averiguar las razones subyacentes tras estas diferencias y entender las necesidades de los consumidores de alimentos funcionales (AU)

Sociodemographic and lifestyle determinants of functional food consumption in an adult population of the Balearic Islands.

BACKGROUND/AIMS: Studies about functional food (FF) consumption among south Europeans are scarce. The aim of this study was to assess sociodemographic and lifestyle determinants of FF consumption in adult inhabitants of the Balearic Islands. METHODS: A population-based, cross-sectional, nutritional survey was conducted. The target population consisted of all inhabitants aged 16-65 years living in the Balearic Islands. FFs were selected from a semiquantitative food frequency questionnaire. Sociodemographic and lifestyle characteristics were also assessed. RESULTS: A high percentage of the population consumed FFs (skimmed milk, fiber-rich bread/cookies, probiotics, breakfast cereals and tea). Gender was a significant determinant for FF consumption. Females were more likely to consume soy milk, fiber-rich bread/cookies and tea; males preferred to consume breakfast cereals. FF consumption was significantly associated with increasing age in both genders. Fiber-rich bread/cookies were especially consumed by individuals with medium education, and breakfast cereals were consumed by respondents with a medium income. Physically active adults were more likely to consume soy milk, breakfast cereals, probiotics and red wine, and obese individuals were less likely to consume breakfast cereals and fiber-rich bread/cookies. CONCLUSIONS: A high percentage of the study population consumed FFs. Gender, age, marital status, education level, body mass index and physical activity are factors associated with FF consumption.

The impact of case mix on timely access to appointments in a primary care group practice.

At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the impact of the size and case-mix on the ability of a multi-provider practice to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician practice as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a practice: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test practices created using patient level data from the primary care practice at Mayo Clinic, Rochester, Minnesota. An important advantage of our approach is that it can be implemented in an Excel Spreadsheet and used for aggregate level planning and panel management decisions.

Veillonella, Firmicutes: Microbes disguised as Gram negatives.

The Firmicutes represent a major component of the intestinal microflora. The intestinal Firmicutes are a large, diverse group of organisms, many of which are poorly characterized due to their anaerobic growth requirements. Although most Firmicutes are Gram positive, members of the class Negativicutes, including the genus Veillonella, stain Gram negative. Veillonella are among the most abundant organisms of the oral and intestinal microflora of animals and humans, in spite of being strict anaerobes. In this work, the genomes of 24 Negativicutes, including eight Veillonella spp., are compared to 20 other Firmicutes genomes; a further 101 prokaryotic genomes were included, covering 26 phyla. Thus a total of 145 prokaryotic genomes were analyzed by various methods to investigate the apparent conflict of the Veillonella Gram stain and their taxonomic position within the Firmicutes. Comparison of the genome sequences confirms that the Negativicutes are distantly related to Clostridium spp., based on 16S rRNA, complete genomic DNA sequences, and a consensus tree based on conserved proteins. The genus Veillonella is relatively homogeneous: inter-genus pair-wise comparison identifies at least 1,350 shared proteins, although less than half of these are found in any given Clostridium genome. Only 27 proteins are found conserved in all analyzed prokaryote genomes. Veillonella has distinct metabolic properties, and significant similarities to genomes of Proteobacteria are not detected, with the exception of a shared LPS biosynthesis pathway. The clade within the class Negativicutes to which the genus Veillonella belongs exhibits unique properties, most of which are in common with Gram-positives and some with Gram negatives. They are only distantly related to Clostridia, but are even less closely related to Gram-negative species. Though the Negativicutes stain Gram-negative and possess two membranes, the genome and proteome analysis presented here confirm their place within the (mainly) Gram positive phylum of the Firmicutes. Further studies are required to unveil the evolutionary history of the Veillonella and other Negativicutes.

Worldwide consumption of functional foods: a systematic review.

The present systematic review was performed to assess differences in the worldwide consumption of functional foods. The Medline and Scopus databases were used to search the existing literature. A total of 23 studies that examined functional food consumption and included information on the country, gender, and age of participants were identified for inclusion. The studies investigated a variety of functional foods, and analysis of the findings indicates it is not possible to reach generalized conclusions about consumer choices regarding functional food consumption. Gender, age, level of education, and personal health status may each predict consumption of one or more functional foods. Further studies aimed at gaining a better understanding of the factors that influence consumption of functional foods are needed.

Defining the Pseudomonas genus: where do we draw the line with Azotobacter?

The genus Pseudomonas has gone through many taxonomic revisions over the past 100 years, going from a very large and diverse group of bacteria to a smaller, more refined and ordered list having specific properties. The relationship of the Pseudomonas genus to Azotobacter vinelandii is examined using three genomic sequence-based methods. First, using 16S rRNA trees, it is shown that A. vinelandii groups within the Pseudomonas close to Pseudomonas aeruginosa. Genomes from other related organisms (Acinetobacter, Psychrobacter, and Cellvibrio) are outside the Pseudomonas cluster. Second, pan genome family trees based on conserved gene families also show A. vinelandii to be more closely related to Pseudomonas than other related organisms. Third, exhaustive BLAST comparisons demonstrate that the fraction of shared genes between A. vinelandii and Pseudomonas genomes is similar to that of Pseudomonas species with each other. The results of these different methods point to a high similarity between A. vinelandii and the Pseudomonas genus, suggesting that Azotobacter might actually be a Pseudomonas.

Genome sequences of two stress-tolerant Campylobacter jejuni poultry strains, 305 and DFVF1099.

Campylobacter jejuni is a food-borne pathogen with a high prevalence in poultry meat, which in fresh unfrozen condition is the major source of campylobacteriosis. C. jejuni strains DFVF1099 and 305 are considered tolerant to several environmental stresses (T. Birk et al., J. Food Prot. 73:258-265, 2010; S. L. On et al., Int. J. Med. Microbiol. 296:353-363, 2006). Here, we report the genome sequences of C. jejuni 305 and DFVF1099, a turkey and a chicken isolate, respectively.

Genome Sequence of Campylobacter jejuni strain 327, a strain isolated from a turkey slaughterhouse.

Campylobacter is one of the leading causes of food-borne gastroenteritis and has a high prevalence in poultry. Campylobacter jejuni subsp. jejuni 327 is a subspecies of the genus Campylobacter of the family Campylobacteraceae in the phylum Proteobacteria. The microaerophilic, spiral shaped, catalase positive bacterium obtains energy from the metabolism of amino acids and Krebs cycle intermediates. Strain 327 was isolated from a turkey slaughter production line and is considered environmentally sensitive to food processing (cold, heat, drying) and storage conditions. The 327 whole genome shotgun sequence of 1,618,613 bp long consists of 1,740 protein-coding genes, 46 tRNA genes and 3 rRNA operons. A protein based BLAST analysis places the turkey isolate 327 close to the human clinical strain 81116 (NCTC 11828).