Background Multiple sclerosis (MS) is a long-term condition in which the immune system attacks the brain and spinal cord, affecting approximately 2.9 million people worldwide. Among the dietary patterns studied in MS, the Mediterranean diet has attracted the most research attention for its potential to reduce inflammation and slow the progression of disability. Objective This study used a survey-based approach to collect data from one hundred MS patients across three countries – Slovakia, Italy, and the United Kingdom/international cohort to explore the association between disability levels, Mediterranean diet adherence, and disease duration. The main aim was to examine how Expanded Disability Status Scale (EDSS) scores and length of time living with MS were associated with how closely patients followed the Mediterranean diet. Secondary aims included looking at how often patients consumed specific food groups, whether they were taking vitamin D or omega-3 supplements, whether their eating habits had changed since their MS diagnosis, and how many patients had received formal nutrition advice from their healthcare team, with results broken down by country and level of disability. Material and Methods This cross-sectional study explored the relationship between disability level, Mediterranean diet adherence measured using the validated 14-item Mediterranean Diet Adherence Screener (MEDAS), and disease duration in 100 MS patients from Slovakia (n=47), Italy (n=36), and a UK/International cohort (n=17). Results The overall mean MEDAS score was 3.96 ± 2.26, reflecting predominantly poor dietary adherence across the entire sample: 77% of patients fell into the low-adherence range (score 0-5), 22% into the moderate range (6-9), and only one patient (1%) reached high adherence (10-14). MEDAS scores were highest in patients with the lowest disability (mean 4.73 at EDSS 0-2) and declined across higher EDSS groups, with the proportion of low-adherence patients rising from 63.6% at EDSS 0-2 to 90.0% at EDSS 6-8. Vegetable consumption, the most important food component of the Mediterranean diet, declined modestly from 4.64 to 4.33 times per week across the disability spectrum. Regarding disease duration, the lowest mean MEDAS scores were observed in patients diagnosed for 1-5 years (3.75) and those living with MS for 20 or more years (3.69), the latter group also showing the highest rate of low adherence (85.7%). Italian patients had the highest mean MEDAS score (4.56), compared with 4.12 in the UK/international group and 3.45 in Slovakia. A notable discrepancy was found between the 24% of patients who self-identified as following the Mediterranean diet and the objective MEDAS results, in which only one patient achieved high adherence. Only 26% of patients had received formal dietary advice from their doctor, despite 47% having changed their eating habits independently after diagnosis. Conclusions These findings show that higher disability and longer disease duration are both linked to poorer Mediterranean diet adherence when assessed with a validated tool and highlight the need to include structured nutritional support as a regular part of MS care.
Background Population ageing generates important social, economic and health consequences. Economic conditions are key social determinants of health and quality of life in old age. Income alone does not fully reflect living standards of older adults; consumption patterns provide complementary information on actual resource use and opportunities for social participation. Objective The aim of the study was to assess income and consumption inequalities among households of individuals aged 60 years or older in Poland and to identify distinct consumption profiles and their socio-economic determinants, with implications for active ageing and public health. Material and Methods The analysis was based on microdata from the 2024 Household Budget Survey conducted by Statistics Poland. The analytical sample comprised 12,211 households in which the reference person was aged 60 years or older. Inequality was measured using the Gini coefficient, Atkinson index, Hoover index, Coulter index and Theil indices for equivalised disposable income and selected COICOP expenditure categories. Hierarchical and k-means cluster analysis identified consumption patterns. Binary logistic regression models examined factors associated with cluster membership. Results Income inequality was moderate. Consumption inequality was substantially higher, particularly for discretionary categories such as miscellaneous goods and services, household furnishings, recreation and culture, restaurants and hotels and transport. Three clusters were identified: low-income basic consumption households, balanced middle-income consumption households and an exploratory high-income outlier cluster. Higher equivalised disposable income and tertiary education increased the odds of diversified consumption patterns, whereas older age and larger household size were associated with expenditure concentrated on basic needs. Conclusions Moderate income inequality coexists with pronounced consumption inequalities among older households in Poland. Economic differences are expressed primarily through the ability to satisfy higher-order needs related to mobility, leisure and social participation. Assessments of well-being in later life and policies supporting healthy and active ageing should therefore consider both income and consumption patterns.
Despite significant advances in neonatal and child health, morbidity related to intrauterine growth restriction (IUGR) remains concerning, particularly in developing countries where resources are limited and geographical and socioeconomic disparities persist. This study aims to describe the clinical, nutritional, and developmental outcomes of children born with IUGR at 2 years of age, as reported in previous studies. It identifies the main findings from the selected literature and proposes ways to improve monitoring. A bibliographic search was conducted using PubMed, Science Direct, and Google Scholar. A total of 15 studies were included. The systematic review was performed in accordance with the PRISMA checklist. Most studies have shown abnormalities related to the health of children born with IUGR at the age of 2 years, including height and weight retardation; cognitive, mental, language, visual, respiratory, neurological, and metabolic impairments; developmental delay in general; and affected social skills. However, two studies showed no significant differences in height and weight or in developmental and behavioral outcomes at 2 years of age. This systematic review highlights several strong and consistent trends, despite differences in methodology, health contexts, and populations studied.
The aim of this study was to present the current state of knowledge regarding the use of the ketogenic diet in the treatment of obesity in adults, with particular emphasis on its safety, indications, and contraindications, and to relate these findings to its established use in drug-resistant epilepsy and other clinical conditions. Despite growing interest in its clinical application, the effectiveness and safety of this intervention remain a matter of debate. A narrative review of the literature available in PubMed and Google Scholar from 2021 to 2024 was conducted using the keywords “ketogenic diet,” “obesity,” “epilepsy,” “type 2 diabetes,” “cardiovascular diseases,” “PCOS,” “neurological diseases,” and “psychiatric disorders,” as well as their combinations with AND/OR operators. Meta-analyses, randomized controlled trials, systematic reviews, and selected clinical trials evaluating the effectiveness and safety of the ketogenic diet were included in the analysis. The ketogenic diet demonstrates effectiveness in short-term weight loss and improvement of selected metabolic parameters in patients with obesity. However, its long-term effects remain equivocal and do not appear to offer significant advantages over other dietary strategies. The diet is associated with a risk of adverse effects and requires appropriate clinical monitoring. While it is a recognized and effective therapeutic option for drug-resistant epilepsy, its use in other conditions has not been established as a standard therapeutic approach. The ketogenic diet may be considered as part of obesity treatment in carefully selected patients, provided that potential benefits and risks are individually assessed. Further high-quality studies are needed to determine its long-term effectiveness and safety.
Occupational burnout among nurses is a significant public health issue. It affects both nurses’ well-being and the quality of patient care. The aim of this narrative review is to provide a comprehensive synthesis of four key aspects of occupational burnout among nurses, namely its prevalence, determinants, consequences for patient care and mental health, and available prevention strategies. Literature was identified through searches of PubMed and Google Scholar. Articles published in English between 2015 and 2026 were reviewed and selected according to predefined inclusion and exclusion criteria. Burnout develops through the interaction of organizational, psychosocial, and individual factors. The most important contributors include work overload, staffing shortages, low autonomy, psychosocial stress, personality traits, and health status. Higher burnout levels are associated with increased medical errors, patient falls, and missed nursing care. Burnout also contributes to lower patient satisfaction and poorer perceived quality of care. Prolonged stress increases the risk of depression, anxiety, sleep disturbances, reduced psychological resilience, and intentions to leave the profession, negatively impacting nurses’ quality of life and social functioning. Effective preventive and therapeutic strategies include mindfulness-based programs, cognitive-behavioral therapy, physical exercise, and resilience training. These interventions may be delivered both in person and digitally. Their effectiveness improves in supportive environments with allocated participation time and leadership engagement. Interventions at individual, team, and system levels reduce emotional exhaustion and depersonalization, enhance staff well-being, and improve patient safety. In the context of a global nursing shortage and increased workloads following the COVID-19 pandemic, multi-level strategies to prevent occupational burnout are essential for protecting nurses’ mental health and maintaining high-quality healthcare. The review highlights the importance of multi-level preventive interventions to reduce burnout and improve healthcare outcomes.
