Search Results (113)

Background/Objectives: Food allergy (FA) is a growing concern in pediatric care, requiring effective avoidance strategies and timely emergency responses. The role of caregivers is central to the daily management of FA. This study aimed to assess parental knowledge, preparedness, and behaviors regarding pediatric FA management, focusing on both prevention and emergency readiness. Methods: A cross-sectional survey was conducted from December 2024 to April 2025 through the SurveyMonkey^® platform, promoted by the Italian Society of Pediatric Allergology and Immunology (SIAIP). The anonymous, structured questionnaire was distributed online and in two Italian university hospitals. A total of 129 fully completed responses from caregivers of children with FA were analyzed. The survey explored self-perceived knowledge, symptom recognition, preventive actions, emergency preparedness, and communication practices. Results: Only 9.3% of parents considered themselves “very informed,” while 54.3% reported limited or no knowledge. Just 16.0% recognized all symptoms of an allergic reaction, and only 24.0% could distinguish mild reactions from anaphylaxis. Notably, 67.4% reported not knowing how to respond to anaphylaxis, and 83.7% did not possess an epinephrine auto-injector. Preventive measures at home were inconsistently applied, and 41.1% took no precautions when eating out. Communication with external caregivers was often informal or absent. Only 33% updated physicians regularly. Conclusions: The findings reveal significant gaps in parental preparedness and highlight critical areas for educational intervention. Enhanced caregiver training, standardized communication protocols, and improved clinical follow-up are essential to strengthen pediatric FA management and safety. Full article

Background and Objectives: Maternal vitamin D (25-hydroxyvitamin D, 25(OH)D) deficiency during pregnancy is associated with adverse outcomes for both mother and fetus. While vitamin D supplementation is commonly recommended, dietary and lifestyle factors influencing maternal 25(OH)D levels at term remain underexplored, particularly in Southern Europe. Aim: This study aimed to investigate prenatal determinants of maternal 25(OH)D levels at the time of delivery, focusing on dietary intake, supplement use, and seasonal variation. Materials and Methods: We conducted a cross-sectional study on 248 pregnant women admitted for delivery at the General Hospital of Piraeus “Tzaneio” between September 2019 and January 2022. A structured questionnaire was used to assess prenatal intake of vitamin D-rich foods (such as fatty fish, eggs, dairy, and fortified products), supplement use (dose, frequency), sun exposure habits, and lifestyle factors. Maternal serum 25(OH)D concentrations were measured from blood samples collected at the time of admission for delivery. Statistical analysis included descriptive statistics and multivariate linear regression to identify independent dietary and supplemental predictors of maternal vitamin D status. Results: A high prevalence of maternal vitamin D deficiency (VDD) was observed, particularly during the autumn and winter months. Women who reported regular intake of vitamin D supplements (400–800 IU daily) had significantly higher 25(OH)D levels compared to those who did not. Dietary intake of vitamin D-rich foods was positively associated with maternal 25(OH)D status, although the effect size was smaller compared to supplementation. Seasonal variation, BMI, and limited sun exposure were also independent predictors. Conclusions: Both vitamin D supplementation and increased dietary intake were positively associated with maternal 25(OH)D concentrations at delivery. These findings underscore the importance of prenatal nutritional assessment and targeted supplementation strategies to prevent maternal VDD in Mediterranean populations. Full article

Sustainability has also become an increasingly important issue as an international trend for the hospitality industry in recent times, with a positive message for both restaurant operators and consumers. Restaurants can become more sustainable in three main areas: (1) water and energy efficiency, (2) waste management, and (3) employees—social topics. This study examines the role of green practices and innovation in hospitality using three methods in parallel. In connection with a current tourism project, this paper describes some of the green practices for hospitality management in Hungary. Based on the survey, the most common sustainable practices are sourcing from local producers and using seasonal menus. The most popular food waste reduction strategies are Munch, nose-to-tail, and other food utilization options, totaling 65.0%. A total of 72.0% of consumers prefer the green restaurants. Our data show that sustainable operation is not just an environmental issue, but also increasingly a strategic business advantage. The findings are supported by the everyday practices of two of Dining Guide’s member restaurants, Iszkor and Sulyom in the Northeastern Hungary region. Both restaurants focus on locally sourced food and drink ingredients. Some dairy products, domestic fruit, and vegetables come from sustainable farming. For restaurants, adopting sustainable solutions can provide a long-term competitive advantage. Full article

Objectives: The present study examined cross-sectional and longitudinal associations between dysphagia and a variety of health-related parameters, including physical performance, cognitive function, malnutrition, sarcopenia, disability, frailty, falls, hospitalization, and mortality in a cohort of octogenarians living in the mountainous Sirente region of Central Italy. Methods: Dysphagia was operationalized as the need to modify the diet to facilitate swallowing and/or the exclusive consumption of specific food consistencies due to swallowing difficulties. Physical performance, cognitive function, malnutrition, disability, falls, and hospitalizations were assessed via the Minimum Data Set for Home Care. Sarcopenia was defined as the coexistence of low muscle mass and dynapenia, while frailty was operationalized according to Fried’s phenotype. History of falls and incident falls, as well as disability, were tracked over two years, while survival status was followed for up to ten years. Results: Data of 362 older adults (men age: 85.9 ± 4.8; body mass index: 25.6 ± 4.53; women: 66.9%; multimorbidity: 21.5%; dysphagia: 6.6%) were analyzed. The results indicated that dysphagia was significantly and cross-sectionally associated with poor physical performance and reduced cognitive function. In contrast, no longitudinal associations were observed. Conclusions: Dysphagia appears to be linked to deficits in physical and cognitive domains, underscoring the value of comprehensive geriatric assessment and the development of multidomain intervention strategies. Full article

This study highlights the importance of managing and analyzing customer reviews to gain a competitive advantage and improve customer experience in the hospitality industry. In this context, a deep learning-based sentiment analysis system of hotel customer reviews is developed to evaluate service quality within the scope of sustainable tourism. The study analyzed 15,522 customer reviews of five-star hotels in Antalya using text mining, topic modelling, and deep learning-based sentiment analysis. The reviews were classified as positive, negative, or neutral. The findings show that Hotel HB2 has the highest performance, with an F1 score of 97.9%. Overall customer satisfaction is 91%, while emotional satisfaction stands at 77%. Key factors, such as cleanliness, food quality, and staff professionalism, were found to play a critical role in customer loyalty. Additionally, this study integrates sustainability-orientated themes by identifying customer feedback related to environmentally friendly practices and sustainable hotel operations. The results provide evidence that customer satisfaction is not only influenced by service quality but also by the perceived environmental and social responsibility of the hotel. Machine learning techniques have emerged as effective tools for analyzing large-scale customer reviews, offering valuable insights to rapidly and accurately capture customers’ emotions, expectations, and perceptions. As a comprehensive application of sentiment analysis and text mining, this research offers hotel managers a practical framework to enhance service quality, foster customer loyalty, and develop sustainability-orientated strategies. This study contributes to the literature by linking AI-driven sentiment analysis with sustainability practices in the tourism sector. Full article

Background: Nutritional management has become an integral part of Inflammatory Bowel Disease (IBD) care, with growing evidence supporting specific dietary interventions alongside pharmacologic therapy. However, clinical guidance remains fragmented due to heterogeneous study designs and variable endpoints. Objectives: This review critically examines the current evidence on dietary strategies and oral nutritional supplementation (ONS) in both Crohn’s Disease (CD) and Ulcerative Colitis (UC), highlighting their clinical applications, mechanisms of action, and limitations. Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases, analyzing studies on various dietary approaches and ONS in IBD. Results: Exclusive Enteral Nutrition (EEN) is a first-line therapy in pediatric CD, while partial enteral nutrition (PEN) and the Crohn’s Disease Exclusion Diet (CDED) show promising efficacy and better adherence in both children and adults. Whole-food-based interventions, including the Mediterranean Diet, Specific Carbohydrate Diet, plant-based diets, and emerging strategies such as CD-TREAT and the Tasty & Healthy diet, have demonstrated varying levels of benefit in disease maintenance and symptom control. Targeted exclusion diets—such as low-FODMAP, low-emulsifier, and low-sulfur diets—may relieve functional symptoms and influence inflammatory activity, although evidence remains preliminary. ONS plays a pivotal role in addressing malnutrition and improving outcomes in perioperative and hospitalized patients. Conclusions: Dietary interventions and ONS represent valuable therapeutic tools in IBD management. Future research should prioritize standardized, well-powered clinical trials and personalized nutritional approaches to better define their role within integrated care pathways. Full article

The consumption of fresh produce has significantly increased in recent years, contributing to improved diets through the provision of essential nutrients, vitamins, and fiber. However, there has been a rise in foodborne illness outbreaks linked to fruits and vegetables, often caused by pathogens such as Escherichia coli O157:H7, Salmonella spp., and Listeria monocytogenes. These outbreaks have led to severe health consequences, including illnesses, hospitalizations, and even deaths. Once produce is contaminated by foodborne pathogens, these pathogens are difficult to eliminate. Traditional decontamination methods, such as water washes and chlorine-based sanitizers, have been widely used to address these microbial concerns. However, these methods may not be effective against pathogens in crevices or biofilms on the surface of produce, and their effectiveness varies depending on the type of produce and pathogens. Moreover, the chemicals used may raise health and environmental concerns. As a result, novel technologies for pathogen inactivation are gaining attention. These include ozone, ultraviolet light, cold plasma, pulsed light, ultrasound, microbubbles, nanobubbles, electrolyzed water, high-pressure processing, chlorine dioxide gas, and among others. This paper reviews a range of emerging and innovative technologies for the sanitization of fresh produce. The mechanisms, advancements, and practical applications of these technologies are examined with a focus on enhancing food safety and preserving produce quality. These innovative methods provide new opportunities for both research and industry to develop practical, affordable, and safe solutions for maintaining produce safety and quality. Recent studies highlight the effectiveness of combining methods, showing that using multiple sanitization techniques can significantly improve pathogen inactivation on fresh produce. For example, more than 5 log reductions of Listeria innocua and E. coli on avocado, watermelon, and mushroom can be achieved with the combined application of pulsed light and malic acid in previous research. In this review, we recommend the application of combined sanitization methods, emphasizing that integrating multiple techniques can provide a more effective and comprehensive approach to pathogen inactivation. This combined-method strategy has become a promising and innovative trend in the ongoing efforts to improve produce safety and quality. Full article

Background: Food waste is a significant global issue with environmental, social, and economic consequences. In 2022, approximately 1.05 billion tons of food were wasted worldwide, with 220 million tons lost during the production and processing stages. Strategies to reduce food waste include full food utilization and the reuse of clean leftovers, which promote food security, efficient resource use, and the valorization of nutrients found in food. Objective: The aim of this study was to map existing scientific literature on nutritional intervention programs that incorporate full food utilization and the reuse of clean leftovers as tools for promoting sustainability and reducing food waste. The review seeks to consolidate existing knowledge, support public policy development, and encourage the adoption of sustainable food practices. Methods: A scoping review was conducted based on the Joanna Briggs Institute (JBI) manual and following the PRISMA-ScR checklist. The search was conducted in four scientific databases (PubMed, Embase, Cochrane Library, and Virtual Health Library) and included articles published between 2014 and 2025. Intervention studies promoting full utilization of plant-based foods and the reuse of clean leftovers were included. Results: After analyzing 2268 studies, 14 relevant studies were selected, with interventions including culinary workshops and educational programs on using parts of food typically discarded, such as peels and seeds. These programs were successful in reducing waste and promoting more sustainable and nutritious diets. Conclusions: Nutritional intervention programs that promote full food utilization and clean leftover reuse are effective in reducing waste and fostering sustainable diets. To maximize their impact, these practices should be integrated into public policies and scaled in institutional settings such as schools, hospitals, and community kitchens. Full article

Background: The rapidly growing elderly population in Sri Lanka faces multiple challenges, including the ill effects of tooth loss. Tooth loss and denture wear could both affect the amount and variety of food intake of the elders, leading to a state of compromised health. Therefore, it is essential to identify whether both tooth loss and denture wear affect the nutritional status of the elderly. This study evaluated the associations between tooth loss, denture-wearing status, and nutritional levels among a sample of the elderly population attending the Dental Teaching Hospital in Peradeniya, Sri Lanka. Methods: An analytical cross-sectional study was carried out at the Dental Teaching Hospital in Peradeniya, Sri Lanka. Using the G*Power v3.1 statistics software, a sample size of 61 patients aged 60 years and above was determined as the minimum sample size. Data were gathered by means of a self-administered questionnaire, patients’ files, and an examination to identify height and weight for assessing body mass index (BMI). Minitab v18.0 statistical software was used for analysis of data, and a p-value < 0.05 was considered statistically significant. Results: One hundred patients were recruited for this study, and the majority (sixty-seven) were female. The majority (71%) were between the ages of 60 to 69 years. The majority (60%) were denture wearers and 8% had nine or more occluding pairs (of natural teeth), 25% had five to eight, and 67% had four or fewer occluding pairs. Fifty-two percent (52%) were of normal weight, while 40% were over-weight and 8% were underweight, respectively. No statistically significant associations were identified between BMI and the denture status or number of missing teeth (p-values > 0.05). There were no statistically significant associations between the underweight or overweight status and denture wearing or occluding pairs (p-values > 0.05). However, the frequency of grain intake and the number of occluding pairs were significantly associated with each other (p-value = 0.024). Also, the frequency of taking snacks was associated with denture wearing (p-value = 0.006). Conclusions: The nutritional status (BMI) of the elderly does not necessarily correlate with their denture-wearing status or the number of existing occluding pairs/number of missing natural teeth. There is no significant association noted between the denture-wearing status and the food avoidance (soft, hard food, fruits, and grains, except snacks). There is no significant association between the number of occluding pairs available in natural dentition and the avoidance of soft foods or snacks, except for grains. Given the limitations of this study, it can be suggested that nutritional strategies for the elderly population could be designed universally, irrespective of their dentate or denture status. However, further research with a larger cohort is needed to validate these findings. Full article

Healthcare organisations in the United Kingdom must comply with national standards for food and drink, including sustainable sourcing and minimisation, mitigation, and management of food waste. Despite this, an estimated one in six plates of food served in hospitals are wasted daily, producing 12% of the UK’s food waste, equating to 6% of carbon dioxide emissions (CO₂e) nationally, and a waste-management cost of GBP 230 m per annum. Within healthcare, there is a move towards the implementation of “plant-based diets by default” to reduce the environmental impact, improve nutritional outcomes, and reduce costs. However, plant-based diets are often perceived as being difficult to prepare by caterers, less enjoyable, and potentially resulting in more food waste. We conducted a scoping review to examine the influence of the social, medical, and physical environment on food intake during inpatient admission to a mental health hospital. Fourteen studies were included. We identified five critical knowledge areas: (i) food and socio-cultural environment, (ii) evidence-based measures and strategies to reduce food waste, (iii) economic food environment, (iv) inevitability of weight gain, and (v) applications of theoretical models for behaviour change. Future research should explore the development of a behaviour-change framework inclusive of training, education, and goal-setting components for staff, patients, and visitors. Full article

Antibiotic resistance is a well-documented global health challenge that disproportionately impacts low- and middle-income countries. In 2019, the number of deaths attributed to and associated with antibiotic resistance in Western Sub-Saharan Africa was approximately 27 and 115 per 100,000, respectively, higher than in other regions worldwide. Extensive research has consistently confirmed the persistent presence and spread of antibiotic resistance in hospitals, among livestock, within food supply chains, and across various environmental contexts. This review documents the environmental risk factors contributing to the spread of antibiotic resistance in West Africa. We collected studies from multiple West African countries using the Web of Science and PubMed databases. We screened them for factors associated with antibiotic-resistant bacteria and resistance genes between 2018 and 2024. Our findings indicate that antibiotic resistance remains a significant concern in West Africa, with environmental pollution and waste management identified as major factors in the proliferation of antibiotic-resistant bacteria and resistance genes between 2018 and 2024. Additional contributing factors include poor hygiene, the use of antibiotics in agriculture, aquaculture, and animal farming, and the transmission of antibiotic resistance within hospital settings. Unfortunately, the lack of comprehensive genetic characterization of antibiotic-resistant bacteria and resistance genes hinders a thorough understanding of this critical issue in the region. Since antibiotic resistance transcends national borders and can spread within and between countries, it is essential to understand the environmental risk factors driving its dissemination in West African countries. Such understanding will be instrumental in developing and recommending effective strategies nationally and internationally to combat antibiotic resistance. Full article

Food service is one of the major contributors to food waste globally. The Food Waste Index report has recently showed that the world generates about 1052 million tons of food waste per year, out of which 290 million tons come from food services. This study is focused on food service within the hospitality industry, which plays a significant role in generating food waste in the tourism sector. This study explores an innovative approach to the implementation of food donation systems through hospitality practitioners in tourist destinations for a sustainable future. By employing a blend of qualitative and quantitative research methods, this study analyzes the effectiveness of optimizing the redistribution of surplus food through the implementation of food donation systems through hospitality practitioners and focuses on identifying the existing challenges in the food donation system. This study identifies food waste as a global threat, and the results reveal that implementing various food donation systems can lead to a sustainable future. This study contributes solution strategies for various existing challenges in food donation systems. Full article

Background/Objectives: Oral intake and secretions need to be assessed separately, especially in patients with tracheal tubes, as they are vital for dysphagia treatment and may require different management strategies. This study aims to validate the Italian version of the Munich Swallowing Score (IT-MUCSS) by examining its content and construct validity in relation to the fiberoptic endoscopic evaluation of swallowing (FEES) and oral intake in adults with neurogenic dysphagia, as well as assessing intra- and inter-rater reliability. This tool is clinically and scientifically useful as it includes two subscales: IT-MUCSS-Saliva, which assesses saliva/secretion management and the presence of a tracheal tube, and IT-MUCSS-Alimentazione, which evaluates feeding methods. Methods: In this prospective cross-sectional study, a total of 50 dysphagic patients with a neurological diagnosis were recruited from a neuro-rehabilitation hospital and underwent both clinical and instrumental assessments. The main outcome measures included evaluating food and liquid intake using the Italian versions of the Functional Oral Intake Scale (FOIS-It) and the IT-MUCSS. Pharyngeal residues were assessed using the Yale Pharyngeal Residue Severity Rating Scale (IT-YPRSRS), and airway penetration/aspiration were evaluated using the Penetration–Aspiration Scale (PAS) during FEES. Results: The IT-MUCSS demonstrated excellent reproducibility (K = 0.91) and internal consistency (Cronbach’s alpha = 0.72). Strong correlations were found between IT-MUCSS and the FOIS-It scale, indicating the effective assessment of dysphagia. Test–retest reliability was high (ICC = 0.96 for total score). Construct validity was confirmed through significant correlations with instrumental measures during FEES. Conclusions: The IT-MUCSS is a valid tool for assessing functional oral intake and the management of saliva/secretions, specifically in relation to the level of saliva/secretions management compared to FEES measures of swallowing safety and efficiency in patients with neurogenic dysphagia. Full article

Background/Objectives: Binge Eating Disorders are severe mental and physical health conditions, closely linked to lifestyle habits. The aims are to describe the prevalence of Binge Eating Disorders and their correlation with nutritional habits and lifestyle factors within the Spanish population. Methods: A descriptive, cross-sectional design was employed. Using non-probabilistic snowball sampling, an electronic survey was released. A total of 22,181 Spanish adults were evaluated, excluding those with any pathology or limitation at the time of survey response that could potentially affect their diet, such as hospitalization or confinement. The validated Nutritional and Social Healthy Habits (NutSo-HH) scale was used to collect data on nutrition, lifestyle, health habits, and socio-demographic variables. Descriptive and inferential statistics were used. Non-parametric tests were applied due to non-normal distribution. Results: Of the 22,181 sample subject (80.8% female), a total number of 260 individuals reported Binge Eating Disorder. The prevalence of Binge Eating Disorder was higher in women than in men (239 vs. 21 respectfully; 91.9%). Individuals with Binge Eating Disorder exhibited poorer nutritional indices (p < 0.001), higher consumption of ultra-processed and fast food (p < 0.001), sugary soft drinks (p = 0.01), and worse sleep quality (p < 0.001). Although time dedicated to physical activity was not different, individuals with Binge Eating Disorder were more sedentary and had lower health status (p = 0.11 for sport practice). Behavioral regulation plays a key role in managing BED, highlighting the need for personalized intervention strategies. Conclusions: Binge Eating Disorders are associated with lifestyle and health habits and worse quality of life. These data can help design public health programs for early detection and effective treatment. Full article

Research published about the restaurant industry has experienced consistent growth over the past few decades. Yet, a comprehensive bibliometric review of this research has not been performed. This study aimed to perform such a review by examining peer-reviewed articles (n = 792) focused on restaurant business research published in the Scopus and Web of Science databases. Articles related to health or food science were not examined in this study. Articles were categorized as focusing on one of five types of restaurants (i.e., fast food, fast casual, casual dining, fine dining, and general restaurants), and the articles were analyzed within three research fields: consumer behavior, organizational behavior, and finance. The increasing number of research articles focused on the restaurant industry was found to have occurred during the same time as the number of hospitality scholars and the fast food restaurant sector expanded. Fast food restaurants received the most research attention and the fast casual types received the least. Consumer behavior research dominated the restaurant research, reflecting a focus on customer satisfaction and purchase intentions. Organizational behavior topics, such as workforce dynamics and organizational structure, received slightly less attention. Finance research was the least explored research field, likely due to its complexity and perceived indirect connection to consumer-facing outcomes. The study emphasizes the need for integrative research linking consumer behavior, organizational strategies, and financial decisions to provide a holistic understanding of restaurant performance and industry practices. Full article