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Background:Approximately 20% of children and adults avoid certain foods because of perceived food intolerance. Valid and reliable health-related quality of life instruments are needed to measure changes following clinical, therapeutic or policy interventions. However, there are no disease-specific quality of life instruments for adults with food intolerances.Objective:To develop the Food Intolerance Quality of Life Questionnaire FIQLQ. Then to conduct psychometric validation including reliability and construct validity.Methods:We adapted the existing Food Allergy Quality of Life questionnaire (FAQLQ) for interviews with 14 adults with food intolerance. For preliminary psychometric validation, 229 adults with food intolerances completed the online electronic version of FIQLQ.Results:The resultant FIQLQ had 18 items which loaded onto 3 subscales—Emotional Impact, Social and Dietary Restrictions, Reactions and Avoidance. Each subscale had excellent internal consistency reliability (Cronbach’s α 0.81–0.94). Content, convergent and construct validity was supported by significant correlations of FIQLQ subscale scores with hypothesised variables including age, numbers of symptoms and level of stress experienced due to intolerance.Conclusion:The FIQLQ has good reliability, construct validity and internal consistency. It is short and easy to use, providing a good tool for evaluating quality of life in the clinical research setting and to inform health and regulatory policies.

Axial spondyloarthritis (axSpA) is an inflammatory rheumatic condition that is often subject to diagnostic delays. Individuals with axSpA report using complementary and alternative therapies prior to and following diagnosis, though little is known concerning reasons underlying use of such therapies. This study provides detailed insights into the motivation and experiences of complementary and alternative medicine use within a population of individuals with axSpA. Open-ended surveys were completed by 30 individuals (20&ndash, 69 years, 17 females) diagnosed with axSpA. Subsequent telephone interviews were conducted with eight individuals (39&ndash, 70 years, five females) diagnosed with axSpA. Data were analyzed using reflexive inductive thematic analysis. Themes of &ldquo, a learning curve&rdquo, &ldquo, barriers to complementary and alternative therapy use&rdquo, and &ldquo, complementary or mutually exclusive&rdquo, illustrated how participants&rdquo, increasing understanding of their condition empowered them to explore complementary and alternative therapies use as an adjunct to mainstream care. Individuals with axSpA recommended greater integration between mainstream and complementary and alternative therapies, valuing informed advice from mainstream healthcare professionals before selecting appropriate complementary and alternative therapies for potential use. Healthcare professionals should be proactive in discussing complementary and alternative therapy use with patients and supply them with details of organizations that can provide good-quality information.

Following the discovery of horsemeat in beef products in Europe in 2013, restoring consumers' confidence in processed meat products as well as in all the agencies involved - producers, food safety authorities, retailers - soon became a key priority. However, the European public's confidence in processed meat products and their views about government and industry actions to manage fraudulent practices in the wake of this incident are poorly understood. The objective of this study was to identify the core issues affecting consumers' confidence in the food industry, particularly in the meat processing sector, and to explore the impact of the horsemeat incident on consumers' purchasing and eating behaviour. It involved the use of an online deliberation tool VIZZATA™ to collect detailed views of 61 consumers in the UK and the Republic of Ireland. Many participants reported buying fewer products containing processed meat as a result of the horsemeat incident. These respondents also claimed that their confidence in processed foods containing meat was lower than before the incident. Participants suggested restoring consumer confidence through improved traceability, sourcing local ingredients, providing clearer and correct labelling and stating the origin of meat on pack. Overall, findings indicate that rebuilding consumer confidence in processed meat products following a food adulteration episode is a multifaceted and difficult process. Food authorities and the food industry can benefit from the insights provided by this study to address issues affecting consumer confidence and to improve their communication strategies during future food adulteration incidents.

Background: Strict allergen avoidance is important in day-to-day management of food allergy and avoidance when eating outside the home can present particular difficulties. EU legislation (EU FIC) introduced in December 2014 aimed to improve food allergen information provision for customers by requiring retailers of non-prepacked foods to provide information related to the content of one or more of 14 specified food allergens within their foods.Objectives: To investigate the impact of EU FIC on the behaviours, experiences and attitudes of consumers with food allergy when eating out.Methods: As part of longitudinal research, participants with food allergy from across the UK took part in either (A) pre and post legislation in-depth interviews, or (B) pre and post legislation surveys. In-depth interviews were carried out with 28 participants pre and post legislation and analysed using the framework approach. Self-report surveys were completed by 129 participants pre and post legislation, and responses were subject to quantitative analyses.Results: Improvements in allergen information provision and raised awareness of food allergy in eating out venues were reported following introduction of EU FIC. Whilst participants favoured written allergen information, they expressed greater confidence in communicating with eating out staff and in trusting the allergen information that they provided. Improvements were judged to be gradual, sporadic or inconsistent in implementation.Conclusion & clinical relevance: For many participants, the “ideal” eating out experience was one in which a range of information resources were available and where written allergen information was complemented by proactive and accommodating staff within an allergy-aware environment. Whilst the onus is on legislators and food providers to ensure that adequate allergen information is provided, clinicians play an important role in encouraging patients with food allergy to pursue their legal right to make allergen enquiries to avoid accidental allergen ingestion when eating out.

BackgroundAvoiding food allergens when eating outside the home presents particular difficulties for food allergic (FA) and intolerant (FI) consumers and a lack of allergen information in restaurants and takeaways causes unnecessary restrictions. Across Europe, legislation effective from December 2014, aims to improve allergen information by requiring providers of non-prepacked foods to supply information related to allergen content within their foods.MethodsUsing in-depth interviews with 60 FA/FI adults and 15 parents/carers of FA/FI children, we aimed to identify FA/FI consumers’ preferences for written and/or verbal allergen information when eating out or ordering takeaway food.ResultsA complex and dynamic set of preferences and practices for written and verbal allergen information was identified. Overwhelmingly, written information was favoured in the first instance, but credible personal/verbal communication was highly valued and essential to a good eating out experience. Adequate written information facilitated implicit trust in subsequent verbal information. Where written information was limited, FA/FIs depended on social cues to assess the reliability of verbal information resources, and defaulted to tried and tested allergen avoidance strategies when these were deemed unreliable.ConclusionUnderstanding the subtle negotiations and difficulties encountered by FA/FIs when eating out can serve as a guide for legislators and food providers; by encouraging provision of clear written and verbal allergen information, and training of proactive, allergen-aware staff. This, in tandem with legal requirements for allergen information provision, paves the way for FA/FIs to feel more confident in eating out choices; and to experience improved eating out experiences.

There is a growing awareness amongst critical care practitioners that the impact of intensive care medicine extends beyond the patient to include the psychological impact on close family members. Several studies have addressed the needs of relatives within the intensive care context but the psychobiological impact of the experience has largely been ignored. Such impact is important in respect to health and well-being of the relative, with potential to influence patient recovery. The current feasibility study aimed to examine the acute psychobiological impact of the intensive care experience on relatives. Using a mixed methods approach, quantitative and qualitative data were collected simultaneously. Six relatives of patients admitted to the intensive care unit (ICU) of a District General Hospital, were assessed within 48 h of admission. Qualitative data were provided from semi-structured interviews analysed using interpretative phenomenological analysis. Quantitative data were collected using a range of standardised self-report questionnaires measuring coping responses, emotion, trauma symptoms and social support, and through sampling of diurnal salivary cortisol as a biomarker of stress. Four themes were identified from interview: the ICU environment, emotional responses, family relationships and support. Questionnaires identified high levels of anxiety, depression and trauma symptoms; the most commonly utilised coping techniques were acceptance, seeking support through advice and information, and substance use. Social support emerged as a key factor with focused inner circle support relating to family and ICU staff. Depressed mood and avoidance were linked to greater mean cortisol levels across the day. Greater social network and coping via self-distraction were related to lower evening cortisol, indicating them as protective factors in the ICU context. The experience of ICU has a psychological and physiological impact on relatives, suggesting the importance of identifying cost-effective interventions with evaluations of health benefits to both relatives and patients.

OBJECTIVE: Acute changes in social belonging are important triggers for alterations in health and well-being, yet research has emphasised the negative effects of 'exclusion' at the expense of evaluating the potentially positive effects of 'inclusion'. This study examined the impact of acute belonging on physiological and psychological outcomes. DESIGN AND MAIN OUTCOME MEASURES: A healthy population (N = 138) were randomly allocated to 'included' or 'excluded' conditions. Condition-dependent differences in pre/during-task heart rate and pre/post-task self-reports of negative/positive mood, and social self-esteem, were assessed. RESULTS: Included participants showed decreased heart rate and negative mood, and increased social self-esteem. No inclusion-related change in positive mood was shown. An increase in heart rate was observed in excluded participants though no changes in negative/positive mood or social self-esteem were shown. Shifts in social self-esteem acted as a mechanism through which inclusion/exclusion impacted upon negative and positive mood alterations. Results remained significant in presence of covariates (sex, global self-esteem, rumination and social anxiety). CONCLUSION: Findings suggest that acting to enhance belonging through 'inclusion' resulted in adaptive physiological and psychological outcomes. Neutral and potentially protective responses were observed in the immediate aftermath of 'exclusion'. Self-esteem served as one route through which these effects were transmitted.

This study examined the role of social belonging and self-esteem in acute physical health and mood in 159 young adolescents (aged 11 to 14 years). Standardized self-report measures of belongingness (school, home and community), self-esteem, acute physical symptoms, and affect, were completed for the previous month. Higher levels of inclusive belonging were associated with fewer physical symptoms and better affect. Domain specific belonging was independently linked to acute physical symptoms and level of affect, with pathways between belonging and outcome mediated by self-esteem. Findings emphasize the need for greater recognition of the role of belonging in physical health outcomes.