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Background. Invasive Meningococcal Disease is a severe disease mainly affecting infants and young children. Most infections are caused by serogroups A, B, C, W, X, and Y. In the last 10 years, serogroup B has been the main cause of Invasive Meningococcal Disease in Europe. Recent data resulting from an observational study conducted in Italy show a significant reduction in the number of Invasive Meningococcal Disease cases due to Neisseria meningitidis B after the introduction of vaccine 4CMenB. Thus, the Naples Team of Federation of Italian Primary Care Pediatricians and the Public Health Department started an active collaboration focused on vaccination process management (named “Progetto Via”) with the aim of increasing Meningococcal B vaccination coverage. Study design. Source of data is the regional platform “GE.VA.”. Every Primary care Pediatrician uses daily to record vaccination activity. This platform is integrated with data entered by operators of the District/ Vaccination Center. Methods. Time: January 2019 – December 2019. The Federation of Italian Primary Care Pediatricians/ Naples organized a meeting to identify six coordinators. The pediatricians could choose to counsel in their own offices and send children to the vaccination center or to counsel and vaccinate directly in their own clinics. Results. A total of 78 pediatricians took part in the project: 46 did only counseling and 32 did both counseling and vaccination in their medical clinic. Data obtained show an overall average vaccination coverage growth of about 13% in the first 4 months of the survey, and a further growth of about 11% in the following seven months, with a total growth in the entire period of 24%. The pediatricians’ counseling is essential to recover non-compliant subjects, considering both the relationship of trust with the families and the visits already scheduled as an ideal moment for vaccinations’ status check. Conclusions. The project highlights how an effective collaboration between family pediatricians and the Local Health Authority becomes valuable in getting closer to reach the Ministerial goal of 95%. Vaccination coverage increased significantly when family pediatricians supported the activity of vaccine centers in distress in many regional situations. The trust relationship, the hourly availability and the capillary network of family pediatricians’ clinics were key elements for the success of this project and were also recognized by parents. [ABSTRACT FROM AUTHOR]

Introduction: Recommender systems, digital tools providing recommendations, and digital nudges increasingly affect our lives. The combination of digital nudges and recommender systems is very attractive for its application in preventing overweight and obesity. However, linking recommender systems with personalised digital nudges has a potential yet to be fully exploited. Therefore, this study aims to conduct a scoping review to identify which digital nudges or recommender systems or their combinations have been used in obesity prevention and to map these systems according to the target population, health behaviour, system classification (eg, mechanisms for developing recommendations, delivery channels, personalisation, interconnection, used combination), and system implementation., Methods and Analysis: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline was used to inform protocol development. The eligibility criteria are based on the PCC framework (Population: any human; Concept: recommender systems or digital nudges; Context: obesity prevention). MEDLINE, PsycINFO, Web of Science, CINHAL, Scopus, ACM Digital Library and IEEE Xplore were searched until September 2023. Primary studies with any design published in peer-reviewed academic journals and peer-reviewed conference papers will be included. Data will be extracted into a pre-developed extraction sheet. Results will be synthesised descriptively and narratively., Ethics and Dissemination: No ethical approval is required for the scoping review, as data will be obtained from publicly available sources. The results of this scoping review will be published in a peer-reviewed journal, presented at conferences and used to inform the co-creation process and intervention adaptation in the context of a HealthyW8 project (www.healthyw8.eu)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Despite international efforts, the number of individuals struggling with obesity is still increasing. An important aspect of obesity prevention relates to identifying individuals at risk at early stage, allowing for timely risk stratification and initiation of countermeasures. However, obesity is complex and multifactorial by nature, and one isolated (bio)marker is unlikely to enable an optimal risk stratification and prognosis for the individual; rather, a combined set is required. Such a multicomponent interpretation would integrate biomarkers from various domains, such as classical markers (eg, anthropometrics, blood lipids), multiomics (eg, genetics, proteomics, metabolomics), lifestyle and behavioural attributes (eg, diet, physical activity, sleep patterns), psychological traits (mental health status such as depression) and additional host factors (eg, gut microbiota diversity), also by means of advanced interpretation tools such as machine learning. In this paper, we will present a protocol that will be employed for a scoping review that attempts to summarise and map the state-of-the-art in the area of multicomponent (bio)markers related to obesity, focusing on the usability and effectiveness of such biomarkers., Methods and Analysis: PubMed, Scopus, CINAHL and Embase databases will be searched using predefined key terms to identify peer-reviewed articles published in English until January 2024. Once downloaded into EndNote for deduplication, CADIMA will be employed to review and select abstracts and full-text articles in a two-step procedure, by two independent reviewers. Data extraction will then be carried out by several independent reviewers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and Peer Review of Electronic Search Strategies guidelines will be followed. Combinations employing at least two biomarkers from different domains will be mapped and discussed., Ethics and Dissemination: Ethical approval is not required; data will rely on published articles. Findings will be published open access in an international peer-reviewed journal. This review will allow guiding future directions for research and public health strategies on obesity prevention, paving the way towards multicomponent interventions., Competing Interests: Competing interests: MSD works as a consultant and an advisory board member at Theralution, Germany. Otherwise, the authors declare no conflict of interest., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Invasive Meningococcal Disease is a severe disease mainly affecting infants and young children. Most infections are caused by serogroups A, B, C, W, X, and Y. In the last 10 years, serogroup B has been the main cause of Invasive Meningococcal Disease in Europe. Recent data resulting from an observational study conducted in Italy show a significant reduction in the number of Invasive Meningococcal Disease cases due to Neisseria meningitidis B after the introduction of vaccine 4CMenB. Thus, the Naples Team of Federation of Italian Primary Care Pediatricians and the Public Health Department started an active collaboration focused on vaccination process management (named "Progetto Via") with the aim of increasing Meningococcal B vaccination coverage., Study Design: Source of data is the regional platform "GE.VA.". Every Primary care Pediatrician uses daily to record vaccination activity. This platform is integrated with data entered by operators of the District/Vaccination Center., Methods: Time: January 2019 - December 2019. The Federation of Italian Primary Care Pediatricians/Naples organized a meeting to identify six coordinators. The pediatricians could choose to counsel in their own offices and send children to the vaccination center or to counsel and vaccinate directly in their own clinics., Results: A total of 78 pediatricians took part in the project: 46 did only counseling and 32 did both counseling and vaccination in their medical clinic. Data obtained show an overall average vaccination coverage growth of about 13% in the first 4 months of the survey, and a further growth of about 11% in the following seven months, with a total growth in the entire period of 24%. The pediatricians' counseling is essential to recover non-compliant subjects, considering both the relationship of trust with the families and the visits already scheduled as an ideal moment for vaccinations' status check., Conclusions: The project highlights how an effective collaboration between family pediatricians and the Local Health Authority becomes valuable in getting closer to reach the Ministerial goal of 95%. Vaccination coverage increased significantly when family pediatricians supported the activity of vaccine centers in distress in many regional situations. The trust relationship, the hourly availability and the capillary network of family pediatricians' clinics were key elements for the success of this project and were also recognized by parents.

The objective of this paper was twofold. First, we estimated consumer preferences for an Italian cheese (Provolone Valpadana) with respect to several attributes and levels, such as price, origin certification, production system, 'free from' labelling, and brand. Second, we identified consumer clusters with similar preferences for various cheese characteristics. Preferences were estimated using the conjoint analysis method. Then, a cluster analysis was used to classify consumers into different (three) clusters followed by a market simulation. In all three clusters, the attribute most preferred by Italian consumers was the brand of the cheese: consumers preferred to purchase Provolone cheese having the lowest price, produced by Auricchio, bearing a European Union (EU) quality certification, produced organically, and non-lactose-free. The results of our study provide helpful information to food companies for better segmenting their market and targeting their consumers, as well as effectively promoting their products using brands, certifications as organic and lactose-free. This study contributes to the literature on consumer preference for the EU labelling scheme (voluntary and mandatory). To our knowledge, this is the first study to investigate this combination of multiple labels displayed on the front of Italian cheese packaging.

Several studies have demonstrated the usefulness of nutritional claims (NCs) to help consumers make more informed food decisions. However, fewer studies have investigated the effect of personal and psychological consumer characteristics on their food purchase decision. Hence, the main aim of this study is to examine the impact of body image, emotional eating style, anxiety traits, and body mass index on consumer preferences for multiple NCs on the front of the package (FOP) of hedonic (potato chips) and utilitarian (toasted bread) products carrying the same NCs. Therefore, a real choice experiment (RCE) has been used and the willingness-to-pay-space model was estimated to analyse the interaction between personal and psychological characteristics and consumer preferences. The main finding suggests differences in purchase behaviour between potato chips and toasted bread. In particular, consumers are willing to pay more for toasted bread with one NC than potato chips with one NC. Moreover, personal and psychological consumer characteristics influence the purchase behaviour regarding food products with nutritional claims. However, only the anxiety trait appears to explain the differences between the selection of both types of food products. In line with this new evidence, we proposed some behavioural, political, and managerial implications.

Nutritional and health claims are a useful tool for promoting healthier food choices and prevent non-communicable disease[s] (NCDs). Exhaustive literature that has investigated consumer evaluation of the presence of nutritional and/or health claim(s) during the decision-making process suggests that consumers' sensitivity towards nutritional claims (NCs) and health claims (HCs) are still fragmented and should be further investigated. Our objective is to study the relationship between choice behaviour, attitudes and socio-demographic characteristics in order to evaluate the effectiveness of consumer characteristics in predicting Spanish consumers' choice of products with NCs and HCs. A discrete choice experiment for yoghurt was conducted on a sample of 218 Spanish consumers, stratified by age, gender, education level, and income. Applying a latent class approach has enabled us to identify a niche of individuals, sensitive of NCs and HCs and to characterize them with respect to the rest of population. Results suggest that consumers positively valued most claims, however, the valuation was heterogeneous, and three consumer segments were identified: 'health-claims oriented', 'nutritional- and health-claim oriented' and 'indifferent'. The results supply insights for the development of more targeted promotion campaigns, as well as for further actions in food marketing.

In face of the high prevalence of non-communicable diseases, nutritional claims represent a useful tool to help people to make healthier food choices. However, recent research notes that when some people experience an intense emotional state, they increase their food consumption, particularly of energy-dense and sweet foods. In consequence, this study aims to assess whether emotional eating (EE) style influences the purchase of food products carrying these claims. To this end, a real choice experiment (RCE) was conducted with 306 participants who were asked to evaluate different types of toast. An error component random parameter logit (ECRPL) was used to analyze their preferences for reduced-fat and low-salt claims toast and the effects of the variation of the EE score on individual preferences. Findings of this study suggest that emotional eating negatively impacts purchasing behavior related to nutritional claims. In particular, a decrease of the willingness to pay between 9% and 16% for every unit of toast with nutritional claims was noted when an increase of EE individual score was registered. In this regard, to increase the effectiveness of the nutritional claims, policymakers and private sectors should consider the management of individuals' emotional states in designing public health policies and marketing strategies, respectively.

Nutritional claim (NC) requirements on food packages are among the most important and influential EU policy measures related to diet and have the capacity to promote healthy eating. This study combines a discrete choice experiment (DCE) method with eye-tracking (ET) technology to assess consumer preferences for multiple NCs in yogurt selection and explores the relationships between the NC preferences and the visual attention paid to these claims and the visual attention and choice decisions. The results indicate that the low-sugar NC was the least-preferred claim in all the models. Overall, the presence of NCs generally increases visual attention in terms of fixation count, which may be linked to an increased likelihood of affecting the final decision to purchase yogurts with NCs., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Introduction: Although previous studies have provided relevant information regarding the progress in the implementation of Regulation (EC) No 1924/2006 of the European Union. So far it not determined the prevalence of relevant nutrition claims in preventing obesity in the Spanish market. Objective: To determine the prevalence of relevant nutritional claims related to prevent the obesity in the Spanish market. Material and methods: A database with 9 food product categories and it nutritional claims was created. Three supermarket chains were included because they represent the 40% of market share. Only the nutritional claims that mention nutrients related obesity was considered. Results: A total of 4,568 products were examined and a total of 900 nutrition claims were found in 20% of the products found. The most frequent nutrients referred in the nutritional claims were fat (42%), sugar (32%), dietary fibre (20%) and salt (6%). Conclusions: In accordance with previous studies, findings reported a low prevalence of nutritional claims indicating that agrifood sector should include more nutritional claims to help consumers making better food choices.

The aim of this study is to assess the influence of body image on consumers' willingness to pay (WTP) for potato chips carrying nutritional claims among obese and non-obese people. About 309 non-clinical individuals participated in a Real Choice Experiment. They were recruited by a company and grouped in: (i) non-obese with good body image; (ii) non-obese with body image dissatisfaction; (iii) obese with good body image; (iv) obese with body image dissatisfaction. Results indicate differences in consumers' willingness to pay among consumer groups. Body image dissatisfaction of normal people did not influence the WTP for healthier chips. Obese people with body image dissatisfaction were willing to pay more for healthier chips (i.e., low-salt content potato chips) than normal ones with body image dissatisfaction. Examining the role of knowledge in the light of how this could impact on body image is relevant to improve the health status of individuals and their diet. Knowledge about nutrition could improve the body image of obese people., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

The aim of this study is to test whether projection bias exists in consumers' purchasing decisions for food products. To achieve our aim, we used a non-hypothetical experiment (i.e., experimental auction), where hungry and non-hungry participants were incentivized to reveal their willingness to pay (WTP). The results confirm the existence of projection bias when consumers made their decisions on food products. In particular, projection bias existed because currently hungry participants were willing to pay a higher price premium for cheeses than satiated ones, both in hungry and satiated future states. Moreover, participants overvalued the food product more when they were delivered in the future hungry condition than in the satiated one. Our study provides clear, quantitative and meaningful evidence of projection bias because our findings are based on economic valuation of food preferences. Indeed, the strength of this study is that findings are expressed in terms of willingness to pay which is an interpretable amount of money.

This paper analyzes consumers' preferences for different lamb meat attributes using a choice experiment. In particular, preferences for the type of commercial lamb meat ("Ternasco" and "Suckling") and the origin of production (locally produced "Ojinegra from Teruel") were evaluated. Moreover, we endogenously identify consumers' segments based on consumers' preferences for the analyzed attributes. Data come from a survey administrated in Spain during 2009. A latent class model was used to estimate the effect of the attributes on consumer utility, derive the willingness to pay and determine consumers' segments. Results suggest that consumers' preferences for both attributes are heterogeneous and two homogenous consumers' segments were detected. The largest segment (79%) did not value any of the analyzed attributes while the smaller one (21%) valued both of them positively. In particular, consumers in this second segment are willing to pay an extra premium for the "Ternasco" lamb meat, around double the premium they are willing to pay for the locally produced lamb meat "Ojinegra from Teruel"., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objectives: To determine the utility of the technetium-labeled autologous white cell scintigraphy (Tc-WCS) for detecting intestinal inflammation in children with suspected inflammatory bowel disease (IBD). Tc-WCS was compared with colonoscopy and histologic examination., Study Design: Forty-eight children (26 boys; median age, 10 years; range, 2-17 years) with symptoms and signs suggesting IBD had colonoscopy with exploration of terminal ileum and mucosal biopsies. The scans were judged to be abnormal if activity was seen in the gut within the first hour., Results: Twenty-one patients had a diagnosis of IBD (Crohn's disease, 13; ulcerative colitis, 5; indeterminate colitis, 3); results of scintigraphy were positive in 16 and negative in 5 (sensitivity, 76.2%); the latter had a moderate degree of intestinal inflammation. In 27 patients, IBD was ruled out. Results of scintigraphy were negative in children with non-specific colitis and in those with lymphoid hyperplasia of the terminal ileum, whereas results were positive in 6 of 12 patients with spondyloarthropathy. In children with IBD, there was a significant correlation between results of scintigraphy and endoscopy for the intensity of inflammation (r = 0.70); however, there was a poor correlation regarding the number of involved segments (r = 0.30) because in 16 patients, endoscopy revealed additional diseased segments as compared with scintigraphy., Conclusions: A positive Tc-WCS result indicates the presence of an inflammatory process of the gut, whereas a negative test result does not rule out intestinal inflammation, especially when the latter is of moderate degree. Colonoscopy and biopsy are the investigations of choice to establish the diagnosis of IBD and are superior to Tc-WCS in assessing topographic extension of IBD.

The diagnostic usefulness of intraepithelial cells with irregular nuclear contours (CINC) (squiggle cells) in esophageal biopsies was investigated in 76 children (range age: 6 months-12 years) with gastroesophageal reflux disease. A further 20 subjects (range age: 10 months-11 years) served as controls. Based on the microscopic changes of the esophagus, according to traditional histological criteria, four groups of patients were identified; esophagitis was severe in 27, moderate in 20, mild in 21, and 8 patients had no clear-cut evidence of microscopic esophagitis. Data are given as mean +/- SD. Intraepithelial CINC had an immunohistochemical profile consistent with T lymphocytes. Patients with severe esophagitis had a CINC density (number per high-power filed) (9.0 +/- 3.5) significantly higher than patients with mild esophagitis (7.0 +/- 3.0) and those without evidence of microscopic esophagitis (6.5 +/- 1.9) (P < 0.05), but not different from those with moderate esophagitis (8.0 +/- 3.6); in all patients groups the CINC density was higher than in controls (2.2 +/- 0.3) (P < 0.01). The percentage of reflux at 24-hr intraesophageal pH monitoring was higher in severe esophagitis patients (11.4 +/- 6.0) as compared to the other groups (moderate: 7.8 +/- 6.3; mild: 6.5 +/- 3.6; no microscopic esophagitis: 6.3 +/- 2.0; P < 0.05). There was no correlation between CINC density and the amount of intraesophageal acid exposure in all patients. Furthermore, 27 of our patients had a normal intraesophageal acid exposure at the prolonged pH test (24-hr % of reflux < or = 4.5): the CINC density was significantly higher in them than in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

In this report, the effects of adenosine on the promyelocytic cell line HL-60 and on T-lymphocytic clones are compared. According to previous reports, adenosine induces a dose-dependent inhibition of DNA synthesis in T-lymphocytes. Conversely, adenosine dose-dependently enhances DNA synthesis in HL-60 cells, as documented with [3H]thymidine uptake studies and flow cytometric cell-cycle analysis. Unlike its effect on lymphocytes, the adenosine effect on HL-60 cells does not seem to be mediated by receptor binding, but it appears to be correlated with an intracellular mechanism following active uptake. Despite the different effects exerted by adenosine on lymphocytes and myeloid cells, a purinergic pathway appears to be more generally involved in the regulation of some phases of cell growth.