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Background: Regular physical activity (PA) is one of the most cited health protective factors for the prevention of the leading noncommunicable diseases. Four-fifths of adolescents are not reaching public health guidelines for recommended levels of PA globally. Understanding factors that influence PA can aid the design of more effective interventions. Objective: The aim of the study was to assess the association between potential parental and peer correlates and PA recommendations compliance among 13-16 years old adolescents. Methods: We used nationally representative data originated from the Health Behaviour in School-aged Children survey realized in 2014 in Slovakia. Data were obtained by questionnaires measuring potential parental and peers' correlates. Gender differences were assessed using chi square test. The associations between potential parental or peers' correlates and moderate-to-vigorous PA (MVPA) of adolescents were explored using logistic regression models adjusted for gender, age, and family affluence. Interaction of the effect of each parental and peer correlate with gender on MVPA was tested. Results: Prevalence of sufficient MVPA was higher among boys than among girls (p < .001). Boys reported more frequently than girls that their best friend does sport every week or that they used to play sport with parents at least once a week (p < .001). All explored variables representing potential parental and peers' correlates were significantly associated with sufficient MVPA of adolescents. However, only the association of a best friend and father doing sport every week and playing sport with parents remained significantly associated with sufficient MVPA of adolescents in mutually adjusted model. Conclusion: Our findings indicate that best friends and fathers may play role in PA behaviour of adolescents through behaviour modelling, and parents in general through tangible parental support (playing sport with children).

Objectives Spirituality and religious attendance (RA) have been suggested to protect against adolescent health-risk behaviour (HRB). The aim of this study was to explore the interrelatedness of these two concepts in a secular environment. Methods A nationally representative sample (n = 4566, 14.4 ± 1.1 years, 48.8% boys) of adolescents participated in the 2014 Health Behaviour in School-aged Children cross-sectional study. RA, spirituality (modified version of the Spiritual Well-Being Scale), tobacco, alcohol, cannabis and drug use and the prevalence of sexual intercourse were measured. Results RA and spirituality were associated with a lower chance of weekly smoking, with odds ratios (OR) 0.57 [95% confidence interval (CI) 0.36–0.88] for RA and 0.88 (0.80–0.97) for spirituality. Higher spirituality was also associated with a lower risk of weekly drinking [OR (95% CI) 0.91 (0.83–0.995)]. The multiplicative interaction of RA and spirituality was associated with less risky behaviour for four of five explored HRB. RA was not a significant mediator for the association of spirituality with HRB. Conclusions Our findings suggest that high spirituality only protects adolescents from HRB if combined with RA. Electronic supplementary material The online version of this article (10.1007/s00038-018-1116-4) contains supplementary material, which is available to authorized users.

Objective To investigate the association between sleep duration and self-rated health and psychosomatic health complaints in a representative sample of Slovak adolescents aged 13 and 15 years. Background According to empirically supported recommendations adolescents age 13 to 18 years old should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Methods We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia comprising 8,405 adolescents aged from 11 to 15 years (mean age 13.43; 50.9% boys). Presented are results for specific age groups of 13-years old (n = 1,909) and 15-years old (n = 1,293) adolescents. Linear regression models adjusted for age and gender were used to asses associations between sleep duration and self-rated health and psychosomatic complaints. The modifications of the associations by age and gender were also explored. Results Insufficient sleep duration (less than 8hours) was significantly associated with worse self-rated health and more overall as well as specific psychosomatic health complaints including headache, backache, feeling low, irritability and bad temper, feeling nervous, sleeping difficulties and feeling dizzy. Conclusion In order to promote the health and well-being of adolescents, interventions to improve sleep duration are needed (Tab. 3, Ref. 36).

Cardiovascular comorbidities are independent risk factors for mortality in dialysis patients. MicroRNA signaling has an important role in vascular aging and cardiac health, while physical activity is a primary nonpharmacologic treatment for cardiovascular comorbidities in dialysis patients. To identify the relationships between muscle function, miRNA signaling pathways, the presence of vascular calcifications and the severity of cardiovascular comorbidities, we initially enrolled 90 subjects on hemodialysis therapy and collected complete data from 46 subjects. A group of 26 subjects inactiv group (INC) was monitored during 12 weeks of physical inactivity and another group of 20 patients exercise group (EXC) was followed during 12 weeks of intradialytic, moderate intensity, resistance training intervention applied three times per week. In both groups, we assessed the expression levels of myo‐miRNAs, proteins, and muscle function (MF) before and after the 12‐week period. Data on the presence of vascular calcifications and the severity of cardiac comorbidities were collected from the patients’ EuCliD® records. Using a full structural equitation modelling of the total study sample, we found that the higher the increase in MF was observed in patients, the higher the probability of a decrease in the expression of miR‐206 and TRIM63 and the lower severity of cardiac comorbidities. A reduced structural model in INC patients showed that the higher the decrease in MF, the higher the probability of the presence of calcifications and the higher severity of cardiac comorbidities. In EXC patients, we found that the higher the increase in MF, the lower the probability of higher severity of cardiovascular comorbidities., miRNA‐206 associated with the myosynthetic signalling pathway that seems to have a positive effect on muscle function and associated with the presence of vascular calcifications and severity of cardiovascular comorbidities among dialysis patients.

Pandemic management increases the burden on healthcare workers to provide care and also affects their personal lives, with dentists being at particular risk. Therefore, we aim to describe the quality of life (QoL) and limitations experienced due to pandemic management-related measures (PanMan), as well as to assess the association of PanMan with QoL during the first lockdown after the coronavirus outbreak. We obtained data from 500 dentists (33.2% males, M/SD = 43.8) registered with the Slovak Chamber of Dentists using an online questionnaire. We categorized PanMan as the availability of personal protective equipment (PPE) and the ability to implement anti-pandemic measures, information overload, pandemic-related limitations and QoL in terms of their impact on family life and activities, housekeeping, relationships with relatives, financial situation and mental well-being. PanMan mainly affected financial situation, mental well-being and housekeeping. Factors contributing most towards the worsening of QoL were information overload (odds ratio/95% confidence interval, OR/CI: 5.79/2.64–12.71) and several pandemic-related limitations. These consisted of (OR/CI): a lack of PPE (5.17/2.48–10.77), infection risks in the work environment (3.06/1.57–5.95), obligatory safety measures (3.02/1.47–6.21), lack of staff (2.85/1.30–6.25) and client concerns (3.56/1.70–7.49). Pandemic management has led to a considerable worsening of dentists’ QoL.

BACKGROUND The creation of vascular access is an essential condition for providing hemodialysis, which remains the only option for most patients suffering from end-stage renal disease. Selection of the type of vascular access affects patients' clinical outcomes, access maintenance frequency, risk of infection and major adverse cardiac events during dialysis. To improve the decision-making process, we performed a retrospective clinical data analysis of dialyzed patients and critically compared the survival rates between two types of vascular access applied during dialysis therapy during a 5 years follow-up period. METHODS Using nationally representative data from 18 dialysis centers across Slovakia, we explore and compare survival rates of 960 adult patients undergoing hemodialysis using either a central venous catheter (CVC) or an arteriovenous fistula (AVF). Length of dialysis, protein malnutrition and comorbidities were examined as possible covariates that might influence survival rates. RESULTS Chances of surviving for a one-year period were higher by 52% in AVF patients compared to CVC patients (HR 1.52; 95% CI 1.27-1.83; P

Background: Health characteristics associated with uric acid (UA) in the Roma minority remain less well known. The study sought to determine the ethnicity- and sex-specific associations of serum UA with health factors in Eastern Slovakian Roma and non-Roma populations. Methods: Data from the comparative cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The study enrolled 452 Roma subjects (35.2% men) and 403 non-Roma individuals (45.9% men) aged 18–55 years. Results: All study parameters differed between the sexes in both the Roma and non-Roma participants (p &lt, 0.05). UA was related to sex with odds ratio for female sex 0.873, 95% CI 0.853–0.893 (p &lt, 0.0001) per 10-unit increase of UA. Average level of UA ± standard deviation was lower in Roma than in non-Roma (226.54 ± 79.8 vs. 259.11 ± 84.53 umol/L, p &lt, 0.0001). The Roma population presented with greater levels of high-sensitivity C-reactive protein (hsCRP) (3.07 ± 4 mg/L vs. 1.98 ± 2.83 mg/L, 0.0001) and ferritin in Roma males (403.78 ± 391.84 vs. 302.67 ± 236.26 mg/L, 0.0001). Conclusions: Serum UA is sex- and ethnicity specific. Elevated levels of hsCRP and ferritin particularly in Roma males can reflect low-grade systemic inflammation and thus serve as a marker of an increased cardiovascular risk.

The aim of this study was to investigate the test&ndash, retest reliability of the motives for undertaking physical activity (PA) items from the Health Behavior in School-Aged Children (HBSC) study questionnaire among Slovak and Czech adolescents and to determine whether this reliability differs by gender, age group and country. We obtained data from 580 students aged 11 and 15 years old (51.2% boys) who participated in a test and retest study with a four-week interval in 2013 via the Health Behavior in School-Aged Children cross-sectional study in the Czech Republic and Slovakia. We estimated the test&ndash, retest reliability of all 13 dichotomized motives by using Intraclass Correlation Coefficients (ICC) and Cohen&rsquo, s Kappa statistics, for continuous and dichotomized motives, respectively. Test&ndash, retest reliability showed moderate agreement for nine motives (ICC from 0.41 to 0.60) and fair agreement for four motives (ICC from 0.33 to 0.40). Kappa statistics were similarly moderate to large (0.33 to 0.61), except for three motives with small or trivial correlations. The motives &ldquo, To improve my health&rdquo, and &ldquo, To enjoy the feeling of using my body&rdquo, had consistently low Kappas and correlations. Overall, the results of this study suggest that most questions on motives for PA on the HBSC questionnaire have acceptable test&ndash, retest characteristics for use among adolescents.

Care for adolescents with emotional and behavioral problems (EBP) is frequently unequally distributed. Parents may play a role in the access to this care. Therefore, the aim was to explore the association between parental characteristics and their adolescent&rsquo, s enrollment in psychosocial care. We used data from the Care4Youth cohort study. Our sample consisted of 446 adolescents (mean age 13.22 years, 48% boys) and 382 parents (mean age 42.95 years, 14% males). EBP combined with enrollment created four groups: 1, no EBP/no care, 2, no EBP/care, 3, EBP/no care, 4, EBP/care. We assessed differences in parental characteristics among the groups. Group 2 had a significantly lower socioeconomic position (p &lt, 0.01), more psychological distress (p &lt, 0.001), poorer supervision (p &lt, 0.001) and lower family social support (p &lt, 0.05) than Group 1. Group 4 had a significantly lower socioeconomic position (p &lt, 0.01) and poorer supervision (p &lt, 0.001) than Group 1. Group 3 had significantly poorer supervision (p &lt, 0.001) than Group 4. The poor supervision in Group 3 requires attention, as these adolescents receive no care. The quality of parental supervision should be addressed generally, e.g., by providing better parenting support and more parental training.

The miRNA-206 and miRNA-23a play an important role in muscle tissue hypertrophy, regeneration and atrophy. Both of these miRNAs have been highlighted as promising adaptation predictors; however, the available evidence on associations is inconclusive. Therefore, our aim was to assess the expression levels of these two miRNAs as predictors of change in muscle function during strength training and physical inactivity among dialysed patients. For this purpose, 46 haemodialysis patients were monitored for 12-weeks of either intradialytic strength training (EXG, n = 20) or physical inactivity during dialysis (CON, n = 26). In both groups of patients, we assessed the baseline expression levels of miRNA-23a and miRNA-206 and the isometric force generated during hip flexion (HF) contraction before and after the 12-week period. Among the EXG group, the expression of miRNA-206 predicted the change in HF (R2 = 0.63, p = 0.0005) much more strongly than the expression of miRNA-23a (R2 = 0.21, p = 0.027). Interestingly, baseline miRNA-23a (R2 = 0.30, p = 0.006) predicted the change in HF much more than miRNA-206 (p = ns) among the CON group. Our study indicates that the baseline expression of miRNA-206 could predict the response to strength training, while miRNA-23a could serve as a potential predictive marker of functional changes during physical inactivity in dialysis patients.

Background The Internet may serve as a suitable environment for discriminated adolescents as they may consider the online space as the place where they have possibility to build social ties they are missing in their offline life or manage their self-presentation. Therefore, our aim was to explore the association between different types of discrimination by peers (because of gender, physical appearance, culture/skin color/language, unfavorable family situation) and excessive Internet use (EIU), and whether gender moderates this association. Methods We used data from a representative sample of 6,462 Slovak adolescents (mean age: 13.00, 49.6% boys) from the HBSC study conducted in 2018. Data were collected through online self-reported questionnaires. We assessed the association between various types of discrimination by peers and EIU using linear regression, and the role of gender as potential moderator. Results Discrimination because of physical appearance was most prevalent (18.0%). Adolescents exposed to discrimination by peers reported higher levels of EIU. We found an interaction of gender on the association of discrimination because unfavorable family situation with EIU. Boys who experienced this type of discrimination were at higher risk of EIU compared to girls. Conclusion Discriminated adolescents are more likely to use the Internet excessively, with some associations being stronger for boys than for girls. Prevention strategies focused on raising adolescent awareness of the risks and benefits of the Internet should target discriminated adolescents, especially boys, as they seem to be the vulnerable group.

Background and Aims Depression and anxiety is common in dialysed patients (Ng et al., 2015; de Brito et al., 2019) and associated with decreased quality of life, worse health outcomes and increased mortality (Schouten et al., 2019, Lopes at al., 2002). Health literacy (HL) as the ability to gain access, understand, and use information to promote and maintain good health (WHO, 1998) may be hampered by emotional problems such as depression and anxiety. The aim of our study is to examine the association of HL with depression and anxiety in dialysed patients in Slovakia. Method Cross-sectional study on 542 dialysed patients (mean age = 63.6, males = 60.7%) was conducted in 20 dialysis clinics in Slovakia from January to November 2018. Socio-demographic data, data on 9 domains of HL and data on depression and anxiety were collected by questionnaires. Hierarchical cluster analysis was used to create three clusters of patients (low, moderate, high HL). Depression and anxiety was dichotomized as 0-no/low symptoms and 1-moderate/severe symptoms. Association of HL clusters with depression and anxiety was analysed using logistic regression adjusted for age and gender. Results We found that patients in low HL cluster and moderate HL cluster were more likely to have moderate/severe symptoms of depression and anxiety than patients in high HL cluster. Odds ratio (OR) for depression for low HL cluster: 7.60; 95% Confidence Interval (CI): 2.88 – 20.06; p Conclusion Patients with lower levels of HL suffer from anxiety and depression more than patients with higher levels of HL. These findings point to the need of regular screening of emotional problems such as depression and anxiety and their treatment as they may hamper capacities of dialysed patients for self-management as well as effective treatment of the disease from the perspective of healthcare providers.

Background: People exposed to childhood trauma show insecure attachment patterns and are more prone to chronic and pain-related conditions, including migraine. The aim of this study was to explore the mediating role of attachment in the association between childhood trauma and adulthood chronic health conditions, with a focus on migraine. Methods: Respondents from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male) were asked to report various chronic and pain-related conditions, childhood trauma (The Childhood Trauma Questionnaire, CTQ), and attachment anxiety and avoidance (The Experience in Close Relationships Revised, ECR-R) in a cross-sectional, questionnaire-based survey conducted in 2016. Structural equation models (SEM) adjusted for sociodemographic variables were used to assess the relationship between childhood trauma, adulthood attachment, and adulthood chronic health conditions (migraine, other pain-related conditions, chronic health conditions other than pain, no chronic health complaints). Results: After adjusting for sociodemographic variables, SEM confirmed a significant mediation of the relationship between childhood trauma and migraine through adulthood attachment. There was no mediation effect of adulthood attachment found in other health complaints. Conclusion: This study highlights the mediation effect of attachment in the link between childhood trauma and migraine. Attachment-based therapeutic interventions can be useful in the treatment of patients with migraine.

Background: The aim of our work is to objectify the manner of transmission of HBV infection in young adult and middle-aged Roma people who live in the settlements. Methods: We used data from the cross-sectional study HepaMeta. We analyzed Roma people living in the settlements in East Slovakia, who have had HBsAg and anti HBc IgG antibodies examined. Results: We analyzed a cohort of 452 Roma participants with a mean of age 34.67 ± 9.14 years—159 (35.2%) were males. HBsAg positivity was diagnosed in 12.4% and the presence of anti HBc IgG antibodies was confirmed in 52% of participants. Prevalence of HBsAg positivity increases significantly with higher age, (p = 0.026), as well as the presence of anti HBc IgG antibodies (p &lt, 0.0001). The prevalence of HBsAg positivity has doubled and anti HBc IgG positivity has tripled within two decades (&lt, 25 years vs. 35–45 years) in Roma settlements in East Slovakia. Conclusions: These findings allow us to express an opinion that horizontal transmission in adulthood may play an important role in the spreading of HBV infection.

Periodontal disease is inflammation of the gums and without good oral hygiene, it can progress to periodontitis. Oral hygiene might be related to a patient&rsquo, s health literacy (HL), defined as ability to gain access, understand, and use information to promote and maintain good health. The aim of our study is to examine the associations of HL with indicators of periodontal disease. A cross-sectional study on 1117 adults (36.2% males, mean age = 36.4, SD = 14.2) attending dental hygiene treatment was conducted. Data on demographics, socioeconomic status, and nine domains of HL (Health Literacy Questionnaire, HLQ) were collected by questionnaire, and Community Periodontal Index of Treatment Needs (CPITN) was established by the dental hygienist. Data were analysed using t-tests and logistic regression. Respondents with periodontal disease (N = 152) had statistically significantly lower levels of HL in seven out of nine HLQ domains compared to intact patients (N = 818) (t from 3.03 to 4.75, p &lt, 0.01). Association of higher HL in seven domains with lower chance of diagnosed periodontal disease remain significant even after adjustment for age, gender and educational attainment (adjusted ORs 0.55&ndash, 0.67, p &lt, 0.05). Our findings confirm that an individual&rsquo, s lower HL is significantly associated with higher chance of periodontal disease incidence, specifically among Slovak adults attending oral hygiene clinics. HL might be a promising factor in the improvement of oral health in this population, worthy of consideration in intervention and preventive activities.

The aim is to describe a profile of systemic lupus erythematosus (SLE) patient (socio-demographic data, course of disease, health status, and health care utilization, SLE impact on their life, SLE awareness) and to explore the association of patient&rsquo, s perspective with clinical indicators. Adult patients diagnosed by SLE were recruited in outpatient clinics (n = 76, 88% female, data collected in 2012&ndash, 2016, Slovakia). The association of patients&rsquo, perspective (SLE status, health complaints during remission, SLE impact, hospitalizations) with clinical activity (European Consensus Lupus Activity Measurement Index - ECLAM) and inflammatory marker (erythrocyte sedimentation rate - ESR) was assessed by t-test for independent variables and one-way ANOVA. Almost 17.9% of patients reported relapse. During remission, they mostly suffered fatigue and pain. Nearly all patients were on chronic pharmacological treatment. Most of the patients assessed SLE impact on their life as restrictive (56.9%) or very restrictive (23.1%). The most frequent source of information was their physician, and 67.2% reported that they have sufficient information about the disease and its treatment. Only the association of SLE status and hospitalization with clinical activity (ECLAM) and inflammatory marker (ESR) were confirmed. With recent improvements in diagnostics and therapy options, the prognosis for patients with SLE has improved. Nevertheless, the impact of this disease on all areas of a patient&rsquo, s life is extensive.

Effective vascular access (VA) is an essential condition for providing hemodialysis, affecting patients&rsquo, health outcomes. We aim to explore how health literacy (HL) as a non-clinical factor is associated with the decision-making process regarding VA type selection. Using data from 20 dialysis centers across Slovakia (n = 542, mean age = 63.6, males = 60.7%), the association of HL with type of VA (arteriovenous fistula (AVF) vs. central venous catheter (CVC)) was analyzed using a logistic regression model adjusted for sociodemographic characteristics and comorbidity. Sociodemographic data and data on nine domains of HL were collected by questionnaire. Data on VA and comorbidity were obtained from a medical records. Patients with a greater ability to engage with healthcare providers (odds ratio (OR): 1.34, 95% confidence interval (CI): 1.00&ndash, 1.78), those with a better ability to navigate the healthcare system (OR: 1.41, 95% CI: 1.08&ndash, 1.85), those more able to find good health information (OR: 1.52, 95% CI: 1.15&ndash, 2.03), and those who understand it well enough to know what to do (OR: 1.52, 95% CI: 1.12&ndash, 2.06) are more likely to have AVF. Patients&rsquo, HL is associated with the type of VA, therefore, it should be considered in the decision-making process regarding the selection of the type of VA, thereby informing strategies for improving patients&rsquo, HL and doctor&ndash, patient communication.

Introduction Health literacy (HL) is a key concept for interventions that aim at improving the health of individuals and populations, but it is also a way to improve the health care system, especially in the field of interaction between healthcare providers and patients. The aim of the study was to determine the level of health literacy among students of medical faculties. Methods A cross-sectional study was realized at three faculties of medicine in the academic year 2015/2016. In the study there were 390 students of medicine (male 41.5%, Slovak students 50.1%) with an average age of 23 (SD = 3). We administered the health literacy questionnaire (HLQ) with items including school characteristics and health status. We tested associations between HL and sex, year of study, study and health status with Pearson χ2 test in statistical program SPSS 21.0. Results The surveyed students more often had an optimal HL, with deficiencies in the appraisal of health information and the ability to actively cooperate with healthcare (HC) providers. Women more often had the deficiency of HL in cooperation with HC providers and navigation in the HC system. Students of the first to third grade of study had a more frequent deficiency of HL in information to manage health and understanding the health information (compared with higher year of study). Foreign students more often had an optimal level of HL in social support in health, cooperation with HC providers and in navigating the HC system. Health respondents more often had a deficiency of HL in understanding health information when compared to students who had a chronic disease/health complications. Conclusion We found that students of medical faculties demonstrate a lack of HL, which is mainly related to the ability to cooperate with HC providers, to assess and understand health information, but also to navigate the HC system. On the basis of our findings, we will be able to develop an appropriate intervention to improve HL in a targeted group of medical faculty students.

The aim was to explore the associations of family composition, family support and communication with emotional and behavioural problems among adolescents as well as a possible moderating effect of gender on these associations. Data from the Health Behaviour in School-aged Children study conducted in 2014 in Slovakia were used. The final sample consisted of 2908 students (mean age 14.36; 49.7% boys). We explored the association using generalized linear models. We found that non-intact family was significantly associated with a higher score in emotional and behavioural problems. Family support and communication were found to be significantly associated with a lower score in emotional and behavioural problems. Significant interactions of gender and family communication with emotional and behavioural problems were found, showing that family communication decreased emotional and behavioural problems only in girls. Family composition, family support and communication play an important role in the occurrence of emotional and behavioural problems in adolescence. Family communication lowers these problems only in girls. Prevention and intervention programmes could be focused on parent–child communication strategies with the importance of differences in the needs of boys and girls.

Objectives We aimed to assess the associations of involvement in selected unstructured activities (UA) with health-risk behaviours and academic achievement and the degree to which the participation in organized leisure-time activities (OLTA) changes these associations. Methods Using a sample of 6935 Czech adolescents aged 13 and 15 years, we investigated adolescents’ weekly involvement in hanging out, visiting shopping malls for fun and meeting friends after 8 p.m., OLTA and engagement in three health-risk behaviours and academic achievement. Results Weekly involvement in the selected UA was associated with higher odds for regular smoking, being drunk, having early sexual intercourse and low academic achievement. Concurrent participation in OLTA did not buffer these negative outcomes, except for sexual experience. However, those highly engaged only in UA were more likely to participate in the health-risk behaviours and report worse academic achievement than those participating in any OLTA concurrently. Conclusions The selected UA are strongly associated with an increased occurrence of adolescents’ health-risk behaviours and low academic achievement. Concurrent participation in OLTA does not buffer these negative outcomes significantly, but adolescents engaged only in UA consistently report the least favourable outcomes.

Background: This study examined the associations of Internet and computer screen time with school difficulties and the role of sleep quality and soft and energy drinks consumption.Methods: We used data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents (aged 11.0-15.9 years, N = 7595, 48.1% boys). We examined the inter-relations between time spent with on digital devices (time spent playing digital games or Internet use), sleeping quality (sleeping shortage, sleeping difficulties), soft/energy drinks consumption and school problems (low academic achievement, disliking school, being pressured by schoolwork and truancy), using structural equation modeling.Results: Results showed that the more time adolescents spent on digital devices during leisure time, the more school problems they had. This association was mediated by a higher consumption of soft or energy drinks and a lower quality of sleeping. The direct effect of time spent on digital devices on school problems and its indirect effect via sleeping quality were relatively small (-0.26 and -0.30, respectively, standardized solution), compared with the indirect effect of time spent on digital devices via soft/energy drinks consumption as well as sleeping quality (0.65, standardized solution).Conclusions: Time spent on digital devices is associated with school problems, with sleeping and soft/energy drinks consumption playing a substantial role in this association.

Objective: The aim of this study was to analyse differences in health, eating habits and social support in adolescents with type 1 diabetes mellitus (T1DM) in comparison to peers with another long-term illness or without any medical condition. Methods: We used self-reported data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents as well as data from adolescents with T1DM collected in outpatient settings (11 to 15 years old, N = 8,910, 50.3% of boys). Logistic regression models and general linear models were used to analyse differences between adolescents with T1DM and their peers with and without long-term illness in self-rated health, life satisfaction, health complaints, regular breakfast, sweets and soft drink consumption, and perceived support from family, teachers and classmates. Results: Adolescents with T1DM reported worse self-rated health and suffer from more health complaints, but they have lower chance of having breakfast irregularly in comparison to their peers with another long-term illness or without any medical condition. Moreover, compared with their peers, adolescents with T1DM perceived stronger support from teachers and classmates, but weaker support from their family. We did not confirm any differences in life satisfaction, sweets and soft drink consumption between adolescents with T1DM and their peers. Conclusions: Adolescents with T1DM reported more regular eating habits, no difference in life satisfaction and more social support outside the family in comparison to their peers. However, their worse self-rated health, more health complaints and weaker support from family should be considered in interventions targeting psychosocial adjustment of adolescents with T1DM.