Objective. To systematically review the evidence available on the effects of art therapy and music therapy interventions in patients with breast cancer. Design. Systematic search was conducted in PubMed, EBSCO, and Cochrane Central databases. Articles were scanned using the following keywords: “art therapy” or “music therapy” and “breast cancer” or “breast neoplasms,” “breast carcinoma,” “breast tumor,” and “mammary cancer.” Only RCTs published in English, with a control group and experimental group, and presenting pre-/post-therapy results were included. PRISMA guidelines for this systematic review were followed. Results. Twenty randomized controlled trials matched the eligibility criteria. Nine studies evaluated the effect of art therapy, and eleven evaluated the effect of music therapy. Improvements were measured in stress, anxiety, depression reduction, pain, fatigue, or other cancer-related somatic symptoms’ management. Overall, the results show that art therapy was oriented towards the effects on quality of life and emotional symptoms while music therapy is the most often applied for anxiety reduction purposes during or before surgeries or chemotherapy sessions. Conclusion. Art and music therapies show effective opportunities for breast cancer patients to reduce negative emotional state and improve the quality of life and seem to be promising nonmedicated treatment options in breast oncology. However, more detailed and highly descriptive single therapy and primary mental health outcome measuring RCTs are necessary to draw an evidence-based advise for the use of art and music therapies.

Results from several studies show that only obese, unfit subjects, but not obese, fit subjects, are at higher mortality risk than are normal-weight fit subjects. The aim of the study was two-fold: (1) to examine the differences in C-reactive protein levels across different metabolic phenotypes (healthy and unhealthy) of weight status and (2) ascertain whether high levels of cardiorespiratory fitness (CRF) attenuate the association of C-reactive protein and metabolic phenotypes of weight status. This was a pooled study, which included data from three cross-sectional projects (1706 youth (921 girls) aged 12–18 years). We used a Shuttle run test to assess CRF. Adolescents were classified into six metabolic phenotypes (healthy and unhealthy) of weight status (non-overweight, overweight and obese), based on age- and sex-specific cutoff points for triglycerides, systolic blood pressure, HDL-cholesterol, glucose and body mass index. High-sensitivity assays were used to obtain the C-reactive protein as inflammatory biomarker. After adjustment for potential confounders (age, sex, pubertal stage and country), the analysis of covariance (ANCOVA) shows that C-reactive protein is directly associated with metabolic phenotypes of weight status. Subjects with obesity, regardless of their metabolic profile, had higher levels of C-reactive protein Z-score. In addition, (after adjustments for potential confounders) a two-way ANCOVA showed that high levels of CRF attenuated the associations of C-reactive protein levels in metabolic healthy non-overweight and in adolescents with obesity. In conclusion, higher CRF levels may attenuate the detrimental association between obesity and C-reactive protein independently of metabolic phenotype. Findings from this study are important for prevention, clinical practice on issues associated with adiposity and metabolic disorders.

SummaryChildren leisure time is usually decided by their immediate environment, i.e. their family. Therefore, leisure activities which are designed in a family and which enable children to discover pleasant experiences and motivate them to care of their own health are of extreme importance. The aim of the study was to highlight the peculiarities of the organization of leisure time activities in a family for elementary school students in the context of health education. The respondents of the study were 614 elementary school students from eight Western Lithuania schools and 604 of their parents. The study has shown that elementary school students rate their health more favourably than their parents. Almost half of the respondents-children (42.7%) have rated their health as very good and around the same number of children (45.3%) have rated it as good. One fifth of respondents-parents (20.7%) have rated the health of their children as very good and more than half of parents (62.3%) have said that the health of their children is good. The opinion of parents and their children on the issue of the time allocated for leisure activities has been discovered as being similar. Respondentschildren indicate that on weekdays their leisure time averages to 2.4 hours/day and at the weekends to 4.3 hours/day. Respondents-parents indicate that children's leisure time on weekdays lasts for 2.2 hours/ day, and at the weekends it reaches 4.4 hours /day. It has been revealed that the longer the leisure time the children have, the better their health is. The majority of children (78%) believe that they have enough leisure time. Those, who assume that they do not have enough leisure time, and those, who are undecided, make almost one-fourth (24%). A third of elementary school students enjoy physically active forms of leisure time activities (going in for sports) while about a half of respondents-children prefer passive forms

Background: Recently, the leptin/adiponectin (L/A) ratio has been suggested as a novel predictor of cardio-metabolic and other chronic diseases. Aim: To evaluate the ability of leptin (L), adiponectin (A), and the L/A ratio in identifying high risk of insulin resistance IR in adolescents, adjusted by cardiorespiratory fitness, adherence to the Mediterranean diet, and body fat percentage. Subjects and methods: This is a cross-sectional analysis with 529 adolescents aged 12–18 years-old. Blood samples were taken to analyze glucose, insulin, leptin, and adiponectin levels. IR (homeostasis model assessment of insulin resistance (HOMA-IR) was estimated from fasting serum insulin and glucose). Results: Adiponectin, leptin, and L/A ratio were accurate to predict IR among adolescents. The optimal L/A cut-off value to indicate risk of IR development was >0.35 in boys and >0.97 in girls. Logistic analyses showed that the suggested cut-off points for adiponectin (girls: OR: 2.87 (1.26–6.53); p = 0.012); leptin (boys: OR: 5.23 (1.16–7.14) p = 0.006; girls: OR: 2.99 (1.10–8.09) p = 0.031), and the L/A ratio (boys: OR: 8.38 (2.6–26.8) p < 0.001; girls: OR: 6.1 (2.1–17.0) p < 0.001), were significant predictors of IR, after adjustments for age, pubertal stage, adherence to the Mediterranean diet, cardiorespiratory fitness, and body fat percentage. Conclusion: Leptin and L/A ratio were associated with IR risk, after adjustments for confounders in both sexes and adiponectin in girls. The L/A ratio seems to have a higher diagnostic accuracy to identify IR risk than adiponectin or leptin, in both sexes.

Survival of organizations nowadays depends on their ability to learn properly and quickly increase their efficiency and their performance and to adapt to the changing environment. Creating an organizational learning culture (OLC) could achieve an increase in the survivability of organizations. This paper examines the OLC questionnaire, the developed research methodology, adapted andapproved by Israeli local authorities. This study analyses 529 questionnaires filled in by municipalitiesi employees. The aim of the research: the development of a mechanism for increasing the efficiency of the local authorities by influencing the behavior of employees through the creation of Organizational Learning Culture (OLC).