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Existing research underscores the significance of early childhood experiences in the childcare context for the development of socioemotional skills and competencies. However, the practices adopted within childcare for the enhancement of children's socioemotional development and the factors mediating these practices are less adequately researched. The present study contributes to this understanding, through studying the perceptions of 34 educators working in childcare centres in Greece with regard to children's socioemotional development and its promotion. Results showed that although they acknowledged the significance of social and emotional competencies for children's adjustment, learning and well-being, they did not report consistent use of practices having as a goal the promotion of such skills. Explanations involve on the one hand the lack of formal policy and the existence of structural barriers and on the other hand a perception that socioemotional development is mostly affected by factors beyond their influence. Results are discussed in relation to prior research and in terms of their implications for designing interventions, curricula and staff training. © 2014, Taylor & Francis.

The objective of the present survey was to assess the extent and socio-economic determinants of population exposure to secondhand smoke (SHS) in Greece in 2011. The national household survey Hellas Health IV was conducted in October 2011. SHS exposure was based on self-reported exposure within home, workplace and public places. Thirty-three per cent of the respondents reported living in a smoke-free home. Smokers ( p < 0.001) and single individuals ( p < 0.017) were less likely to prohibit smoking at home. SHS exposure at work, in restaurants and in bars/clubs/cafes was frequently mentioned by 41.6, 84.2 and 90.5%, respectively. SHS exposure in a bar/club/cafe was noted more among single individuals ( p = 0.004) and those aged 18-34 years ( p = 0.007). Inhabitants of rural areas were more likely to report someone smoking indoors in all the above venues. Public health education and effective enforcement of the nationwide smoke-free legislation are imperative. © 2013 Taylor & Francis.

Background: Early childhood education services create potentially optimal opportunities to identify and respond effectively to preschoolers' mental health problems. However, little is known about the knowledge, skills and competencies of early childhood educators in the area of mental health. The present study aimed to contribute to this field through conducting focus group interviews with professionals from public early childhood education centres in Greece.Methods: Thirty-four educators attended five focus group meetings, with each group consisting of five to nine participants and two discussion facilitators. A thematic analysis was conducted using line-by-line open coding. Constructed codes from the wording used by the participants in the interviews were created, and constant comparisons for developing themes as well as seeking data not conforming to each theme were used independently by two researchers. At the end of this process, no new information was being provided and there was repetition in each of the categories.Results: The analysis identified three themes in the data: risk factors for preschoolers' mental health problems, signs of preschoolers' mental health problems and practices of helping preschoolers with mental health problems. Results suggested that early childhood educators had satisfactory awareness of many preschoolers' mental health issues, although they showed a rather limited understanding in some domains. Moreover, they seemed to deliver inadequate practices in responding effectively to children's and families' mental health problems.Conclusions: Best practice training in working with preschoolers, families and mental health services seems essential for helping young children receive the best level of support through early identification and intervention services for possible mental health problems. © 2014 Giannakopoulos et al.; licensee BioMed Central Ltd.

Objectives: The objective of the present study was to explore the trends in the intention to quit smoking among adults in Greece between 2006 and 2011, a period characterized by financial instability and newly endorsed tobacco control initiatives. Methods: Trend analysis of 3 representative national and cross-sectional surveys, 'Hellas Health I' (2006), "Hellas Health III" (2010) and Hellas Health IV (2011). Results: Since 2006, the intention to quit smoking has significantly increased among both genders (33.3% [in 2006] to 42.4% [in 2011], p=0.002), among respondents aged >. 54. years (26.9% [in 2006] to 45.1% [in 2011], p=0.019) and among residents of rural areas (26.4% [in 2006] to 46.7% [in 2011], p=0.001). Both highest (32.1% [in 2006] to 49.4% [in 2011], p=0.036) and lowest (31.7% to 46.0%, p=0.021) socioeconomic (SE) strata showed an increase in the proportion of smokers who intend to quit. However, in 2011, quit attempts were more frequent (35.3%, p=0.009) in smokers of high socioeconomic status. Moreover, smoking prevalence has significantly decreased (43.1% [in 2006] to 38.1% [in 2011], p=0.023), mainly among men (52.4% to 45.7%, p=0.037), respondents of low socioeconomic status (38.9% to 29.4%, p=0.008) and residents of urban areas (45.2% to 37.9%, p=0.005). Conclusions: Over the past 5. years and possibly as a combined result of the implemented tobacco control policies and austerity measures, the intention to quit smoking has increased among all SE strata, however actual quit attempts were higher among those less disadvantaged. Further effort should be made to support quit attempts, especially among vulnerable populations. © 2013 Elsevier Ltd.

Background: Economic crises may have a significant impact on public health. The objective of this study was to assess trends in health-related behaviours and cardiovascular risk factors within Greece before, at the beginning and during the current financial crisis by comparing data from three waves of the Greek cross-sectional household 'Hellas Health' surveys. Methods: Data from three waves were analysed. The first wave was conducted in 2006 (n = 1005), the second in 2008 (n = 1490) and the third in 2011 (n = 1008). Samples were representative of the Greek adult population in terms of age and residency. Smoking status, height, weight and fruit and vegetable consumption were self-reported. Physical activity levels were assessed with the International Physical Activity Questionnaire. Results: The prevalence of smoking in Greece decreased from 42.6 to 38.1% during the crisis period 2008-11 (P = 0.026), but not during 2006-8. The prevalence of high levels of physical activity increased among Greek adults (from 21.9 to 31.7%, P < 0.001) in all socio-economic and demographic groups, with the exception of the highest socio-economic status (SES) group. On the contrary, the consumption of at least five portions of fruit and vegetables per day significantly decreased during the crisis among those of lower SES (from 9.0 to 4.1%, P = 0.006). Prevalence of obesity did not show significant trends. Conclusions: During the economic crisis, fruit and vegetable consumption alarmingly decreased, especially among those of lower SES, whereas trends in smoking prevalence and physical activity levels seem favourable. These results indicate that the economic crisis may unequally impact cardiovascular risk factors among different socio-economic groups. © 2013 The Author.

Objective The purpose was to assess the validity and reliability of health belief model variables (perceived benefits, perceived barriers, and self-efficacy beliefs) that are often the target of mammography screening interventions. Methods Based on Champion's health belief model scales, questionnaire data were obtained from a nationally representative sample of 408 Greek women, 40 years of age or older and with no personal history of cancer. Results Using confirmatory factor analysis, we found all items to load significantly on their respective factors. Standardized factor loadings ranged from 0.55 to 0.88. An analysis of localized areas of respecification of a three-factor model revealed that measurement error correlations between a few items existed. Known-groups and criterion-related validity was supported for all scales, while internal consistency reliability of the scales was satisfactory, with Cronbach's alpha ranging from 0.71 to 0.88. Conclusions The Greek version of the scales measuring perceived benefits, perceived barriers, and self-efficacy beliefs is a reliable and valid tool when used to assess health beliefs for mammography screening among women. Implications for intervention strategies aimed at increasing the likelihood of mammography utilization are considered. Copyright © 2012 John Wiley & Sons, Ltd.

In this paper, we examined dimensions of child health-related quality of life in Greece in relation to parental assessments of neighbourhood social capital and social support networks. For the analysis, two main measures were used: (1) child self-reported health-related quality of life in ten dimensions, as measured by the KIDSCREEN questionnaire; (2) subjective measures of parental neighbourhood social capital and social support. Parental assessments of neighbourhood social capital and social support were both independently and positively associated with child self-reported health-related quality of life. However, they were not associated with the same dimensions of child well being, nor were they associated with all dimensions of child well being. These results suggest that greater attention in future research needs to be paid to the differential associations between the various dimensions of social capital and child health-related quality of life, with clear focus implications for social and health policies. © 2010 Springer Science+Business Media B.V.

Previous research has shown that, although routine mammography screening can reduce mortality from breast cancer, the use of annual mammography screening remains well under 65%. In an effort to determine the factors that are associated with women's mammography behaviors, this study used the health belief model and the common-sense model of self-regulation as the theoretical frameworks to explore health beliefs, illness representations, and women's mammography practice. Data were obtained from a nationally representative sample of 408 Greek women, 40 years of age or older, with no personal history of cancer. Three dependent variables were considered: recent mammography, repeat mammography, and no mammogram during lifetime. Predictors included socio-demographic and medical variables, perceived benefits of mammography screening, perceived barriers to mammography screening, self-efficacy, as well as illness perceptions. Multivariate analyzes indicated that never having had a mammogram was more likely for women who perceived fewer benefits and more barriers to mammography screening, had more negative emotional representations of breast cancer, and had no private health insurance coverage. Factors associated with recent mammography were younger age, a good knowledge of the recommended mammography screening interval, a family history of breast cancer, and use of patient reminders for next mammogram. Adequate knowledge about the recommended mammography screening interval and higher values for breast cancer worry were associated with an increased number of repeat lifetime mammograms. Implications of the results and suggestions for future research are outlined. © Springer Science+Business Media, LLC 2011.

PURPOSE: To investigate the quality of life (QOL) outcomes of femtosecond laser-assisted LASIK using the Quality of Life Impact of Refractive Correction (QIRC) questionnaire. METHODS: Translation of the QIRC questionnaire from English to Greek followed standard international protocols. The questionnaire was completed by 190 individuals, aged 18 to 39 years with myopia (range: -0.75 to -8.50 diopters) and corrected distance visual acuity (CDVA) of logMAR 0.2 or better (Snellen equivalent 20/32) in the worse eye. Half of this sample underwent LASIK with femtosecond laser flap creation and ablation with the Visx Star S4 IR excimer laser (Abbott Medical Optics). The questionnaire was scored with Rasch analysis. Validity was tested by internal consistency reliability (Cronbach's α) and repeatability by intraclass correlation coefficient (ICC) and Bland-Altman limits of agreement, convergent validity was examined with inter-item correlations, and construct validity was evaluated by known groups comparison analysis. RESULTS: The total QIRC score improved with femtosecond laser-assisted LASIK from mean 38.9±5.7 preoperatively to 53.7±5.1 postoperatively (P

Objectives: To investigate lifestyle health behaviours, such as smoking, physical activity, weight status and dietary habits, in a representative sample of the adult Greek population. Study design: Cross-sectional, household interviews (Hellas Health I survey, 2006). Methods: A stratified representative sample (n = 1005, 483 males, 522 females) of the Greek adult population (mean age 47.39 years, median age 46 years, range 18-99 years) was interviewed. Self-reported demographic and lifestyle behaviour data were obtained. The Food Frequency Questionnaire (FFQ) was used to record dietary habits, and a Mediterranean score was derived from the FFQ to assess adherence to the Mediterranean diet. A higher Mediterranean score indicates greater adherence to the Mediterranean diet. Physical activity was evaluated using the International Physical Activity Questionnaire. Results: Smoking is highly prevalent in the Greek population (43.1%), particularly among people aged 18-36 (52.9%) and 37-56 years (51.9%). Smoking prevalence was 52.4% in men and 34.5% in women (P < 0.001). In total, 54.1% of men and 45.3% of women were classified as physically active (P = 0.007). The proportion of physically active subjects decreased with age (P for trend

Compliance with laws making certain environments smoke free has focused mainly on smokers behavior, while the role of non-smokers has scarcely been investigated. Our cross-sectional study interviewed 4043 adults (2037 smokers and 2006 non-smokers) in the general population of Greece during April 2009. Non-smokers reported that they would actively work for compliance with the law. The non-smokers were older, more educated (odds ratio, OR 1.4), and were more likely to be annoyed by the smell of environmental tobacco smoke (OR 2.4) or report that it irritates their eyes (OR 1.8). Policymakers should evaluate how non-smokers could actively support smoke-free laws through reporting of violations using media campaigns that inform them of their rights, and other measures. © 2011 Macmillan Publishers Ltd.

Objectives This study was intended to present evidence for the reliability and validity of a Greek translation of the Medical Outcomes Study-HIV Health Survey (MOS-HIV). Design: Sample consisted of 154 HIV-positive men and women, regardless of disease stage, who are being followed at the department of Infectious Diseases of a tertiary hospital of Athens, Greece. Methods The translated Greek version of the MOS-HIV instrument, a brief, comprehensive 35-item health-related quality of life questionnaire, was used to assess ten dimensions of health including overall quality of life, pain, physical functioning, role functioning, social functioning, mental health, energy/fatigue, cognitive function, health distress, and health transition. Additional socio-demographic data and clinical parameters were also collected. Standard guidelines were followed for questionnaire translation to the Greek language. Internal consistency reliability using Cronbach's alpha and the range of measurement of the MOS-HIV subscales were examined. Convergent validity was further examined with the intercorrelations of subscales. ROC analysis was used to estimate the ability of the subscales to discriminate patients according to the characteristics of the disease [i.e. asymptomatic, symptomatic and AIDS, CD4+ lymphocyte count ( 200 cells/mm 3)] and assess concurrent validity. Results All the MOS-HIV scales exceeded the minimum reliability standard of 0.70. Physical functioning and health distress had the greatest reliability coefficient, equal to 0.87 and 0.88, respectively. Correlations among MOS-HIV scales were all significant. Physical functioning, pain, and physical health summary scales were significantly lower for AIDS patients compared to asymptomatic HIV+ individuals. All scales except for role functioning and health transition could discriminate well subjects with CD4+ lymphocyte count200 cells/mm3. Conclusions The Greek version of the MOS-HIV had good reliability and validity among patients with AIDS. Convergent and concurrent validity were generally confirmed. The MOS-HIV may be useful in assessing health-related quality of life in AIDS patients in Greece. Further research is needed for the evaluation of the Greek version of the MOS-HIV responsiveness to changes over time.

Background. Although several studies have reported findings concerning the association between smoking and emotional/behavioural problems, little research has investigated this association after controlling for confounding factors which have been found to be significantly correlated with both cigarette smoking and emotional/behavioural problems and may have a strong effect on the relationship between adolescents' mental health and smoking. The present study attempted to assess the association between adolescents' smoking status and their emotional/behavioural problems after controlling for a number of possible confounders (i.e. age, gender, parental smoking status, exposure to family smoking, family socioeconomic status, adolescents' leisure time) in a Greek nation-wide school-based sample. Methods. Participants completed a questionnaire which retrieved information about age, gender, family socioeconomic status, smoking status, parental smoking, adolescents' leisure time and emotional/behavioural problems. Data were modelled using multiple logistic regression analysis with adolescents' smoking status as the dependent variable. Results. A total of 1194 (i.e. 63% response rate) of self-reported questionnaires (40.1% boys, 59.9% girls; 12-18 years old) were returned. Data from 1030 participants with full data were analyzed. Cigarette smoking was strongly associated with higher levels of emotional/behavioural problems (p < 0.001) and the association was not moderated (OR = 1.13, 95% CI: 1.08-1.18) after controlling for the effects of other covariates. Emotional symptoms, conduct problems and hyperactivity/inattention were all significantly associated with adolescents' current smoking. Conclusions. This study supports the association between smoking and emotional/behavioural problems among adolescents. Addressing adolescents' needs regarding their emotional/behavioural health could be helpful in the development of effective anti-smoking strategies in school environment and elsewhere. © 2010 Giannakopoulos et al.

The frequency of health care use is crucial for adolescent well-being and health systems. The present study was the first to test a set of variables in a representative sample of Greek adolescents in order to identify factors that predict health care use and contribute to improving health service planning. Questionnaires were administered to a random sample of adolescents (N=1 194) aged 11-18 years and their parents (N=973) in 2003. Data from 894 participants with full data were analyzed. Parents' education, adolescents' chronic health needs, physical well-being and emotional/behavioural problems as well as parent-child relationship were independent predictors of health care use, although some factors, such as gender, age, type of residence, family affluence, social support and parental health status that previous research identified as predictors were not confirmed. Beyond the need of health care, other factors also play an important role in the utilization of health services by adolescents and their families. © 2009 The Association for Professionals in Services for Adolescents.

Background: The Strengths and Difficulties Questionnaire (SDQ) is a practical, economic and user-friendly screening instrument of emotional and behavioural problems in children and adolescents. This study was aimed primarily at evaluating the factor structure of the Greek version of the SDQ. Methods: A representative nationwide sample of 1,194 adolescents (11 to 17 years old) completed the questionnaire. Confirmatory factor analysis (CFA) was conducted to assess the factor structure of the SDQ. Results: CFA supported the original five-factor structure. The modification of the model provided some improvements. Internal consistency was acceptable for total difficulties, emotional symptoms and prosocial behaviour scale, moderate for hyperactivity/inattention scale and inadequate for peer and conduct problems scale. Older adolescents (aged 15 to 17 years) reported more hyperactivity/inattention and conduct problems than younger ones (aged 11 to 14 years) and girls reported more emotional symptoms and less prosocial behaviour problems than boys. Adolescents of low socioeconomic status (SES) reported more difficulties than those of medium and high SES. Conclusion: The Greek SDQ could be potentially considered as a community-wide screening instrument for adolescents' emotional and behavioural problems. © 2009 Giannakopoulos et al; licensee BioMed Central Ltd.

This study estimated the rates of age-appropriate screening practices for breast, cervical, colon and prostate cancer within the general population in Greece and explored the influences of social factors on their use. Data were based on the cross-sectional Hellas Health I survey (2006) conducted on a representative sample of 1005 adults, aged 18-69 years. The percentage of women aged 21-69 years having received the papanicolaou smear test within the past 3 years was 59.4%, and the percentage of women aged 50-69 years having received mammography and the faecal occult blood test (FOBT) within the past 3 years was 53.8 and 8.3%, respectively. There were significant effects of age, education and marital status on carrying out the papanicolaou smear test, age on carrying out mammography, and existence of a family doctor on carrying out the FOBT. In men aged 50-69 years, 40.6% had received the prostate-specific antigen test and 10.9% of men had received the FOBT during the past 3 years. The percentage of men aged 50-69 years who had undergone digital rectal examination within the past 5 years was 20.3%. Multivariate analyses showed significant effects of age, social class, smoking status and type of insurance on carrying out the prostate-specific antigen test and of age on carrying out the digital rectal examination. No effects were revealed for the FOBT in men. The percentage of the population in Greece receiving screening services recommended by the European Council is low and seriously affected by social factors. Public health policies should direct their efforts towards introducing good-quality universal cancer screening and find culturally sensitive ways of addressing the barriers that prevent Greek people from adopting poor-quality cancer screening practices. © 2009 Lippincott Williams & Wilkins, Inc.

Aim: To investigate the associations of some family characteristics with adolescents' self-reported emotional/behavioural problems. Methods: Questionnaires were administered to a Greek nation-wide random sample of adolescents (N = 1194) aged 11-18 years and their parents (N = 973) in 2003. The present analysis included the questionnaires completed by mothers and their offspring (639 families). Adolescents' emotional/behavioural problems, as measured by the Strengths and Difficulties Questionnaire, were assessed in relation to family socioeconomic status and residence type, parental marital status, educational attainment and subjective mental health, family cohesion and parent-child relations. Results: The analysis showed that parental marital status other than being married, poor parent-child relations and low levels of maternal subjective mental health were independently correlated with significantly more adolescents' emotional/behavioural problems. Conclusion: Family factors are potential determinants of adolescent emotional/behavioural problems and therefore are potential targets for prevention and/or intervention. © 2009 Foundation Acta Pædiatrica.

Background: This study aimed at examining the relationship between parental subjective health status and adolescents' health-related quality of life (HRQoL) as well as the role of gender, socioeconomic status, presence of chronic health care needs and social support on the above interaction.Methods: Questionnaires were administered to a Greek nation-wide random sample of adolescents (N = 1 194) aged 11-18 years and their parents (N = 973) in 2003. Adolescents' and parents' status was assessed, together with reports of socio-economic status and level of social support. Various statistical tests were used to determine the extent to which these variables were related to each other.Results and Discussion: Parental subjective mental health status was significantly correlated with adolescents' better physical and psychological wellbeing, moods and emotions, parent-child relationships, school environment and financial resources. Parental subjective physical health status was strongly associated with more positive adolescents' self-perception. Adolescents' male gender, younger age, absence of chronic health care needs, high social support, and higher family income were positively associated with better HRQoL.Conclusions: This study reinforces the importance of parental subjective health status, along with other variables, as a significant factor for the adolescents' HRQoL. © 2009 Giannakopoulos et al; licensee BioMed Central Ltd.

The objective of this study is to determine the level of depressive symptoms among a sample of Greek children aged 8-12 years, as measured by the Greek Children's Depression Inventory (CDI), as well as to examine CDI's psychometric properties. A nationwide school-based sample of 650 children was initially recruited and depressive symptoms were assessed with the CDI among 538 children who provided all relevant information. Statistical evaluation included assessment of CDI internal reliability, test-retest reliability, determination of age, gender and socioeconomic status (SES) effects. Based on the distributions of CDI scores observed in this normative sample, a recommended cutoff score, identifying a high probability of serious levels of depressive symptoms that need to be further evaluated, was defined. Internal reliability and test-retest reliability were satisfactory and the expected associations with age and gender were observed. High SES was correlated with significantly less depression symptoms. The prevalence of depressive risk, when the cutoff point of 19 or 13 was taken as threshold, was much lower than those obtained from studies in other countries. The cutoff point of 15, corresponding to 90th percentile of the present sample, may be used as a screening threshold for further assessment. The present results are encouraging providing evidence about the psychometric properties of the CDI and implications for child mental health promotion planning in Greece. Further validation of the CDI against other measures and psychiatric diagnoses is needed. © 2009 Springer-Verlag.

Objectives: The main purpose of this study was to assess the construct validity of the Greek EQ-5D instrument in measuring health-related quality of life, as well as to address the issues of concurrent validity, internal consistency reliability, and sensitivity. Methods: A stratified, representative sample (n = 1388) of the Greek general population was approached for interview (response rate 72.4%). The survey included the EQ-5D, the SF-36, and questions on sociodemographic and clinical characteristics of the sample. Results: The EQ-5D dimensions, the EQ visual analog scale, and the UK-based utility index were capable of distinguishing between groups of respondents, in the expected manner, on the basis of sex, age, education, socioeconomic status, self-reported health problems, and health services utilization, thus providing evidence of construct validity. Convergent and divergent validity of the EQ-5D descriptive system were supported by expected relationships with SF-36 scale and summary scores. Additionally, reporting a problem in a given EQ dimension was generally associated with lower SF-36 scores, supporting concurrent validity. Internal consistency reliability and sensitivity were also satisfactorily demonstrated. Conclusions: The results provide initial support for the construct validity of the EQ-5D in Greece, and, in conjunction to future studies addressing test-retest reliability and responsiveness, they support administering the instrument in health status studies, which in turn can contribute to transnational comparisons. © 2008, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Objectives: The aim of this study was to investigate the psychometric properties of the Greek version of the Pediatric Quality of Life Inventory TM 4.0 (PedsQLTM 4.0) as a population health outcome measure. Methods: After cultural linguistic validation, a cross-sectional study with the participation of 645 children (8-12 years old) and their primary caregivers was conducted in a nation-wide representative school-based sample to evaluate the psychometric properties of the measure. Results: All PedsQL 4.0 scales showed satisfactory reliability, with Cronbach's α exceeding 0.70-except in self-reported Physical Functioning (α = 0.65). Test-retest stability intraclass correlation coefficients (ICCs) were above 0.60 in all subscales. No floor effects were detected in either the self-report or parent proxy versions. Ceiling effects ranged from 2.2% (self-report Total Score) to 31.1% (parent-report Social Functioning). Poor to moderate agreement between self report and proxy report was observed, especially for the younger age groups of children. Impact of gender, health status, and family affluence status were detected, as hypothesised from previous bibliography, with girls reporting lower health-related quality of life (HRQOL) than boys on the Emotional Functioning subscale, healthy children scoring significantly higher on all scales than those with chronic illnesses, and lower socioeconomic groups scoring significantly lower than higher socioeconomic groups. Factor analysis showed mainly comparable results with the original version. Conclusions: Present results support the reliability and validity of the PedsQL 4.0 Greek version. The instrument could be a valuable tool in HRQOL measurement in school health care settings and population-based studies in Greek-speaking children, though it should be stressed that when possible, the child should be considered the first informant of his/her HRQOL. © 2007 Springer Science+Business Media B.V.

This study describes the development and reports the first psychometric results of the European KIDSCREEN-52 generic health-related quality-of-life questionnaire for children and adolescents. The KIDSCREEN-52, including ten dimensions, was applied in a European survey involving 12 countries (i.e., Austria, Switzerland, Czech Republic, Germany, Greece, Spain, France, Hungary, The Netherlands, Poland, Sweden and the UK) and 22,110 children and adolescents aged between 8 and 18 years of age. Questionnaire development included a literature search, expert consultation, and focus group discussions with children and adolescents. After definition of dimensions and collection of items, a translation process following international translation guidelines, cognitive interviews and a pilot test were performed. Analysis regarding psychometric properties showed Cronbach-α ranged from 0.77 to 0.89. Correlation coefficients between KINDLR and KIDSCREEN-52 dimensions were high for those assessing similar constructs (r = 0.51-0.68). All KIDSCREEN-52 dimensions showed a gradient according to socioeconomic status and most dimensions showed a gradient according to psychosomatic health complaints. The first results demonstrate that the KIDSCREEN-52 questionnaire is a promising cross-cultural measure of health-related quality-of-life assessment for children and adolescents in Europe. © 2005 Future Drugs Ltd.

Objective: Good reproductive health depends to a great extent on how well informed people are on contraception issues. Contrary to the situation existing in many European countries, in Greece there has been a lack of studies investigating how well informed Greek women and men are. Also, the sources on which they draw are equally important. The aim of this study was to examine the knowledge of Greek women and men on issues of contraception, with the ultimate goal of identifying which groups should be the focus of prevention planning programs. Method: A country-wide survey was conducted through a self-administered questionnaire. The sample, numbering 1500 people, was representative of the Greek population aged 16-45 years. Results: A key finding was that only a small percentage of the respondents were able to answer correctly 50% or more of the questions on knowledge of basic contraceptive issues (30.6% of women and 14.7% of men). Regarding sources of information, media and friends were reported as the primary sources of information for men of all ages and young women. The gynecologist becomes a significant source of consultation for women only after the age of 25 years. Even then, only 4% of women visiting a gynecologist do so to obtain information on prevention of pregnancy. The majority of women asking professional advice have already experienced an unwanted pregnancy. Conclusion: The need for health education is apparent, especially for young people.

The mental health needs of adults with learning disabilities have not been adequately addressed in many European countries. Although carers can play a significant role in identification and referral, they usually lack the expertise necessary to identify signs of mental disorders. This study evaluated a care staff training programme aiming at improving awareness on issues of dual diagnosis in a group of 36 care staff from residential and community centres in Greece. Training was based on the British Mental Health in Learning Disabilities Training Pack and the PAS-ADD Checklist. The overwhelming majority of staff were very satisfied with training. Staff from institutional work settings, with no previous training on dual diagnosis and with a lower level of education, benefited to a significant degree. Changes occurred mostly in their knowledge and attitudes rather than practice. Supervised practical training is vital to transfer, strengthen and maintain positive changes at work. © 2004 Sage Publications.

Objectives: The study objectives were to explore current contraceptive behavior of Greek women during reproductive age. Study design: Data were drawn from a country-wide survey, conducted with the use of a self-administered questionnaire. The sample, numbering 797 women of ages 16-45 years, was representative of the Greek female population of reproductive age. Results: The most common contraceptive method reported was the male condom (MC) (33.9%) followed by coitus interruptus (CI) (28.8%), oral pill (4.8%), and coil (3.6%). Other methods counted for a 5% and no use of contraception reached a 23.8%. Attitudes over responsibility of using contraception were also explored. The majority of respondents (52%) stated that contraception use is the responsibility of men. The probability of reporting that women should be responsible in using contraception was higher in women aged 25-34 years, in those with higher level of knowledge over contraception issues and in those with an experience of abortion. Conclusions: The need for sexual education and easy access to counseling services is apparent in order to promote optimal contraception decision-making. The role of women in taking active responsibility over contraception use should be of great importance in reproductive health promotion projects. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

The aim of the present paper is to describe and compare services for adults with intellectual disability (ID) and mental health needs in five European countries: Austria, England, Greece, Ireland and Spain. A framework and structure for collecting information about service provision was designed. This information was collected through a mixture of interviews with service providers, questionnaires and a review of the research literature within each country. Information was collected on historical context, policy, legislation, assessment, treatment and the structure of services for people with ID and mental health problems. Overall, the needs of those with additional mental health needs have not been specifically addressed at a national level with perhaps the exception of England and Ireland, although there are still gaps in services in these nations. Normalization has been adopted in each of the five countries, and there are moves toward deinstitutionalization, integration and inclusion. Families and self-advocacy groups have grown. The pace of this change varies between and even within countries. The main findings of the study include: unclear policy, trends for legislative changes, increased prevalence of mental health problems, inadequate generic service provision, a need for specialist mental health services, a need for improved interconnections of services, and a need for training developments. Policy and legislation in the five European countries under consideration tend to separate the disability aspects of people with ID from their mental health needs. Consequently, the service needs of this group remain largely invisible. This might be a direct reflection of policy clarity and legislation, or could be the result of a failure to implement existing guidelines. This has a detrimental effect on the lives of people with ID, and their families and carers.