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Introduction The global COVID-19 pandemic and subsequent lockdowns have significantly impacted global wellbeing and highlighted the close link between mental and physical health. Social isolation and quarantine have proven to be major stressors, leading to emotional distress and unpredictable psychological consequences. Objectives We explored the pandemic’s impact on individuals’ physical and mental health and social relationships. Methods We conducted a cross-sectional study using a questionnaire which included among other socio-democratic questions, the Fear of COVID-19 Scale, the World Health Organization Quality-of-Life Scale (WHOQOL-BREF) and the Toronto Empathy Questionnaire (TEQ). Results A total of 511 adults (55.1% males) participated in this study. Participants reported increased social media use (more than 4-5 times/week) during the lockdown, which was associated with increased fear of COVID-19 and negative effects on mental and physical health, and social relationships (p

Introduction Autism spectrum disorders (ASD) represent a major public health concern on a global scale. The increasing prevalence of ASD worldwide, coupled with the arising demand for treatments, underscores its important role in the public mental health discourse. Ensuring the equitable integration of children with ASD and their families into all aspects of society becomes an imperative task, in order to eradicate the stigma associated with the broad spectrum of autism, encompassing both visible and concealed dimensions. Objectives The primary objective of this study was to determine the crude prevalence of ASD in Greece nationwide, while also examining regional disparities in both prevalence and therapies. The study spanned a three-year period from February 2019 to February 2022 and relied on retrospective data sourced from the Greek National Organization for Healthcare Services Provision (EOPYY). Methods EOPYY provided de-identified data, including information such as sex, age, diagnosis, and treatment for each child, facilitated by hashed social security numbers. Statistical analysis of the dataset was performed using the open-source statistical program R. Results A total of 18,245 children aged 2 -17 years were diagnosed with ASD in Greece, representing a nationwide crude prevalence rate of 1.16%. Regional disparities were evident, with prevalence rates ranging from 0.49% in the North Aegean to 1.57% in Crete. Over the three-year study period, a total of 15,328,327 non-medical therapies were prescribed, corresponding to an annual average of 264 therapies per child. Statistically significant differences between the thirteen regions in Greece were observed, ranging from 230 to 323 annual therapies per child. Conclusions Our findings align Greece’s ASD prevalence with the global estimate of 1 in 100 children, as per the World Health Organization. Disparities between rural and urban areas in Greece may be attributed to differences in diagnostic procedures and the availability and accessibility of specialized services for autistic individuals. Thus, the establishment of a national surveillance system for ASD is recommended to enhance our understanding of the autism spectrum, monitor changes in prevalence, and identify potential contributing factors to autism conditions. Furthermore, these evidence-based results offer invaluable insights for crafting policies concerning healthcare, education, and employment for individuals with ASD in order to ensure the development of people with autism, their wellbeing, and a good quality of life. Disclosure of Interest None Declared

Introduction Older individuals constitute a significant portion of the population, and concerted efforts are underway to enhance the quality of this life stage by minimizing health issues and maximizing opportunities. Objectives This study aims to investigate the impact of psychosomatic exercises, including practices like yoga, meditation, and tai chi, as an alternative approach to promoting healthy aging and ultimately enhancing the quality of life among elderly individuals. Methods The study comprised 84 participants, with 51 individuals engaging in various forms of psychosomatic exercises and 33 serving as the control group, having no prior exposure to such practices. Data collection was carried out electronically, with the initial section gathering socio-demographic information and health-related details about the participants. The second part consisted of the WHOQOL-BREF quality of life scale, consisting of 26 questions, which assessed six domains: Overall Quality of Life and General Health, Physical Health, Psychological Health, Social Relationships, and Environment. Statistical analysis was performed with SPSS 26. Results The average age of the participants was 66.7 years. A statistically significant positive correlation was identified within the first subscale of the tool, “Overall Quality of Life and General Health,” with scores of 74.3/100 for those engaging in psychosomatic exercises and 66.7/100 for those who did not (t(82) = -2.513, p = 0.014). However, no statistically significant differences were observed in the remaining subscales. Conclusions Psychosomatic exercises, including yoga, meditation, and tai chi, hold promise as a means to improve the overall quality of life and general health of elderly individuals. These practices could serve as valuable components of strategies aimed at promoting healthy aging. Further research is needed to explore their effects in greater detail and across various dimensions of well-being. Disclosure of Interest None Declared

Introduction Children, who are particularly vulnerable in emergency situations, need tailored mental health strategies. Objectives We investigated the impact of the COVID-19 pandemic on anger and life satisfaction in children. Methods September 2021, we conducted a cross-sectional study in Preveza, Greece, interviewing 91 students aged 10-12 years from four elementary schools. The survey included socio-demographic questions, the Anger Expression Scale for Children (AESC), and the Satisfaction with Life Scale (SWLS). AESC scores range from 6 to 30 indicating anger severity, while SWLS scores between 5-9 signify extreme dissatisfaction and 31-35 extreme satisfaction. Results Significant correlations were found between the number of siblings (p 0.004), duration of electronic play (p 0.005), and duration of sleep (p 0.014) with life satisfaction. Children without siblings, with limited play consumption, and early bedtimes had lower life satisfaction. The presence of a television in their room (p 0.027) and daily use of television and social media (p 0.007) correlated with anger management and behavior. Social media/TV use was associated with better anger management. Conclusions Despite the pandemic lasting almost two years, children’s anger levels in Preveza remained stable, possibly due to outdoor activities and online interactions. These findings provide insights for policy makers, healthcare professionals, and parents seeking to improve anger management of children. Disclosure of Interest None Declared

Introduction Humanitarian workers (HWs) face significant challenges while providing aid to those in need, often leading to psychological exhaustion and the risk of primary or secondary trauma. Objectives Our study aimed to validate and adapt the Greek version of the Brief Resilient Coping Scale (BRCS) for HWs in Greece. Methods We conducted a cross-sectional study between September and December 2022. Participants were recruited through a self-administered questionnaire distributed via social media to humanitarian groups. Additionally, the questionnaire was sent via email to these groups’ members, who then forwarded it to their respective networks. The questionnaire included the BRCS, a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner. A score of 4-13 points indicates low resilient copers, 14-16 points medium resilient copers and 17-20 points high resilient copers. Cronbach’s alpha was used to assess internal consistency. Confirmatory Factor Analysis (CFA) was employed to evaluate model fit. Adequate or good fit criteria included a χ2 test p-value ≥ 0.05, Root Mean Square Error Approximation (RMSEA) ≤ 0.08, Standardized Root Mean Squared Residual (SRMR) ≤ 0.05, and a Comparative Fit Index (CFI) or Tucker–Lewis Index (TLI) ≤ 0.90. Statistical analyses were performed using STATA and SPSS software. Results A total of 151 humanitarian workers (76% females), with a mean age of 39.3±10.6 years participated in the study. The mean BRCS score was 65.6/100. Participants were categorized as follows: 34.6% as low resilient copers, 38.6% as medium resilient copers, and 26.8% as high resilient copers. Cronbach’s alpha for the BRCS was 0.84, indicating good internal consistency. CFA results supported the one-factor solution proposed by the original researchers, with acceptable global fit indices: Chi-square p-value = 0.303, SRMR = 0.028, RMSEA = 0.036, CFI = 0.991, TLI = 0.974. Conclusions The findings of our study show that the Greek version of BRCS is a valid and reliable tool that can be used to evaluate resilient coping among humanitarian workers in Greece. Disclosure of Interest None Declared

Introduction Understanding coronophobia, or the heightened fear and anxiety related to the COVID-19 pandemic, involves assessing physiological, cognitive, and behavioral measures. Objectives We aimed to develop a Greek version of the Coronavirus Anxiety Scale (CAS), the Obsession with COVID-19 Scale (OCS), and the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), to identify groups that appear vulnerable to this form of pandemic-related anxiety. Methods We conducted a cross-sectional online study from February to April 2021 in Greek-speaking people living in Cyprus. Participants completed sociodemographic questions and questions related to COVID-19, the CAS, OCS, and the CRBS. All three scales are rated on a 5-point scale, from 0 (not at all) to 4 (nearly every day). For CAS, a score ≥ 9 indicates probable dysfunctional coronavirus-related anxiety, for OCS a ≥ 7 score indicates probable dysfunctional thinking about COVID-19, and for CRBS score ≥ 12 suggests above-average reassurance-seeking activity. Results A total of 405 adults (66.4% women) from Cyprus participated in this study. The results of this study demonstrate that these Greek adapted measures have adequate reliability (Cronbach’s alphas >0.70) and factor structure (exploratory and confirmatory factor analysis support). However, only the CAS demonstrated both convergent and divergent validity. Education personnel, housekeepers, and older adults were also found to have higher coronavirus anxiety relative to their counterparts. Conclusions The findings of this research support the use of these coronaphobia scales in Cyprus and other Greek-speaking populations. Assessing the potential for fear-driven behaviors may be of great benefit to both clinicians and researchers, helping to identify individuals at risk, adapt interventions, and improve our understanding of the psychological consequences of surviving a public health emergency. Disclosure of Interest None Declared

Introduction Depression is a very prevalent mental disorder among older people. Exercise and physical activity may have beneficial effects on depressive symptoms that are comparable to those of antidepressant treatments. Objectives The purpose of the present study was to estimate the role that physical activity plays in wellbeing of older people, as well as its association with depression. Methods A cross-sectional study was conducted among 101 people over the age of 60, who are active members of the Open Day Care Centers (K.A.P.I) of the municipality of Serres, North Greece. An anonymous questionnaire was created to record the basic demographic data of the studied population. The Greek version of the Geriatric Depression Scale (GDS-15) was used to assess depressive symptoms in the elderly, and the (IPAQ) short edition - 7 items, was applied to evaluate the physical activity of the participants. Statistical analysis was performed with a SPSS 21. Results According to our results, as the age of the participants increases, so does the severity of the depression according to GDS-15. In addition, depressive symptoms were associated with marital status, widows in comparison to divorced, with participants living in urban areas and with illiterates and high school graduates. Furthermore, older adults with monthly income of 1000 to 2000 Euros presented to suffer more from depression than those who had a monthly income of up to 2000 Euros (p

Introduction Studies have shown that dementia family caregivers to be significantly more burdened than non-dementia caregivers. Objectives The aim of the present study was to analyze factors affecting the quality of life and the burden of dementia family caregivers. Methods 70 dementia family caregivers who lived in the Attica Region, Greece participated in the study from February to April 2022. An anonymous questionnaire was used including 16 items regarding demographic and socio-economic factors. The 22 -item Zarit Burden scale was used to estimate the burden of dementia family caregivers. Statistical analysis was performed with SPSS 21. Results 1.4% of caregivers showed minimal to no burden (n = 1). 28% of caregivers (n = 20) a mild to moderate burden. 40.6% (n = 29) presented a moderate to severe burden, while 28% (n = 20) a very serious burden. According to the results of the present study, there are three main factors that affect the quality of life of caregivers. Caregivers who spend more time with the patient have an increased burden compared to caregivers who spend less time. The patient’s low Mini Mental score is associated with an increase in burden. Caregivers who have attended training and management programs for the care of a patient with dementia have a lower burden than those who have not attended programs. Conclusions The study highlights an increased burden on caregivers. Social supports with multiple coping strategies focusing on different levels of patients with dementia and caregivers’ needs should be planned to relieve the caregiver burden. Disclosure of Interest None Declared

Introduction The COVID-19 pandemic has placed extraordinary mental health burdens on healthcare professionals. For women, it is a major challenge to reconcile the diverse roles of a professional, mother, and wife. The COVID-19 pandemic has exacerbated this, increasing their vulnerability to mental health issues. Objectives The aim of the study was to assess COVID-19-related mental health of healthcare professionals and to investigate whether possible gender differences as well as other parameters are associated with mental health disturbances. Methods We conducted a nationwide cross-sectional study of healthcare professionals working in hospitals or primary care settings in Greece from April to June 2022. Participants answered a questionnaire that included socio-demographic and other parameters, the Coronavirus Anxiety Scale (CAS), the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), and the Obsession with COVID-19 scale (OCS). Results A total of 464 healthcare professionals participated in the study, 71.2% were females and two-thirds were 31-50 years old. Elevated levels of anxiety, frequent reassurance seeking activities and persistent troubling thoughts related to COVID-19 were found in 5.8%, 3.2% and 6.1%, respectively. However, females reported significant higher mean levels on CAS and CRBS compared to males (2.41 vs 1.60, p=0.015, and 3.36 vs 2.64, p=0.041, respectively). Participants living in smaller areas had increased levels on all three scales (CAS, p < 0.001; CRBS, p = 0.007; OCS, p < 0.001), indicating thus higher coronaphobia, more frequent reassurance-seeking behaviors and disturbed thinking about COVID-19, compared to healthcare workers living in urban regions. Furthermore, lower educational level is also associated with higher values on CAS, CRBS and OCS (p < 0.003; p = 0.017; p < 0.023, respectively). Nurses experience higher anxiety scores (2.96) than physicians (1.92, p=0.013) or other healthcare workers (1.87, p=0.016). No dysfunctional thinking about COVID-19 is observed in medical doctors, whereas nurses and other healthcare workers experience higher levels on OCS. Conclusions Our study does not show any worrying increased psychological dysfunction related to COVID-19 pandemic among healthcare workers in general. However, females have increased levels than males. Thus, support and mental health protecting strategies should be applied primarily to female healthcare professionals when necessary. Disclosure of Interest None Declared

Introduction The prison environment and health of people who experience incarceration increase the risks of contracting COVID-19. Aside from the risks of infection and transmission, one should also examine the impact on their mental health state and identify their needs, since prison inmates experience already disadvantages and inequalities to a large extent. Objectives The aim of the study was to explore the experiences of inmates with the pandemic and the restrictions, their insights into the pandemic and the impact of social distancing in prison on their emotional status and management. Methods We used in-depth interviews with 5 inmates and 6 prison employees of a state prison in Athens, to produce an analysis of the challenges that the inmates faced during the pandemic. The study took part from February till June 2022. Each participant was asked semi-structured questions and a thematic content analysis was performed. Results The results of the interviews revealed several key themes, that have emerged from the COVID-19 pandemic. The challenges that the participants faced were in relation to communication, feelings of heightened isolation and detachment from family, friends, and the normal rhythms of life in and out of prison. Furthermore, our study has shown that COVID-19 pandemic resulted in higher levels of anxiety, lack of positive stimuli, of work and education, of day-to-day interaction, and of information. Conclusions This study highlights the dramatic reduction in opportunities for prisoners to rehabilitate themselves and build productive and meaningful lives. A decline in the emotional, psychological and physical well-being of the prisoners as well as resignation with their situation can be expected due to the lack in purpose. There is a need to improve the information and communication and support them with continuous psychological care, especially when prison services are confronted with additional health or other crises. Disclosure of Interest None Declared

Introduction According to the World Health Organisation (March 2022), it is estimated that one in 100 children worldwide has autism spectrum disorder (ASD). People with ASD very often face stigma, discrimination, and violations of their human rights. The aim of this study was to examine the knowledge and the attitudes of the general population regarding autism spectrum disorder as well as to raise awareness and promote appropriate behaviors towards people with ASD. Objectives The purpose of this study was to investigate the knowledge, attitudes, and the behaviors of the general population towards people with autism spectrum disorder in Greece. As far as is known, this is the first study carried out in Greece on this research topic. Methods A cross-sectional study was conducted online via social media and completed by 642 participants with various characteristics. The questionnaires were anonymous, their completion was voluntary and included the “Societal Attitudes Towards Autism” (SATA) scale. Linguistic validation and cultural adaptation of the SATA scale into the Greek language was based on the World Health Organization specifications. Data analysis was performed using the Statistical Package for the Social Sciences. Results A total of 642 people participated in the survey, 81.2% women and 18.8% men. The majority had a very good knowledge of autism (mean score 9.1 out of 13). However, women achieved significantly higher scores than men (p = 0.003). Respondents showed moderate to positive attitudes towards people with ASD (mean score 57.9 out of 80). The knowledge score is associated with the level of education, the place of residence, the existence of a person with autism in their friend or family environment, their income and occupation. The highest scores were observed in psychiatrists, following by teachers and other mental health professionals. Notably, 220 people believed autism to be caused by vaccination. Conclusions Educational and public health interventions should be organized in the general population in Greece to discard childhood vaccination as a causative factor of autistic spectrum disorder. There is significant need to educate the public in acquiring knowledge about autistic spectrum disorder. Disclosure of Interest None Declared

Introduction A pandemic can have significant effects on people’s emotional wellbeing. Infection control measures such as social distancing can lead people to feel isolated and to increased feelings of fear, anxiety, anger, and sadness. Recent research showed a worrying increase in depression and anxiety disorders, general distress, and sleep disorders. People who already suffer from a mental illness may be more vulnerable to stress caused by the pandemic and may experience a deterioration of already preexisting symptoms of anxiety and depression. Objectives The purpose of the present study was to assess the pandemic’s psychological impact on people with preexisting mental illness, to investigate their COVID-19-related fear, anxiety, and depression in association with various variables and to explore their behavioral responses regarding the measures against the pandemic. Methods A cross-sectional study was conducted from March to May 2022 in the outpatient mental health clinic of a provincial hospital in Greece. Participants were patients, who were not fully disorganized and have been diagnosed with a mental illness before the COVID-19 pandemic. Among the 50 adult patients, 11 lived in assisted living facilities. The study included sociodemographic questions, questions about fear of COVID-19, negative feelings, safety measures and behaviors, disease progression, and compliance with their therapists. DASS-21 scale was used to measure the 3 subscales of emotional states. Results Sadness was reported as the most unpleasant emotion of the lockdown, following by hopelessness and denial. Several participants (36%) reported high levels of COVID-19-related fear, mainly patients living in the community and not in assisted facilities (40.1% vs 18.2%) and males compared to females (42.1% vs 32.3%). The majority (70%) declared high compliance with the therapy. A moderate to severe deterioration in disease progression during the pandemic was observed in 28%, mainly in females compared to males (38.7% vs 10.6%). Based on DASS-21 the mean scores ranged from moderate to severe symptoms in depression (16.2/42), anxiety (14.3/42), and stress (18.4/42) without a statistically significant correlation with age, gender, and living situation. However, 34%, 22% and 56% screened positive for severe and extreme severe depression, anxiety, and stress, respectively. Conclusions The study revealed a substantial proportion of patients with mental disorders to experience unpleasant emotions and increased levels of psychological distress and highlights the need for supportive mental health services to address the increased mental health symptoms in people with pre-existing mental illnesses during a pandemic. Disclosure of Interest None Declared

Introduction Those who have lost loved ones to COVID-19 may be considered at risk of complicated grief. A 5-item mental health screening tool called the Pandemic Grief Scale (PGS) was developed to find likely instances of dysfunctional grief during the pandemic. Objectives To develop a Greek version of PGS and to explore the validity and reliability among the general population in Greece in order to further use it as clinical mental health screener. Methods We conducted a cross-sectional study between January and April 2022, and 342 persons were recruited. The questionnaire included socio-demographic parameters, the PGS, the Brief Resilience Coping Scale to capture tendencies to cope with stress and the Athens Insomnia Scale to assess the insomnia symptoms. Based on experiences over the previous two weeks, each PGS item is scored on a 4-point scale, from 0 (not at all) to 3 (almost every day), with higher rating and a cut-off of 7 indicating dysfunctional grief. Prior to the psychometric validation a linguistic validation and adaptation in Greek was performed. Results A total of 342 patients participated in the study, 67.8 % were females and 27.8% were 18-30 years old. Coefficient Validity Ratio (CVR) results showed that 100% (n = 5) of items were acceptable. Value of Cronbach’s alpha was found 0.848. A one-factor model was conducted by Confirmatory Factor Analysis (CFA), giving acceptable global fit indices. The resulting global fit indices [Standardized Root Mean Square Residual (SRMR) = 0.037, Comparative Fit Index (CFI) = 0.952, Tucker–Lewis Index (TLI)= 0.903] showed that the 5 items in one-factor solution proposed by the primary researchers shouldn’t be rejected for the Greek version. The Bartlett Test of Sphericity was 758.08 (p

Introduction Imposing quarantine as a measure to manage the coronavirus pandemic is a stressful event that is often associated with negative psychological effects. Eating habits seemed to be significantly affected during the quarantine, while strong negative emotions were triggered as the feeling of loneliness increased at the same time. Objectives This study aims to investigate the eating habits of individuals during quarantine and the role of positive and negative emotions and loneliness in shaping these habits. Methods An online cross-sectional study was performed using 3 validated scales, EAT-26 (3 subscales: Dieting, Bulimia and Food Preoccupation, Oral Control), Modified Differential Emotions Scale and UCLA Loneliness Scale. Data was collected between April and May 2021 mainly from social media platforms. Statistical analyses included linear regression and mediation analyses. Results Abnormal eating habits were detected in 25% of the participants (N= 450, ages 18-74) while the majority reported medium rates of negative/positive emotions and loneliness. Female sex is associated with abnormal eating habits (p=0.010) and mainly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) seem to be predictive factors of eating habits in general and bulimic behaviors. Negative emotions correlate directly with eating habits. However, we found a significant mediation of loneliness (p=0.032). Furthermore, the observed association between negative emotions and bulimia is partly mediated by loneliness (p=0.018). Conclusions Negative emotions and loneliness seemed to play an important role in shaping eating habits during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemic in general. Disclosure No significant relationships.

Introduction The COVID-19 pandemic was immediately realized to pose a considerable threat both to the physical, and the mental health of people. For healthcare professionals, it marks frantic work rhythms, anxiety for their patients and exposure to an invisible enemy. Those who hold administrative positions are called upon to make unprecedented decisions, facing a high degree of uncertainty. Hence, hospital staff is expected to experience severe psychological distress. Objectives The aim of this study was to investigate the psychological distress and possible associations with demographic characteristics, professional duties, hierarchy and predisposing factors to severe COVID-19 disease. Methods Online questionnaires were distributed to all employees of two hospitals in Thessaloniki, Greece, from March until May 2021. The questionnaires comprised two sections, one concerning the aforementioned purported risk factors, and another involving three psychometric scales, i.e. Coronavirus Anxiety Scale, Coronavirus Reassurance-Seeking Behaviors Scale and Obsession with COVID-19 Scale. Results The psychological pressure experienced by healthcare professionals was low, compared to the literature. A history of COVID-19 disease, existence of predisposing factors to severe COVID-19 illness and frequent contact with infected patients were shown to significantly increase the likelihood of psychological distress. Furthermore, an age of 30-34 years, a higher level of education, existence of infected family members and non-vaccination were identified as possible risk factors. Conclusions Contrary to previous research results, our sample did not experience severe COVID-19-related psychological distress. Nevertheless, emphasis should be placed on initiatives to support the mental health of this professional group, as many of them do struggle with psychological difficulties. Disclosure No significant relationships.

Introduction The COVID-19 has affected both physical and mental health of the elderly. Objectives The purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people. Methods A cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0 Results 222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p

Introduction The pandemic that broke out by the new coronavirus SARS-CoV-2 and the imposition of restrictive measures to reduce the dispersion, affects both the physical and mental health of all population groups. Objectives The main objective of the study was to investigate how these measures have impacted the students during the first quarantine period (Spring 2020). Also we wanted to know what they lacked most after the six-weeks-lockdown. Methods More than 2,000 students from all Schools of the University of Patras participated in the research, completing an online questionnaire. Emphasis was placed on the question “What is the FIRST thing you will do immediately after lifting the measures”. The open last option ‘Other’ was qualitative investigated with thematic analysis by gender. Results The answer options of the evaluated question were to ‘Go out for coffee/food/drink/fun with friends’ (58%) or ‘with family’ (5%), to ‘Visit beauty and hair salons’ (16%), to ‘Travel’ (6%), or to ‘Go shopping’ (2%). The option ‘Other’ was answered by 246 (13%) students. The thematic analysis revealed 13 categories, with first place ‘Restoring immediately social life without restrictions’, followed by ‘Seeing and being together with boyfriend/girlfriend’, but at the same time ‘Continue to be careful and take self-restraining measures after the end of the quarantine’. Conclusions Students of both genders lacked mainly social life and companionship. The need to return to a new daily routine with protection measures that limit both exposure to the new virus and the spontaneity, is obvious. Disclosure No significant relationships.

Introduction Exercise has been repeatedly reported as an effective means of preventing and treating mood disorders. Therefore, there is a significant research interest for the way exercise is connected with depression and the effectiveness of different exercise parameters as intensity, duration and modality. There is significant research evidence supporting the hypothesis that exercise can alleviate the symptoms of clinical depression. Nevertheless, there has not enough evidence to compare the effectiveness of deferent types of exercise as complementary therapy in depression. Objectives The purpose of the present study was to review the available research concerning the effect of exercise modality in depression and attempt to code and analyze the programs used in elderly (>65). Methods A systematic review was contacted of randomized control trials published in electronic journals. The electronic data bases PubMed, EBSCOhost and Trip Medical Database were used. Results Combined programs are predominate used for improving mood in elderly and the combinations used more frequently was short-term, light to moderate sub maximal aerobic exercise combined with dynamic resistance exercise following by Short-term, light to moderate sub maximal aerobic exercise combined with static exercise. Other psychosocial factors that commonly included in the combined exercise programs are group interaction, mindfulness and music. Conclusions Combined exercise programs are as effective as simple programs in alleviated the symptoms of depression in elderly. Their advantages over simple programs are that they can promote other health benefits; they are less time consuming and more pleasurable to participants. Therefore, they are good exercise choice for elderly.

Introduction The coronavirus pandemic has challenged the world with an unprecedented situation. Social distancing, self or quarantine isolation, personal hand hygiene, self-protection, and the fear of becoming infected with the virus, come with a psychological fallout. The COVID-19 pandemic has affected students around the world, in terms of their education and lifestyle. Objectives To investigate the impact of COVID-19 pandemic on the students’ mental health and well-being at the University of Patras, in Western Greece. Methods An online questionnaire was prepared to collect responses from students during April 2020. Socio-demographic data, academic status, opinions about distance learning, changes in daily routine during the lockdown and anxiety and depression scores, according to the Greek version of the Hospital Anxiety and Depression Scale (HADS), were gathered. Results The total number of responders was 2009, of which 67.3% women. During lockdown, the 68% of the students returned to their family home. Anxiety and depression scores were higher in students with a low income, poor self-rated health, not informed about COVID-19, not satisfied with distance learning and being annoyed at staying home. Prevalence of anxiety and depression was found to be 35.8% and 51.2%, ranging from 26.7% to 48.2% for anxiety and from 36.3% to 60.5% for depression in Health Sciences and Humanities and Social Sciences, respectively. Conclusions Depression rates among university students in Greece were alarmingly high, denoting the impact of lockdown and changes in students’ life, due to the COVID-19 pandemic.

Introduction Children with traumatic brain injury (TBI) are at risk for post-traumatic stress disorder (PTSD). The vast majority of TBI are of mild severity (MTBI), however, they may develop persistent neurophysiological symptoms. Objectives The purpose of this study was to investigate the incidence of PTSD in children with MTBI in Western Greece. Methods A one-year prospective study was conducted at the Children Hospital of Patras. A total of 175 children aged 6-14 years screened for risk of PTSD at one-week and one-month post-injury, completing the Child Trauma Screening Questionnaire (CTSQ). The Children’s Revised Impact of Event Scale (CRIES 13) was administered to the parents, to inquire their assessment of PTSD in the children. Statistical analysis was performed with IBM SPSS v.22.0 Results There were 59 (33.7%) children (27.2% boys, 45.9% girls) whose screen result was at risk. At the rescreening one-month postinjury, 9.9% were still at risk. Parents assessed presence of PTSD in 19% of their children at one-week and in 3.9% at one-month post-injury. There was a positive correlation between parenting and child reporting on symptoms of PTSD in children. However, 23.4% mistakenly estimated their children did not experience stress while in fact they did and 24.2% mistakenly estimated the contrary. Conclusions The findings revealed the risk of PTSD even in mild TBI, justifying thus the screening to identify these children for intervention strategies. On the other hand, the rescreening demonstrated that not all at-risk children required intervention, since a natural remission in PTSD symptoms was observed one-month post-injury.

Introduction COVID-19 pandemic and lockdown has brought a serious impact on physical and mental health. Objectives The purpose of the present study was to estimate the impact of the first lockdown in Greece, on both quality of life and anxiety levels in different occupational groups. Methods A cross-sectional on- line survey was conducted from 20th of April to 4th of May 2020. A 24-item anonymous questionnaire was administered to collect basic demographic and socioeconomic data. The 5-item WHO Well-Being Index (WHO-5, 0-100%, cut-off 52%) and the Generalized Anxiety Disorder Assessment (GAD-7) tools were used to assess well-being and anxiety, respectively. Statistical analysis was performed with SPSS for Windows v.24.0 Statistical Package. Results A total of 575 participated in the study, 62.8% females, 48.5% aged between 40 to 59 years. 32.5% were employed in education sector, 32.5% in health sector and 20.3% as season workers in tourism sector. Males showed slightly higher levels of wellbeing (52.1 vs. 47.3, p=0.023) and lower levels of anxiety (7.1 vs. 8.2, p=0.023) compared to females. Factors associated with higher wellbeing and lower anxiety were higher education and income level, optimism, taking less protection measures, and being seasonal worker. Furthermore, participants with comorbidities and symptoms like headache, musculoskeletal pain, as well as feeling depressed or stressed revealed lower wellbeing and higher anxiety scores. Conclusions Our study revealed an overall poor wellbeing and mild to moderate levels of anxiety during the lockdown. Actions should be taken to address and to prevent its serious impact on mental health. Disclosure No significant relationships.

There is a global initiative to reduce the use of restrictive care practices in mental health settings. Variations in the reported rates across regions complicate the understanding of their use and tracking trends over time. However, it remains unclear whether these discrepancies reflect real differences in the implementation of these practices or are sourced from inconsistencies in incident classification and reporting methods. This study employed a co-design approach to identify contexts that would influence the classification and reporting of restrictive care practices. The research involved 29 mental health stakeholders, including 22 professional experts from 13 countries across Europe, Africa, North America, Asia and Australasia and seven service users and family carers from Australia. Recruitment was conducted through email invitations, snowball sampling and social media outreach. Six web-based panel meetings, each lasting 90-120 minnutes were held. These discussions focused on exploring various contexts that might lead to uncertainty among professionals when classifying and reporting actions whether or not as restrictive care practices. A final list of 23 contexts was identified and considered for the development of 81 case scenario items. Finally, all the 29 panel members selected 44 from 81 case scenarios for inclusion in an upcoming international survey to examine variations in the classification and reporting of restrictive care practices. The findings from this co-design work emphasise the involvement of a wide range of factors and contexts in the classification and reporting of restrictive care practices that may contribute to the observed variations in the in the reported rates of these practices. The case scenarios developed in this study will support future research and serve educational purposes, illustrating real-life situations in the mental healthcare context., (© 2024 John Wiley & Sons Australia, Ltd.)

Background/Objectives : Depressive and anxiety syndromes are associated with elevated disability and are more prevalent in women. Data on the prevalence of depressive and anxiety disorders in the rural context are limited and contradictory. It is relevant to study common mental disorders in rural areas in the most vulnerable population of women, particularly in the post-COVID-19 pandemic era. Methods : This is a cross-sectional study that was conducted in two primary healthcare sites in the rural region of Farsala, Central Greece after the obviation of all restrictive measures that had been posed due to the COVID-19 pandemic. All consecutive female patients that attended the study sites for any non-emergent reason were asked to participate in the study. For the recording of symptoms of depression and anxiety, the self-reported Depression, Anxiety, Stress Scale-21 (DASS-21) was used. Results : The study sample consisted of 129 women. The majority of participants were >50 years, with 27.9% being older adults. A small percentage (13.2%) suffered a chronic physical disease. A large proportion of the sample, slightly exceeding 40%, reported clinically relevant symptoms of anxiety, whereas a lower percentage of women with depressive symptoms was detected (17.1%). Symptoms of anxiety and depression were found to be interrelated, while a number of sociodemographic variables were associated with both, such as older age, education (primary), living status (alone, OR 123.5; 95% CI: 7.3-2098.8 for anxiety; OR 3.5; 95% CI: 1.3-9.8 for depression), employment (not working, (OR 0.157; 95% CI: 0.06-0.41 for anxiety; OR 0.08; 95% CI: 0.01-0.62 for depression) and the history of a chronic disease (OR 33.8; 95% CI: 4.3-264.7 for anxiety; OR 37.2; 95% CI: 10-138.1 for depression). Self-rated financial status was not related to symptoms of anxiety or depression. Conclusions : The study highlights the importance of inquiring for symptoms of depression and anxiety in women attending the rural primary care setting. The use of valid and reliable self-reported instruments that are easy to administrate may be helpful in this regard.

Background/Objectives : The COVID-19 pandemic has posed significant challenges, particularly for individuals residing in psychiatric facilities. This study aims to investigate the impact of COVID-19 on psychiatric patients, focusing on factors such as their vaccination status, comorbidities, medication regimens, and biomarkers like C-reactive protein (CRP) and ferritin. Methods : This retrospective study analyzed 100 patients with confirmed SARS-CoV-2 infections admitted to the private psychiatric clinic "Asclepius of Upper Volos" from March 2020 to March 2023. The data collected included sociodemographic characteristics, vaccination status, symptom severity, medication regimens, and levels of CRP and ferritin. Statistical analyses using IBM SPSS Statistics version 29 included Pearson's chi-square tests, Student's t-tests, and a survival time analysis via the log-rank test to assess associations between clinical characteristics and outcomes. Results : Among the participants, 64% were female and 74% received two doses of the COVID-19 vaccine. The majority experienced mild symptoms, with a survival rate of 74%. Statistically significant findings include a higher survival rate among vaccinated individuals (98.6%) versus unvaccinated individuals (1.4%, p < 0.001). Comorbidities like chronic obstructive pulmonary disease (COPD), coronary artery disease, and renal failure were associated with severe symptoms and higher mortality rates. Higher ferritin levels were significantly associated with poorer outcomes, with survivors having a mean ferritin level of 246.2 (SD = 150.3) compared to the 416.9 (SD = 215.9) seen in non-survivors ( p < 0.001). Similarly, mean CRP levels were lower in survivors (1.58, SD = 1.96) than in non-survivors (3.46, SD = 2.92), with a p -value of 0.002. Conclusions : The findings underscore the importance of tailored health protocols and continued support for this vulnerable population. Enhanced strategies for managing comorbidities and utilizing biomarkers can aid in better predicting and improving psychiatric patient outcomes.

Purpose: The treatment of mental disorders has shifted from inpatient wards to community-based settings in recent years, but some patients may still have to be admitted to inpatient wards, sometimes involuntarily. It is important to maintain the length of hospital stay (LoS) as short as possible while still providing adequate care. The present study aimed to explore the factors associated with the LoS in involuntarily admitted psychiatric patients., Methods: A ten-year retrospective chart review of 332 patients admitted involuntarily to the inpatient psychiatric ward of the General University Hospital of Ioannina, Northwestern Greece, between 2008 and 2017 was conducted., Results: The mean LoS was 23.8 (SD = 33.7) days and was relatively stable over the years. Longer-stay hospitalization was associated with schizophrenia-spectrum disorder diagnosis, previous hospitalizations and the use of mechanical restraint, whereas patients in residential care experienced significantly longer LoS (52.6 days) than those living with a caregiver (23.5 days) or alone (19.4 days). Older age at disease onset was associated with shorter LoS, whereas no statistically significant differences were observed with regard to gender., Conclusion: While some of our findings were in line with recent findings from other countries, others could not be replicated. It seems that multiple factors influence LoS and the identification of these factors could help clinicians and policy makers to design more targeted and cost-effective interventions. The optimization of LoS in involuntary admissions could improve patients' outcomes and lead to more efficient use of resources., (© 2024. The Author(s).)

Objective This study investigates the overall survival (OS) of elderly patients who underwent total laryngectomy for laryngeal cancer (LC) and examines the impact of tumor-node-metastasis (TNM) staging on survival rates. Methods A retrospective cohort study utilized data from the Otorhinolaryngology Clinic at the University Hospital of Patras, including 75 elderly patients (>65 years) who underwent total laryngectomy for LC between 2000 and 2015. Survival analysis was performed using the Kaplan-Meier estimator, with comparisons made using the Log-rank test. Statistical significance was defined as the p-value being less than or equal to 0.05. Results Over the 16-year period, new LC cases were predominantly male (97.3%) with a mean age of 73.88 years (range: 65-89 years). Most patients were smokers (96%) and alcohol users (54.7%). Histologically, 18.7% of tumors were classified as poorly differentiated, 65.3% as moderately differentiated and 16% as well differentiated. Post-surgical TNM staging indicated 10.7% stage II, 37.3% stage III and 52% stage IV, primarily located in the glottis (62.7%) and followed by supraglottis (34.7%). All patients underwent total laryngectomy, with 69.3% and 37.3% receiving neck dissection and adjuvant therapy (chemotherapy or radiotherapy), respectively. During follow-up, 39 patients died, with 74.3% due to disease-related causes. Five-year OS rates were 44.6%, with variations by stage (stage II: 62.5%, stage III: 55.8%, stage IV: 32.4%; p=0.039) and age (65-75 years: 51.7%, >75 years: 34.7%; p=0.039). Conclusions TNM staging of the laryngeal cancer significantly influences the overall survival of elderly patients undergoing total laryngectomy for LC. Early diagnosis of the disease is crucial for patient survival., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Avdulla et al.)

Purpose: The implementation of quarantine measures in response to the COVID-19 pandemic presented challenges linked to adverse psychological effects, notably affecting individuals' eating patterns. This study aimed to investigate the eating patterns of individuals during lockdowns compared across sex, age, and income levels, and examine the influence of positive and negative emotions, as well as loneliness, on these patterns., Methods: A cross-sectional online study was conducted with 450 participants (aged 18-74 years old). One questionnaire about demographics, the Demographic Questionnaire, and three validated self-report scales (Eating Attitudes Test, comprising the Dieting, Bulimia, and Food Preoccupation, and Oral Control subscales, the Modified Differential Emotions Scale, and the UCLA Loneliness Scale) were employed. Convenience and snowball sampling were used. The data were collected between April and May 2021, primarily through social media platforms, such as Facebook, Instagram, and Twitter. The survey questionnaire was shared via these platforms and users could answer if they wanted. Also, they were asked to send the questionnaire to their close contacts. Additionally, the survey questionnaire was distributed face-to-face to 80 participants. The statistical analyses included linear regression and mediation analyses., Results:  Abnormal eating patterns ( e.g. eating behaviors that tend to have signs of diet such as constant avoidance of fattening foods, the individual's involvement with becoming leaner, extreme control or preoccupation with food, overeating and purging methods )  were identified in 25% of the 450 participants participated in this survey, aged 18-74 years. Moderate levels of negative/positive emotions and loneliness were predominantly reported. Female sex was significantly associated with abnormal eating patterns (p=0.010), particularly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) emerged as predictive factors for overall eating patterns and bulimic behaviors. Negative emotions exhibited a direct correlation with eating patterns, while loneliness played a significant mediating role (p=0.032). Furthermore, the association between negative emotions and bulimia was partially mediated by loneliness (p=0.018)., Conclusions: This study underscores the pivotal roles of negative emotions and loneliness in shaping eating patterns during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemics in general. Screening tests for mental health in the school and job environments could highlight the need for shaping interventions, such as counseling, group empowerment, and family support in order to mitigate the negative impact of the COVID-19 pandemic on eating behaviors and mental health in general., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Savvopoulou et al.)

Background: Studies assessing the psychological impact of the COVID-19 pandemic on populations highlight the emergence of mental health difficulties, especially if a mental health disorder is already present. Patients with severe mental illnesses (SMIs) may be even more vulnerable to the psychosocial effects of the pandemic. However, little is known regarding the possible impact of the pandemic on SMI patients supported by community-based mental health day centers., Methods: A two-year prospective study comprising 29 individuals with SMI was conducted by the Skitali Mental Health Day Center in Ioannina, Northwest Greece. The described group of examined patients consisted mainly of psychotic patients (65.5%). Patients were assessed using the Health of Nations Outcome Scale and the Global Assessment of Functioning scale, and scores prior to and after the onset of the pandemic were compared., Results: The results indicated that participants did not present any significant decline in their overall clinical status during the COVID-19 pandemic and the national lockdown measures., Conclusions: This finding is relevant because previous research has shown that the pandemic may negatively impact adherence to treatment and service attendance and that the symptomatology of patients with SMIs may further deteriorate. It is suggested that the operation of mental health day centers during collective stressful events should be preserved, but further research is needed to evaluate their role in maintaining continuity of care during such events.

Background: The widespread availability of antiretroviral therapy has led to improvements in life expectancy and thus an increase in the number of people living with HIV/AIDS (PLWHA) worldwide. However, a similar increase in the number of newly-diagnosed patients in Cyprus suggests the need for solutions designed to improve monitoring, planning, and patient communication. In this study, we aimed to determine whether the use of an information system to manage PLWHA might contribute to improved quality of life and critical adherence to prescribed drug regimens and ongoing medical care., Methods: A randomized controlled trial study was conducted in Cyprus based on information that we collected using the highly valid and reliable Greek translation of the World Health Organization (WHO) Quality of Life (QOL) HIV-BREF questionnaire to assess sociodemographic variables and patient compliance. We distributed 200 questionnaires before implementing a Health Medical Care (HMC) information system at our clinic. Six months after implementing this system, 68 of the completed questionnaires were selected, including two groups of 34 participants who had been assigned at random to the intervention or the control group. Participants included PLWHA aged ≥ 18 years who had been receiving antiretroviral therapy for more than 12 months between July 15, 2020, and July 15, 2022., Results: The changes in baseline to six-month scores reported for the intervention group were significantly higher than in the control group in all six subscales assessed with the WHOQOL-HIV-BREF questionnaire, as well as in the assessment of compliance. Furthermore, compliance with treatment was associated with higher scores in the questionnaire subscales, including physical health, psychological health, degree of autonomy, social relationships, life circumstances, and spirituality/religious/personal beliefs. We also identified specific demographic factors and behaviors that were associated with better compliance with scheduled medical care and the prescribed drug regimen. Specifically, men exhibited better compliance than women and younger PLWHA exhibited better compliance than the elderly as did individuals who reported a higher level of educational attainment. Additionally, individuals who did not use addictive substances, consumed less alcohol, and were managed using the monitoring information system all exhibited better compliance compared to those in the control group., Conclusion: The results of this study suggest that management of PLWHA via the use of an information system can contribute to improved QOL and drug compliance., (© 2024. The Author(s).)

Multidrug-resistant Acinetobacter baumannii infections have become a threat for public health worldwide. The aim of the present study was to follow-up resistance patterns of Acinetobacter spp. bloodstream isolates in a Tertiary University Hospital over the last nine years, from 2014 to 2022. Susceptibility patterns were followed for the following antimicrobial agents: amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, imipenem, meropenem, tigecycline, trimethoprim/sulfamethoxazole, and colistin. Minimal inhibitory concentration (MIC) values to ampicillin/sulbactam, cefepime, ceftazidime, minocycline, piperacillin/tazobactam were evaluated from 2020 to 2023. During the study period, 853 Acinetobacter spp. bloodstream infections (BSIs) were recorded, accounting for 5.36% of all BSIs. A . baumannii was isolated in 795 cases (93.2%), during the study period. Most BSIs were recorded in adult intensive care units (ICU) (46.2%) and medical wards (42%). Among A. baumannii isolates, 4.5% were multidrug-resistant, 84.7% were extensively drug-resistant, and 8.5% were pandrug-resistant. Resistance to carbapenems was over 95%. Resistance to tigecycline increased significantly during the last years of the study (2020-2022); A. baumannii isolates with MIC ≤ 2 μg/mL accounted for 28.5% of all isolates. Resistance to colistin exhibited an increasing pattern up to 42.2% in 2022. Increasing resistance rates and the evolution of pandrug-resistant isolates call for the urgent application of preventive and response actions.

Background: Head trauma is one of the most common pediatric emergencies. While the psychological effects of severe head injuries are well studied, the psychological consequences of mild head injuries often go overlooked. Head injuries with a Glasgow Coma Scale score of 13-15, with symptoms such as headache, vomiting, brief loss of consciousness, transient amnesia, and absence of focal neurological signs, are defined as mild. The aim of this study is to evaluate the stress of children with mild head injuries and their parents' relevant perception during the early post-traumatic period., Methods: This is a prospective cross-sectional study on a cohort of children with mild head injuries and their parents. Two questionnaires were implemented, the Child Trauma Screening Questionnaire (CTSQ) which was compiled by the children, and the Children's Revised Impact of Event Scale (CRIES-13), compiled by their parents. Both questionnaires are widely used and reliable. The first presents an excellent predictive ability in children with a risk of post-traumatic stress disorder, while the second is a weighted self-completed detecting instrument for the measurement of post-traumatic stress in children and adolescents, with a detailed evaluation of their reactions to the traumatic incident. The participants responded one week and one month after the traumatic event., Results: A total of 175 children aged 6-14 years and 174 parents participated in the study. Stress was diagnosed in 33.7% of children after one week, and in 9.9% after one month. Parental responses suggesting stress presence in their children were 19.0% and 3.9%, respectively. These outcomes showed that mild head injuries are not so innocent. They are often underestimated by their parents and may generate a psychological burden to the children during the early post-traumatic period., Conclusions: Mild head injuries may affect the emotional welfare of children. Healthcare providers should understand the importance of the psychological effect of this overlooked type of injury. They should be trained in the psychological effect of trauma and be aware of this probability, promptly notify the parents accordingly, and provide psychological assistance beyond medical treatment. Follow-up and support are needed to avoid the possibility of future post-traumatic stress disorder. More extensive research is needed as the outcomes of this study regarded a limited population in numbers, age, and survey period. Furthermore, many children with mild head injuries do not ever visit the emergency department and stay at home unrecorded. Community-based research on the topic should therefore be considered.

Background Olive gathering involves tree climbing, carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injuries among olive workers. The aim of this study is to evaluate the prevalence and risk factors of occupational injuries among olive workers in a rural Greek area and to assess the financial burden on the health system and insurance funds. Methods A questionnaire was administered to 166 olive workers in the Aigialeia municipality in the Achaia region, Greece. The questionnaire contained detailed information on demographic characteristics, medical history, working environment, protective measures, gathering tools, and type and site of injuries. Moreover, data were recorded about the duration of hospitalization, medical examinations and treatment received, sick leaves, complications, and rate of re-injury. Direct economic costs were calculated for hospitalized and non-hospitalized patients. The associations between olive workers' characteristics, risk factors, and occupational injury within the last year were examined using log-binomial regression models. Results In total, 85 injuries were recorded in 50 workers. The prevalence of one or more injuries in the last year was 30.1%. Factors associated with a higher rate of injury were male gender, age > 50 years, working experience > 24 years, history of arterial hypertension and diabetes mellitus, climbing habits, and non-use of protective gloves. The average cost of agricultural injuries was more than 1400 € per injury. The cost seems to be associated with the severity of the injury, as injuries requiring hospitalization were associated with increased costs, higher cost of medication, as well as more days of sick leave. Losses due to sick leave cause the greatest financial costs. Conclusions Farm-related injuries are quite usual among olive workers in Greece. Injury risk is influenced by gender, age, working experience, medical history, climbing habits, and use of protective gloves. Days off work have the greatest financial cost. These findings can be useful as a starting point to train olive workers to reduce the incidence of farm-related injuries in Greece. Knowledge of risk factors for farm-related injuries and diseases could help the development of proper interventions to minimize the problem., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Politis et al.)

This study estimated the crude prevalence of autism spectrum disorders (ASD) in Greece in 2021. A retrospective study was conducted for 2021 using data provided for research purposes for the first time by the Greek National Health Service Organization for Healthcare Services Provision (EOPYY) related to the ICD-10 diagnosis codes F84.0-F84.9 (ASD). Treatments were categorized by gender, age, and location. Statistical analysis was performed using the open-source software R. In total, 15,706 children aged 2-17 years were registered with ASD: 12,380 boys and 3326 girls. In total, 6,117,910 therapies were prescribed: 4,844,173 for boys and 1,273,737 for girls. Boys are estimated to be diagnosed 3.5 times more often than girls. On average, approximately 390 treatments are prescribed per person per year for both sexes. The annual prevalence is estimated at 0.94%, ranging from 0.42% to 1.44% depending on geographic region. Our findings provide evidence-based data for the planning of policies regarding health, education, and employment for people with ASD. The number of children and treatments makes ASD a public health concern to support children and their families and ensure equal participation in all aspects of society.

Data on the use of long-acting injectable antipsychotics (LAIs) in rural community mental healthcare settings are scarce. This study aimed to investigate the prescription patterns of LAIs in a clinical sample of patients with schizophrenia-spectrum disorders in rural Greece. All patients with schizophrenia-spectrum disorders who regularly attend the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T) in northwestern Greece were included in the study. The sample consists of 87 patients (59 males and 28 females) with a mean age of 54.4 years and a mean illness duration of 28 years. Most patients (72.4%) received antipsychotic monotherapy, and nearly 30% received an LAI formulation, mostly a second-generation LAI (20 of 26 patients, 76.9%). The treatment regimen comprised benzodiazepines in one-third of the patients and antidepressants in one-quarter. There was no statistically significant association between treatment regimen and the clinical and demographic variables studied, except for biological sex (female). The percentage of patients treated with LAIs in this study was almost three times higher than the rate previously reported in Greece and is higher than the rates reported in other countries. Patients with schizophrenia-spectrum disorders in rural Greece may have adequate access to innovative treatment with second-generation LAIs. Further research is needed to demonstrate the cost-effectiveness of LAI treatment in rural communities and to elucidate the factors associated with such treatment.

Background: Involuntary psychiatric admissions are a widely used practice despite ethical concerns about coercion. There are particular concerns that vulnerable groups, such as single, unemployed or racial minorities, may be more subjected to such practices., Aim: We aimed to investigate the social patterns of involuntary psychiatric admissions from 2008 to 2017 at University General Hospital in Ioannina, Greece., Method: We retrospectively assessed inpatient records from 2008 to 2017 of patients admitted to the Department of Psychiatry of the Ioannina University General Hospital, Northwestern Greece. Alternative patients of alternative years were selected for inclusion; this yielded 332 patients involuntarily admitted, corresponding to 28.5% of total involuntary psychiatric admissions., Results: Over the 10-year period, the overall numbers of annual involuntary psychiatric admissions remained relatively stable, as did the length of hospital stay (mean = 23.8 days). The most common disorder upon admission was schizophrenia spectrum disorders, accounting for approximately two-thirds of all admissions, followed by mood disorders (about 20%). There was evidence that people who lacked social support or experienced financial hardship were more greatly represented among those admitted: 70.2% of admitted patients were single and 64.8% were unemployed. Most patients had been admitted to the psychiatric ward in the past (64.2%)., Conclusion: Our study indicates potentially worrisome evidence that patients who are in vulnerable positions are at elevated likelihood of being involuntarily admitted to psychiatric wards. Future research is needed to evaluate the socio-demographic patterning of involuntary admissions in other European countries.

Objective: University teachers, who primarily provide guidance and advice to their students, can play a significant role in educational process transformation. As there is no particular e-learning framework, it is important to understand the factors and variables that may impact both its effective usage and further successful implementation. The current study aims to outline the influence of university faculty, and possible barriers preventing medical students from using apps for learning purposes., Subjects and Methods: Α cross-sectional study was conducted with an online survey questionnaire. The population of the study included 1,458 students from all the seven Greek schools of medicine., Results: University faculty (51.7%), followed by fellow students and friends (55.6%), constitute the second most common source of information on adopting apps for medical education. 45.8% of students rated their educational guidance as insufficient/inadequate, 33.0% as moderate, 18.6% as quite good, and only 2.7% as sufficient/complete. University professors have proposed certain apps to 25.5% of students. PubMed (41.7%), Medscape (20.9%), and Complete Anatomy (12.2%) were the leading suggestions. The main barriers to app usage were the lack of knowledge of apps' benefits (28.8%), insufficient updates of their content (21.9%), their cost-effectiveness (19.2%), and financial reasons (16.2%). Most students preferred using free apps (51.4%) and 76.7% preferred universities to cover apps' expenses., Conclusions: University faculty represent the main source of information regarding the adaptation of medical apps in the educational process. However, students need improved and enhanced guidance. The main barriers are ignorance about apps and financial reasons. The majority prefer free apps and universities to cover their cost.

Objective: This study aims to record the overall perception of healthcare professionals on child abuse and identify potential affecting factors in a nationwide scale in Greece as well as to provide information that might be useful for future educational actions., Materials and Methods: A total of 1,185 healthcare professionals in 60 hospitals with pediatric departments across Greece participated in this cross-sectional study. Participants included pediatricians, pediatric surgeons, residents, nurses, psychiatrists, psychologists, and social workers. Sections under investigation involved experience and training in child abuse, knowledge of formal and judicial issues, clinical knowledge, and self-assessment., Results: Although more than half of the participants had confronted child abuse (n=712, 60.08%), only 273 (38.34% of them) submitted reports. One third of participants reported that they had received some training (n=440, 37.13%), mainly of postgraduate nature and based on personal initiative. Of those who reported child abuse, 175 (64.10%) had been trained. Each professional category was aware of topics regarding its own interest, without adequate knowledge of other disciplines. One third of psychiatrists, psychologists, and social workers felt confident in discussing with children and parents. Relevant scores were lower in the other categories. The lower scores were recorded among nurses and residents. The training deficit and reluctance to engage with judicial issues were the main causes of avoidance to deal with child abuse., Conclusions: Focused and organized training in child abuse is crucial to create reliable professionals in the field. The internet is a considerably helpful tool. Professionalism must characterize knowledge and practice in child abuse at the same level as in other medical topics. Motivation to engage should be early inspired and developed during the graduate years.

Background: Multiple studies report reductions in air pollution associated with COVID-19 lockdowns., Methods: We performed a systematic review of the changes observed in hazardous air pollutants known or suspected to be harmful to health, including nitrogen dioxide (NO2), nitrogen oxides (NOx), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3) and particulate matter (PM). We searched PubMed and Web of Science for studies reporting the associations of lockdowns with air pollutant changes during the COVID-19 pandemic in Europe and North America., Results: One hundred nine studies were identified and analyzed. Several pollutants exhibited marked and sustained reductions. The strongest was NO2 (93% of 89 estimated changes were reductions) followed by CO (88% of 33 estimated pollutant changes). All NOx and benzene studies reported significant reductions although these were based on fewer than 10 estimates. About three-quarters of PM2.5 and PM10 estimates showed reductions and few studies reported increases when domestic fuel use rose during COVID-19 lockdowns. In contrast, O3 levels rose as NOx levels fell. SO2 and ammonia (NH3) had mixed results. In general, greater reductions appeared when lockdowns were more severe, as well as where baseline pollutant levels were higher, such as at low-elevation and in densely populated areas. Substantial and robust reductions in NO2, NO, CO, CO2, PM2.5, PM10, benzene and air quality index pollution occurred in association with COVID-19 lockdowns. O3 levels tended to increase, while SO2 and NH3 had mixed patterns., Conclusions: Our study shows the profound impact of human activity levels on air pollution and its potential avoidability., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.)

Objective: Healthcare associated infections affect both patients and employees, in terms of morbidity, mortality, and financial costs. Routine hand hygiene is the most important factor against this pestilence. Hand hygiene knowledge and compliance of healthcare workers are considered poor worldwide. Herein, we aimed to measure knowledge and compliance with hand hygiene of the healthcare workers at a university hospital., Materials and Methods: The "WHO hand hygiene knowledge questionnaire for healthcare workers" was translated in the Greek language, and was validated linguistically, culturally, and psychometrically. Reliability, content, construct, and convergent validity were measured. A survey on hand hygiene knowledge, and compliance, based on this questionnaire, was conducted on 439 employees., Results: The translated questionnaire presented good reliability, with Guttman's Lambda-6 evaluation (0.7). Content Validity Ratio was 84.6%. Confirmatory and exploratory factor analysis showed moderate construct validity. Convergent validity showed low correlation between the questionnaire items. Regarding the answers received, it was found that only 55.3% of the respondents received formal training on hand hygiene during the last three years prior to the study. Furthermore, 74.0% of them used alcohol-based solutions routinely. Only 54.3% of the participants presented an acceptable level of hand hygiene knowledge., Conclusions: The translation and validation of the WHO questionnaire resulted in an acceptable, reliable, and valid instrument. The survey showed that hand hygiene is rather a matter of habit, than of knowledge, and that there is great need of more organized training.

Objective: Medical applications ("apps") can offer innovative educational capabilities, facilitating the acquisition of learning objectives and enhancing decision making. The present study aims at demonstrating the usage characteristics and relevant perceptions among students in seven medical schools in Greece., Materials and Methods: A descriptive cross-sectional study was conducted through an online survey. Popularity, usage patterns and medical student perceptions regarding medical apps were studied., Results: A total of 1,458 undergraduate medical students participated, 99.2% owned a smartphone, 72.8% were aware of medical apps' existence, although only 53.9% used them. Apps awareness was higher in higher-ranked universities. Overall, 46% used 1-3 apps, 7.9% more than four apps. 40.3% stated apps' usage at least 1-3 times a month, followed by 16.0% using them 1-3 times per week. Only 2.5% reported daily usage. Students who used more apps tend to use them more frequently. 77.3% used at least half of the downloaded apps. Awareness of medical apps, number of apps in use and frequency of usage tend to increase in each succeeding year of study. The most popular apps and the main reasons of usage are presented in this study. Current and future perceptions have been investigated. No disparities have been observed between genders., Conclusions: Overall medical apps usage was relatively low, despite the high percentage of smartphone ownership. Quantitative traits are enhanced across the progression of medical studies. Utilization frequency is higher in those using more apps. Distinct utilization patterns were identified between preclinical and clinical students, possibly depicting particular needs, portraying apps as a special adjunctive educational tool.

Aim: To investigate the prevalence of overweight, obesity and central obesity in students of primary and secondary education, and the association with lifestyle parameters., Methods: A total of 3504 students, aged 10-16 years old, from Western Greece participated in this cross-sectional epidemiological study (participation rate: 90%). Demographic, socioeconomic, dietary, physical activity and screen time data were obtained using a questionnaire. Anthropometric measurements were also obtained. Overweight and obesity were estimated using the Centers for Disease Control and Prevention (CDC) and International Obesity Task Force (IOTF) criteria and central obesity using the WHtR ≥0.5 and IDF criteria., Results: The prevalence of overweight and obesity was 19.2% and 12.1% with CDC criteria, respectively, and 20.9% and 7.2%, with IOTF criteria respectively. Central obesity was 31.1 and 32.8% using the Waist-to-Height ratio (WHtR) ≥0.5 and International Diabetes Federation (IDF) criteria respectively. Male gender, small number of meals, breakfast skipping, frequent consumption of school food and sweets and the presence of a computer in children's rooms, were identified as the strongest lifestyle factors affecting weight., Conclusion: Overweight, obesity and central obesity rates remain high among children and adolescents in Greece. The identification of risk factors associated with the manifestation of obesity and central obesity, may contribute to the implementation of targeted prevention and treatment interventions., (©2021 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)