George Kavadias

Social determinants of self-reported emotional and behavioral problems in Greek adolescents

ObjectiveThis study aimed to assess the social factors associated with self-reported emotional and behavioral problems among Greek adolescents.MethodsAt age 18, a population-based sample of 3373 Greek adolescents completed the Youth Self-Report (YSR) questionnaire.ResultsThe results from the multivariate analysis indicated that both lack of intimate friendships and not having parental monitoring were independently associated with problem behavior among both male and female adolescents. Engagement in sexual activities was significantly associated with higher YSR scores among both genders. Absence of academic motivation was associated with higher YSR scores in girls only.ConclusionsOur results confirm that social factors, including negative family functions, lack of academic motivation and not having close friends, were associated with emotional and behavioral problems among adolescents and imply the need to develop a supportive social network for adolescents.

The generation gap in numbers: parent-child disagreement on youth's emotional and behavioral problems : A Greek community based-survey

ObjectiveTo evaluate discrepancies between parent and child reports on youth’s emotional and behavioral problems in a representative, community based sample of Greek 18-year-olds, and to identify associated factors.MethodsA total of 2,927 completed pairs of parent-child questionnaires were studied, including the child behavior checklist (CBCL) and the youth self-report (YSR). Linear regression analysis was used to identify both child and parental characteristics significantly associated with parent/child disagreement on scores for youth’s Internalising, Externalising and Total problems scales for both genders separately.ResultsAlthough there was a strong correlation between scores on the YSR and CBCL corresponding scales, parent/child discrepancies were more likely to occur when the later: had good academic performance, were dissatisfied from their self-image or their life. Parental factors that influence discrepancies in parent/child scale scores were: low paternal education for both genders, father being the informant for boys, and maternal stress and lack of awareness of leisure activities for girls.ConclusionThe associations found highlight the contributions of both parents and children to the discrepancies on emotional and behavioral problems in adolescence. This study may facilitate constructive parenting practices through generations.

Does exclusive breastfeeding increase after hospital discharge? A Greek study.

To monitor the rate of exclusive breastfeeding in Greek maternity wards and to investigate possible changes in infant-feeding practices during the first month after hospital discharge, the authors questioned 4310 Greek mothers from 7 hospitals on the fourth day postpartum. Odds ratios were calculated to estimate the effects of health system, demographic, psychosocial, and environmental factors. Any breastfeeding and full breastfeeding initiation rates were 85% and 23%, respectively. One month postpartum, the corresponding rates of any and exclusive breastfeeding were 79% and 61%, respectively. Mothers of infants who lacked continuous rooming-in while in the maternity ward (OR, 2.08; 95% CI, 1.27-3.40) and with previous experience of breastfeeding (OR, 1.46; 95% CI, 1.19-1.79) were more likely to reestablish exclusive breastfeeding at home despite the use of supplementation in the maternity ward. It seems women are capable of overcoming supplementation in hospital and can revert to exclusive breastfeeding at home. J Hum Lact. 23(2):165-173.

397 Do Eating Habits have an Effect on Obesity Among Greek Adolescents

Introduction: It has been shown that there is a high prevalence of overweight and obese children at 7 and 18 years in Greece, but there is limited information from the literature regarding their eating habits.Aim: To identify a possible association of eating habits among adolescents with their body mass index (BMI) at 18 years. Population and method: Individuals were 3415 adolescents born in April 1983, who responded to pre-coded questionnaires sent out through the high schools of the country. The self-reported data was examined using multiple linear regression analysis with BMI as the dependent variable. Independent variables were breakfast meals, devouring large amounts of food, stress-related eating, participation in family meals, consumption of home-delivery food, eating elsewhere- not at home and gender.Results: Adolescents that have breakfast daily (p<0.001) or 1–3 times a week (p=0.008) have lower BMI. Youngsters who often eat elsewhere, not at home, also have a lower BMI (p=0.001). In contrast, devouring large amounts of food (p<0.001) and stress-related eating (p<0.001) are significant risk factors for higher BMI. Differences appeared when stratified by gender. BMI for grls rises when devouring large amounts of food (p=0,003), whereas this was non-statistically significant for boys. BMI for boy decreases when they often order home-delivery food (p=0.04), which was found to be non-statistically significant for girls.Conclusions: Greek families need to realize the contribution of breakfast to body shape, as it is one of the most important meals of the day. Obesity prevention programs ought to establish healthy eating habits from an early age. Alternative methods to deal with stress, rather than eating, need to be promoted.

191 The Importance of Supportive Environmental Mechanisms in Emotional Stability During Adolescence. Cross-Sectional Study in Greece.

Background: Relevant information from studies and empirical observations suggest that supportive environment -families, schools, peers- do play a significant role in emotional balance during adolescence.Aim: We examined the relationship between supportive environmental mechanisms with the emotional stability in the process of puberty.Methods and population: Pre-coded questionnaires were disseminated to the last grade of senior high school pupils (18-year-olds) across the country. Finally, 3415 self-completed questionnaires were returned from a representative sample of Greek adolescents. Behaviour was estimated by Youth Self Report (YSR, 1991 profile, Achenbach) and disturbance was defined as the score above the 98th percentile included. Demography, family structure and personal relationships were regressed against the dichotomy normal/deviant for all children and from each YSR subscale.Results: Adolescents who have supportive friends score themselves lower on the subscales Withdrawn, Anxious/Depressed, Social Problems and Internalising behaviour (p=0.001). Indeed, regression confirmed that these adolescents have a much lower risk of deviation at the same scales (OR=0.096/CI=0.049–0.187, OR=0.311/CI=0.148–0.655, OR=0.164/CI=0.087–0.310, OR=0.185/CI=0.092–0.370 respectively). Logistic regression analysis also revealed that parental concern for their childrens friends and leisure activities play a protective role in their emotional and behavioural stability. What seems to risk it, is the premature start of their sex life, a fact that doubles the chance of deviation on almost all scales.Conclusions: Adolescents may pass easier through this unstable phase of life by sharing it with their peers exchanging feelings and experiences. It seems that family structure becomes less important in shaping the behaviour of adolescents, whereas it is substantial for parents to be close and aware of choices made by their children. The early start of sex life seems to be a hazard for their balance, as it is difficult for them to rationalise their emotions and cope with them.

150 Prevalence of Overweight and Obesity Among Greek Children At the Ages of 7 and 18Y by Gender. A Longitudinal Study

Background: The obesity epidemic has alarmed consciousness against it in aim to prevent future mortality and morbidity.Objectives:: To investigate longitudinally the prevalence of overweight/ obesity among Greek children by gender. Population and methods: Data was obtained from a prospective follow-up study of 2000 children from birth to 18 y of age. Information was gathered by self-completed questionnaires. The age and sex specific BMI cut off points of the International Obesity Task Force were used to define overweight and obesity in 7 and 18 year olds.Results: 1 out of 3 overweight/ obese 7y old children remain overweight/ obese at 18y. More specifically 1 out of 2 boys and 1 out of 4 girls do so. Logistic regression revealed no significant factors for boys who remain overweight/obese during adolescence. On the contrary, 7y old overweight/ obese girls are 7 times more likely to become normal at 18y when they have an incorrect impression of their body shape and consider themselves overweight (33%). Also girls with overweight/ obese mothers run a 3 times higher risk of remaining overweight/obese during adolescence. No other factor from those entered into the regression appeared to be significant.Conclusion: Prevalence of obesity in both genders is similar and high (22–25%) at 7 years. 1 out of 2 overweight/ obese boys will become an overweight/ obese adolescent. This is not predictable so far. Girls are liable to psychosocial aspects of modern lifestyle and manage to lose their excess body weight.

Inappropriate Days of Care in A Pediatric Hospital 49

To assess the extent of inappropriate hospital use in pediatric inpatients the “Pediatric Appropriateness Evaluation Protocol” was applied to 1,400 children, randomly admitted during one year in the bigest pediatric department in Greece, with a total of 6,450 days hospitalization .Results: The mean length of stay in hospital was found 4.6±4.4 days. Almost half of them (3.167 days, 49%) namely 2.26 days per child were found to be medically inappropriate. Factors significantly associated with inappropriate hospital use such as demographic and social characteristics, nature of disease, type of primary care offered to the child, process of hospital admission and medical intervantions during hospitalization were thrown into multiple regression model. It appeared that the number of tests done and the number of specialists examined the child attribute to increased inappropriate days. Children with infections disease, to divorced parents and non insured were more likely to fall into this category. Less inappropriate hospital days are associated with: the number of tests performed the day of admission: the flexibility of clinical hospital practice; the poor physical condition of the child and the admission in emergency at night .In conclusion, since social status and nature of disease are not changable better coordination of hospital diagnostic and therapeutic intervantions may reduce inappropriate hospital use and its consequences.