A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women.

Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with sexual violence. A systematic review was applied. Inclusion criteria were English language published between 2003 and 2013; reporting on delivery and/or evaluation; focusing on any form of sexual violence; delivered to professionals, affected or at-risk women; targeting migrant, at-risk women or domestic workers. Data were extracted on the setting, content, evaluation process and target population. Four studies which focused on prevention or responding to sexual violence were included. One study provided sexual violence training to vulnerable female and one provided a HIV prevention intervention to marginalized women. Learning objectives included increasing knowledge around issues of sexual violence and/or gender and human rights, prevention and response strategies. Two studies aimed to train trainers. All studies conducted an outcome evaluation and two a process evaluation. It seems there is a gap on participatory empowerment training for marginalized women. Community train-the-trainer interventions are imperative to protect themselves and deal with the risk of sexual violence.

Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: a multi-level analysis.

Data are presented on young people's sexual victimisation and perpetration from 10 European countries (Austria, Belgium, Cyprus, Greece, Lithuania, the Netherlands, Poland, Portugal, Slovakia and Spain) using a shared measurement tool (N = 3480 participants, aged between 18 and 27 years). Between 19.7 and 52.2% of female and between 10.1 and 55.8% of male respondents reported having experienced at least one incident of sexual victimisation since the age of consent. In two countries, victimisation rates were significantly higher for men than for women. Between 5.5 and 48.7% of male and 2.6 and 14.8% of female participants reported having engaged in a least one act of sexual aggression perpetration, with higher rates for men than for women in all countries. Victimisation rates correlated negatively with sexual assertiveness and positively with alcohol use in sexual encounters. Perpetration rates correlated positively with attitudes condoning physical dating violence and with alcohol use in men, and negatively with sexual assertiveness in women. At the country level, lower gender equality in economic power and in the work domain was related to higher male perpetration rates. Lower gender equality in political power and higher sexual assertiveness in women relative to men were linked to higher male victimisation rates.

Driving Behaviour in Depression Based on Subjective Evaluation and Data from a Driving Simulator.

Road traffic collisions are a major issue for public health. Depression is characterized by mental, emotional and executive dysfunction, which may have an impact on driving behaviour. Patients with depression (N = 39) and healthy controls (N = 30) were asked to complete questionnaires and to drive on a driving simulator in different scenarios. Driving simulator data included speed, safety distance from the preceding vehicle and lateral position. Demographic and medical information, insomnia (Athens Insomnia Scale, AIS), sleepiness (Epworth Sleepiness Scale, ESS), fatigue (Fatigue Severity Scale, FSS), symptoms of sleep apnoea (StopBang Questionnaire) and driving (Driver Stress Inventory, DSI and Driver Behaviour Questionnaire, DBQ) were assessed. Gender and age influenced almost all variables. The group of patients with depression did not differ from controls regarding driving behaviour as assessed through questionnaires; on the driving simulator, patients kept a longer safety distance. Subjective fatigue was positively associated with aggression, dislike of driving, hazard monitoring and violations as assessed by questionnaires. ESS and AIS scores were positively associated with keeping a longer safety distance and with Lateral Position Standard Deviation (LPSD), denoting lower ability to keep a stable position. It seems that, although certain symptoms of depression (insomnia, fatigue and somnolence) may affect driving performance, patients drive more carefully eliminating, thus, their impact.

Perceived Knowledge and Attitudes of Faculty Members towards Inclusive Education for Students with Disabilities: Evidence from a Greek University.

The current paper aimed at investigating factors affecting the perceptions and attitudes of faculty members towards inclusive education for students with disabilities in a Greek University. A questionnaire, based on the "Expanding Cultural Awareness of Exceptional Learners-ExCEL" was distributed online to 311 faculty members, during the first semester of 2020. The questionnaire explored participants' sociodemographic and academic background, prior training and personal experience with disability, perceived knowledge, beliefs and attitudes towards inclusive education practices. A total of 80 questionnaires were completed (males 56.3%; aged 41-50 years 43.7%; working experience > 16 years 52.4%; prior training on disability 77.5%). Factor analysis identified four constructs relevant to: (a) perceived knowledge regarding the legal framework ("Perceived Knowledge"), (b) intention towards the provision of general accommodations in class ("Help in Class"), (c) intention towards resource provision ("Material Offer"), and (d) beliefs about the provision of accommodations to students with disabilities ("Negative Attitude"). Gender, faculty subject and prior training on disability were shown to affect the participants' "Perceived Knowledge", while working position was shown to affect "Material Offer". Age, working experience, and personal experience with disability did not reveal any significant effect. More research is needed to investigate the attitudinal and practical barriers of faculty members towards meeting students' educational needs.

Overestimation of Relative Risk and Prevalence Ratio: Misuse of Logistic Modeling.

The extensive use of logistic regression models in analytical epidemiology as well as in randomized clinical trials, often creates inflated estimates of the relative risk (RR). Particularly, in cases where a binary outcome has a high or moderate incidence in the studied population (>10%), the bias in assessing the relative risk may be very high. Meta-analysis studies have estimated that about 40% of the relative risk estimates in prospective investigations, through binary logistic models, lead to extensive bias of the population parameters. The problem of risk inflation also appears in cross-sectional studies with binary outcomes, where the parameter of interest is the prevalence ratio. As an alternative to the use of logistic regression models in both longitudinal and cross-sectional studies, the modified Poisson regression model is proposed.

Seeking for risk factors of Intimate Partner Violence (IPV) in a Greek national sample: the role of self-esteem.

The objective of this article is to gain a better understanding of the magnitude of intimate partner violence (IPV) in Greece and to explore factors associated with increased risk of IPV prevalence. A cross-sectional study was undertaken among 1,122 men and women, aged 18 to 65, who are residents of urban areas of Greece. The questionnaire used included 3 sections and 39 items that examined the sociodemographic characteristics of the participants, rate of IPV victimization and perpetration (physical, sexual, emotional), childhood experience of violence, and level of self-esteem. Statistical analysis showed self-esteem to be significantly associated with physical violence victimization and perpetration (odds ratio [OR] = .975, confidence interval [CI] = .955-.996; OR = .972, CI = .951-.993, respectively), whereas experience of abuse during childhood was shown to be a strong predictor in all six models of IPV victimization and perpetration (p < .001). Finally, gender, age and years of cohabitation were some sociodemographic and background characteristics found to increase the risk of specific forms of IPV. Conclusions drawn from the current study should be taken into account in attempts aiming at preventing or ameliorating the problem.

Physical, psychological and economic burden of two-wheel users after a road traffic injury: Evidence from intensive care units of three EU countries.

INTRODUCTION: This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization. METHODS: A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), "Impact of Event Scale" (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of 'Direct' and 'Indirect' costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. RESULTS: A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50-64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65+ and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50-64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person. CONCLUSIONS: There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences. PRACTICAL IMPLICATIONS: A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner.

Applying the concept of lifestyle in association with aggression and violence in Greek cohabitating couples.

The current study investigated the role of lifestyle as a significant factor related to the aggression and violence between cohabitating partners. Based on previous research, lifestyle was defined as a special reflection of socialization into society and working life, where different lifestyles should also be able to produce different patterns of socialization into people's roles as partners. It was found that gender and years of cohabitating were significantly related to Emotional aggression and Sexual violence; lifestyle patterns were associated with specific forms of violence. More specifically, the lifestyles of Pleasure & Elegance and the one of Culture-Intellectualism were found to promote Emotional aggression. Also, the lifestyle of Yuppies/Workaholic and that of Physical activities stimulated the appearance of Sexual violence between partners. Moreover, individuals with Tradition-Religiousness lifestyle were more likely to show lower levels of Physical & Sexual violence while the adherents of the Substance abuse lifestyle pattern appeared to have an inclination towards Physical & Sexual Violence. Finally, the occurrence of one form of violent behaviour was likely to be related to the other forms of violent behaviour.

Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries.

The current study aimed to follow-up a group of road crash survivors for one year and assesses the impact of injury on their psychological and physical condition. All crash survivors that were admitted to the intensive or sub-intensive care units of selected hospitals in Greece, Germany and Italy over one year period (2013-2014), were invited to participate in the study and were interviewed at three different time-points as follows: (a) at one month (baseline data), (b) at six months, and (c) at twelve months. The study used widely recommended classifications for injury severity (AIS, MAIS) and standardized health outcome measures such as the Disability Assessment Schedule II (WHODAS 2.0) to measure disability, "Impact of Event Scale" (IES-R) to measure Post-Traumatic Stress Disorder (PTSD), Center for Epidemiological Studies Depression Scale (CES-D Scale) to measure depression. A total of 120 patients were enrolled in the study in all the partner countries and 93 completed all follow up questionnaires. The risk of physical disability was 4.57 times higher [CI 1.98-2.27] at the first follow up and 3.43 times higher [CI 1.43-9.42] at the second follow up as compared with the time before the injury. There was a 79% and an 88% lower risk of depression at the first and the second follow up respectively, as compared with the baseline time. There was also a 72% lower risk of Post-Traumatic Stress at the second follow up as compared with the baseline time. A number of factors relevant to the individuals, the road crash and the injury, were shown to distinguish those at higher risk of long-lasting disability and psychological distress including age, marital status, type of road user, severity and type of the injury, past emotional reaction to distress. The study highlights the importance of a comprehensive and holistic understanding of the impact of injury on an individual and further underlines the importance of screening and treating psychological comorbidities in injury in a timely manner.

Cross-cultural differences in driving skills: a comparison of six countries.

The first aim of the present study was to investigate the applicability of the two-factor structure (perceptual-motor skills by 11 items, e.g., "fluent driving"; safety skills by 9 items, e.g., "conforming to the speed limits") of the Driver Skill Inventory (DSI) among British, Dutch, Finnish, Greek, Iranian, and Turkish drivers. It was also hypothesized that the combination of self reported high ratings of perceptual-motor skills and low ratings of safety skills creates a serious risk for dangerous driving and road accident involvement. The second aim of this study was, therefore, to investigate this asymmetric relationship between perceptual-motor and safety skills in traffic penalties and accident involvement. Two hundred and forty two drivers were chosen from each of the six countries, matched for age and sex. The results of exploratory factor analyses together with target rotation showed that the two-factor structure of DSI found in "safe" Northern and Western European countries were highly congruent. However, the safety skills factor of DSI in Greece, Iran, and Turkey was relatively incongruent in spite of high factor similarity found in perceptual-motor skills. The asymmetric relationship between perceptual-motor and safety skills on traffic penalties was found in Finland and Turkey. A negative relationship between safety skills and the number of accidents was found both in Greece and Iran while a positive relationship between perceptual-motor skills and the number of accidents was found only in Iran.

Freight transport and non-driving work duties as predictors of falling asleep at the wheel in urban areas of Crete.

BACKGROUND: This study investigated the impact of subjective reports of drowsy driving and non-driving duties on the falling asleep responses and road crash involvement of professional drivers in Crete. An attempt was also made to elucidate other driving parameters, such as freight transportation, which could be potential predictors of risky driving, after controlling for lifestyle patterns. METHOD: A sample of 317 professional drivers was studied through personal interviews. The interview questionnaire included items about sleep and fatigue as contributing factors to falling asleep probability and crash risk. In addition, the drivers reported the type of freight they carried in their last trip, as well as practices such as smoking and alcohol consumption. RESULTS: The first logistic regression analysis showed that the most significant predictors of falling asleep at the wheel were transportation of fruits/vegetables and livestock, non-driving hours of work, insufficient hours of sleep, and smoking. The second logistic regression analysis revealed all the previous items as powerful factors of crash probability, including the transportation of express freight and freezer. IMPACT: The findings of the current study are discussed as they pertain to directions for future studies and for the development of fatigue countermeasures.

Aggressive behavior while driving as predictor of self-reported car crashes.

PROBLEM: In Greece, there is a lack of scientific evidence on the relationship between aggressive behavior while driving and young drivers' involvement in car crashes; this study examined this potential relationship. METHODS: The randomly selected samples of 356 young drivers (18-24 years old) were interviewed through a questionnaire of self-reported car crash involvement, which mainly focused on their behavior on the road and the number of car crashes in which they had been involved. RESULTS: The statistical methods used were principal components analysis (PCA) and multiple regression analysis. Two factors relevant to aggressive driving emerged: (a) driving violations and (b) irritability while driving. The multivariate model suggested that driving just for fun (joyriding) and irritability were predictors of young drivers' involvement in car crashes. It was found that younger age was negatively associated with young drivers' involvement in car crashes. IMPACT ON GOVERNMENT AND INDUSTRY: The findings of this study can contribute in the formation of public policies aiming to prevent young drivers' car crashes. These findings can also be the starting point of some health promotion interventions trying to reduce car crashes and casualties on the road. Finally, the insurance companies may be interested in applying these findings into their field of interest.

Psychosocial dimensions of exceptional longevity: a qualitative exploration of centenarians' experiences, personality, and life strategies.

This qualitative study provides a comprehensive account of the social and life experiences and strategies and personality attributes that characterize exceptional longevity (living to 100 or over). It is based on nine semi-structured interviews of relatively healthy and functional Greek centenarians of both sexes. The analytic approach was thematic and based on grounded theory. We found that our participants were characterized by selectiveness in their socializing with other people and tendency to avoid conflicts. Also, we found that they predominantly used the "flight" response whenever confronted with stressors. Further, they appeared to be much adaptive as they had managed to overcome adversity and adapt successfully to major life changes. These findings provide insights into three possible pathways (social selectivity, conflict avoidance, and adaptiveness) through which psychosocial factors might be associated with aging and exceptional longevity.

Predicting human cloning acceptability: a national Greek survey on the beliefs of the public.

BACKGROUND: In the era of human genome research, there is a large theoretical debate among scientists and authorities on the ethical dimension based on the moral liberty of the individuals and the scientific and economic dimension based on the freedom and the independence of the scientific and technological activities. Meanwhile, the understanding of beliefs on human cloning (HC) and its acceptability are important for the development of evidence-based policy making. However, previous research in the field of public beliefs towards human genetics is limited. Therefore, in the present study, we investigated the role of public beliefs as predictors of the acceptability of the respondents to use HC. METHODS: Personal interviews were conducted with 1020 men and women of urban areas in Greece. Stratified random sampling was performed to select participants. Several scientists, experts in HC, evaluated the content of the instrument initially developed. The final questionnaire was the result of a pilot study. RESULTS: The acceptability of HC for the cure of incurable diseases and transplantation need is very high (70.7 and 58.6%, respectively). Public's intention to have recourse to HC because of "bringing" back to life a loved person or because of reproductive disorders was reported by 35 and 32.5%, respectively. With respect to the role of beliefs: increasing scores of reasons of social benefits, moral/religious reasons and legislative reasons increased the public's intention to have recourse to HC; inversely, decreasing scores of reasons of human commodification/exploitation increased public's intention to have recourse to HC. Additionally, low rates of church attendance appeared to be correlated with high reported acceptability of HC. CONCLUSION: There is great public concern regarding the application of HC, which probably reflects the existing ambivalence over the relationship between technology and society. Scientists and policymakers should take into account these indicators of public disquiet and should manage the public involvement in policy decisions, from which they have so far been excluded.

Identifying the public's knowledge and intention to use human cloning in Greek urban areas.

PURPOSE: The understanding of the public's knowledge on human cloning (HC) and its acceptability are considered important for the development of evidence-based policy making. The aim of this research study was to investigate the demographic and socioeconomic variables that affect the public's knowledge and intention to use HC in urban areas of Greece. Additionally, the possible association of religiousness with the knowledge and the intention to use HC were also investigated. METHODS: Individual interviews were conducted with 1020 men and women of urban areas in Greece. Stratified random sampling was performed to select the respondents. Several scientists, experts in HC, evaluated the content of the instrument initially developed. The final questionnaire was consequently the result of a pilot study. RESULTS: Almost half of the respondents (51.5%) believed that "HC is a sort of in vitro fertilization" and 42.9% that "it has already been applied to human being." They were not aware that "the cloned fetus grows in the woman's uterus" (41.5%) and that "HC could regenerate human organs" (41.7%). The acceptability of human cloning for the cure of terminal diseases and transplantation need is very high (70.7% and 58.6%, respectively). The public's intention to have recourse to cloning on the grounds of "bringing" back to life a loved person or because of reproductive disorders was reported as desire by 35% and 32.5%, respectively. The occupational category (scientists, self-employed, and artists), the Intention to use HC, and the number of children are highly significant predictors of valid knowledge about HC. Low rates of church attendance appeared to relate with high reported Intention to use HC, and increasing scores of valid knowledge about HC increased the public's Intention to use HC. CONCLUSIONS: A number of specific demographic and socioeconomic characteristics and high scores of knowledge provide a persuasive justification in demonstrating intention toward HC. The current study suggests that these findings should receive further attention by policymakers and scientists within the Greek context.

A relationship between traditionally motivated patterns and gamete donation and surrogacy in urban areas of Greece.

BACKGROUND: Although gamete receipt or donation has become an integral part of infertility management, previous research in the field of social attitudes and intention to use medical technologies is limited. The aim of this paper was to investigate people's intentions to receive or donate sperm, oocyte or uterus (surrogacy) and to identify possible motivational patterns explaining this intention. METHODS: Personal interviews were conducted with 365 men and women of reproductive age (18-45 years). Stratified random sampling was performed to select the men and women for interview. The content of the instrument used was derived from in-depth qualitative interviews with physicians experienced in assisted reproductive technologies, as well as from people who had recourse to gamete donation and surrogacy. RESULTS: The results obtained highlighted the following major aspects: (i) approximately 50% of the survey's participants would be prepared to receive/donate sperm and oocyte; (ii) the results from multiple regression analysis suggest that the 'traditional gender roles' pattern is positively associated with 'intention to use gamete donation and surrogacy'. On the contrary, 'confidence in emotional relationship' is negatively associated with 'intention to use gamete donation and surrogacy, and (iii) men are more likely than women to report 'intention to use gamete donation and surrogacy'. CONCLUSION: These data suggest that specific motivational patterns of the population need to be thoroughly analysed and taken into consideration, in order that appropriate counselling be addressed to individuals and couples.

Using attitudinal indicators to explain the public's intention to have recourse to gamete donation and surrogacy.

BACKGROUND: Although the donation and receipt of gametes has become an integral part of infertility management, previous research in the field of social attitudes and intention to use medical technologies is limited. This study aimed to investigate attitudinal indicators and their potential relationship with the public's intention to have recourse to gamete donation and surrogacy. METHODS: A total of 365 individuals of reproductive age (49.3% men and 50.7% women) completed a questionnaire referring to their intention to receive or donate sperm/oocytes and their acceptance of becoming a commissioning couple or surrogate mother, and also to explore their attitudes towards gamete donation and surrogacy. Two attitudinal indicators emerged from the principal component analysis identifying (i). recipients' and donors' choice for anonymity, donors' renunciation of parental obligations and refusal of children's rights to know their biological parents and (ii). favourable attitudes towards legislative and financial measures to be adopted by the Government for the promotion of reproductive technologies. RESULTS: It was found that the indicator of 'Donors Anonymity and Refusal of Children's Rights' (DARCR) and the 'Legislative and Financial Support' (LFS) scale are positively associated with intention to have recourse to Gamete Donation and Surrogacy (GDS) (regression coefficients 0.31 and 1.08 respectively). Moreover, among the other variables used in the analysis only the 'church attendance' variable is negatively related with reported rates of intention to have recourse to GDS (P = 0.029), suggesting that the more religious respondents are less willing to use GDS. CONCLUSION: Social, legislative and financial implications provide a convenient rationale for adopting a favourable intention towards reproductive technologies. The findings of the present research should be given close consideration by policy makers and health education campaigns.

Greek Christian Orthodox Ecclesiastical lifestyle: could it become a pattern of health-related behavior?

BACKGROUND: Although past research has globally supported the salutary impact of religion on health and health-related behaviors, it has not extensively examined the impact of the Christian Orthodox Church's way of living on people's health and health-related behavior. METHODS: Semistructured personal interviews were used to investigate a stratified sample of 20- to 65-year-old individuals in the greater Athens area. Constructs were compared to single items and indices, which varied across data sets. RESULTS: Multiple-regression analysis specify that persons adopting the Christian Orthodox Church's lifestyle were more likely to behave in ways that enhance their health (e.g., relaxation, life satisfaction, healthful nutrition, personal hygiene, and physical activity), after controlling for a set of socio-demographic factors and their current health status. CONCLUSION: These results suggest that the Christian Orthodox Church's lifestyle constitutes a pattern of health-related behavior.