Community-Based Virtual Reality Interventions in Older Adults with Dementia and/or Cognitive Impairment: A Systematic Review.

INTRODUCTION: Virtual reality devices have been widely used for the rehabilitation among older people with cognitive impairments. They enable the user to navigate in three-dimensional environments, which are constructed by a computer. Recent studies have been focused on the cognitive benefits of virtual reality for people with cognitive deficits. The current study aimed to investigate the overall impact of community-based virtual reality interventions in older adults with dementia and/or cognitive impairment. METHODS: A systematic review of the literature was conducted according to the PRISMA guidelines. Google Scholar, PubMed, Science Direct and Scopus databases were searched for the years 2010-2022. RESULTS: Of the 245 articles 20 met the inclusion criteria. The results of the current systematic review indicated that virtual reality improved older adults' cognitive and motor skills and increased their positive emotions while minimizing less positive ones. However, there is insufficient data of its impact on their overall quality of life. CONCLUSION: There is a need to implement and evaluate interventions that examine its impact not only on cognitive functioning, but also on other aspects of older people with cognitive deficits.

The Association Between Spirituality, Self-Esteem, Anxiety and Depression: A Comparative Exploratory Study Between People with a Spinal Cord Injury and Healthy Subjects in Greece.

The purpose of this study was to evaluate spirituality, religiosity, self-esteem, depression, and stress in people with spinal cord injuries. The Royal Free Questionnaire for Spiritual and Religious Beliefs, the Rosenberg Self-Esteem Scale, the Center for Epidemiologic Studies Depression Scale, and the Spielberger State-Trait Anxiety Scale were all designed for the current study to collect demographic and injury-related information. In the study, 88 patients with traumatic SCI and 88 healthy subjects were included. Half of the participants and healthy subjects were women, while the mean age of the healthy subjects was 42.8 years and that of the subjects was 42.4 years. The majority of participants were Greek (97.2%), while 44.1% were married or with a partner and 43.2% were single. The mean depression and stress score was higher in patients than in healthy subjects, and the mean score of self-esteem was lower in patients than healthy subjects. Multivariable linear regression model showed that patients who believed more that a spiritual force or power outside of ourselves can influence what happens in everyday life had less depression and stress. People with spinal cord injuries experience extreme stress, anxiety, and depression. Spirituality and religiosity can play a significant role in their recuperation, rehabilitation, and adaptation.

Health promoting schools and COVID-19: preparing for the future.

We face an unprecedented period of history during which COVID-19 is clustered with other global conditions, such as obesity, undernutrition, an infodemic, and climate change. This syndemic (synergy of epidemics) calls for the development of children's and youth's health literacy and socioemotional skills, support for behavioural hygiene (e.g. washing hands, wearing masks), and adults' responsibility and caring. Moreover, it calls for creating conditions for healthy living and learning for all and paying extra attention to inequalities that have increased during the pandemic. Today, more than ever, there is an essential demand for schools to create environments that maintain and promote health for all. Within this commentary, we argue that whole-school approaches, such as the health promoting school, are essential to fight against the pandemic and to prepare schools for future challenges.

Informal carers' experiences and feelings during rehabilitation.

The purpose of this study was to explore the experiences and feelings of people caring for patients with long-term diseases in a rehabilitation centre. A qualitative research approach was used. Fifteen informal carers were interviewed. The study was conducted in a rehabilitation centre in Greece. Three themes emerged. The first was feelings regarding the patient and the carers themselves, as well as the type of care provided and life at home after discharge from the rehabilitation unit. The second was experiences regarding health professionals and delivered care, and other carers. The third theme was expectations and thoughts about the future. Health professionals should plan and implement support interventions within rehabilitation settings in order to address carers' needs in terms of practical guidance not only within the framework of patient care but also relating to the psychological and physical wellbeing of informal carers.

Family characteristics and children's knowledge of cardiovascular risk factors.

BACKGROUND: Cardiovascular disease has the highest mortality rate than any other disease globally. Some major risk factors seem to be established in the early stages of life, suggesting preventive strategies as a major means to reduce cardiovascular mortality. The aim of the present study was to investigate the role of socioeconomic status and family characteristics on children's knowledge and perceptions concerning cardiovascular disease risk factors. METHODS: A cross-sectional survey was conducted among 1,728 children (46% male) aged 10-12 years, attending Greek primary schools in Athens; Heraklion (capital city of the island of Crete); Kalamata; Pyrgos; and Sparti (Peloponnese peninsula), Greece. Sampling was conducted on school premises, during the school years 2014-15 and 2015-16 (participation rate, 95-100%). Data were collected via self-administered, anonymous questionnaire. Children's knowledge of various issues related to cardiovascular risk, such as nutrition, physical activity and smoking was also examined. Data on family characteristics were collected through another questionnaire completed by parents. RESULTS: Paternal education level and living with both parents instead of single-parent upbringing, were positively associated with children's knowledge of cardiovascular risk factors (b = 0.42; 95%CI: 0.01-0.83; P = 0.04; and b = 0.78; 95%CI: 0.013-1.43; P = 0.02 respectively). Moreover, children with more siblings seemed to have less sufficient knowledge compared with peers with fewer siblings (b per 1 sibling = -0.24; 95%CI: -0.47 to -0.014; P = 0.04). CONCLUSIONS: The present findings enhance the link between the micro-environment and children's knowledge and perceptions concerning cardiovascular health, providing information to health-care professionals while counseling youths.

Exploring Religiosity, Self-Esteem, Stress, and Depression Among Students of a Cypriot University.

The purpose of this study was to explore the relationship between Religiosity, Self-esteem, Stress, and Depression among nursing students, social work students, and early-education students of a Cypriot University. The data were collected using four questionnaires. The results indicate a significant positive association between Depression and Stress. Greater levels of Self-esteem were found to be associated with lower depression levels in correlation analysis, while strength of Religious and Spiritual Beliefs was correlated negatively with depression. The results of the current study highlight the need for early intervention in order to promote students mental well-being.

Greek fathers' experiences from their wife's/partner's labour and delivery: A qualitative approach.

This study aimed at exploring Greek fathers' experiences from their wives/partners' labour and delivery, and their perceptions about aspects of delivery care that need to be improved. It took place at hospital maternity clinics at the greater area of Thessaloniki, Greece. Participants were fathers whose wife/partner had given birth one week to one year before the data collection. The data were collected with the use of the Kuopio Instrument for Fathers (KIF). In this article we present the data obtained by KIF's four open-ended questions, which were analyzed using the method of content analysis. Three core categories emerged: (i) Meaning of presence during the delivery process; (ii) Experiences of the delivery process; and (iii) Suggestions for improving delivery services. Fathers take their role seriously and seek an active participation. Healthcare professionals and health education interventions should take into account the fathers' perspectives and aim to meet their needs.

Greek adolescents' views of people with mental illness through drawings: mental health education's impact.

People with mental illness are among the most stigmatized and discriminated against as a result of lack of knowledge among the public. Our study explored adolescents' perceptions of people with mental illness through drawings, described these perceptions, and tested the possible changes in perceptions after an educational mental health intervention. Drawings were collected before and after an educational mental health intervention from 59 Greek secondary school students. One group of participants served as the experimental group and received the educational mental health intervention. Content analysis of the drawings was used to analyze data. The drawings provided a clear understanding of adolescents' perceptions towards people with mental illness. After the educational mental health intervention the negative elements presenting the people with mental illness were less among the experimental group, while the drawings among the comparison group did not change. The findings support that educational mental health intervention can have a positive impact on adolescents' perceptions towards people with mental illness. Health professionals can use the findings of our study in order to develop and implement similar interventions.

Palliative Care in the Community: The Greek Version of the Supportive and Palliative Care Indicators Tool (SPICT™).

INTRODUCTION/OBJECTIVES: Systematic identification of persons with palliative care needs constitutes a major challenge for promoting palliative care in all levels of the health system, including primary care. The aim of this study was to translate, cross-culturally adapt, and content validate Supportive and Palliative Care Indicators Tool (SPICT) for use in the Greek primary care context. Secondary objectives were to probe the use of SPICT-GR in exemplary case vignettes, to discuss the clarity and comprehensibility of its content as well as the appropriateness, acceptability, and feasibility of the tool within the Greek primary care. METHODS: The Greek translation and cross-cultural adaptation of SPICT™ followed World Health Organization recommendations for translation and adaptation of instruments. For this purpose a working group was set up consisting of 2 senior researchers, a primary care professional with postgraduate training in Palliative Medicine and a general practitioner (GP) with special interest in primary palliative care. Three focus groups comprised of health professionals (n = 23) working in primary care settings participated in the pilot testing phase. Participants also completed a questionnaire including rating their perceptions on tool's utility and feasibility as well as on the clarity and relevance of its items. Thematic analysis was used for focus groups discussions on how the tool was perceived and interpreted by health professionals in a Greek healthcare context and descriptive statistics for the quantitative analysis of the questionnaire data. RESULTS: The majority assessed the tool as useful (65%), considered its implementation in primary care as feasible (91%) and rated its items as "relevant" or "very relevant" and "clear" or "very clear." Three themes emerged from focus groups discussions: Guiding clinical practice and facilitating collaboration; promoting comprehensive care and awareness for palliative care; applicability in and suitability for primary care. CONCLUSIONS: SPICT-GR™ was identified as a practical and applicable tool for primary care, a source of guidance for the comprehensive identification of patients' palliative care needs, promoting awareness on palliative care and facilitating a shared language among health care professionals.

Perceptions and attitudes of people with severe mental disorders towards smoking in Greece.

Despite its significant decline in the general population, smoking remains endemic and highly prevalent among people with mental disorders. The impact of smoking-attributable morbidity on life expectancy is significant since, in comparison to the general population, people with severe mental disorders have a 15-20-year reduction in life expectancy. A cross-sectional study was conducted among 1015 people with mental disorders through personal interviews. The questionnaire was designed to examine these patients' knowledge, perceptions, and attitudes towards smoking. Individuals were recruited from the mental health residential community services, the outpatient department, and the inpatient facilities of the Psychiatric Hospital of Attica. Statistical analysis was performed using SPSS 26.0. In the sample analyzed, the current-smoking prevalence stood at 68.4% (n=643), while 12.3% reported being former smokers. A staggering 86.3% smoked their first cigarette within 30 minutes of waking up, indicating a high level of dependence. Most of the former smokers (83.6%) reported that their main reason for quitting smoking was to improve their health, and the overwhelming majority (97.4%) had done so using no smoking cessation aid. Although slightly over half of the participants (53.7%) believed that health professionals adequately inform smokers about the harmful health effects of tobacco products, the information provided by health professionals on smoking cessation programs and tobacco harm reduction alternatives was considered sufficient by a mere 11.2%. Multiple logistic regression analysis demonstrated that outpatients tended to have a greater likelihood of being current smokers as compared to inpatients (OR=1.45), while users of mental health residential community services showed a significantly lower likelihood of being current smokers in comparison to inpatients (OR=0.49). Additionally, it was found that women had a lower likelihood of being current smokers compared to men (OR=0.51), while divorced/ widowed participants had a greater likelihood of being current smokers compared to single ones (OR=1.93). Finally, multiple regression analysis indicated that participants with psychotic disorders displayed a 2.39 times greater likelihood of being current smokers compared to those with mood disorders (OR=2.39). Understanding the knowledge, beliefs, and attitudes of people with mental disorders towards tobacco is an essential first step to confronting this neglected epidemic.

Perceptions and educational needs of social and healthcare professionals in the prevention of domestic violence - A focus group study.

OBJECTIVE: To explore and describe social and healthcare professionals' perceptions and educational needs in relation to domestic violence and its prevention. METHODS: A qualitative research was conducted in three European countries. Two multidisciplinary focus group interviews were conducted (in each country) among professionals and higher education teachers in the field of social and health care. Total number of participants were 32 (Finland n=12, Greece n=12, Portugal n=8). The transcribed data were analyzed by thematic analysis. RESULTS: Participants' perceptions of domestic violence and its prevention included: multidimensional phenomenon, consequences, and addressing concern. Domestic violence was seen as a multidimensional phenomenon, which has various consequences for several aspects of life. Professionals have difficulties addressing their concern due to lack of knowledge and tools. Solutions to prevent domestic violence that the participants shared were: education, intervention, and strategies. Education was seen as the key aspect for the prevention of domestic violence. Also, professionals' communication and situation management skills, as well as national and international strategies, were seen as valuable solutions. Educational needs for prevention of domestic violence were expressed based on content, methods, and practices, such as services system and legislation. CONCLUSION: The findings of the current study highlight the social- and healthcare professionals' need for education about domestic violence. It is essential that these professionals receive appropriate training to effectively identify and address domestic violence. The current study provides useful information for the development of relevant training/education for this group of professionals.

[The model of co-production in mental health services].

Service users' right to be involved in decisions concerning their health and quality of life is not only an ethical issue, but also a key aspect for the efficiency and effectiveness of services in modern health systems. Through co-production, service users have an equal partner position in a comprehensive process that includes services design, provision and evaluation. The co-production model is not a new concept but an emerging idea for health services and in particular mental health services. This model is governed by basic principles and values, such as recognizing individuals as active and equal participants with valuable experiences, taking advantage of existing opportunities, sharing and mutual understanding, peer support, tackling discrimination, and facilitation instead of just services provision. Τhe benefits are many and important, both for users (i.e. enhancing trust in services, reducing stigma), and for health professionals and settings (i.e., extroversion and dissemination, increasing needs understanding, changing professionals' attitudes, more efficient use of resources). However, there are limitations which should be considered when co-production is implemented. Regarding co-production, the literature is relatively limited; while there is a plethora of publications on the concepts related to co-production and its principles (e.g., empowerment, advocacy, recovery, etc.). The adoption of the co-production approach in Greece could benefit significantly the mental health services, within the psychiatric reform by establishing an equal relationship between professionals and service users.

Differences between Urban and Rural Environments on Cardiovascular Health: A Systematic Review.

The effect of the urban vs. rural environment on cardiovascular health is an extremely significant issue, nowadays. Up to date, there is a number of studies revealing that there is environmental impact on the prevalence of cardiovascular disease (CVD). The aim of the current systematic review was to investigate the relationship between the natural environment and cardiovascular health, through the differences between urban and rural environments. A literature search was conducted during July 2022-November 2022 using the databases PubMed/Medline, Scopus and Google Scholar (limited to the last 10 years). The search identified four studies that fulfilled the main aim of the present review. Regardless of the limited number of studies, it was shown that the different environments have a great impact on cardiovascular health. Specifically, various factors seem to affect the occurrence of CVDs in both urban and rural environments. The present review highlights the effect of urban vs. rural environment in relation to cardiovascular risk factors. However, there is a necessity for further investigation in this field in order to shed more light on the environmental components with the most significant impact.

Adolescents' difficulties, strengths and feelings of insecurity: a cross-sectional descriptive survey in Finland.

The present study aimed to describe adolescents' self-reported emotional and behavioural strengths and difficulties, as well as their insecurity feeling. In addition, the aim was to examine the association with background characteristics, and explore the association between strengths and difficulties and insecurity factors. The study was conducted among 114 secondary school pupils in Finland, using an online questionnaire. Adolescents' emotional and behavioural difficulties and strengths, were mostly classified as normal. Strengths and Difficulties Questionnaire total score as well as internal and external score, were inversely associated with insecurity factors. Girls had significantly higher prosocial behavior compared to boys (P = 0.0007). The age of adolescents was found to be related to their internal difficulties (P = 0.02) and prosocial behavior (P = 0.01). Adolescent's perception of their family relations as poor was associated with external difficulties (P = 0.04). The current results, can be helpful for mental health professionals who work with adolescents in order to implement appropriate and needs specific mental health promotion interventions at individual but also community level. Finally, more research is needed to validate measures for insecurity. This will support mental health professionals in their clinical practice by providing them with all the important factors needed to support adolescents.

Digital Health and Health Promotion: A Scoping Review of Systematic Reviews.

INTRODUCTION AND METHODOLOGY: Health Promotion is moving into a new technological era, that of Digital Health Promotion (DHP). The aim was to collect systematic reviews of digital health promotion interventions. RESULTS AND DISCUSSION: 147 articles met the criteria and were included in the present study. A diverse range of digital health promotion topics was identified, with certain topics garnering significant attention. While this scoping review provides valuable insights into the field of digital health promotion interventions, a more detailed analysis of their alignment with health prevention stages will serve as a critical next step.

"DOMINO - Stop Domestic Violence". An Educational Mobile Application.

Domestic violence affects people of all socioeconomic backgrounds and education levels and can happen to anyone. It is a public health issue that needs to be addressed with health and social care professionals playing an essential role in prevention and early intervention. These professionals need to be prepared through proper education. A European funded project developed "DOMINO - Stop domestic violence" educational mobile application which was piloted among 99 social and/or health care students and professionals. Most of the participants (n= 59, 59.6%) indicated that the DOMINO mobile application was easy to install and over half of them (n=61, 61.6%) would recommend the app. They found it easy to use, and quick access to useful materials and tools. Participants found case studies and the checklist good and useful tools for them. The DOMINO educational mobile application is available open access, in English, Finnish, Greek, Latvian, Portuguese and Swedish, for any stakeholder worldwide who is interested to learn more about domestic violence prevention and intervention.

Technologies in Home-Based Digital Rehabilitation: Scoping Review.

BACKGROUND: Due to growing pressure on the health care system, a shift in rehabilitation to home settings is essential. However, efficient support for home-based rehabilitation is lacking. The COVID-19 pandemic has further exacerbated these challenges and has affected individuals and health care professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet clients' needs and ease the growing pressure on the health care system, it is necessary to provide an overview of existing, relevant, and future solutions shaping the constantly evolving market of technologies for home-based DR. OBJECTIVE: In this scoping review, we aimed to identify digital technologies for home-based DR, predict new or emerging DR trends, and report on the influences of the COVID-19 pandemic on DR. METHODS: The scoping review followed the framework of Arksey and O'Malley, with improvements made by Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. The search spanned January 2015 to January 2022. A bibliometric analysis was performed to provide an overview of the included references, and a co-occurrence analysis identified the technologies for home-based DR. A full-text analysis of all included reviews filtered the trends for home-based DR. A gray literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic on the development of DR. RESULTS: A total of 2437 records were included in the bibliometric analysis and 95 in the full-text analysis, and 40 records were included as a result of the gray literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital and mobile apps are already used in home-based DR; however, artificial intelligence and machine learning, exoskeletons, and digital and mobile apps represent new and emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches but has not led to the development of new technologies. CONCLUSIONS: Multiple tools are available and implemented for home-based DR; however, some technologies face limitations in the application of home-based rehabilitation. However, artificial intelligence and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the health care system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients' needs and adhere to framework conditions, regardless of exceptional situations such as the COVID-19 pandemic.

Education on Vaccination Competence: an Intensive Course for Skillful Health Science Students.

Background: Vaccination is one of the most successful and cost-effective interventions for public health. Studies have shown that health professionals who have good knowledge and positive attitudes towards vaccination are more likely to provide effective vaccination protection to people, including themselves. Therefore, health science students must acquire evidence-based knowledge during their education to meet the challenges of healthcare. Objective: The aim of this study was to investigate the knowledge, attitudes and feedback of health science students who participated in the Educating Vaccination Competence (EDUVAC) Intensive Course. Methods: A five-day Intensive Course was implemented for health science students, which included a pre-assignment. The EDUVAC Intensive Course used different teaching methods (lectures, workshops, interactive games, discussions), group work, study visits, and cultural programs to encourage students' motivation. For the purpose of the study, students filled out an online questionnaire after giving informed consent. Results: Sample consisted of 31 health science students from five European Higher Institutions. They had very good knowledge on most knowledge questions. In the post measurement it was significantly greater and equal to 81%, p<0.001. Almost all students (93.5%) totally agreed that "It is important for adults to receive all recommended vaccines according to national guidelines". The statement "I have had an active attitude and participation in the Intensive Course" received 80.6% total agreement. Over 90.3% rated the Intensive Course as "excellent" or "above average". Conclusions: After completing the EDUVAC Intensive Course, students felt confident in their vaccination knowledge and skills, which benefited their professional development.

eHealth Literacy Among Health Sciences Students in Greece.

eÎUealth literacy is a necessary skill to find and make good use of online health information. However, the general public lacks this skill; it is essential for future health professionals to be able to guide and facilitate the public. The study aimed to examine the perceived eHealth literacy level of health sciences students in Greece. A cross-sectional, online survey was conducted (N=113 students). The questionnaire included socio-demographic data and the eHealth Literacy Scale (eHEALS). Participants' mean eHEALS score was 31.9 with medicine and dentistry students having the highest score (33.7) and other health and caring sciences students the lowest (29.8). There was no statistically significant difference at eHEALS score among participants of different academic year. However, there was a statistically significant difference at eHEALS score among University Departments (p=0.009). Further research in representative samples is required to assess specific needs and improve current educational curricula.

Health knowledge and motives on tattooing: A community-based cross-sectional study in Greece.

BACKGROUND: Tattooing is becoming an increasingly common trend mainly but not merely among the youth. However, the choice of ink body art is associated with an increase of dermatological complications. AIM: To assess young persons' health knowledge and motives toward tattooing. METHODS: The main instrument used was an online structured questionnaire with scaling and dichotomous questions, consisting of three components: (a) the participants' sociodemographic profile, (b) health knowledge assessment, (c) motives toward or against tattooing. Simple univariate techniques and multiple logistic regression were used to data analysis. Two logistic models were developed having as dependent variable whether the respondents have or would like to have a tattoo. The independent variables in the models were sociodemographic characteristics of participants and three variables concerning respondents' health knowledge and motives on tattooing. RESULTS: The study sample amounted to 629 young adults living in Athens, the capital city of Greece. The prevailing age group among tattooed persons was 19-25 years old (69.5%), with females being more likely to be tattooed than males. Among tattooed participants, knowledge in specific health complications appeared high, while in other potential complications was particularly low. The main motives identified were ideology/message and aesthetics/fashion (77% in total). Quite interesting, participants with medium and high health knowledge level showed, respectively 50%, and three times higher probability of having tattoos compared to low level. Only 16.2% of the tattooed participants regarded tattoo as dangerous to health (p < 0.0005). CONCLUSIONS: The likelihood of acquiring ink body art is increasing critically among young adults. Even though this tendency is accompanied with adequate levels of knowledge concerning health hazards, systematic health education programs for more informed and safe choices are needed to be implemented, with particular emphasis on young people.